When Plan A Fails

Dear Leading Ladies,

A few weeks ago, we wrote about Plan C and the possibilities of providing those pregnant with the medications to terminate unwanted pregnancies through at least the first trimester. With some ingenuity and commitment from organizations and individuals, we hope Plan C will be accessible to people in states where surgical abortions are becoming more and more difficult to obtain.

Now, there is another discussion capturing the attention of college students and the adults in their lives. Should Plan B (also known as levonorgestrel, emergency contraception, and the morning after pill) be available to college students in campus vending machines? Plan B must be taken within 72 hours of unprotected sex in order to prevent impregnation. Boston University has already installed these machines, as have schools such as UC Davis, while students at Northeastern and other schools throughout the country are either considering the initiative or awaiting decisions from administrations.

Arguments against Plan B vending machines

Even among pro-choice advocates, there are arguments against vending machines for Plan B. For instance, some maintain that if a young person can just pay seven or eight dollars and receive a pill from a machine, they may not receive the education and counseling around contraception that could help them protect themself in the future. Furthermore, if they were coerced into having sex, or raped, they might not seek the care and medical help they may need, including medication for STDs and support for psycho/emotional issues.

There are those who also argue that the easy access to Plan B will encourage premarital sex. This is a weak argument, as the majority of college students today already have sex. Just as most historians agree that the birth control pill did not cause the sexual revolution but, instead, the pill and sexual revolution “collided,” the ready availability of Plan B will not lead to more promiscuity.

Arguments for vending machines

Without the easy availability of Plan B from vending machines, a student may struggle to get an appointment at a clinic or with a doctor. Going to a pharmacy may mean not getting the medication in time and/or paying more. Students may decide more readily to take their chances and hope they don’t get pregnant. At the University of Florida, a campus pharmacy supplied Plan B to students at the reduced price of $10, as compared to up to $50 at an off-campus pharmacy, but the school pharmacy was closed for 43 consecutive hours over the weekend. That left many students unable to get the pill when most needed. Final approval for a vending machine at UF is pending.

A research thesis by Janhavi Nemawarkar, a student at the University of Texas at Austin, found that a majority of students indicated that maintaining their anonymity when purchasing emergency contraception was important to them, and that interacting with a pharmacist to request emergency contraception was uncomfortable at best. Nemawarkar argued that a vending machine located in a somewhat remote but safe location could provide some privacy for student buyers, and machines should sell painkillers such as Tylenol and menstrual care products, as well as condoms, which would give buyers some “cover.” He referenced the “Wellness To Go” machines at UC Davis as an example.

Information should accompany machines

Nemawarkar strongly believes that his campus should have a vending machine that sells emergency contraception pills, but his research confirms that many students are unaware of how Plan B works, the time limits of its efficacy, its availability at local pharmacies and college pharmacies, and its cost on the free market versus when provided by a nonprofit entity on campus.

To address this void of knowledge, Nemawarkar suggested in his thesis that there were opportunities for health workers to collaborate on the installation of the vending machines. At UC Davis, Nemawarkar said, “health promotion coordinators worked with the university medical director to develop posters that were pasted next to the machine: one which had information about how to get help when the student health center was closed, and one about the effectiveness of levonorgestrel emergency contraception.”

Certainly, other information could be posted near the vending machine advising students whom to call if they have been sexually assaulted; if they would like to speak to a counselor; or if they want to learn about contraception. There could be a rack with information cards from Planned Parenthood or the school health center, from the school counseling center and from a local women’s center. This is a prime opportunity for schools to offer effective outreach backed up with appropriate resources.

The bottom line

No one would suggest that Plan B should be a college student’s contraception of choice.

If you take the pill within 72 hours after you've had unprotected sex, levonorgestrel can reduce the risk of pregnancy by up to 87% if taken as directed. If you take Plan B within 24 hours, it is much more effective. But it doesn’t protect against sexually transmitted diseases. And there can be some unpleasant side effects such as nausea, vomiting, dizziness, abdominal pain, menstrual changes, headache, fatigue, or breast tenderness.

Plan B is there for an emergency, in case a person had unprotected sex by force or mistake. It prevents a pregnancy that could derail a student’s life. And if they can get it on their college campus for less than ten dollars, so much the better.

But access should not be the end of the story. Administrators and student leaders should make sure they are also giving these young people the information and means to take care of themselves going forward. Otherwise, just providing Plan B could prevent some young people from seeking care they need — either medical treatment or birth control information.

If you are a student, faculty member, administrator, staff, parent, or alumnus at a college or university, find out what your school is doing about making Plan B available to students, along with birth control, sex education, and health and wellness support. Share your perspective and use any influence you may have.

We support the vending machines, but they are not sufficient by themselves.

Choice should always be informed.

Stay cool,

Therese
Judy
Mary
Leading Ladies Executive Team
Leadingladiesvote.org
ladies@leadingladiesvote.org