Hospitals still reluctant to offer Plan B

Hospitals Still Reluctant To Offer Plan B Pill

By Hilary Waldman, The Courant (Hartford, Connecticut), January 19, 2007

Even as the Plan B emergency birth control pill was heading toward more widespread availability at pharmacy counters, 40 percent of rape victims who sought care at Connecticut hospitals in the first half of 2006 were not offered the medication or were sent home without the full dose of the drug needed to prevent pregnancy, rape counselors say.

The continuing reluctance of hospitals - both Catholic and secular - to dispense the pills has prompted women's advocates to once again push the legislature to pass a law requiring all hospitals to provide the pill as a routine part of rape examinations.

Last year, a similar measure died in the final days of the legislative session amid strong opposition from the Catholic Church.

But rape counselors say that the problem is not limited to Catholic hospitals.

Since the controversy erupted last year, rape crisis counselors have been documenting hospital practices in dispensing Plan B to rape victims, said Laura Cordes, director of policy and advocacy for Connecticut Sexual Assault Crisis Services, an umbrella group representing rape crisis counselors.

In the first six months of 2006, they found that 40 percent of rape victims who were accompanied by counselors during rape examinations were not offered emergency contraception, or were not given the full dose of two pills.

"The situation has not changed and rape victims are still waiting," Cordes said.

Although no scientific survey was conducted, Cordes said, a variety of reasons were offered: Some hospital personnel were unaware that they could provide the pills, while others expressed reluctance to give patients the full dose of medication because while one pill is taken immediately, the second must be swallowed 12 hours later - outside the hospital.

Jennifer Barrows, a spokeswoman for the Connecticut Hospital Association, said that her group has been working closely with the rape crisis counselors and had not heard the 40 percent statistic until Thursday.

She said that the association, which represents the state's 31 hospitals, has not taken a position on the Plan B issue because the Catholic hospitals are members and asked that the trade group remain neutral.

Although there is some uncertainty about exactly how the Plan B pill works, church leaders contend that hormones in the drug could prevent a fertilized egg from implanting in the uterus, an event they equate with abortion.

But medical experts say that the hormones in the pills more likely prevent pregnancy by delaying or preventing ovulation.

Regardless, advocates say, the neighboring states of New York, New Jersey and Massachusetts have found a way to provide the pill to rape victims in both Catholic and non-Catholic hospitals. In Connecticut, Catholic hospitals will dispense the pill only after a woman has taken a test to ensure that she is not ovulating.

Barry Feldman, general counsel to St. Francis Hospital and Medical Center in Hartford and a spokesman for the state's four Catholic hospitals, said that requiring the Catholic hospitals to provide Plan B would violate a law that restricts the state from interfering with religious freedom.

"I hope we can find a solution that does not interfere with the Catholic hospitals' freedom of religion," Feldman said Thursday.

"This tiny pill does not need to be given in a hospital," he said.

In August, Plan B was approved for sale without a prescription for women 18 and older at pharmacies. But Cordes said there are still plenty of compelling reasons for hospitals to provide it.

First, she said, Plan B is more effective when given immediately, and sending a woman out to a pharmacy can cost precious time. The drug has been shown to be 95 percent effective in blocking a pregnancy if it is taken within 24 hours of unprotected sexual relations. That effectiveness drops to about 60 percent when taken 48 to 72 hours after sex, according to the manufacturer.

And, Cordes said, a rape victim might wait several hours or even days to seek an exam at a hospital. All the while, the clock is ticking in terms of preventing a possible pregnancy.

In addition, although the state reimburses hospitals for Plan B provided as part of a rape examination, the victim must pay the $40 to $60 cost if she purchases it at a pharmacy.

Finally, Cordes said, teenagers under 18 are barred from buying the drug on their own.

State Sen. Mary Ann Handley, D-Manchester, filed a bill last week requiring all hospitals to provide emergency contraception to rape victims. The bill has 53 co-sponsors, but still might face opposition even from some Democrats, advocates said.

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