Plan B

OK, so what if someone comes in a couple times of year seeking emergency contraception? Do you know her background? The whole situation? Maybe, maybe not.

Even so, it's better for her to go on to have an abortion possibly or have a child she doesn't want? Or to use something like Plan B to prevent a pregnancy to begin with!

So, in a small town with only one pharmacy that will not be carrying Plan B, she will still have to come to the ER for emergency contraception. If it were available at K-Mart, she could simply walk in and buy it. They could still require you to be 18 or whatever rules they wanted to buy it...they lock up the Sudafed, they could certainly lock up the Plan B.

If a woman needs to use Plan B as emergency contraception twice a year because of a broken condom then she needs to make sure her partner uses a different brand, or she needs to get herself on another form of birth control. Emergency contraception should be used as just that.....emergency. Unless she has the great misfortune of being an assault victim more than once (many apologies to those who have been victims, I'm not trying to be cruel), most women should have few occasions to use emergency contraception.

Exactly!

What I am picking up from some on this thread is judgemental and moralizing, not patient safety concerns, without facts to back it up.

Why that is a judgment of others in itself. :trout: To assume that people who are voicing their opinions here, and aren't even concerned for the pts, or up on the facts.

There is a difference between personal opinions, and how the pts are treated. Perhaps some will let one affect the other, but not all will.

I don't think anyone is being judgemental, just expressing opinions and birth control is a hot topic.

I have definite concerns about Plan B...the one dcotor here who will prescribe it insists on a pelvic exam and pap before prescribing it...now that it is OTC, many women will forgo exams because they don't have to. I have concerns about what effects frequent use could have on a woman's body...I have concerns about women being so desparate for Plan B that they will attempt to steal it...I have concerns that many women will still not have access to emergency contraception because of the cost and limited availability. I doubt anyone on this forum is unconcerned.

If I understand it right, the "morning after" pills, basically automatically induce your period, and happens to be extremely painful (intense cramping) from the unnatural uterine contractions. I'm sure it would definitely be an experience that a young woman would not want to go through again. So, I doubt it that it would be frequently used by the same person.

If you re-read my post, you will see I did not say that anyone had no concerns about patient safety. (At least you would see that if I made more sense!) What I meant to say is that many are focusing on their opinions of the client's behaviors/morals/irresponsibility, not legitimate safety concerns based on documented adverse effects of the use of the drug.

It is my opinion that it would be stretching credibility to find the patient is displaying a pattern of engaging in high-risk behaviors by requesting Plan B once or twice a year.

What, b/t/w, would be the rationale behind insisting on a pelvic exam before prescribing? What could you find that would contraindicate the drug except unexplained bleeding? And a PAP test is desirable in general, but is it your opinion that it should be mandatory before ANY birth control use? (If the prescription is dependent on the results, that is just delaying until the window of efficacy has passed.)

Additionally, this has only been approved OTC for women 18 y/o and over. At this age, I would think most would have a good idea where they can get counseling about BC, STDs, and sexual abuse, etc. IF THEY WANT IT.

Edited to add to MarieLPN: Point taken. I am judging certain biases I perceive. Additionally, you are quite right in separating personal bias from patient interactions. Thank you.

What I meant to say is that many are focusing on their opinions of the client's behaviors/morals/irresponsibility, not legitimate safety concerns based on documented adverse effects of the use of the drug.

They all go hand in hand

I can't believe insurance doesn't cover BC pills......is that common? I've never had to buy them.

Ours used to be that way. It wouldn't cover BC pills, yet it covered Viagra for ED.

What, b/t/w, would be the rationale behind insisting on a pelvic exam before prescribing? What could you find that would contraindicate the drug except unexplained bleeding?

Depends on the situation that brought the pt. in.

I would be willing to read any studies you might point to that indicate Plan B is unsafe due to a patient's morals.

BEHAVIOR, IRRESPONSIBILITY, and SAFETY go hand in hand.

(LP here)

I say the USE OF THE DRUG is safe, regardless of the patient's irresponsibility in their sexual life. That is a separate issue and a matter of choice. Until proven otherwise, the drug will remain on the approved list.