President Barack Obama promised in his inaugural address to "restore science to its rightful place." He should have added "unless politics gets in the way." By rejecting over-the-counter emergency contraception for all females of child-bearing age, his administration has put his re-election campaign above protecting adolescent girls from unwanted and potentially harmful pregnancies. The science flows entirely in one direction — toward better access — but the political undertow pulled the policy backward.
For more than a decade the Food and Drug Administration has been carefully evaluating the safety and effectiveness of emergency contraceptives, better known as morning-after pills, for over-the-counter use. Currently, any female 17 or older may obtain the product known as Plan B One-Step without a prescription, but younger teenagers still need the intervention of a doctor. After considerable scientific research, the FDA was poised to end that distinction and make Plan B easily available to everyone. The agency conclusively found that adolescent girls would benefit from having access to a pregnancy prevention drug that has minimal risks — particularly relative to pregnancy — and can be taken within 72 hours of unprotected intercourse.
For the first time in history, the Health and Human Services secretary publicly overruled the agency. Secretary Kathleen Sibelius claimed that the drugmaker had not submitted enough information on whether girls as young as 11 could understand the label and use the product appropriately. This claim was directly disputed by FDA Commissioner Margaret Hamburg, who said in a statement that the evidence showed that adolescent females were able to use the product, understood that Plan B was not for routine use and recognized it wouldn't protect them from sexually transmitted diseases.
The administration's decision was an unhappy surprise to people who thought science would drive public policy decisions, particularly after Obama had positioned himself as the antidote to President George W. Bush's willingness to put politics above all else. But the Obama administration made a cynical political calculation with Plan B, forestalling an election-year fight in the Republican-controlled House over the issue. The administration also bettered relations with the U.S. Conference of Catholic Bishops, after a recent dispute over the health care reform law's requirement that health insurers offer contraceptives for free.
The losers are adolescent girls who will continue to find it difficult to access Plan B quickly enough for it to be effective in preventing pregnancy, as well as every American who thought Obama's inauguration promises meant something.