Contraception misconceptions

By Kate Ready

In an era of patchwork state laws that make abortion rights confusing for women, the same rings true for birth control options. A new poll found that many don’t know whether it’s legal to buy or use emergency contraceptives such as Plan B.

“In our office experience, most of the confusion with regards to Plan B has to do with the fact that it’s available without a prescription,” said Dr. Giovannina Anthony, an obstetrics and gynecology specialist in Jackson. “There are also a lot of patients who think it’s an abortion.”

It is not.

Plan B One-Step is an emergency contraceptive, a backup method of birth control that’s used to reduce the chance of pregnancy when taken within 72 hours after unprotected sex. It is not for routine contraceptive use, and according to the Food and Drug Administration it does not harm the fetus for women who are already pregnant.

In June 2013 the FDA approved Plan B for use without a prescription and without age restrictions. The pill contains levonorgestrel, one type of the hormone called progestin that is commonly found at lower doses in birth control pills and intrauterine devices.

Although for now Plan B is 100% legal in all 50 states, a third of adults, 32%, said in a poll conducted by the nonprofit Kaiser Family Foundation that they’re unsure if Plan B is legal in their state, and 5% said they think emergency contraceptive pills are illegal in their state.

The Kaiser Family Foundation, a nonprofit organization focused on national health issues, said in the poll that “confusion is more widespread in states where abortions are currently banned.”

More than half of people living in those states, including half of women, are unaware that Plan B is still legal. And while Plan B is available over the counter in many places, in Wyoming it’s often located behind the counter of a pharmacy.

The Albertsons pharmacy in Jackson confirmed that an ID isn’t needed to purchase Plan B, which retails for around $55, but the purchaser will need to ask a pharmacist for it.

Jodie Pond, the director of health at the Teton County Health Department, and Dr. Anthony said this may deter teens from buying it if they feel they’ll need to speak to a pharmacist.

Valerie Peprovich, a pharmacist at Albertsons for 16 years, told the News&Guide the pharmacy doesn’t sell much Plan B.

“In fact, I can’t think of the last time I’ve sold one,” Peprovich said.

Scientifically false FDA labeling contributed to the widespread belief that Plan B ends pregnancies.

Data from Kaiser found that 73% of U.S. adults incorrectly think that emergency contraceptive pills can end a pregnancy in its early stages. That includes two-thirds of women of childbearing age, 18-49.

The FDA changed the wording on Plan B on Dec. 22 to clarify that the pill does not prevent a fertilized egg from implanting in the womb.

The New York Times reported that scientific evidence has never shown that Plan B affects a fertilized egg’s ability to attach to the uterus and the FDA explained in an accompanying document that the products cannot be described as abortion pills.

“We used to use oral contraceptives in high doses for 48 hours to prevent ovulation, which is essentially what Plan B does,” Dr. Anthony said. “With a high dose of standard birth control for 48 hours you could potentially stop ovaries from ovulating — but it doesn’t cause an implanted or fertilized egg to abort.”

Leaflets inserted in Plan B packages say that the medication “works before release of an egg from the ovary,” meaning that it acts before fertilization, not after.

The FDA told The Times it made the change now because it had “completed a review of a 2018 application to alter the label that was submitted by Foundation Consumer Healthcare,” a company that in 2017 bought the Plan B brand from Teva Pharmaceutical Industries.

FDA officials said the political climate was not a motivation for updating the labeling and cited the pandemic as a delay in the review process.

Why were false claims about implantation placed on the label to begin with?

Experts said it was likely because daily birth control pills, some of which contain Plan B’s active ingredient, appear to alter the endometrium, the lining of the uterus into which fertilized eggs implant.

First, altering the endometrium has not been proven to interfere with implantation and, second, scientists have said that while daily doses of birth control pills accumulate levonorgestrel, morning-after pills do not have time to affect the uterine lining.

Dr. Anthony said she’s seen women in her Jackson women’s health clinic who believed all contraceptives were outlawed.

“I’ve had patients from conservative communities in Idaho come to me for gynecological care, who were ... under the perception that contraception in general was illegal,” Dr. Anthony said. “Plan B is a great option where contraception access is restricted.”

Even if abortion were ultimately banned in Wyoming, which might be the case by the end of the year, Plan B would remain legal.

Dr. Anthony recommended a website as a source of information for women with questions about abortion access.

“We try to direct women who call to the Chelsea’s Fund website to get accurate, upto-date information in Wyoming,” Dr. Anthony said. “I think it’s important to have a central source of information.”

Contact Kate Ready at 732-7076 or kready@jhnewsandguide.com.