Menus Subscribe Search

Follow us


plan-b

(ILLUSTRATION: DONSCARPO/SHUTTERSTOCK)

Why Everyone Should Have Access to Plan B

• May 17, 2013 • 10:00 AM

(ILLUSTRATION: DONSCARPO/SHUTTERSTOCK)

Give them the benefit of the doubt: Adolescents are more competent in thinking about their decisions than many people suspect, and the science suggests they won’t abuse over-the-counter contraceptives.

Last month, Judge Edward Korman ordered the Food and Drug Administration (FDA) to make the emergency contraceptive, Plan B, available over the counter to people of all ages, rather than requiring prescriptions for those under 17. Last week, he stood by that decision. In his harshly worded ruling, Korman rejected the claim that easier access to Plan B would allow adolescents to make decisions that were beyond their capabilities.

The scientific evidence supports his ruling. Indeed, it shows adolescents to be more competent in thinking about their decisions than many people suspect. However, the research also shows how social and emotional pressures can lead young people to act against their own better judgment.

There is little dispute about Plan B’s effectiveness. It greatly reduces the probability of pregnancy if taken within 72 hours of unprotected sex. Nor is there much question that easier access will help many women, especially those without regular access to physicians who can write prescriptions and those who need it over the weekend, when unprotected sexual encounters (and assaults) often occur. Serious side effects are too rare to consider.

As for older adolescents, the research shows little evidence of Plan B becoming their Plan A, used routinely so that they can have unprotected sex without getting pregnant.

In 2011, the FDA moved to make Plan B universally available. However, Secretary of Health and Human Services Kathleen Sebelius overruled that decision, citing “common knowledge that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age.” She left unchallenged an earlier claim that women under 16 might exhibit “impulsive behavior, without the cognitive ability to understand the etiology of their behavior.”

Judge Korman dismissed the relevance of those “youngest girls,” arguing that “the number of 11-year-olds using these drugs is likely to be minuscule.”

As for older adolescents, the research shows little evidence of Plan B becoming their Plan A, used routinely so that they can have unprotected sex without getting pregnant. However, the research also shows how unprotected sex can happen more often than young women intend—making it all the more important that they have access to Plan B when they need it.

Cognitive research suggests that, by age 15 or 16, teens and adults have similar decision-making abilities, strong in some ways, weak in others. Like adults, teens sometimes make decisions without much thought, and sometimes work hard to get it right. Contrary to folk wisdom, teens do not have a unique sense of invulnerability. Indeed, they often feel especially vulnerable. However, teens know much less about how seemingly safe acts can make them vulnerable, as when they stumble into situations where they are coerced by sexual partners.

How well teens, or adults, use their decision-making abilities depends on how well their thoughts control their impulses. Neuroscience research shows how the structures needed for impulse control evolve in adolescents’ brains. Whether teens have as much control as they need depends on the circumstances. They may have too little control in a moment of passion, but all that they need before or after.

As a result, where teens need help is in avoiding situations where they might lose control and in coping with situations when things have not gone as planned. Parental guidance can help with the former. Easy, informed access to Plan B can help with the latter.

In a study published in the journal Social Science and Medicine, we used in-depth interviews and surveys to learn how young women in Pittsburgh, aged 13-18, think about three key decisions that Plan B’s availability might affect: when to have sex, what contraceptives to use routinely, and what to do after unprotected sex.

As in other studies that let teens speak their minds, ours found them to be very thoughtful, as they navigated a complex, uncertain, sometimes unfriendly world. Although they all knew about Plan B, none described it as anything but an emergency measure. Those opposed to abortion reported having thought through what Plan B meant to them. Nothing that they said suggested that easy access would encourage them to have unprotected sex. Many underestimated its effectiveness and exaggerated its negative side effects.

Despite being unenthusiastic about Plan B, these teens wanted easier access and complained about being embarrassed to ask pharmacists about Plan B and worrying about having their privacy compromised. As a result, easier access would help young women to get the drug when they need it—and reduce the risk of unplanned pregnancy. It would leave the decisions about sex, health, and relationships to the private lives of teens and those who care about them.

Tamar Krishnamurti and Baruch Fischhoff
Baruch Fischhoff is the Howard Heinz University Professor of Social and Decision Sciences and Engineering and Public Policy at Carnegie Mellon University. Tamar Krishnamurti is a postdoctoral fellow within Carnegie Mellon University's Tepper School of Business and Department of Engineering and Public Policy.

