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Feminist Majority Foundation Chat Series of 2003

AIMEE BOONE, Prescribe Choice Coordinator
Tues. March 18, 3-4pm EST

On efforts to get Emergency Contraception "Over the Counter." EC has the potential to prevent half of the unintended pregnancies and 800,000 of the abortions that take place in the United States each year. EC works for 72 hours after unprotected sex, failed contraception, or rape to prevent pregnancy by interfering with ovulation, fertilization, or implantation. EC is up to 95% effective in the first 24 hours and is safer than aspirin.

Aimee Boone is a Senior Campus Organizer and Media Relations Specialist for FMF's Campus Team. She works with pro-choice feminist activists in the Mid-Atlantic states to expand women's health services, increase access to emergency contraception, and save reproductive rights. She also coordinates the Feminist Majority Foundation's Prescribe Choice campaign and the campaign to make Emergency Contraception available over the counter.

Special Guest Dr. Beth Jordan will also be available during the chat to answer medical questions about Emergency Contraception.

Moderator: Welcome.

Aimee Boone: Hi, everyone. Thanks for joining us today. I'm Aimee Boone, the Prescribe Choice campaign coordinator for the Feminist Majority Foundation. Also here with me is Dr. Beth Jordan, Medical Director of FMF. We're here to talk about Emergency Contraception (EC), also known as the morning-after pill, and the fight to make it available over the counter. Emergency contraception could cut in half the number of unintended pregnancies and reduce the number of abortions by 800,000 each year, but restrictive regulations requiring prescriptions keep thousands of women from gaining access to this important drug. The Feminist Majority Foundation is working with thousands of activists across the country to petition the Food and Drug Administration to make Emergency Contraception available over the counter. You can sign the petition online at www.feministcampus.org/prescribechoice/ecotc.asp, tell your friends about the petition, and let us know if you have access to Emergency Contraception in your community. Today I'll answer your questions about Emergency Contraception and talk about what you can do to make Emergency Contraception available over the counter how you can increase access to Emergency Contraception on your campus and in your community. Dr. Beth Jordan will answer any medical questions about EC.

Andrea Briggs: When I tried to obtain emergency contraception from my gynecologist's office, I received the caustic reply: "We don't do that here." I didn't realize that there was a continuing controversy about emergency contraception, what's so different from other forms of contraception?

Aimee Boone: Emergency contraception (EC) is used to prevent pregnancy for up to 72 hours after unprotected sex, failed contraception, or rape. EC works by preventing ovulation, preventing fertilization, or preventing implantation. Emergency contraception is, in fact, a high dose of birth control hormones. It's just used after sex instead of before sex, so it's not that different from other forms of contraception. Some people, even health care providers, confuse emergency contraception with mifepristone, or RU-486, the French abortion pill, or believe that EC can actually cause an abortion. This is not the case, however. Mifepristone is a form of medical abortion, and can be used to terminate a pregnancy during the first 7 weeks, but EC cannot terminate a pregnancy.

Because of conscience clause laws, health care providers and pharmacists can refuse to prescribe or dispense EC based on their own personal beliefs. If your gynecologist is personally opposed to Emergency Contraception, she does not have to provide you information, referrals, or a prescription. The good news is that if you're having trouble finding EC, you can call 1-888-NOT2LATE or go to www.not-2-late.com to find a provider near you.

Felicia Ciaudelli: How long have you been involved as Coordinator and what led you to this position?

Aimee Boone: I've been at FMF since August 2001. I was a Campus Organizer last year and felt like making EC more available to women on campus is one of the most important battles for college women that we can fight.

Patricia: This isn't really a question. I just wanted to thank you for all your efforts to make the morning after pill readily available over the counter. I recently had a problem with my contraception method and needed to take the morning after pill but I had to wait. Luckily I wasn't pregnant, but if I would have been pregnant I would have been in a very difficult situation. Thank you for the awareness and for taking your time to fight for this cause. If there is anything that can be done on the individual level to make this happen, please email me and tell me what I can do. I would really like to help. Thank you.

