It's safe to say sex is common on college campuses: About 57 percent of university students have been involved in "sexual activity" by graduation, according to a 2000 survey conducted by Zogby International, a public opinion polling company. \nIf unprotected sex occurs or if pregnancy prevention methods fail, there is no "magic pill" to protect against the potential union of sperm and egg. But there is a series of emergency contraception pills available by prescription only: Plan B.\nAlthough the Food and Drug Administration rejected an appeal to offer emergency contraception, or EC, over the counter in 2003, Plan B remains the only approved form of EC available in the United States.\nPREVENTING CONCEPTION\nTwenty-six countries across the world, including the United Kingdom, France and Israel, offer EC over-the-counter to prevent unintended and unwanted pregnancies. About 80 countries support some form of EC protection for women regardless of cultural, political or religious disapproval. If the United States follows in these footsteps, any American 16 and older can have access to Plan B without a prescription. \nCurrently, women -- but not men -- interested in obtaining a prescription for EC can contact the IU Health Center, Planned Parenthood, women's health clinics and other medical centers in town.\nAnne Reese, director of health and wellness services at the IU Health Center, said a common misconception about EC is that products such as Plan B are similar to the French abortion pill RU-486. The National Institute of Health, for instance, states that RU-486 is "part of a medical abortion," often used to terminate a pregnancy up to nine weeks of fetal development.\nAccording to the FDA, "If a fertilized egg is implanted prior to taking Plan B, Plan B will not work." \nPlan B works like other birth control pills to prevent pregnancy in one or in all of three ways, according to the FDA. The first is that the synthetic steroid Levonorgestrel, Plan B's primary component, might prevent ovulation. Plan B might also disrupt tubule motility, preventing fertilization in the fallopian tubes. Lastly, Plan B might manipulate the endoderm -- the lining in the uterus -- preventing a fertilized egg from implanting in the womb, according to the FDA.\nPlan B is administered in a single course of treatment and consists of two tablets -- each tablet contains 0.75 milligrams of Levonorgestrel. According to the Plan B brochure, the first pill must be taken as soon as possible within 72 hours of intercourse. The second pill should be taken about 12 hours after the first dose. \nReese said women can also take both pills at the same time if needed.
PRE-PLANNED PROTECTION \nDr. Edward Linn, director of women's health services at Rush Medical College in Chicago, said progestin-only emergency contraceptive is a reliable product -- and "scientifically the most effective." \nLinn said he counsels patients that common side effects of Plan B include bloating and breast sensitivity, but the medication is "very well-tolerated" because it is taken during a short period of time. The FDA also cites nausea and menstrual changes as other common side effects.\nCouples whose preferred contraception method, such as a condom, failed during sexual activity and couples who needed contraception but did not have access to other birth control methods are also common recipients of EC prescriptions.\n"Any woman, at any time, can come in and get EC. It's more effective the sooner it's taken," said Kelly E. McBride, director of training for Planned Parenthood in Bloomington. \nMcBride said standard contraceptives -- such as condoms or birth control pills -- are more effective at preventing pregnancy and should be a first-choice method for family planning before EC is considered. She said the majority of women who have requested EC thus far are sexual assault victims.\nReese said each woman should investigate her individual value and belief systems before engaging in any form of sexual activity in which pregnancy is a risk, because "the most effective birth control method is abstinence" and the use of EC is a controversial topic among some religious faiths.\nAcademic research estimates that widespread EC availability and use can prevent between 1.7 and 2.3 million unplanned pregnancies annually.
PRESCRIBING PREVENTION\nTo be prepared, some experts recommend women obtain a prescription for Plan B to have the pills ready at home in case of emergencies.\nReese said students seeking an EC prescription can stop by Room 217 of the IU Health Center to speak with a registered nurse. She said a physical examination is not required to receive Plan B from the pharmacy.\nMcBride said Planned Parenthood signed about 8,500 prescriptions of EC to Hoosier women statewide in 2003, the last year for which data is available. This number might seem relatively small considering an estimated 6 million women reside in Indiana, according to the 2003 Census.\nThe FDA currently is reviewing the practicality of permitting Plan B for over-the-counter use, despite objections from faith-based organizations concerned with premarital coitus and public speculation of increased sexual activity among teenagers. \n"There is no evidence that access to emergency contraceptives has any discernible effect on teen sexual activity," according to the 2002 Guttmacher Report on Public Policy. The Alan Guttmacher Institute, a nonprofit organization focused on sexual and reproductive health research, estimated that more than 3.5 million unintended pregnancies developed each year in the early to mid-1990s.\nLinn said women might benefit from having access to Plan B before they need it so they can effectively prevent unintended pregnancies.\n"Mistakes happen. (A woman's) needs may change faster than they have control over." Linn said. "It may be much more practical to fill a prescription and go get it. Have a discussion with your doctor."\n-- Contact City and State Editor David A. Nosko at dnosko@indiana.edu.
