This month, the political fight over emergency contraception has intensified, as the Obama administration continues to resist making the morning after pill available to women of all ages over the counter. After a federal judge ordered the FDA to remove all age restrictions on emergency contraception, the administration disagreed, maintaining that girls under 15 years old should still be required be obtain a prescription to purchase the contraceptive method — a position that baffles medical experts.

At the American Congress of Obstetricians and Gynecologists’ recent annual meeting, MedPage Today asked women’s health experts what they thought of the ongoing fight over Plan B. Multiple medical experts went on record to say that they don’t understand why emergency contraception has been such a contentious issue, and they don’t support restricting it for younger teens:

– Owen Montgomery, MD: “I would much rather have a 13- to 14-year-old girl who needs emergency contraception have access to it than come to my office with an unwanted pregnancy… In our clinics in the university, we see lots and lots of teenagers. And many of these young ladies have no access to good parental role models, and they need access to emergency contraception when they need access. And they can’t wait for permission from a judge, or someone else of authority.”

– Alison Edelman, MD, MPH, of Oregon Health & Science University: “Emergency contraception is a really, really important part of our toolkit for contraception. It helps women who have emergencies, i.e., they aren’t using contraception at the time of sexual activity or they had a misstep with their contraception, like a condom break or slip.”

– Barbara S. Levy, MD, ACOG’s vice president for health policy: “There’s failure of other methods. There are rapes. There are other things that occur. Women need to be able to access emergency contraception and have the knowledge and understanding of how to use it, so we can prevent unwanted pregnancies and unintended pregnancies that happen, because life happens.”

– Laurie J. McKenzie, MD, of both the University of Texas and Baylor College of Medicine: “I find it very interesting that there are these concessions that are being made in terms of age limitation … There are more deaths associated with Tylenol overdose than there are with oral contraceptive overdoses or potential overdose with Plan B. There have never, to my knowledge, been any overdoses with hormonal contraception.”

– Eve Espey, MD, MPH, of the University of New Mexico in Albuquerque: “Plan B should be over the counter… All emergency contraceptives should be over the counter with no age restrictions.”

Indeed, there’s no scientific basis for imposing an age limit on Plan B. Multiple medical groups, including the American Academy of Pediatrics, have expressed support for making emergency contraception easily accessible to women of all ages.

Developing nations around the world aren’t doing enough to ensure that women have access to the family planning services they need, a new report from the Guttmacher Institute finds. The women who want to prevent pregnancy but don’t have access to modern forms of birth control are concentrated mostly in poorer countries, and those countries are lagging far behind wealthier nations when it comes to ensuring women’s ability to use the contraceptive services of their choice.

And the problem is getting worse. Between 2003 and 2012, the total number of women in need of birth control because they wanted to avoid pregnancy increased from 716 million to 867 million — and most of that growth was among women in the 69 poorest countries, where birth control is already more difficult to come by. About 222 million women in developing countries want to use birth control but aren’t currently able to access a modern contraceptive method, and nearly three quarters of those women live in the world’s poorest countries.

“Unless the adequacy of family planning services improves more rapidly than it has in the past decade, he number of women with an unmet need for modern contraceptives will continue to rise, especially in the 69 poorest countries,” Jacqueline E. Darroch, one of the study’s authors, explained in a statement.

Last year, the United Nations declared access to contraception to be a “universal human right.” But that right isn’t being realized for millions of women around the world — and the continued failure to ensure better access to modern birth control results in serious consequences for women in developing nations. Higher rates of unintended pregnancies lead to higher rates of preventable deaths from unsafe abortions, as well as higher rates of infant deaths around the world. Furthermore, giving women the family planning resources they need is an important step toward helping those women achieve economic success and independence.

Unfortunately, persistent class divides plague contraception access even in wealthy nations. Here in the United States, poorer women still struggle to access the birth control method of their choice — and research has demonstrated that when cost barriers are removed, those low-income women choose more effective methods than they would have otherwise.

North Carolina is advancing a measure that would effectively allow personal beliefs to trump women’s access to birth control. Under HB 730, employers in the state could decide not to include contraceptives in their workers’ insurance plans for any reason — a direct violation of the popular Obamacare provision that stipulates women should receive birth control coverage at no additional cost to them. But as lawmakers debate HB 730, women’s health advocates in the state want them to know they’re not willing to be dragged back to the 1960s without a fight.

“We love a good vintage look — but not when it’s running the state legislature,” the local Planned Parenthood affiliate explained in a press release. That’s why Planned Parenthood supporters dressed up in 1960s clothing to attend a House committee hearing about HB 730 on Wednesday.

