In February, the Maine Legislature passed into law LD 1152, which allows Maine pharmacists to work in collaboration with Maine doctors and other health care providers to make Plan B and other emergency contraceptives (EC) more widely available to Maine women, particularly those living in rural parts of the state. On Monday, Gov. John Baldacci will sign the measure into law, making Maine just the sixth state in the nation to expand access to emergency contraception in this way.

Meanwhile, in Washington, D.C., the U.S. Food and Drug Administration announced that it would need an additional three months to complete its review of an application to make Plan B emergency contraceptive pills available over-the-counter (OTC) to women nationally.

The need for further consideration runs counter to the decision of two FDA Reproductive Health Advisory Committees, which on Dec. 16 recommended by a vote of 23 to 4 that the FDA approve the request to change the status of Plan B emergency contraceptive from “prescription only” to OTC. A broad range of health professionals believe that barriers to more timely access to Plan B should be removed, including making the product more available without prescription.

As its name suggest, this medication is about responding to emergencies – emergencies that are a result of contraception failure, unprotected sex, or forced sex. To claim that young women will use this medication as a regular birth control method runs contrary to our three decades of providing clinical family planning services and information to teens. EC is an effective backup form of contraception that should not be seen as more controversial than other methods.

Public health supporters across the country strongly suspect that the postponement of the decision is driven by political concerns that have nothing to do with the safety or efficacy of Plan B. Conservative advocacy groups, along with conservatives in Congress, have made their opposition to the OTC application loud and clear, claiming that improved access to EC would lead to increases in unprotected sex among teens. In response, the American College of Obstetricians and Gynecologists pointed out in its January letter of support for OTC application, “this has not been the case at all in situations where EC was made more easily available. Furthermore, there is no evidence that requiring a teen to obtain a prescription for EC in a crisis situation from a physician she does not know will further a positive patient-physician relationship.”

As a result of the publicity, the decision rests squarely with FDA Commissioner Dr. Mark McClellan. Supporters of the OTC application, including the Family Planning Association of Maine, view the decision as a clear test of whether the drug approvals will be based on scientific data or politics. Adding to the political pressure on the FDA, press reports have indicated that Dr. McClellan is under consideration by President Bush for a prestigious post heading up the Centers for Medicare and Medicaid Services.

The availability of Plan B as an OTC product meets a significant unmet medical need. Each year in Maine, half of all pregnancies are unintended and 40 percent of these end in abortion. Access to emergency contraception has the potential to cut these rates in half.

While the issue of teen access may be a sensitive political issue, from a public health perspective it is imperative that teens have access to EC. According to the Maine High School Risk Behavior Survey (2003), 43 percent of Maine high school students reported having had sexual intercourse and 59 percent of Maine youth have had sexual intercourse by the 12th grade.

While these numbers represent a decrease over the last decade, they alone necessitate action based on the realities faced by Maine families, rather than our collective wish that teens postpone sexual activity. Teens have the most to lose when faced with an unintended pregnancy – medically, socially and economically – and the most to gain from avoiding it.

Emergency contraception poses no safety concerns for teens or adults. We shouldn’t lose sight of the fact that the health risks associated with an unintended teen pregnancy are far greater than those posed by the use of EC.

George A. Hill is president and chief executive officer of the Family Planning Association of Maine.