Yesterday, the Department of Defense (DOD) quietly made public its decision to require that emergency contraception (EC or Plan B) be available at all overseas military facilities. (Until it was picked up by the press, only the most avid readers of the minutes of the quarterly meetings of the DOD Pharmaceutics and Therapeutics Committee could have known about the decision).
This is a welcome change: Today, women make up 15 percent of the military. More than 356,000 women currently serve in the Armed Forces and more than 222,000 women have been deployed thus far to fight in Iraq and Afghanistan. It should go without saying that these women should have access to basic contraceptive care — EC can prevent pregnancy if taken less than 72 hours after unprotected sex or a contraceptive accident (the earlier the better).
The DOD deserves more credit than it sought for reversing a nearly decade-long policy that undermined servicewomen's reproductive health. But given what happened the last time DOD tried to make EC available to its servicewomen, it's easy to see why they might have been a bit gun-shy about publicity.
After EC became available in 1999, the press reported that nearly two-thirds of military treatment facilities (MTF) carried it. In February 2002, the DOD Pharmaceutics and Therapeutics Executive Council considered whether to officially add EC to the basic core formulary — the list of drugs that must be stocked at all military treatment facilities. Ethics consultants from all three military branches — hardly a group of rabid reproductive rights activists — had already concluded "that there are no apparent reasons to preclude the use of Plan B at MTFs, since it is an FDA-approved contraceptive and not, as some argue, an abortifacient." The council thus saw no reason that EC should not be "uniformly and immediately available" to servicewomen and voted to add it to the formulary.
However, when news of the decision became public, the then-Assistant Secretary of Defense for Health Affairs immediately rescinded the decision to place EC on the military formulary so that he could have a chance to "review" it. (I confess that I do read the minutes from the quarterly committee meetings, and I've never seen any drug submitted for a similar "review"). And so this FDA-approved contraceptive remained under "review" at the highest levels of DOD for more than seven years — until yesterday.
Hopefully, the decision to guarantee that EC is available to women serving overseas is the beginning, not the end, of needed changes. To reflect the reality of women's participation in the military, we must fully meet servicewomen's reproductive health needs — from access to birth control and regular gynecological exams to abortion care. Servicewomen dedicated to serving our country deserve no less.