Aimee Boone: Thank you so much for your inspiring words. Sharing your story with other women and men will help people realize how many obstacles women face in getting EC and how important access to EC is for our reproductive freedom.

Lauren Brydle: What can I do to help make the availability of the "morning after pill" a reality?

Aimee Boone: First of all, sign the Feminist Majority Foundation's petition to the Food and Drug Administration asking that Plan B, a progestin-based form of emergency contraception, be made available over the counter at www.feministcampus.org/prescribechoice/ecotc.asp. Emergency contraception could cut in half the number of unintended pregnancies and reduce the number of abortions by 800,000 every year in the United States, but women must have access to EC for its promise to be realized. Second, visit your campus health center and take FMF's Campus Health Center survey (download at http://www.feministcampus.org/prescribechoice/CampusHealthCenterSurvey.pdf). Find out if your health center already offers Emergency Contraception. If not, why? If so, do people on campus know that it is available and how to use it? Is the health center open on weekends and does it offer advance prescriptions for EC to increase access for women on campus? Finding out what health services are currently available is the first step in expanding access to Emergency Contraception for women on campus. The next is to contact your Campus Organizer at campusteam@feminist.org so that we can work with you to make changes in health care policy on campus.

Trixie: What are some barriers that currently prevent women from accessing Emergency Contraception?

Aimee Boone: Conscience clauses, which I mentioned earlier, allow doctors and pharmacists to refuse to prescribe or dispense EC, which can make finding and filling a prescription a challenge especially for women who live in rural areas. In addition, Walmart refuses as a matter of corporate policy to fill any prescriptions for emergency contraception when Walmart is increasingly the only pharmacy in many rural areas.

For women on college campuses, many campus health centers are not open on weekends or do not dispense EC at all. Many health centers also refuse to offer advance prescriptions. Emergency contraception can be kept on hand for up to three years, so advance prescriptions allow women to be prepared for an emergency. All of these things make it difficult, if not impossible, for college women to access EC.

Only 1 in 5 rape victims is offered emergency contraception in emergency rooms. This is becoming a greater problem as Catholic hospitals merge with other hospitals. Catholic hospitals generally do not offer any kind of EC or a referral for EC to women who come through their doors.

Finally, only 1 in 3 women know about emergency contraception at all, and the lack of knowledge prevents many women from even knowing to ask their healthcare providers about EC.

Lindsey : What you think it will take to get the "morning after" pill available over-the-counter? And how long do you think it will take to become over-the-counter?

Aimee Boone: It will definitely take all of us working together to let the Food and Drug Administration know that we demand over the counter access to Emergency Contraception, which is why we are working so hard to get thousands of signatures to our petition to make Emergency Contraception available over the counter (EC OTC). Women's Capital Corporation, the makers of Plan B, will submit their request for over the counter status to the FDA in early April. At that time, Feminist Majority Foundation will submit thousands of EC OTC petitions from activists all over the country to the FDA. In addition, over 70 organizations, including the American Public Health Association, signed a citizens petition to the FDA in February 2001 requesting that emergency contraception be made available over the counter. Many people are concerned that anti-abortion politics will hold up the over the counter approval of Plan B, which is why it is so important for our voices to be heard. The American Medical Association and the American College of Obstetrics and Gynecology have both called EC's prescription status "medically unnecessary". The public is overwhelmingly in favor of increasing access to EC by making it available over the counter and with your help, our voices will be to loud to ignore.

After the Women's Capitol Corporation submits their request to the FDA, the process could take a matter of months, but we will continue to submit waves of EC OTC petitions to the FDA to demonstrate widespread public support until we achieve over the counter status for this important drug.

Maria: How long does it usually take the FDA to make a drug available over the counter? And what sort of medical evidence is necessary for the FDA to make that determination?

