Granting Equal Access to Emergency Contraception

The Indian Health Service, or IHS, has released a long overdue policy to make over-the-counter birth control more easily accessible at its clinics. The updated policy aims to equalize access for all women by mandating that IHS-run pharmacies, emergency departments, and health clinics have contraception available according to federal guidelines.

In 2013, a U.S. District Court ruling ordered the Food and Drug Administration to approve one brand of emergency contraception, Plan B One-Step, available for over-the-counter sale to “all women of reproductive potential.” Plan B One-Step is one of four major forms of emergency birth-control—and an incredibly common form of medication. If taken within 72 hours after unprotected intercourse, it works to stop a potential pregnancy by preventing fertilization of an egg. One in nine American women between the ages of 15 and 44 have used emergency contraception at some point in their lifetime.

Several studies conducted by the Native American Women’s Health Education Resource Center on IHS facilities have revealed great disparities in dispensing the pill. According to a 2014 survey of 69 IHS pharmacies, 11 percent still required a prescription for Plan B and 6 percent failed to offer Plan B at all. Further, IHS pharmacies continue to impose an age restriction on accessing the pill; only 28 percent administer without an age restriction—most range from 15-18 years old.

The disparities in contraceptive access are especially grave for Native American women because of their increased likelihood to be victims of assault. One in three American Indian or Alaska Native woman will be raped during her lifetime.

What’s more, Native women are more likely to live in rural areas and without reliable transportation to access emergency contraception at non-IHS pharmacies. As the American Civil Liberties Union has pointed out, distance and potentially insurmountable transportation costs has made accessing critical reproductive health care incredibly difficult—if not impossible—for many Native women. This is especially problematic as emergency contraception is most effective within 12 hours, with effectiveness decreasing every 12 hours after that.

Given these facts, a group of legislators led by Sen. Barbara Boxer (D) previously requested the Department of Health and Human Services implement a policy ensuring IHS facilities followed federal guidelines. If rigorously enforced, the updated policy will help grant Natives the right to fulfill their reproductive health care needs and move towards equal health outcomes for all American women.