The recent Food and Drug Administration's (FDA) approval of levonorgestrel-ethinyl estradiol (Seasonique), manufactured by Duramed Pharmaceuticals, brings the number of available oral contraceptives (OCs) in the United States to an astonishing 74.1 This number, of course, does not include other contraceptive products that are injected, inserted, or otherwise applied. Women frequently request a specific OC by name, but are often confused by the many contraceptive options on the market and seek the nurse practitioner's (NP) counsel to decide. The NP recommends an appropriate contraceptive method after careful evaluation, keeping in mind the woman's practices and preferences. The NP is ultimately the one who will decide whether or not to write a prescription for a requested pill.
Making Great Strides
Technological advances to assist women to conceive are just as remarkable. Women can decide when to have a baby and with whom (sperm donor), and whether or not to use an alternative method, which in certain circumstances is the only possibility for conception.
We have made great strides since Margaret Sanger's struggle in the early-to-mid twentieth century to promote birth control as a means by which a woman could exercise some control over her life and health. She realized then the importance of empowering women by providing education and access to women's health services. Her efforts led to what is today Planned Parenthood. An understanding of contraception and conception options is invaluable for every woman.
The Plan B Debate
Despite all these strides, support for a woman's right to choose and ensuring access to full contraceptive services still generates controversy. The case in point is Roe vs. Wade, an ongoing debate after more than 30 years.
Unplanned pregnancies happen when people have sex. It benefits no one to debate ad infinitum that women should know how to prevent pregnancy or not have sex in the first place. On August 24th, the FDA announced approval of over-the-counter access for the emergency contraception or "morning-after" pill Plan B for women 18 years of age and older, "through licensed drug wholesalers, retail operations with pharmacy services, and clinics with licensed healthcare practitioners." A prescription is still required for women 17 years of age and under.
This proposed plan still does not give women control in trying to prevent a pregnancy. In some states, pharmacists are legally allowed to refuse to dispense emergency contraception, and many times the woman does not receive a referral to another resource.
Proponents of the FDA decision anticipate the move will help prevent thousands of unplanned pregnancies by allowing women to access Plan B. Opponents fear making it easier for women to obtain Plan B will encourage more sexual activity among young women.
But do we really know whether patterns of sexual behavior have changed over the centuries? Also, consider that women under 18 already use prescription OCs safely. The role NPs must play is of educators providing women with correct information throughout the reproductive cycle.
Stay active in the fight for access to full contraceptive health, which includes unhindered emergency contraception for all women.
Jamesetta Newland, PhD, APRN, BC, FNP, FAANP, FNAP
Editor-in-Chief
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