The 1960s apparel is intended to communicate that state lawmakers are trying to turn back the clock to past decades, when women didn’t have the freedom to control their own reproductive decisions. Planned Parenthood raised awareness about HB 703 with a Mad Men-themed event in advance of the committee hearing, and then sent dozens of vintage-garbed supporters to Wednesday’s debate (all photos courtesy of Planned Parenthood Action Fund of Central North Carolina):

“We like watching Mad Men — but we don’t want to live in it,” Paige Johnson, the president of public affairs for the Planned Parenthood of Central North Carolina, pointed out. “Women’s preventive care — including birth control — is basic health care. Politicians and bosses have no business denying women access to this basic health care. This shouldn’t be a revolutionary idea, but unfortunately it is to some.”

North Carolina lawmakers aren’t the only ones to consider a foray into 1960s-esque policies. Even though a similar law in Missouri allowing employers to deny birth control coverage was recently struck down by a federal judge, that hasn’t stopped other states from attempting the same method to restrict women’s access to affordable birth control.

And unfortunately for the women in North Carolina, this is hardly the only measure currently being considered in the legislature that could pose a threat to women’s health. State lawmakers are also considering including biased misinformation about abortion in sex ed classes, imposing unnecessary restrictions on abortion clinics that could force them to close, and forcing teens to get a notarized note from their parents before getting tested or treated for STDs.

In a fiery decision on Friday, U.S. District Judge Edward Korman denied the Obama administration’s motion to delay an order to immediately allow over-the-counter access to emergency contraception to women of all ages. After Korman initially ordered in April that the so-called “morning-after pill” be available to all women and girls without a prescription, the FDA instead decided to lower the age limit to teens 15 and up rather than 17. However, those 15- and 16-year-olds will only have over-the-counter access to one brand of emergency contraception pill, Teva Pharmaceutical’s Plan B One-Step, thanks to what Korman called a “sweetheart arrangement” between the FDA and Teva.

Blasting the Obama administration’s argument as “an insult to the intelligence of women,” Korman attacked the FDA’s decision to lower the age restriction for Plan B rather than comply with his order to allow all women access to any brand of emergency contraception. The judge accused the administration of delaying his ruling so as to give Teva Pharmaceutical sole access to the market of 15- to 17-year olds without a prescription. Generic versions of Plan B, meanwhile, will stay behind the pharmacy counter for this age group.

Korman also noted that Teva will drive up the price of the pill now that it has a monopoly on young women in need:

While this proposal was a boon to Teva, it did little to eliminate the practical obstructions in obtaining emergency contraception to women of child-bearing age whether over or under age 15. On the contrary, Teva will use its privileged marketing status and exclusivity to increase the cost of the drug. The price of Plan B One-Step under the new marketing regime is expected to be $60, significantly more than the one- or two-pill generic version, and could conceivably go higher, if only to accommodate the more expensive packing, age-verification tags, and anti-theft technology that the new marketing arrangement would require.

As Teva profits from the Obama administration’s arbitrary age restriction, the burden on women seeking emergency contraception will only grow larger. Younger teens and undocumented women unable to prove their age with government-issued ID will still not have access, and may not be able to afford the new cost. As Korman points out, the Teva-FDA deal still requires Plan B to be sold over the counter at stores with on-site pharmacies, even though many women do not live near such facilities. The decision also cites a survey of 943 pharmacies in 5 cities, which found that only 4.7 percent stayed open 24 hours. Given the time-sensitive and often urgent need for emergency contraception, limiting the hours and locations where women can buy the drug could have serious consequences.

Moreover, there is no medical reason to limit access to the morning-after pill. Despite the Obama administration’s concern that it could be “dangerous” to young teens, an enormous body of research has demonstrated emergency contraception is safer than aspirin for women of all ages.

A recent report found that the United States has the highest rate of first-day infant death in the industrialized world. It’s unclear why the U.S. continues to struggle so much with infant mortality, but it’s likely partly tied to some women’s substandard prenatal care. Women’s health experts agree that there’s one way to ensure that women’s pregnancies are as healthy as possible: ensuring access to affordable family planning programs.

At first glance, the link between birth control and healthy babies may not seem obvious. But, according to research from the Guttmacher Institute, there’s actually a big correlation between giving women the resources to determine the timing of their pregnancies and the health outcomes of those pregnancies. When women who have multiple children are able to space out their pregnancies, their children are less likely to be born prematurely or have low birth weights. There’s also mounting evidence that women who unintentionally become pregnant tend to receive worse prenatal care than the women who who are able to plan their pregnancies — partly because when pregnancies are unintended, women may go weeks or even months without realizing they’re pregnant. And when couples don’t use contraception, they have about an 85 percent chance of an unintended pregnancy within a year.

Guttmacher estimates that public family planning programs — specifically, the publicly funded services that are supported by Medicaid and Title X funding — help avoid 1.94 million unintended pregnancies every year. On the other hand, if low-income women in the United States didn’t have access to the preventative care at those clinics, there would be an annual additional 860,000 unplanned births and 810,000 abortions in this country.

