Obama opposes safe birth control

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Obama opposes safe birth control

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Yesterday, the FDA approved the emergency contraception Plan B for over-the-counter sales -- meaning no prescription needed, no identification necessary, no restrictions of any kind -- because "the drug could be used safely by women of all ages." Health and Human Services Secretary Kathleen Sebelius disagreed, and used her office's power to override the FDA for the first time in HHS history.

This did not go over well. "Left blogs fume over Plan B decision" was Politico's headline. Reactions ranged from disappointment to anger to utter surprise; criticism was alternately scientific and political in nature. In nearly every case, the decision was laid at President Obama's doorstep.

The President noted today that this was Secretary Sebelius' decision alone. Even so, he made it clear he agrees with her:

"I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine," Obama said during an impromptu news conference at the White House.

He said Sebelius decided 10- and 11-year-olds should not be able to buy the drug "alongside bubble gum or batteries" because it could have an adverse effect if not used properly. He said "most parents" probably feel the same way.

His statement seems aimed like a laser at parents (who vote), was that politically wise? My friend Irin Carmon doesn't think so, writing last night on the bigger picture:

Although it’s hard to believe that conservative voters would be particularly swayed by the president’s capitulation on this front, teen sex has always had a special place in paternalistic and politicized approaches to public health. It doesn’t matter that teenagers can, and do, get pregnant (or contract sexually transmitted diseases) just like women over 17. They still have to be “protected” by parental-notification laws about abortion or from comprehensive, scientifically grounded information about sex. Politically speaking, teenagers aren’t exactly a powerful voting bloc — but their terrified parents are presumed to be.
More links: NYT, Washington Post Editorial

So basically, despite the FDA declaring that Plan B is perfectly safe regardless of age, Obama is against it being available to underage teenagers. So much for his promise not to get politics in the way of science.
Just further confirms my notion that he's a power-grubbing politician who doesn't care about civil liberties unless they suit him.
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Re: Obama opposes safe birth control

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It's not really as cut and dry as that, I don't think. The FDA doesn't say "of all ages," it says "of childbearing potential." Leaving it OTC with no requirements at all means an 8 year-old could buy it, and it's certainly going to have some major side effects on a girl who isn't capable of menstruating yet. When girls have their first period varies wildly, some as young as 9 or 10, many as old as 12 or 13.

The 10 to 11 range Obama cited is pretty much the exact range where the most uncertainty lies.

How exactly do you propose the FDA handle this? Present a bloody tampon when buying? Trust a literal child to know the ramifications of taking a megadose of hormones?
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Re: Obama opposes safe birth control

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Change the age required to get it without perception to a more reasonable one?
Currently it's only available over the counter for women over 17 - which means that the 15-year old who just had sex with her boyfriend when their condom broke has no access to it (you can not reliably get a prescription for it in time). 17 is simply to high as a cut-off stage.
Putting the cut-off age to the age "of childbearing potential" instead of 17 would be the right thing to do, i did not advocate removing it entirely.
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Re: Obama opposes safe birth control

Post by Dalton »

Don't know why he bothered. No social conservative would ever vote for him.
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Re: Obama opposes safe birth control

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Terralthra wrote:It's not really as cut and dry as that, I don't think. The FDA doesn't say "of all ages," it says "of childbearing potential." Leaving it OTC with no requirements at all means an 8 year-old could buy it, and it's certainly going to have some major side effects on a girl who isn't capable of menstruating yet. When girls have their first period varies wildly, some as young as 9 or 10, many as old as 12 or 13.

The 10 to 11 range Obama cited is pretty much the exact range where the most uncertainty lies.

How exactly do you propose the FDA handle this? Present a bloody tampon when buying? Trust a literal child to know the ramifications of taking a megadose of hormones?
Aspirin can have major side effects on a prepubescent child with a fever, yet there are no special age restrictions on its sale. Lots of OTC's can cause sever injury or death if misused. Why single out this one drug to make it impossible for minors to get it without their parents' supervision?


