WASHINGTON, Aug. 7 (UPI) -- American women may be one step closer to accessing emergency contraception without a prescription.
Despite widespread over-the-counter access and acceptance worldwide, expanding access to emergency contraception -- also known as the "morning-after pill" -- in the United States has faced politics as usual.
For the past three years the U.S. Food and Drug Administration has stalled on a decision about OTC availability for Plan B, the most common emergency contraceptive pill in the country.
Despite numerous public health and reproductive-rights groups supporting the move, along with internal FDA panels, it is only the threat of a new FDA nominee left unconfirmed that has prompted the agency to take the subject up again.
Former National Cancer Institute Director Andrew C. von Eschenbach faced confirmation hearings before the Senate this week, but Sens. Hillary Clinton, D-N.Y., and Patty Murray, D-Wash., vowed to put a hold on his confirmation until the FDA makes a final decision on non-prescription Plan B.
"Rather than moving this process forward and doing right by the American people, the Administration is continuing to play a game of smoke and mirrors," the senators said in a joint statement.
The latest snafu hinges on whether Plan B's manufacturer can ensure it is only available for women over 18. While the drug -- which is essentially a high dose of birth-control hormones -- has been proven safe even for young teenagers, some conservatives worry that making it available for all ages will encourage risky sexual behavior.
But these worries seem to bother few of the 45 other nations that offer emergency contraception without a prescription.
Deborah Billings has worked to make emergency contraception available in pharmacies and health clinics throughout overwhelmingly Catholic Mexico, where the drug became legal over-the-counter in 2004.
The reaction from women has been fabulous, said Deborah Billings, a researcher who specializes in Mexico for the women's health group Ipas.
"They are impressed that their government has made yet another option available to them," Billings said.
"We say, 'We're Catholic. But we can't have six kids.' The average family size is 2 to 3 children in Mexico now. You can't achieve that without family planning."
Canada has seen a similar pattern. Plan B became available directly from pharmacies just over a year ago, and sales of the drug have skyrocketed, according to Canadian Women's Health Network President Madeline Boscoe.
And it appears that making information about the drug available may discourage risky behavior.
Billings added that women who received educational information on emergency contraception from her group were actually less likely to engage in unprotected sex -- because they knew all of their family planning options.
"(Emergency contraception) does not enter into the logic of whether or not they're going to have sexual relations," Billings said. "People who are informed about contraceptives in general tend to use condoms more often than people who are not informed."
Basically, abstinence-only education doesn't work, she added.
While Billings said there is still some resistance from anti-abortion groups, she said overall the drug has seen significant acceptance and widespread use.
The pill may also reduce the number of abortions, according to research from countries where emergency contraception is easily accessible.
The "morning-after pill" is not an abortion drug; it prevents fertilization. Both Billings and Boscoe said that more widespread knowledge of emergency contraception is driving down the number of women who seek abortions, as well as the number of unwanted pregnancies.
But some women's health experts in other countries seek even more education and availability for emergency contraception.
"We think (emergency contraception) should be accessible in the same way that condoms and Tylenol are -- in a variety of places," Boscoe.
"It should become part of the repertoire (of family planning options) that people have available for their own use."
