EC on Campus

After having unprotected sex, Charvat wanted a way to try and prevent getting pregnant. She turned to Plan B, a brand of emergency contraception (EC), also known as "morning-after" contraception. "I'm not sure what I would have done without it," she says. Fortunately, Charvat was able to take Plan B in time. (The sooner EC is started, the better; it can reduce the risk of pregnancy by 75-89 percent when the first dose is taken within 72 hours.)

Access on Campus Expanding

According to a recent study by Laura McKeller Miller and Robin G. Sawyer in the Journal of American College Health, EC has become increasingly available for undergraduate college students in the past 10 years. In fact, the number of colleges and universities that prescribe Plan B has risen from 35 percent in 1996 to 48 percent last year. Still, more than half of colleges polled do not prescribe EC at their health centers, reflecting the challenges to access that remain. Opponents of EC have claimed that increasing access will increase "promiscuity," but scientific studies have suggested that there's no correlation between the availability of EC and sexual behavior.

For many schools, the idea of prescribing post-coital contraception is not a new one. According to Dr. Robert Winfield, director of health services at the University of Michigan, his school has been prescribing some form of EC for at least 20 years. "EC has become a standard of care for students," he says. Before Plan B came on the market, doctors gave students a double dose of birth control pills, a common off-label method of preventing pregnancy. With longstanding and open support for EC, the University of Michigan has actively promoted its use through an education campaign that includes posters in university buses and brochures in health centers. Each March, students run a seminar in the student union devoted to information about the effective use of EC.

Florida State University (FSU), another large state school, began prescribing Plan B after seeing the results of a 1996 study on its availability. But the school takes a discrete approach to distribution. While the school's health center will write a prescription for any student who requests EC, "we definitely don't advertise it," says Candace Wells, a nurse practitioner and manager of FSU's Women's Clinic. In Tallahassee, FL, a fairly conservative city where the university is located, only one pharmacy near the university campus will fill a Plan B prescription. Still, Wells estimates at least eight women at the college get Plan B each week. And in their study, Miller and Sawyer found that FSU's position is becoming increasingly rare: In 1996, 42 percent of schools chose not to advertise their EC service, but by 2005, that number had fallen to 22 percent.

Of course, not all colleges are jumping on the EC bandwagon. St. Michael's College in Colchester, VT, is one of several Catholic colleges in the United States that do not dispense any form of birth control. According to Susan Jacques, the director of student health services at St. Michael's, the college health center will refer students who ask for Plan B to a nearby partner — in their case, the University of Vermont. Thirty percent of all colleges use such partnerships, an encouraging number when you consider that in 1996, no colleges had reported using such partnerships in lieu of direct access. But access could be expanded further if the health center at St. Michael's and other colleges like it were able to offer and promote EC on campus.

Over the Counter?

For now, Plan B is still available to most Americans only by prescription. But in 2004, two FDA advisory committees voted 23-4 to make a non-binding recommendation that the agency approve Plan B, manufactured by Barr Laboratories, for over-the-counter use. In an unusual move, the FDA broke with the advisory opinion and denied the application, citing unfounded concerns for young women under 16.

So Barr filed another application asking that the drug be sold over the counter for women 16 and older, and by prescription only for anyone younger. Last summer, the FDA rejected that application, as well, citing "concerns associated with the difficulty in enforcing the over the counter age restrictions." It became clear to many observers that the FDA had been swayed by politics and ideology in flagrant disregard of bona fide scientific evidence. Susan Wood, assistant FDA commissioner for women's health and director of the Office of Women's Health, resigned from the agency in protest, saying the ruling was unnecessary and merely a politically motivated way to stall.

With Plan B available only by prescription, some health experts have advised students to secure EC in advance of an emergency situation. On May 8, the American College of Obstetricians and Gynecologists, which represents more than 49,000 doctors, launched a campaign, "Ask Me," which encourages patients to stock up on EC in case they need it.

Similar efforts at universities have run into roadblocks. Two years ago, the University of Wisconsin launched a campaign before spring break that told students to use sunscreen, drink responsibly, and fill Plan B prescriptions before heading off for the beach. The Wisconsin legislature was livid, saying the campaign excused, or even encouraged, promiscuity. The state assembly promptly passed a bill that would take away funding for EC at state schools, though it stalled in the Senate and the governor threatened to veto it.

Unless EC finally moves to the other side of the pharmacy counter, stocking up will remain a valuable option for college students — especially since Miller and Sawyer's study found that the number of health centers that stay open on the weekends fell from 60 percent in 1996 to 38 percent last year, presumably due to budget cutbacks. Julia Charvat, the sophomore at Clark, got her prescription for Plan B before she actually needed it. "It was more of a back-up measure," she says. "For me, Plan B is so important to have, just in case."

© 2006 Planned Parenthood Federation of America, Inc. All rights reserved.