Unfortunately, however, those essential public family planning clinics are under attack across the country. Since Planned Parenthood affiliates often run women’s health clinics with Medicaid dollars, anti-choice Republicans have seized on the opportunity to target the organization by defunding its publicly-funded programs. Even though GOP lawmakers have framed their crusade against Planned Parenthood in terms of their opposition to abortion, public funds cannot actually finance abortion services. When family planning clinics get defunded, it doesn’t do anything to stop abortion — but it does deal a blow to the quest to improve infant death rates by undercutting women’s critical preventative care.

Over the past two years, Republicans have attacked family planning in ten different states. The consequences of those battles have perhaps been most evident in Texas, where state officials slashed Title X funds and excluded Planned Parenthood from the local Medicaid program. After realizing that unintended births are likely to rise dramatically, Texas Republicans have finally pledged to start working to restore the women’s health funding that they slashed in 2011.

Unintended pregnancy doesn’t just take a physical and financial toll on a woman; according to a new study published on Wednesday, it also has emotional consequences.

Researchers at the University of North Carolina spoke with 680 women — 433 who had an intended pregnancy, 207 who said their pregnancy was mistimed, and 40 with an unwanted pregnancy — to gauge the impact of an unintended pregnancy on a woman’s mental health. They found that a women who didn’t mean to get pregnant were much more likely to suffer from postpartum depression, and more likely to risk long-term mental health issues:

Results show that postpartum depression was more likely in women with unintended pregnancies at both three months (11% vs. 5%) and twelve months (12% vs. 3%). The increased risk was highest at 12 months and indicates that this group of women have a long term risk of depression. When age, education level and poverty status were factored into the results, women with unintended pregnancy were still twice as likely to have postpartum depression at twelve months.

The research offers yet another reason why it’s important for women to have readily available access to contraception. Access to birth control would lower rates of unintended pregnancy — and therefore both abortion and, as this study indicates, maternal depression.

Rates of unintended or mistimed pregnancy are particularly high among low-income women, who struggle to find access to affordable contraception. Unfortunately, there is little being done to increase access to family planning that would ultimately be beneficial to preventing such pregnancies. Instead, states are continually pushing to make it more difficult for all women, and particularly low-income women, to access this type of reproductive care.

(HT: Kay Steiger)

U.S. District Judge Edward Korman did not take well to the Obama administration’s appeal of the judge’s recent order to lift all age restrictions on the Plan B “morning-after pill.” In his original ruling last month, Korman chided the administration for its “political interference” into the FDA’s recommendation to allow women of all ages to obtain emergency contraception without a prescription. On Tuesday, the federal judge did not hesitate to express his displeasure once again, calling the Justice Department’s appeal “a charade.”

During a hearing in Brooklyn, Korman accused the administration of trying to “sugarcoat this appeal of yours” to hide their true attempt to stall the court order. Though the court’s ruling is not expected until the end of the week, Korman made his outrage over the “total and complete corruption of the administrative process” quite clear:

When the government lawyer argued that delaying Korman’s order while it was on appeal was in the public interest, the judge responded, “Is there a public interest in unwanted pregnancies … that can often result in abortions?”

The judge also expressed outrage at another provision under the new FDA rules that would require government-issued photo identification to get the pills, placing an “impossible burden” on disadvantaged people without IDs.

“The poor, the young and African-Americans are going to be put in the position of not having access to this drug,” he said.

Making the same point earlier, he asked, “Is that the policy of the Obama administration?”

Korman also speculated that the FDA’s new policy restricting Plan B for girls under 15 instead of under 17 was intended to undermine his ruling, which would have removed all limits on the drug’s availability this week. Indeed, the Obama administration’s apparently arbitrary age limits have no basis in scientific research. Multiple studies have found Plan B to be safer than even aspirin for all ages. Moreover, making women prove their age before buying Plan B creates an unnecessary burden for undocumented women and teens who don’t have government-issued documents. Women’s advocacy organizations erupted in protest over Obama’s decision to appeal the court order to remove these limits.

Each year, about one million infants around the world die on the same day they’re born. That figure includes about 11,300 U.S. babies — the highest first-day infant mortality rate of any other country in the industrialized world, according to a new report from Save the Children. In fact, the United States’ rate of first-day infant death is 50 percent more than all the other industrialized countries in the report combined.

Many babies who die at birth were born too early, and others suffer infections or complications at birth. Many of those infants could be actually be saved with fairly cheap medical interventions, the advocacy group says. The first day of life is the most dangerous day for mothers and babies, but expanding access to several products that cost under $6 each — bag-and-mask devices to help babies breathe, antiseptic to prevent umbilical cord infections, antibiotics to treat infections, and steroids to delay pre-term labor — could help save an estimated one million infants around the world.

