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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

One-third of women did not understand that the morning-after pill is not to be used as a regular form of birth control, according to a 2003 study by Barr Pharmaceuticals. The chairman of the Food and Drug Administration (FDA) Advisory Committee study called these results an “overall failure.”

The committee also noted that a “maximum safe dose for levonorgestrel [the active drug in the Plan B pill] has not been determined by scientific study, or the effects of overdose” and that “It is unknown whether there is a maximum safe daily dose, monthly dose or yearly dose. The health risks for those who may use Plan B repeatedly at one time or over years are unknown.”


Jagged Little Pill

Think of it as the little pill that might. What was once referred to as a “best-kept secret” is quickly becoming many women’s best friend, due to edgier, bolder marketing campaigns and increasing availability.

Much like traditional birth control pills, the active ingredient in Plan B—the only brand of EC available in the U.S.—is levonorgestrel, a laboratory-made hormone that prevents ovulation during the three days that sperm can stay alive in the body, and thickens the uterine lining to prevent eggs from implanting themselves. If pregnancy has already occurred, EC has no effect. The Plan B pill does not harm or abort a fetus. The difference between EC and daily birth control pills like Ortho Tri-Cyclen is that EC contains a much higher hormone level in a single dose.

“Certainly there are conditions where it’s dangerous to take hormones,” says Prince.

EC comes with an increased risk for things like blood clots and hormone-related cancers, like many traditional forms of birth control. But no studies have been done on women who use EC excessively, exposing themselves to very high hormone levels on a regular basis.

“We tell our students that [EC] is a megadose of birth control—it’s a lot—and that they should only take it when they need it,” says Sheila Beckmann, a registered nurse at SUNY Old Westbury’s Student Health Center, which documents frequency of visits and use of EC by students—a practice many schools don’t follow.

“It’s not like you’re going to a pharmacy,” says Beckmann. “We don’t like to see patterns. If somebody comes in four or five times, we know.”

But that’s unusual—oftentimes,  schools’ health clinics keep no such watch.

At student health centers, where employees work in different shifts and there are students coming in for treatment for everything from a splinter to the flu, it’s not possible to remember every student, the last time they’ve been in or how often. If schools do not keep some form of documentation, patterns can go unnoticed.


The “Say It With Sperm” downloadable font, a promotional campaign for the Plan B pill.

“We certainly give all our students education—that’s what our goal here is,” says Maureen Houck, director of the Health & Wellness Center at Hofstra University. “There are no standard or national or federal or even state guidelines. Since it is over-the-counter, they could buy it in any local pharmacy, and I’m sure some of them do that.”

EC does not require a prescription for those 17 and over, and schools are not required by law to keep records.

“They can purchase the pills at any time the pharmacy is open,” says Lauren Sheprow, director of media relations at Stony Brook University. “We no longer keep statistics on use, since the physicians are no longer prescribing the pills [for those under age 17].”

Because of this, there is no paper trail left behind, and students don’t have to worry about anyone—including their parents—finding out.

“I knew all I had to do was show ID and I would get it, no questions asked,” says Erica.

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