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Contraceptive availability issue for women

The Health Center is closed on weekends and can't give out Plan B when many need it most

by Sarah Mirk

Stumbling home Friday night from a Harris Party, an unexpected and unprotected hook-up can lead to a weekend of anxiety.

The Health Center has often acted as the safe-sex safety net that many students rely on, but with no prospect of weekend hours, the Health Center the Health Center can't allay post-hook -up fears.

For five years, the Health Center has provided the emergency contraceptive pill, Plan B, to female students fearful of unwanted pregnancy. Commonly know as the "morning after pill," Plan B can be taken up to 72 hours after unprotected sex.

But Plan B's effectiveness sharply declines after 72 hours. According to the Jacobs Institute for women's Health, Plan B is 95 percent effective in preventing unwanted pregnancy if taken within the first 24 hours after unprotected sex. After 72 hours the effectiveness rate can drop to as low as 61 percent effective in preventing pregnancy.

The Health Center is closed from Friday afternoon to Monday morning. Students have to venture off campus to obtain Plan B when it would be most effective, and if they choose to obtain Plan B over the weekend, they can face obstacles of policy, distance and cost.

Plan B is a set of two pills, each about the size of a conventional birth control pill. Each pill contains .75 milligrams of a synthesized version of the female hormone progestin and must be taken 12 hours apart.

In 2003, the FDA rejected an appeal by the manufacturer of Plan B to change the status of the drug from prescription only to over the counter. The proposal was rejected in part because the FDA claimed it did not have sufficient evidence that more ready availability of Plan B would not change the sexual behavior of adolescents, making them more likely to practice unsafe sex.

The college has made efforts to make Plan B available to women despite the FDA's decision.

After a 2001 student initiative requested Plan B availability at the Health Center, students had a resource on campus for emergency contraception. Grinnell students do not need a prescription before obtaining the pill. The school has an agreement with a local doctor. The Health Center employees follow a strict protocol when distributing the pill and in exchange, students do not have to go through the lengthy process of seeing an off-campus doctor and obtaining a prescription. Part of this protocol involves signing an informed consent form, taking a pregnancy test and promising to return for a follow-up pregnancy test in two weeks.

When the Health Center is open, students can take Plan B there for only $15 a dose, one of only two things for which the Health Center charges students.

Female students who forget their birth control or break their condoms on the weekends have three other options. They can drive to one of the three Planned Parenthood offices in Des Moines and, between 10 a.m. and 1 p.m., pick up Plan B for a price that dependant on their income level. They can head over to the Grinnell Regional Medical Center and obtain the pills for $100, or they can wait until Monday morning.

"We set it up with the idea that you can get Plan B within the 72-hour grace period. If you have unprotected sex Friday night, you can still take the pill Monday morning," said Karen Cochran, director of the Health Center.

The plan is only problematic when there is the occasional four-day weekend, but Cochran said that she has never heard of a Grinnell student becoming pregnant because of the Health Center's lack of weekend hours.

Some students feel the reduced effectiveness after 72 hours should be addressed.

"I do think something should be done to make Plan B accessible on the weekends," wrote Feminist Action Coalition co-leader Theresa Bruckner '06 in an e-mail to the S&B,?"I understand the feasibility aspects of it, but I think that the extra organizational effort is worth it to make sure that people have access to the necessary resources when they need them."

Paige Wheeler '07 also wants weekend availability of Plan B on campus. "As it stands, students with Friday night trysts are in for a scary weekend and a higher risk of unwanted pregnancy," she said in an e-mail from abroad. Wheeler said that she has counseled several of her friends about what their options are.

"My suggestion to Grinnellians would be to get a hold of the ?morning after pill' before the morning after," Bruckner said.

Women with prescriptions can pick up Plan B from either the Medicap or Hy-Vee pharmacies in town, where a dose will cost from $30 - $45. As a national policy, the Wal-Mart pharmacy does not stock Plan B.

"People who are at colleges like Grinnell where access to Plan B is consistent and cheap might want to think about getting Plan B before they are in an emergency situation," said Bruckner. "[Women should] keep it in your room in case something does happen on a Friday night or sometime and you're stuck without access for a few days."

"It's just how kids use their resources," Cochran said, mentioning that she hosts several study breaks during the year to inform students and SAs about birth control options.

"If someone comes in repeatedly for Plan B, we don't want them to use it as their birth control, so we will suggest other ways they can get birth control." This was the case with a student recently who requested Plan B from the Health Center twice in one month. "We don't deny service, but give them information for pills, the ring, the patch," said Cochran "You have to sit down and educate some people."

Sidebar: By the numbers

101: Plan B doses distributed during the 2004-2005 academic year

3.37: doses dispensed on average by the Health Center each Monday during 2004-2005

6: doses dispensed the Monday of Winter Hell Week, a semester high

7: doses dispensed the Monday of Spring mid-sems week, a semester high

15: doses dispensed the Monday of Spring mid-sems week, a semester high

30 - 45: doses dispensed the Monday of Spring mid-sems week, a semester high

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