Sebelius' Morning After Pill Decision: Politics or 'Anti-Science' Pro-Life

On Wednesday, Health and Human Services Secretary Kathleen Sebelius overruled an expert panel at the FDA which had recommended allowing children under 17 to purchase the "morning after pill" Plan B One-Step over the counter. Under current regulations, Plan B is available without a prescription to people 17 and over, but those 16 and under would need a prescription in order to purchase it. The pill is designed to be taken within 72 hours after having "unprotected" sex and is claimed to reduce the chances of pregnancy from such sex from 1 in 20 to 1 in 40. It does this by preventing ovulation through a boost in hormones. Like other forms of hormonal birth control, it also serves to make the uterine lining more resistant to implantation by a fertilized egg, so even if ovulation does occur (or has already done so) it can make spontaneous miscarriage/abortion of the zygote far more likely. As such, it is often considered potentially a form of early abortion, though the frequency with which it acts through preventing a zygote from implanting (versus acting through preventing ovulation) is not known.

In prior policy moves in relation to Plan B, the Bush Administration had originally overruled a request that the pill be made available over the counter, but eventually allowed it for purchasers who were 18 or over. The Obama administration acted in 2009 to make Plan B available to those 17 and over, but until now has continued to require a prescription for those young. This means that the pill (which costs around $50 per dose) is generally held behind the pharmacy counter and provided without a presciption to those who show ID proving they are 17 or over.

This latest move on Plan B has many left leaning commentators up in arms, accusing the Obama Administration of ignoring 'science' and bowing to the interests of the religious right. James Fallows at The Atlantic compares the move to something one would expect from a Michelle Bachman administration and suggests Sibelius and Obama should be criticized accordingly. The New York Times says:

“Very few medications are this simple, convenient and safe,” said Dr. Kathleen Hill-Besinque, an assistant dean at the University of Southern California School of Pharmacy.

Jeanne Monahan of the Family Research Council, a conservative advocacy group, said that making Plan B available to young women without a prescription would mean fewer chances that doctors would be able to save them from sexual exploitation, abuse and related diseases. “Secretary Kathleen Sebelius was right to reject the F.D.A. recommendation to make this potent drug available over the counter to young girls,” she said.

Kirsten Moore, president of the Reproductive Health Technologies Project, said Ms. Sebelius had no credible scientific rationale for her decision. “We are outraged that this administration has let politics trump science,” she said.

It's probably inevitable that people will ask whether pro-lifers should consider this an olive branch from the Obama administration, though this seems hard to credit given Obama and Sibelius' hard line support of abortion in all circumstances and the recent moves by Sebelius' DHHS to punish the Catholic bishops for political support for moral causes by defunding Catholic run charitable programs.

The far more likely explanation is that this represents a basic political and cultural calculus on the part of the Obama administration as it nears reelection season. While on the cultural hard left, the only question may be a scientific one of whether Plan B will work as intended on children and young teens, for much of the country situations in which young teens would think they need to take Plan B have a moral dimension as well as a scientific one. While in some sectors of our society there is an almost magical belief that "birth control and abortion make anything better" (I actually read commenters on some articles suggesting this was a bad decision because it might force a 11 or 12 year old girl being sexually abused to have to talk to an adult about the fact she feared she needed Plan B, rather than being able to purchase it without trouble) a lot of people would react against Obama if Republicans were able to claim, "Obama wants your twelve year old daughter to be able to buy the Morning After Pill without talking to you or a doctor!" While most Americans are fine with birth control and probably accept as a given that their teens will eventually have sex outside of marriage, the idea of the government actively making it easier for their children to pursue birth control and abortions without talking to their parents is not widely popular among those parents.

As such, this can be seen as some mainstream positioning by the Obama administration. The cultural far left, after all, has no where else to turn to. Obama is reaching for the cultural center. If he wins, this decision may well get reconsidered in 2013.