Cascadia Scorecard News
June 2005

More than half a million Northwest couples will have sex today. Around 40,000 will take their chances on pregnancy, skipping birth control. In some 2,000 more cases, a condom will inadvertently tear or slip. Emergency contraception offers a safety net for these instances.

More than half of Cascadian women are fortunate to have unusual access to emergency contraception-higher doses of hormonal birth control pills that prevent ovulation and implantation of a fertilized egg.

Alaska, British Columbia, California, and Washington all have programs in place through which women can get Plan B and other emergency contraceptives from pharmacists without visiting a doctor first. In British Columbia, Plan B is available over the counter from virtually all pharmacies. In April, the rest of Canada followed BC's lead: all Canadian pharmacies now offer emergency contraception without a prescription.

But elsewhere in Cascadia-in Oregon, Idaho, and Montana-as in much of the rest of the United States, pharmacy access to emergency contraception remains stalled at the Federal Drug Administration headquarters in Washington, DC. An FDA expert panel advised the FDA to approve over-the-counter sales in 2004, but the federal agency rejected the application.

Many observers suspect that political pressure from social conservatives has blocked a normally science-based process. Plan B has reapplied for approval after limiting sales to those 16 years of age and older. But the FDA missed its January deadline for ruling on the new application and has made no prediction about when it may issue a decision.

Universalizing one-stop access to emergency contraception at pharmacies is one of the best public policy options toward reducing the number of unintended pregnancies-perhaps by as much as half. FDA approval, which is likely to come sooner or later, will expand the number of pharmacies in Northwest states from which Plan B is readily available. And it will expand that service to all other American states, including of course, the rest of Cascadia.

A recent study shows that BC's over-the-counter program has made a big difference. The number of BC women who used Plan B doubled to 18,000 a year after the province moved the medication off the prescription-only list in late 2000. The study's author estimates that expanded access to Plan B has prevented about 200 unwanted pregnancies a year in the province. Of those, about half likely would have ended in abortion. Fewer would have ended in miscarriage. And the remainder would have resulted in unintended births.

More than a third of all births in Washington, Oregon, and Idaho result from mistimed or unwanted pregnancies. Children conceived intentionally receive better prenatal care and have lower infant mortality rates and lower rates of abuse and neglect. Consequently, fewer wanted children end up in the child welfare system, including juvenile courts and foster care.

Ensuring that every Cascadian baby is born wanted would ease a variety of social problems. It would also help put the region on a more sustainable population trajectory. Increasing access to emergency contraception is one key step.

Write to the FDA and ask them to approve over-the-counter emergency contraception:
National Organization of Women's action alert
NARAL's action alert

More resources:
Sightline's population indicator
Sightline's take on Plan B
County-by-county fertility rates
Planned Parenthood information on emergency contraception