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When Plan B Becomes Plan A

More and more college students are relying on the 'morning after pill' for birth control


Jamie*, 20, a local college student,  knew she shouldn’t have gone out last night. She probably shouldn’t have had as much to drink as she did, either. And that guy she met at the bar? He shouldn’t have wound up at her place. But he did. She can’t exactly recall what happened after that, although blips of clumsy embraces and exposed flesh flash in her mind, a few bright moments of clarity, like lightning bolts in a storm.

Last night, she carefully got ready, applying her makeup with an effortless precision, more a feminine ritual than a beauty regimen. Her hair perfectly sculpted to complement the new dress into which she slipped her slender frame, she took one last glance in the mirror to admire her work before she ran out to meet her friends at the bar near campus.


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Now it’s 5 a.m. She is anxious and alone, and frantically trying to backtrack the events of the past night that seem to have been lost in a cerebral slip.

This is the morning after, and it’s not a pretty sight.

Nights like Jamie’s are commonplace in the college landscape. Nights like these are what college kids live for. But it never seems to be the nights that are the problem. It’s the mornings that some girls have to worry about.

But Jamie is no stranger to this situation; she is familiar with emergency contraception and knows where to get it. The school health center hasn’t opened yet. Neither has the pharmacy. Jamie heads straight to the emergency room of a nearby hospital. She can get exactly what she needs and still make it to her 9 a.m. calculus class.

Business As Usual

Casual sex in college is nothing new. But more and more young women are taking a less preventive, more reactive stance on birth control. Many females are relying on emergency contraception (EC) like Plan B—known more commonly as “the morning-after pill,” originally intended as a backup method—as their primary form of birth control. Especially college-age women.

“We get a significant number of college students [for the Plan B pill],” says Dr. Henry Prince, OB/GYN at Planned Parenthood in Hempstead. “Most are between the ages of 20 and 24.”

More than 3 million unplanned pregnancies occur every year in the United States, according to the Guttmacher Institute, a scientific institute in Manhattan that conducts research on sexual and reproductive health worldwide. Of these pregnancies, about 42 percent result in abortion. At best, the effectiveness of emergency contraception in preventing pregnancy is 89 percent when taken within 24 hours of intercourse, according to the manufacturer, Barr Pharmaceuticals. The effectiveness of preventing a sexually transmitted disease is zero. But many young women are OK with those risks, and for those who treat EC as an accessory, it’s just another trip to the pharmacy.

“It was just like going to the store to buy tampons,” says Erica*, a 21-year-old senior at Hofstra University, who says a condom was used nine out of 10 times with her boyfriend, but relied on EC for the times one wasn’t. “I’d rather not wait around until it’s a mistake; I’d rather be safe than sorry.”

It is this casual attitude among college students—and in many cases, the staff—that drove one health-center employee to resign from her job.

“Because they’re 18, there is no real adult supervision,” says Mary*, a former employee who signed in patients at a Rutgers University health center in New Jersey, and who is also a registered nurse. “All they have to do is say they understand and then they get [the drug].”

Mary left her job at the campus after seeing students frequently relying on EC as a form of birth control.

“[These kids] should be better informed,” says Mary. “All it would take is the use of some sort of contraception and they wouldn’t be in that situation.”

Mary noticed visits from many students becoming routine, while staff were promoting education, but not focusing on prevention. Students would come in with their friends and boyfriends—what she calls “the blind leading the blind,” not believing students fully understood exactly what they were putting in their bodies.

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