Serafina wrote:Change the age required to get it without perception to a more reasonable one?
Currently it's only available over the counter for women over 17 - which means that the 15-year old who just had sex with her boyfriend when their condom broke has no access to it (you can not reliably get a prescription for it in time). 17 is simply to high as a cut-off stage.
Putting the cut-off age to the age "of childbearing potential" instead of 17 would be the right thing to do, i did not advocate removing it entirely.
But you know that in many states it is illegal for fifteen-year-old's to have sex. Couples that age have been convicted of statutory rape of each other.
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Re: Obama opposes safe birth control

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Dalton wrote:Don't know why he bothered. No social conservative would ever vote for him.
Because he is a scared angsthase who thinks health matters less than the potential risk of an attack ad (who wll come anyway). And that is the charitable interpretation.
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Re: Obama opposes safe birth control

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But you know that in many states it is illegal for fifteen-year-old's to have sex. Couples that age have been convicted of statutory rape of each other.
Yes, i know. We're talking about a federal regulation here though, and federal guidelines/laws should not be influenced by state laws.

Most European (and Canada i believe) countries have a close-in-age rule, which basically means that you can legally have sex with someone if the age difference between the both of you is small enough (there are of course dozens of variations here on the specifics).
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Re: Obama opposes safe birth control

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Terralthra wrote:It's not really as cut and dry as that, I don't think. The FDA doesn't say "of all ages," it says "of childbearing potential." Leaving it OTC with no requirements at all means an 8 year-old could buy it, and it's certainly going to have some major side effects on a girl who isn't capable of menstruating yet. When girls have their first period varies wildly, some as young as 9 or 10, many as old as 12 or 13.

The 10 to 11 range Obama cited is pretty much the exact range where the most uncertainty lies.

How exactly do you propose the FDA handle this? Present a bloody tampon when buying? Trust a literal child to know the ramifications of taking a megadose of hormones?
Well, its a good thing that this is exactly the type of question asked (and answered) during the normal process of certifying a drug for over the counter use.

Here is the statement from the FDA commissioner regarding this decision:
The U.S. Food and Drug Administration (FDA) has been carefully evaluating for over a decade whether emergency contraceptives containing levonorgestrel, such as Plan B One-Step, are safe and effective for nonprescription use to reduce the chance of pregnancy after unprotected sexual intercourse.

Plan B One-Step is a single-dose pill (1.5 mg levonorgestrel tablet) which is effective in decreasing the chance of pregnancy if taken within 3 days after unprotected sexual intercourse. The product contains higher levels of a hormone found in some types of daily use oral hormonal contraceptive pills and works in a similar way to birth control pills.

Plan B One-Step was originally approved in July 2009 for use without a prescription for females age 17 and older and as a prescription-only option for females younger than age 17. In February 2011, Teva Women’s Health Inc. submitted a supplemental application seeking to remove the prescription-only status for females younger than age 17 and to make Plan B One-Step nonprescription for all females of child-bearing potential.

The Center for Drug Evaluation and Research (CDER) completed its review of the Plan B One-Step application and laid out its scientific determination. CDER carefully considered whether younger females were able to understand how to use Plan B One-Step. Based on the information submitted to the agency, CDER determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted diseases. Additionally, the data supported a finding that adolescent females could use Plan B One-Step properly without the intervention of a healthcare provider.

It is our responsibility at FDA to approve drugs that are safe and effective for their intended use based on the scientific evidence. The review process used by CDER to analyze the data applied a risk/benefit assessment consistent with its standard drug review process. Our decision-making reflects a body of scientific findings, input from external scientific advisory committees, and data contained in the application that included studies designed specifically to address the regulatory standards for nonprescription drugs. CDER experts, including obstetrician/gynecologists and pediatricians, reviewed the totality of the data and agreed that it met the regulatory standard for a nonprescription drug and that Plan B One-Step should be approved for all females of child-bearing potential.

