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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

And when EC is so readily available from pharmacies, emergency rooms and even the Internet, record-keeping by colleges can only accomplish so much.

“In the ER, you cannot deny a patient emergency care,” says John*, a former emergency room front desk employee at Nassau University Medical Center (NUMC). “They can give a fake name or address and we are still obligated to treat them.”

Oops…I Did It Again


A former campaign by the makers of Plan B called “Share Your Oops” invited women to, well, share their “oops,” or their EC experience, and enter catchy names for a rename-the-pill contest like “The I Was Too Drunk To Think Pill” and “The I Should’ve Just Swallowed Pill.” The winning names were printed on posters on college campuses across the U.S. The latest campaign is a downloadable font, made up of cartoon sperm, called “Say It With Sperm.”

Some examples of the “Share Your Oops” campaign, including panties in a tube (with the text “the i should’ve kept my panties on pill”).

The nonchalant, lighthearted way the topic is addressed makes it into something of a game—a game with few rules and even fewer consequences. Made an “oops”? No sweat. Come in for a Plan B pill. On an auction website, one seller has EC for sale and tells potential bidders, “Only bid if you plan on having unplanned unprotected sex within the next couple of months.”

Two decades ago, AIDS was national terror. Today, for some, it’s an afterthought. A lack of protection from STDs is often not a concern for students who use EC.

“Education is our primary goal, but obviously a lot more work has to be done,” says Mike*, an employee of the LI Crisis Hotline, a non-profit organization that helps LI teens in trouble.

Mary, the former Rutgers health center employee, says she noticed a pattern at the health center, where students were looking into birth control and EC at the beginning of the semester, as well as higher rates of accidental pregnancy. By finals time, though, that would change.

“By the end of the year we would have logs and logs of kids with STDs,” she says. “It was a nightmare.”

But today, convenience often outweighs consequence. And unlike RU-486—the “abortion pill”—there isn’t much of a stigma attached to the Plan B pill. RU-486 is designed to detach a fertilized egg from the uterus wall and forces the egg out of the uterus, terminating the pregnancy. You need a prescription to acquire it, but anyone 17 and over can get EC by going into an emergency room, pharmacy, clinic or on-campus health center.

“When these girls come in, they usually look like a wreck,” says John, the former emergency room employee at NUMC. “They’re in sweatpants and an oversized T-shirt, no makeup, their hair isn’t done. Ninety percent of the time, they’re either crying or on the verge of tears.”

There is no physical exam and no follow-up. No appointment is necessary.

Under the cover of anonymity, someone in Jamie’s situation can experience “the morning after” every weekend.

All names with an asterisk have been changed. Jamie’s story is a composite based on the experiences of a real individual unearthed in our reporting of this story. With additional reporting by Jaclyn Gallucci.

Plan B: A Dose Of History

While emergency contraceptives have been around since the 1960s, as birth control was becoming a heavy hitter in women’s reproductive choices, at that time it was only used for special rape cases. It wasn’t until July of 1999 that Plan B was approved by the FDA to be sold to women by prescription in the United States.

In August of 2006, the FDA approved non-prescription access of the morning-after pill to women ages 18 and over. It was stipulated that although now available over the counter, the pill had to be kept behind the counter to ensure that proper ID be checked before issuing it. A prescription-only Plan B was kept available to those 17 and under, pending a doctor’s approval.

This past year has been an important one in the short life of Plan B and its manufacturer, Barr Pharmaceuticals. On March 23 of this year, after years of public dispute and much controversy, a U.S. judge ordered the FDA to allow 17-year-olds to obtain Plan B without a prescription. As of now, any woman aged 17 or older can walk into a local pharmacy to get the pill almost immediately. A prescription is still needed for any girl under the age of 17.

This past July, Barr Pharmaceuticals introduced a new incarnation of the pill, called Plan B One-Step—a single-dose method that may improve success rates of the pill, since the original Plan B requires a two-step process, in which a second pill has to be taken 12 hours after the first. Reports surfaced of problems with women either forgetting to take the second dose or not understanding the proper directions for taking it. This is a potential win-win situation, as it not only makes it more convenient for women so that they don’t have to think about a second pill, but also for proponents of the pill, because if the proper dose is taken more often, rates of effectiveness should improve.

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