On having to go to the pharmacy counter to get Plan B

Posted by Sappho on December 9th, 2011 filed in Health and Medicine, Sexuality

Amanda Marcotte, upset like most feminist bloggers that the FDA approval for making Plan B over the counter for everyone has been overruled, writes

The other reason that it’s just a terrible idea to have these restrictions on Plan B is that doing so means that all women, not just minors, have to go through a pharmacist to get the drug. In order to comply with restrictions, pharmacies have to put Plan B behind the counter with the cough medicine and cigarettes, instead of out in the aisle next to the condoms and aspirin where it would go in a saner country. While some of us can endure having to ask for Plan B out loud and stoutly exclaim, “Hey, the condom broke!” if anyone gives us the stink eye, being afraid to do so isn’t a crime and shouldn’t be punished with unintended pregnancy. In a better world, discussing your personal business with a pharmacist would be easy and shame-free all the time, but in our world, not every woman is so lucky. Putting Plan B on the shelf helps women avoid uncomfortable conversations that may discourage them from buying it.

I’m actually pretty heartless when it comes to women who are too embarrassed to get contraception from a pharmacist. Mature enough to have sex ought to be mature enough to let your pharmacist know that, yes, you’re having sex, and no, you don’t want kids. Now, it’s true, I don’t want women who are too embarrassed to admit to a pharmacist that they want emergency contraception to wind up pregnant, because being too immature to admit you’re having sex isn’t a super good qualification for becoming a parent. And, given that emergency contraception (yes, this does work as contraception, by preventing the sperm from meeting the egg, and no, it’s not an early abortion) has been approved by an FDA panel as sufficiently safe to be an over the counter medication, I’m disappointed that political considerations will, after all, prevail over scientific ones. But the problem with “preventing teens from getting contraception over the counter means that adults will also have to go through a pharmacist to get their OTC drug” isn’t, to my mind, potential adult embarrassment. It’s something else.

There has been, for some years now, a move to allow pharmacists rights of “conscience” to refuse to fill prescriptions for contraceptives. This means that, anywhere such rights are recognized, women can capriciously be denied access to contraceptives. (It also means that, were California to recognize and defend such a right, I, who am nearly menopausal and unlikely to be able to become pregnant, could capriciously be denied the medicine I need to get my current menorraghia-induced anemia under control, should I go the birth control pill route for controlling said menorraghia, and should I encounter a pharmacist with a conscientious objection to the use of birth control pills, and there have indeed been court cases involving such pharmacists.)

This means that there’s a cost to all women in keeping contraception behind a counter, where you have to go through a pharmacist to get it, even if it’s not a prescription drug. Obviously, that’s a cost worth bearing, if the scientific evidence supports keeping a medication prescription only. I don’t think it’s a cost worth bearing to try to keep teenagers from having sex.

3 Responses to “On having to go to the pharmacy counter to get Plan B”

  1. twistedchick Says:

    If it’s not a problem to make women have to speak to a pharmacist in order to have access to contraception, then by all means put the condoms behind the counter, too. Why should shy teenage boys and gormless men have it easier than shy women? Why are women’s sex lives and reproductive systems up for what amounts to public discussion — because speaking to a pharmacist doesn’t occur in a closed, private area — and not men’s? Either put all of it out where it’s equally accessible, or none of it.

  2. Kai Jones Says:

    It’s not just embarrassment, though, it’s keeping private life private. Who else is in the pharmacy–maybe your co-workers, your kid’s friend’s parent, the guy who mows your lawn? Why do they get to overhear you asking the pharmacist for Plan B?

  3. Sappho Says:

    But I haven’t said that it’s not a problem to make women speak to pharmacists to get Plan B. I’ve said that it is a problem to make women speak to pharmacists, because there’s a block of pharmacists who will assert their right of “conscience” to then refuse to give women a perfectly good method of birth control. If the drug’s in the aisles, no single person can make his or her “conscience” a bottleneck that prevents a woman from being served.

    It’s also a problem because there isn’t a blind bit of medical evidence to keep the drug prescription only for teens, and so women shouldn’t be even slightly inconvenienced when buying birth control, in the interest of discouraging teenagers from having sex.

    What I don’t think is that, in and of itself, being ashamed to ask the pharmacist for birth control is all that strong a reason to put it in the aisles. Lots of medications that actually should be prescription only are more stigmatizing than Plan B. Lithium’s more stigmatizing than Plan B, and has a very narrow safety margin, so that there’s a damn good reason to require a prescription for everyone and force people to go to that pharmacist’s counter to get it. If the medical case for making Plan B a prescription drug for teens was actually plausible, I wouldn’t shed any tears over adult women’s embarrassment in buying birth control, any more than I want psych meds made OTC so that people won’t have to go to a pharmacist to buy them.

    Because so many prescription drugs are stigmatizing, I’ve found pharmacy counters more protective of customers’ privacy than the lines at the front of the store. They generally make waiting customers stand a couple of yards back, behind a line, while they service customers at the counter, so that it’s easy to talk in a low voice (or display written scrips) if you don’t want your neighbors to know that you’re on lithium. If I were embarrassed to have my neighbors see me buying Plan B, or condoms, I’d actually go to the pharmacy counter in preference to the front of the store (though that should of course be my choice, not something legally imposed on me).

    If anything, the bigger inconvenience imposed by requiring everyone to go to the pharmacist to get Plan B (besides the greater change for a “conscience” bottleneck) is not so much embarrassment as the fact that the pharmacy often has shorter hours than the rest of the store. For a drug whose effectiveness rapidly declines with time, forcing everyone to go to the part of the store that may not be in business when they most need the drug, just to keep teenagers from having sex, is not a good bargain.