I reviewed and thoughtfully considered the data, clinical information, and analysis provided by CDER, and I agree with the Center that there is adequate and reasonable, well-supported, and science-based evidence that Plan B One-Step is safe and effective and should be approved for nonprescription use for all females of child-bearing potential.

However, this morning I received a memorandum from the Secretary of Health and Human Services invoking her authority under the Federal Food, Drug, and Cosmetic Act to execute its provisions and stating that she does not agree with the Agency’s decision to allow the marketing of Plan B One-Step nonprescription for all females of child-bearing potential. Because of her disagreement with FDA’s determination, the Secretary has directed me to issue a complete response letter, which means that the supplement for nonprescription use in females under the age of 17 is not approved. Following Secretary Sebelius’s direction, FDA sent the complete response letter to Teva today. Plan B One-Step will remain on the market and will remain available for all ages, but a prescription will continue to be required for females under the age of 17.
Emphasis mine.

It was supposed to be approved for nonprescription use for all females of child-bearing potential. It was studied whether younger females could understand how to properly use the drug. Numerous committees, studies, etc were consulted as to whether it would be possible to safely offer this drug over the counter without prescription. But I'm sure that politicians and political appointees know more than scientists studying the question for a decade.

So much for not interfering with scientific matters for political reasons...
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Re: Obama opposes safe birth control

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Serafina wrote:So basically, despite the FDA declaring that Plan B is perfectly safe regardless of age, Obama is against it being available to underage teenagers. So much for his promise not to get politics in the way of science.
Just further confirms my notion that he's a power-grubbing politician who doesn't care about civil liberties unless they suit him.
Two points: since Plan B as an emergency contraceptive almost invariably induces nausea, headache, dizziness, stomach pain, and extreme tiredness, and both vomiting and diarrhea are common side effects, I'm not sure "perfectly safe" is the phrase to describe it. Even when used precisely as directed there are noticeable and unpleasant side effects.

Second, even a lot of people who can be described as Democrats or socially liberal (by US standards) in this nation are opposed to giving minors (that is, those under 18 years of age) access to ANY contraceptive without parental consent. I realize this is a significant difference from many other countries but there it is, a cultural difference. Similarly, the US is also fucking uptight against alcohol and nudity. NO American president is going to sign off on making contraception OTC for minors.

Please note that is a general cultural statement - it is not presented as my personal opinion. It is, however, the opinion of the vast majority of Americans from all categories.
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Re: Obama opposes safe birth control

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No president is going to sign off on making birth control available over the counter... unless the birth control in question is condoms.

Sigh.

(And yes, I know, there was a long period when those weren't so available either, and you had to do all sorts of things like ask whoever was manning the drugstore counter for condoms and risk massive social disapproval if word got out and yes, yes, I know, the world isn't the same place it was X years ago)
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Re: Obama opposes safe birth control

Post by Flagg »

Simon_Jester wrote:No president is going to sign off on making birth control available over the counter... unless the birth control in question is condoms.

Sigh.

(And yes, I know, there was a long period when those weren't so available either, and you had to do all sorts of things like ask whoever was manning the drugstore counter for condoms and risk massive social disapproval if word got out and yes, yes, I know, the world isn't the same place it was X years ago)

It is though. Just not for children. Because the ads would sway the mindless middle into thinking Obama wants kids to have sex.
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Re: Obama opposes safe birth control

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I'm sorry; I was directly replying to Broomstick about the state of American politics, and the "for minors" that was supposed to go after "birth control over the counter" got lost in the shuffle.
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Re: Obama opposes safe birth control

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meh. This reminds me of the time when I was working in 7-11. Apparently, there's a store policy that masquerades itself as law that one can't sell condoms to minors.

