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Native American Women Demand Rightful Access to Emergency Contraception

Alexa Kolbi-Molinas,
Deputy Director, ACLU Reproductive Freedom Project
Charon Asetoyer,
Native American Community Board
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March 1, 2013

Imagine being denied emergency contraception after a sexual assault; to not even be informed about the steps you can take to prevent an unwanted pregnancy; and to later find yourself pregnant as a result of the rape.

For thousands of Native American women this is reality.

That is why the ACLU and NACB have filed a Freedom of Information Act (FOIA) request with Indian Health Services (IHS) seeking information on policies governing access to over-the-counter emergency contraception (sometimes known as “Plan B”) at IHS facilities and demanding to know what steps the government is taking to solve this problem.

Did you know 34.1 percent or more then 1 in 3 Native American women will be raped in their lifetime? Native American women experience sexual assault at a higher rate than all other U.S. populations, which is one reason why it is essential that they have access to Plan B.

According to FDA guidelines, Plan B is available to women 17 and older OTC. If used within 120 hours, EC can safely prevent pregnancy after contraceptive failure, unprotected sex, or sexual assault. But EC is most effective the sooner it is taken, with effectiveness decreasing every 12 hours.

Although Plan B has been available without a prescription to adult women since 2006, 90 percent of Indian Health Service (IHS) facilities do not provide Plan B OTC to the Native American women they serve. Given the rural locations of many reservation communities, if EC is unavailable at the IHS facility the next closest commercial pharmacy may be hundreds of miles away and transportation costs may be insurmountable, making timely access to EC difficult, if not impossible for too many women.

Even in those IHS facilities where EC is “available” many Native American women are forced to go to clinic, wait—sometimes all day—to see a health care provider, and then wait even longer for approval for an order to be sent to the IHS pharmacy for EC. That is, if the health care provider will approve an order for EC (we hear many stories of providers who withhold EC from women for religious reasons or because they believe, incorrectly, that EC can cause an abortion).

To make matters worse, many sexual assaults occur during the weekend when many IHS facilities are closed. This forces some women to have to wait until Monday (when clinics are even more crowded with patients who have been waiting all weekend to see a health care provider) to even try to get an appointment to even be able to ask for EC.

For each of these women, the effectiveness of EC, and her ability to protect herself from an unwanted pregnancy, is reduced with each passing minute, hour, and day.

This is unnecessary, unlawful, and unacceptable. Sadly, this is also nothing new. Through NACB, Native American women have been fighting to raise awareness around this issue and solve this problem since at least 2005—that’s almost a decade. Over and over, we’ve been told that a solution is in the works, but we’ve yet to see it. That is why ACLU and NACB filed this FOIA: to find out what the government is doing to right this wrong. IHS cannot continue to flout its own internal policies, legal obligations, and FDA guidelines by depriving Native women of the health care to which they are entitled and they deserve.

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