Aimee Boone: & Dr. Beth Jordan:

Emergency contraception is 95% effective in the first 24 hours. It is statistically safer than aspirin. And it meets all the FDA's requirements for over the counter status. According to the New England Journal of Medicine (9/12/02), the FDA requires two studies before approving over the counter (OTC) status. One study tests the comprehensibility of the labeling information (can women understand what to do?... the studies show yes. They do.). The other study is a "actual use" study. Neither type of study is required by federal law. One of the principles guiding the change is that if it can be OTC, it must be OTC. Given that the US has one of the highest rates of unintentional pregnancies of all industrialized countries (3 million per year) and EC could cut this number in half, the medical and scientific imperative is clear. In the interest of public health, EC must be made available over the counter.

Jason: How long have women been using emergency contraception to prevent pregnancy?

Aimee Boone: Doctors have been using emergency contraception to prevent pregnancy since the 1960s but it was only in 1998 and 1999 when Preven and Plan B, respectively, were approved as the first pre-packaged forms of emergency contraception. Prior to that, doctors used combinations of birth control pills as emergency contraception.

Jody: At my campus health center, they give out eight regular birth control pills for emergency contraception. How does this work?

Aimee Boone: & Dr. Beth Jordan:

Your healthcare provider should instruct you in what order and when you should take this method of emergency contraception. Only certain brands of birth control pills can be used as emergency contraception in certain combinations. For more information to see if your birth control pill works as an EC, talk to your doctor or go to http://www.NOT-2-LATE.com. Birth control pill combinations contain estrogen and progestin, and while effective, are not as effective as progestin only forms of EC. So you can present this information to your health center so that they can offer the most effective form of EC as possible. For more information about changing the health care services your campus health center offers for women, contact the campus team at CampusTeam@feminist.org or toll-free 1-866-444-FMLA.

Elysse: I've heard that some family planning clinics (including Planned Parenthood) will give an advance prescription for EC in case I need one over the weekend, or during a time when the clinic isn't open. How can I find out what clinics offer advance prescriptions? Thanks so much!

Aimee Boone: To find out what services your health center offers, you can download the campus health center survey at www.feministcampus.org/prescribechoice/prescribechoice.asp. In addition, Planned Parenthood does offer advance prescriptions. For a list of EC providers in your area you can call 1-888-NOT2LATE. The person who answers the phone at your local provider should be able to tell you if their office offers advance prescriptions for EC. It is your right to talk to your healthcare provider and request EC. Ask your ob-gyn, family practitioner or internist about advance prescriptions if she or he does not bring it up during your next visit (no matter what the reason for the visit is).

Trixie: How will making Emergency Contraception available over the counter enhance women's reproductive freedom?

Aimee Boone: Increasing the availability of emergency contraception is the best way that we can fight back against the assaults that the Bush administration has launched against our reproductive freedoms. EC could reduce the number of abortions by 800,000 every year. EC could cut in half the number of unintended pregnancies each year. We must make sure that women have access to this drug so that if their contraception fails, if they have unprotected sex, or if they are raped they are able to take steps to prevent themselves from becoming pregnant if they do not want to be.

Diane: We want to increase awareness of the fact that our health center offers EC, but they are afraid that if we start advertising it people will protest and the administration will force them to stop offering EC at all. What can we do to spread the word, if at all?

Aimee Boone: Actually, a good way to spread the word is to have your health center contact the Association of Reproductive Health Professionals at www.arhp.org. This is the organization that runs the 1-888-NOT2LATE hotline. Your health center can register with the hotline as an EC provider and you can advertise the hotline. You can flyer your campus, you can make announcements in your classes, you can write a letter to the editor at both your campus and community papers, and you can talk to your campus life office about including information on EC in training for resident advisors. This should help assuage any fears that your health center may have while educating your campus about EC and where it is available locally.

Moderator: Thanks for participating.

Aimee Boone: & Dr. Beth Jordan:

Thanks to everyone for coming to our chat today and for asking such terrific questions. Remember, if you have more questions or want to get more information about the Prescribe Choice and EC OTC campaign, e-mail the Campus Team at campusteam@feminist.org, or call us here at the office at toll-free 1-866-444-3652.

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