One wonder why the Secretary will forbid the sale of this on prescription to minors
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Re: Obama opposes safe birth control

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From some of the articles I've read on this issue, it is claimed this is basically the first time the Secretary of Health and Human has overruled the FDA's decision-making process ever. Which means there is now a new precedent for politics trumping science and a new means of lobbying for all those special interest groups and their pet causes. Your companies' new drug doesn't get the FDA approval you wanted as quickly as you wanted or as total as you wanted? New contraception not punishing the whores who have sex enough? Now the buck no longer stops with the FDA, you have an alternative.
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Re: Obama opposes safe birth control

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Oh, please - and the ban on stem cell research wasn't some sort of precedent? This is far from the first time politics has trumped science.
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Re: Obama opposes safe birth control

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Broomstick wrote:Oh, please - and the ban on stem cell research wasn't some sort of precedent? This is far from the first time politics has trumped science.
There is a difference between banning research, and directly intervening in a FDA-decision about existing medication.
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Re: Obama opposes safe birth control

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You're talking about a country where it once required Supreme Court decisions to allow ADULTS to purchase birth control without hindrance. Specifically Giswold v. Connecticut in 1965 and Eisenstadt v. Baird in 1972.

No PotUS is going to OK selling OTC after-sex contraception to minors in such a nation. Yes, it's political. It's also nothing new in the US. While America has undergone considerable social change in the past few decades it's still a collection of uptight sexual prudes compared to Europe.
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Re: Obama opposes safe birth control

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It's not like he had to specifically give his okay to the FDA decision (unless i am seriously mistaken), he could have just done nothing.

Instead his administration specifically stepped in to overwrite the FDA decision, most likely in yet another futile attempt to win over conservatives who are not going to vote for him anyway.
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Re: Obama opposes safe birth control

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What, you don't think it's possible that this might reflect his own personal views on the subject?

The church he attended for 20 years on the South Side of Chicago was affiliated with the United Church of Christ, one of the Congregationalist sects. The Congregationalists, if anyone is unfamiliar with them, were the predominant sect of the Massachusetts Bay Colony. In other words, the Puritans. Granted, the UCC's and current Congregationalists are FAR more liberal than the Colonial Puritans, but there's still a strong anti-sex, especially anti-sex-outside-of-marriage, meme among them.

Now, I don't know for sure that's what's going on here, and let's be honest, it wasn't Obama directly but rather the HHS part of his administration that did this, but you really should consider the notion that, in fact, Obama is on board with this on a personal level and not merely to seek votes.

As I said - even liberal Americans tend to be uptight prudes by European standards. There really are people who, otherwise liberal, really don't approve of minors obtaining ANY form of birth control without parental consent. While I think on a certain level there is a lot of foolishness in that stance (and since some forms, such as condoms, are both legal and widely available a bit nonsensical) but it really is a dominant and largely unquestioned viewpoint of most people in the US. I'm not sure you grasp that. A lot of Democrats would be entirely in favor of this stance, among them Christian blacks and Catholic latinos. Maybe he's trying to curry favor with them?
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Re: Obama opposes safe birth control

Post by Wing Commander MAD »

Regarding the politics trumping science bit, I'm not sure I'd consider the FDA a bastion of incurruptable science. I'm not referring to this incident in particular, and don't intend to poison the well or anything, but I seem to remember there be some issues in the recent past, ie last decade or two, of where the FDA acted in the interests of the big pharma more than in the interest of public health and safety. I can't recall any specifics instances though, only stuff heard in passing. It very well may not be true. However, the upper echelons of the EPA are known to be home to individuals with potentially conflicting interests, as is just about every other U.S. government agency, so I don't think I'm totally off in not giving them blind faith to rule purely based on science. Aren't most these agencies headed by beurocrats, not scientists? Afterall, they play a role in the whole "Legalise Pot" debate, which is very much a politics vs. science debate.

