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Indian Health Services, the agency that provides health care for American Indian and Alaska Native women, will now offer emergency contraception without a consultation or a prescription at its federally-operated facilities. The policy change represents a victory for the reproductive health advocates who have been working to expand Native women’s access to Plan B for years.
IHS doesn’t have any retail pharmacies, so women seeking emergency contraception need to wait along with everyone else at emergency care clinics. Then, they have to fill the prescription they receive. That can prevent some of the women who need Plan B from being able to get it within the recommended 72-hour window — that is, if the IHS-run facility they’re visiting even makes it available at all. A 2012 survey from the Native American Women’s Health Education Resource Center found that 43 percent of the clinics serving Native women didn’t carry any emergency contraception whatsoever.
Native women are unlikely to seek out medication at a non-IHS facility. The federal government provides most primary care services to Native American people free of charge at the facilities run by IHS.
Ensuring this population’s access to emergency contraception is especially pressing considering the high rates of sexual assault among Native women. According to the Department of Justice, about one in three Native American women will be sexually assaulted in her lifetime — a higher per-capita incidence of sexual violence than any other racial group within the United States.
More than a year ago, IHS said it was working on a policy to help address these issues and make Plan B directly available to patients. Even though that policy hasn’t yet been finalized and published, the agency told the Associated Press that “all IHS facilities run by the federal government are now under a verbal directive to provide Plan B to women 17 years and older at pharmacy windows without a prescription.”
Women’s health advocates are welcoming the news, but they warn this issue isn’t resolved. They’re pushing for a formalized policy, pointing out that an informal “verbal directive” could end up being revised or rescinded. And they also want IHS to start adhering to the Food and Drug Administration’s new emergency contraception guidelines, which made Plan B available without a prescription to women of all ages.
“We’ve made some progress, and we have to acknowledge that, but there’s still more,” Charon Asetoyer, the director of the Native American Women’s Health Education Resource Center, noted. “They’re still violating our rights to access by denying women who are age 16 and under. …We have to ask, why are we being treated differently?”
Unfortunately, Native American women don’t represent the only group that’s still struggling to access emergency contraception over the counter. Even though prescription-free Plan B was supposed to hit pharmacy shelves on August 1, there’s still a lot of confusion swirling around it. Some people still incorrectly believe Plan B is an abortion-inducing drug, or assume they won’t be able to buy it without a prescription. Some women still can’t afford the $50 price tag. And some pharmacies are refusing to move emergency contraception out from behind the counter precisely because of that price tag, since they assume it might get stolen.