IT COULD happen to any of us. Lots of situations could put you or me in a position of having to worry about an unplanned pregnancy, either for ourselves or for someone close to us. Unless that actually happens, it's hard to say for sure what any of us might choose to do. But we can say that having as many options as possible in a difficult situation like that would be best. California has taken a big step toward that goal by passing legislation that streamlines the process of obtaining emergency contraception, joining Washington as the only states that have done so. Other states, including Virginia, should follow suit.
We can imagine many different situations where EC might be a reasonable course of action for an unplanned pregnancy. Condoms break. People have sex while drunk and fail to put a condom on. Sometimes the pill doesn't work. No contraception is foolproof. Other times, failed contraception isn't the problem. Men rape women all the time: In an average hour in America, about 30 women experience rape (FBI's 2000 National Victimization Survey). This puts hundreds of thousands of women every year at risk of becoming pregnant.
EC, the so-called "morning-after pill," consists of two doses of hormones taken 12 hours apart, starting as soon as possible after unprotected intercourse, within 72 hours at the latest. The hormones act to prevent the implantation of a pre-embryo into the endometrial lining of the uterus. When taken correctly, EC reduces the risk of unplanned pregnancy by about 90 percent, and it does so at a cost of only $20-30.
It's also important to understand the difference between EC and medical abortion, such as that induced by mifepristone, the abortion drug commonly known as RU-486. EC prevents a pregnancy from beginning; medical abortion terminates a pre-existing pregnancy.
EC certainly isn't the right solution for everyone who has reason to worry about an unplanned pregnancy. It would be a tough choice for anyone in that sort of situation. But EC is the right choice for some people. That's irrelevant, though, if it's so hard to obtain that it's not a real option.
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Gaining access to EC within the narrow 72-hour window of opportunity can be difficult, particularly in Virginia. David Nova, president of Planned Parenthood of the Blue Ridge, explains: "It is much harder to access emergency contraception in Virginia as compared to other states. In order for a woman to obtain EC in Virginia, she must have an established patient relationship with a clinician. Once she has been seen by a physician or nurse practitioner and a medical chart has been established, she can obtain a prescription for EC. She must then find a pharmacy that carries EC - some choose not to. All the while the 72-hour clock is ticking."
California's new legislation makes this process less cumbersome by allowing pharmacists to offer EC directly, condensing the two steps previously required to get EC into one step. This would make it easier for women to obtain EC in a short period of time without compromising the medical attention they receive. Pharmacists would have the same training about how and when to give EC to patients and would perform the same task of teaching patients about the medicine that physicians currently do. Going to a doctor first still would be an option, but it wouldn't be required.
At the University, the situation is slightly better, as students can accomplish both steps at Student Health - by making an appointment first with a Student Health physician and then obtaining the medication at Student Health's pharmacy. Even so, though, the policy change could still benefit students, many of whom may prefer not to go to Student Health - where they are likely to encounter people they know - if they're considering this sort of delicate, highly personal decision. To go elsewhere, though, they must negotiate the same two-step process that women throughout Virginia do.
California's more efficient process will make EC more accessible for women who decide that it's right for them. It won't push EC on anyone who doesn't want it; it merely makes the treatment easier and faster to obtain. That's crucial with EC, where a few hours can make the difference between becoming pregnant and not.
Virginia has had the opportunity to offer a similar policy when a bill passed the State Senate but failed in the House of Delegates last year. Nova predicts that the proposal will come up for consideration again in January 2002. When it does, the General Assembly should take the opportunity to make EC more accessible - not to promote it as the right choice, but to make it a more realistic choice for Virginians.
It's simply a matter of having better options. We should all want that.
(Bryan Maxwell's column normally appears Wednesdays in The Cavalier Daily. He can be reached at bmaxwell@cavalierdaily.com.)
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