On Monday, the Obama administration decided to drop its appeal of a judge's decision that the contraceptive known as Plan B One-Step should be available to women and girls of any age without a prescription.
The first question you might ask is: What effect will the availability of this medicine have on public health? Will it reduce the number of unplanned or teen pregnancies? Will it have any effect on sexual behavior? Could a reduction in unplanned pregnancies also lead to a reduction in, say, low birthweight babies or birth defects?
One could think of any number of important health-related questions raised by this story.
But The Washington Post couldn't. Its story, by Brady Dennis and Sarah Kliff, describes this in the lede as the end of a legal battle. It elaborates on the administration's decision, noting that Obama has not changed his opposition to over-the-counter sales of Plan B One-Step. It gets reaction from birth-control advocates, who say only that this is "a huge breakthrough for access to birth control." Uh, thanks; we got that.
Then the story reports on the criticism of antiabortion groups. Nowhere does the story address the public-health implications of the administration's action. It's all politics all the time. Memo to the Post: This is more than a political bargaining chip; it's medicine intended to combat the serious problem of unwanted pregnancies.
I sought help at The New York Times, to see what I could learn about the public-health implications of Plan B One-Step. The story, by Michael D. Shear and Pam Belluck, likewise failed to shed any light on the public-health implications of the medication's approval.
David Pittman at MedPage Today did a story that answered many of my questions. It sought reaction from the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, the American Congress of Obstetricians and Gynecologists, and the American Association of Pro-Life Obstetricians and Gynecologists. Those groups and their representatives noted that the medication was safe but that doctors would have to continue efforts to make sure that adolescents know how to use Plan B and that contraception can be made available for those with limited resources.
Those are reasonable questions to address in this story–not only in the medical trade press, but in the Post, the Times, and other mainstream news outlets. There are probably a few such stories out there that do address these questions. I did find one, by way of Tabitha M. Powledge at On Science Blogs: A helpful post by Julie Rovner at NPR's Shots blog, which does indeed discuss the public-health consequences of the administration's decision. Powledge also links to The Emergency Contraception Website, operated by researchers and reproductive-health specialists, which also fills the gaps left by the Times and the Post and others.
The politics of the Plan B decision are interesting; I'm a political junkie, and the Obama administration's sudden course change is fodder for endless conversation. But ephemeral political jousting, while it might be entertaining for some of us, isn't nearly as important as the medical issues.
Perhaps what we need, for the reporters who ignored the medical questions, is a drug to combat tunnel vision.
-Paul Raeburn
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