Dear Dr. D.,

I've heard a lot in the news about the emergency contraceptive called "Plan B" being available over the counter. What is with all the controversy about it being made more accessible? Also, I still am not sure exactly how it works.

AC

Dear AC,

Ah yes, a "Pandora's Box" question. Truth be told, I am loving the debate as to whether Plan B should be made more accessible to the population for one simple reason: It is educating women and men about an option that could help them as they make decisions about their reproductive futures.

Having said that, let's recap how it works before we crack open the "box."

Plan B is an emergency contraceptive that, when used properly, can prevent an unplanned pregnancy. It can reduce the risk of pregnancy by as much as 89 percent and should be used when there is a contraceptive failure. For example, this emergency contraceptive can be used when a woman misses two consecutive days of birth-control pills, another birth-control method failed (condom broke or diaphragm slipped), after unprotected sex or when a person was sexually assaulted and a method of contraception was not used or known to be used.

Plan B works similarly to regular birth-control pills, but contains a higher level of the hormone progestin. It should be taken within three days (or 72 hours) of unprotected sex. Keep in mind, the sooner you take it, the more effective it will be. It can prevent pregnancy by stopping the release of an egg from the ovary, prevent the fertilization of an egg or prevent the egg from attaching to the uterus.

The way it works is, in part, at the heart of the controversy. Some people argue that the way it works makes it the "abortion pill."

I will not argue with a person who believes they know when life begins. I will only say that Plan B is not the so-called "abortion pill," and in most cases, it will not affect an existing pregnancy.

Another part of the "Pandora's Box" is the argument that Plan B will be misused or overused. I cannot account for claims regarding misuse. However, if we entertain this debate, then maybe we also should debate every existing product or future product on the market that allows people to decide their destiny (guns, anyone?).

I will say Plan B should not be a substitute for routine birth control. It also will not protect you against sexually transmitted infections or HIV.

Plan B also will not increase the amount of teens and young adults who engage in intercourse.

Even though condom availability on campuses has increased, there has not been an increase in students reporting more intercourse.

I support abstinence and celibacy as healthy choices, but I must say the majority of teens and young adults who choose to be sexually active do so responsibly, whether you agree with their choice or not.

Plan B is just another option for women and their partners to cover their bases if something happens they didn't expect or want. I see no reason why it should not be available over the counter.

Approximately 1.2 percent of MSU students reported last year that they either unintentionally became pregnant or unintentionally got someone pregnant. That is down from 1.8 percent in 2004.

Right now, Plan B is still only available by prescription. Olin Health Center offers Plan B to MSU students. You can call Olin Health Center at (517) 353-4660 for an appointment.

Peace, Dr. D.