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

October 1 • 2:00 PM

Most People With Addiction Simply Grow Out of It. Why Is This Widely Denied?

The idea that addiction is typically a chronic, progressive disease that requires treatment is false, the evidence shows. Yet the “aging out” experience of the majority is ignored by treatment providers and journalists.


October 1 • 1:00 PM

Midlife Neuroticism Linked to Alzheimer’s Disease in Old Age

New research from Sweden suggests that the personality dimension is connected to who ultimately suffers from late-in-life dementia.



October 1 • 11:11 AM

The Creative Class Boondoggle in Downtown Las Vegas

On Tony Hsieh and the pseudoscience of “collisions.”


October 1 • 9:14 AM

Mysterious Resting State Networks Might Be What Allow Different Brain Therapies to Work

Deep brain stimulation and similar treatments target the hubs of larger resting-state networks in the brain, researchers find.


October 1 • 6:00 AM

Would You Like a Subscription With Your Coffee?

A new app hopes to unite local coffee shops while helping you find a cheap cup of good coffee.


October 1 • 4:00 AM

How to Plant a Library

Somewhere outside of Oslo, there are 1,000 newly planted spruce trees. One hundred years from now, if everything goes to plan, they’ll be published together as 100 pieces of art.



September 30 • 10:09 AM

Trust Is Waning, and Inequality May Be to Blame

Trust in others and confidence in institutions is declining, while economic inequality creeps up, a new study shows.


September 30 • 8:00 AM

The Psychology of Penmanship

Graphology: It’s all (probably) bunk.



September 30 • 6:00 AM

The Medium Is the Message, 50 Years Later

Five decades on, what can Marshall McLuhan’s Understanding Media tell us about today?


September 30 • 4:00 AM

Grad School’s Mental Health Problem

Navigating the emotional stress of doctoral programs in a down market.


September 29 • 1:21 PM

Conference Call: Free Will Conference


September 29 • 12:00 PM

How Copyright Law Protects Art From Criticism

A case for allowing the copyright on Gone With the Wind to expire.


September 29 • 10:00 AM

Should We Be Told Who Funds Political Attack Ads?

On the value of campaign finance disclosure.


September 29 • 8:00 AM

Searching for a Man Named Penis

A quest to track down a real Penis proves difficult.


September 29 • 6:00 AM

Why Do So Many People Watch HGTV?

The same reason so many people watch NCIS or Law and Order: It’s all a procedural.


September 29 • 4:00 AM

The Link Between Depression and Terrorism

A new study from the United Kingdom finds a connection between depression and radicalization.


September 26 • 4:00 PM

Fast Track to a Spill?

Oil pipeline projects across America are speeding forward without environmental review.


September 26 • 2:00 PM

Why Liberals Love the Disease Theory of Addiction, by a Liberal Who Hates It

The disease model is convenient to liberals because it spares them having to say negative things about poor communities. But this conception of addiction harms the very people we wish to help.


September 26 • 1:21 PM

Race, Trust, and Split-Second Judgments


September 26 • 9:47 AM

Dopamine Might Be Behind Impulsive Behavior

A monkey study suggests the brain chemical makes what’s new and different more attractive.


September 26 • 8:00 AM

A Letter Becomes a Book Becomes a Play

Sarah Ruhl’s Dear Elizabeth: A Play in Letters From Elizabeth Bishop to Robert Lowell and Back Again takes 900 pages of correspondence between the two poets and turns them into an on-stage performance.


September 26 • 7:00 AM

Sonic Hedgehog, DICER, and the Problem With Naming Genes

Wait, why is there a Pokemon gene?


Follow us


Mysterious Resting State Networks Might Be What Allow Different Brain Therapies to Work

Deep brain stimulation and similar treatments target the hubs of larger resting-state networks in the brain, researchers find.

Trust Is Waning, and Inequality May Be to Blame

Trust in others and confidence in institutions is declining, while economic inequality creeps up, a new study shows.

Dopamine Might Be Behind Impulsive Behavior

A monkey study suggests the brain chemical makes what's new and different more attractive.

School Counselors Do More Than You’d Think

Adding just one counselor to a school has an enormous impact on discipline and test scores, according to a new study.

How a Second Language Trains Your Brain for Math

Second languages strengthen the brain's executive control circuits, with benefits beyond words.

The Big One

One company, Amazon, controls 67 percent of the e-book market in the United States—down from 90 percent five years ago. September/October 2014 new-big-one-5

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.