Save the Children isn’t sure exactly why the United States has such a high rate of first-day infant mortality. But the group suspects it’s partly related to the country’s high rates of unintended pregnancies and teen births, as well as persistent issues of economic and racial inequality:

Teen births are partly to blame, the report says — echoing other research that has shown this. The U.S. has the highest teenage birth rate of any industrialized country.

“Teenage mothers in the U.S. tend to be poorer, less educated, and receive less prenatal care than older mothers. Because of these challenges, babies born to teen mothers are more likely to be low-birthweight and be born prematurely and to die in their first month. They are also more likely to suffer chronic medical conditions, do poorly in school, and give birth during their teen years (continuing the cycle of teen pregnancy),” the report says.

“Poverty, racism and stress are likely to be important contributing factors to first-day deaths in the United States and other industrialized countries.” [...]

Half of all U.S. pregnancies are unplanned, another complicating factor, the report says. Women whose pregnancies are accidental are much less likely to take good care of themselves and to get thorough prenatal care, from vaccines to vitamins, that can protect the baby and her.

Considering the United States’ dismal record on infant mortality, it seems to follow that advancing programs to support youth who may become pregnant, as well as expanding women’s access to preventative health services like contraception and prenatal and maternal care, would be a top priority for both women’s health groups and pro-life groups. But that hasn’t exactly been the case in the United States. Intent on attacking family planning services as well as abortion, anti-choice activists have successfully waged a war against some of the same health resources that could help the U.S. prevent infant deaths at rates closer to other industrialized nations.

Many far-right abortion opponents have fought hard against Obamacare, which helps expand women’s access to gender-specific health care services like birth control and prenatal check-ups, because they claim that insurance coverage for contraception is a violation of religious liberty. And Republican lawmakers have continued to target Planned Parenthood, advancing measures to defund the national women’s health organization even at the expense of the low-income women who rely on those clinics for their primary care. At the education level, anti-abortion activists often fight against comprehensive sexual health resources in public schools — particularly when those services are provided by Planned Parenthood — even though those programs have been proven to do a better job at preventing unplanned pregnancies than abstinence-only curricula.

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On Friday morning, Fox News anchor Martha MacCallum bemoaned the FDA’s recent decision to lower the age restriction on over-the-counter Plan B from 17 to 15 years old. MacCallum and her guest, Republican strategist Brad Blakeman, falsely asserted that easing access to emergency contraception would increase teens’ rates of sexual activity, and suggested that the government is condoning “criminal behavior” among minors.

In order to justify denying contraceptive resources to American teens, Blakeman attempted to construe consensual sexual relationships between minors as criminal activity. Even though state law typically defines statutory rape as a sexual relationship between two individuals with a significant age gap, Blakeman claimed that sexually active 15-year-olds are always engaging in statutory rape, and allowing them to purchase Plan B over the counter is simply condoning this illegal behavior:

BLAKEMAN: This makes no sense at all. You have to be 18 years old to buy a pack of cigarettes, and the president is also encouraging criminal behavior, because in most jurisdictions in America engaging in sexual intercourse at 14, 15 years old is statutory rape. The president is somehow saying in if you engage in that activity, criminal behavior, that is okay because the government is going to provide you the out for your bad decision making. [...]

MACCULLUM: We had Dr. Manny Alvarez here the other day, and he, you know, has delivered thousands of babies, he’s an obstetrician, a gynecologist. He was so upset about this. You know, he said, they are giving them out like candy. He said there are college students who think that this is the — that this is contraception, it’s what they use, the day after pill in order to, you know, as a matter of course in their lives. Does that not trouble you?

BLAKEMAN: This strips away the moral fabric of our country. It’s the government basically being complicit in a criminal act. And also complicit in coming into the houses of America and telling the parents, you’re — we are bringing to bring up your children. We’ll be able to provide better for your decisions than the decisions you may make at home. I think it’s an outrage, but it’s the modus operandi of this administration. [...] Should we decriminalize statutory way up and say if you’re 15, go out and have sex as a matter of law?

Watch it:

The idea that consensual sexual activity among minors is inherently “criminal” is common viewpoint among conservative groups. Earlier this year, the right-wing Family Research Council suggested that unmarried people should be denied birth control and punished for having sex. This attitude helped fuel the abstinence-only movement in the 1990s, which has prevented students across the country from learning accurate information about sexual health resources and has contributed to epidemic levels of STD infections and teen pregnancy rates.

But, contrary to Fox News’ dramatic assertions, studies have shown that providing teens with access to Plan B does not actually increase their sexual activity. In fact, easing young adults’ access to emergency contraception simply helps prevent unintended pregnancies and abortions, which is why it’s a public health policy that has support from prominent medical experts — including the American Academy of Pediatrics.