A federal judge ordered the Food and Drug Administration yesterday to reconsider its 2006 decision to deny girls younger than 18 access to the morning-after pill Plan B without a prescription.
The 4,317,119 births, reported by federal researchers Wednesday, topped a record first set in 1957 at the height of the baby boom.
Behind the number is both good and bad news. While it shows the U.S. population is more than replacing itself, a healthy trend, the teen birth rate was up for a second year in a row.
I was born in 1957, at the height of the baby boom. It was an excellent year for cranking out babies. Apparently, 2008 was as well. One of the reasons that 1957 was an excellent year for bringing babies into the world was that birth control was largely unavailable. The FDA approved an estrogen-based pill in 1957, but for menstrual pain only. A variation of this pill was not approved for birth control until 1960. The first plastic IUD was made available in the United States in 1958, but many women found it uncomfortable to use and serious side effects like uterine bleeding were common. Condoms were available, although they were often hard to procure given that birth control was generally frowned upon and public discussion about sex was largely taboo. When men discovered how much pleasure was lost using those old-fashioned condoms, many preferred to take their chances. In effect, in 1957, contraception was largely unavailable. With plenty of fertile men and women in their prime baby-making years, the nation’s maternity wards were full.
Society today is quite different but many things are still the same. Men and women continue to have sex, and teenagers in particular feel their oats more than most. Condoms can now be readily procured with no questions asked, but it generally falls on the male to buy them and only men can use them. The contraceptive sponge turned out to be a so-so contraceptive device, better than nothing, but no guarantee for preventing pregnancy. For years it was off the market, and was only relatively recently reintroduced in 2005.
The birth control pill is still only available by prescription. Plan B is contraceptive available without a prescription that allows women concerned that they might be pregnant to change the situation, provided they take the medication within 72 hours of intercourse. However, the Bush Administration found Plan B to be deeply offensive. In its view, it was an abortion drug, should not be available to anyone, but in particular should be restricted from use by minors. It gave marching orders to the FDA to drag its feet on approving the drug, which went on for three years. Finally, the FDA approved it for adults only. Even though there was no credible evidence that it was medically unsafe for minors, it required pharmacies to place the non-prescription drug behind the pharmacy counter, and to ID purchasers who appeared to be minors.
While birth rates are up for all age ranges of women, it is disturbing that they are up for teenage girls in particular. Doubtless, some of these girls were trying to get pregnant. Some of them would have liked to have had the option to purchase Plan B discreetly off the shelf.
The Republican theory was that teens could be deterred through abstinence education. There was also doubtless the hope that these adolescents would confide in Mom or Dad before taking a major step like becoming sexually active. I doubt many of these knocked up girls were comfortable with having such conversations with Mom and Dad. I also doubt many of them knew that if they could get to a Planned Parenthood clinic they might have gotten free or reduced costs contraceptive and counseling. One thing is clear: after having sex, they could not get a Plan B from their local pharmacy. So at least some (and likely a great deal of) teenagers gave birth to little baby girls and boys that would otherwise not be here. Call them Bush Babies. The Bush Administration tacitly agreed that if it would mean compromising their principles then it was okay to bring thousands of unplanned babies into the world. In their crazy heads, this apparently was a more moral choice to have babies out of wedlock than to allow minors to procure a safe over the counter contraceptive designed specifically for these teenage encounters with adult life.
Sarah Palin’s daughter Bristol (who recently gave birth to an out of wedlock child and who is now estranged from the baby’s father) recently provided some pragmatic advice. Doubtless Republicans everywhere were stopping their ears full of cotton and singing “La la la la la” when she told Fox News that teenage abstinence was not realistic. The sadder-but-wiser Bristol Palin also suggested that teens should wait ten years before having a child.
Even if the Wasilla, Alaska Wal-Mart had Plan B on its shelf of other non-prescription drugs, there is no guarantee that Bristol would have purchased it. At least if it had been available she would have had the choice. She could be planning for college now instead of trying to figure out how to raise a baby with an absent father.
If abstinence is not realistic, the reality of teenage birth is something far more tangible. Bristol could do teenagers everywhere a favor by documenting her life as an unwed teenage mother. Meanwhile, we can only hope that with a new administration it will not be long before this counterproductive rule on Plan B is rescinded and seventeen year olds like Bristol can postpone the responsibilities of parenting until they are mentally and financially up to the task.
Occam's Razor 
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