I guess my point is, as Broomstick mentioned, this is hardly the first time politics/opinion trumps science in the U.S. legal process.
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Re: Obama opposes safe birth control

Post by SirNitram »

I don't suppose we'll be getting a less alarmist and misleading thread title? Say, more on the point, like 'Obama Opposes OTC Birth Control'?
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Re: Obama opposes safe birth control

Post by Flagg »

SirNitram wrote:I don't suppose we'll be getting a less alarmist and misleading thread title? Say, more on the point, like 'Obama Opposes OTC Birth Control For Minors'?

Fixed that for you.
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Re: Obama opposes safe birth control

Post by Chirios »

Terralthra wrote:It's not really as cut and dry as that, I don't think. The FDA doesn't say "of all ages," it says "of childbearing potential." Leaving it OTC with no requirements at all means an 8 year-old could buy it, and it's certainly going to have some major side effects on a girl who isn't capable of menstruating yet. When girls have their first period varies wildly, some as young as 9 or 10, many as old as 12 or 13.

The 10 to 11 range Obama cited is pretty much the exact range where the most uncertainty lies.

How exactly do you propose the FDA handle this? Present a bloody tampon when buying? Trust a literal child to know the ramifications of taking a megadose of hormones?
I'm sorry but isn't this a bit of an irrelevant question? How many 10-13 year olds are having sex, really? Most people lose their virginities around 14-16.
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Re: Obama opposes safe birth control

Post by Tsyroc »

Serafina wrote:Change the age required to get it without perception to a more reasonable one?
Currently it's only available over the counter for women over 17 - which means that the 15-year old who just had sex with her boyfriend when their condom broke has no access to it (you can not reliably get a prescription for it in time). 17 is simply to high as a cut-off stage.
Putting the cut-off age to the age "of childbearing potential" instead of 17 would be the right thing to do, i did not advocate removing it entirely.
The CE I did on Plan B and Plan B One Step last month said that anyone (male or female) over the age of 17 can purchase the drug over the counter.

Emergency Contraception: An Update of Clinical and Regulatory Changes
In 2006, the FDA widened access to EC by approving over-the-counter (OTC) sale to consumers 18 years of age or older.1,2 At the time, Plan B was the first product to be approved in the U.S. with dual status (a single product approved for OTC sale or prescription only access to consumers based on age). More recently, the FDA further increased access to EC by reducing the age for OTC access to anyone 17 years and older, continuing access to girls under age 17 by prescription only.
There is no limit to the number of packages that may be sold to an eligible consumer. A consumer may purchase one or more packages of the product in a single transaction. In addition, there is no requirement that this OTC product must be used by the purchaser, and men may purchase it as long as they are at least 17 years of age. There is no requirement for purchasers of EC to sign a registry in the pharmacy or to provide photo identification for purchases.
Just an FYI for people. It might lessen slightly the impact of the FDA being overruled on making it OTC for any age. :?
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Broken
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Re: Obama opposes safe birth control

Post by Broken »

Just to clarify, I didn't state this was the first time politics trumped science. Hopefully no one is naive enough to think that was the situation. I stated this was the first time the FDA fully reviewed a drug/treatment, gave it the go-ahead after looking at the studies, and then the Secretary of Health and Human Services stepped in after the approval process was finished to overrule it. To the point where we ended up with dueling press statements:
Health and Human Services Secretary Sebelius press statement wrote: “After careful consideration of the F.D.A. summary review, I have concluded that the data submitted by Teva do not conclusively establish that Plan B One-Step should be made available over the counter for all girls of reproductive age.”
Dr. Margaret Hamburg, FDA Commissioner press statement wrote: “determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted disease.”


While I am certainly less then thrilled that sexual politics have apparently trumped science, I am also quite concerned that there is now yet another loophole for the pharmaceutical companies to appeal to and do an end run around FDA blocks and restrictions. Alarmist, a touch, but I'm not happy the precedent is there now.
"If you're caught with an ounce of cocaine, the chances are good you're going to jail. Evidently, if you launder nearly $1 billion for drug cartels and violate our international sanctions, your company pays a fine and you go home and sleep in your own bed at night." Senator Elizabeth Warren (D-MA)


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