Inside Bush’s War on Birth Control

For those whose nostalgia for the Bush administration is unfulfilled by former Vice President Dick Cheney’s snarling television appearance, there is a new window into the soul of the old regime. It is the brutally frank account of how political operatives and ideological helpmates of George W. Bush violated the law in their efforts to keep birth control away from American women — particularly teenagers at the greatest risk of an unplanned and life-altering pregnancy.

The broad outlines of the case against Bush’s Food and Drug Administration for trying to block the approval of over-the-counter sales of the morning-after pill, or Plan B, are widely known. For more than five years, the loyal Bushies at the agency blocked action by subverting science, overruling medical professionals and abandoning FDA standards that have long governed how drugs are switched from prescription-only to over-the-counter availability.

It was done, of course, at the behest of anti-abortion zealots who consider many commonly used birth control methods as equivalent to terminating a pregnancy. When the FDA finally approved over-the-counter sales in 2006, it restricted them to women 18 and older and tried to impede the pill’s use by insisting that pharmacies keep the drug out of plain view.

U.S. District Judge Edward R. Korman, ruling in a lawsuit brought by the drug’s sponsors and others, now has ordered the FDA to reconsider the age and availability restrictions on the morning-after pill.

His decision is a chilling compendium of accounts by doctors and other FDA professionals who were routinely overruled by the president’s political henchmen. Sandra Kweder, a veteran of the agency’s office that dealt with new drugs, testified of being told by superiors that the Bush White House was behind decision-making on the morning-after pill, and “it was made very clear that there were a lot of constituents who would be very unhappy with … an over-the-counter Plan B and … [there was] part of the public that needed to have the message that we were taking adolescents and reproductive issues seriously.”

But taking these issues seriously would have meant acknowledging that those most likely to benefit from quick availability of birth control after unprotected sex are, in fact, teenagers. In 2004, the court decision says, Curtis Rosebraugh of the FDA’s over-the-counter drug team not only recommended approval, but “he suggested that Plan B could decrease unwanted teen pregnancy by up to 70 percent and reduce teen abortions.”

The court’s decision is tragically relevant. The teen birth rate has increased for the past two years — after 14 consecutive years of decline.

Was the FDA’s ideological war on birth control a cause? No one can know. What we know is that it certainly did not help a distraught teenager.

Nor did the pernicious spread of federally financed abstinence-only sex education programs during the Bush era. Every sound study of these programs has shown them to have failed at preventing teen sexual activity. Some have indicated that when kids who’ve been through abstinence-only programs do begin to have sex, they are less likely to use birth control. Even Bristol Palin says that telling teens to be abstinent “is not realistic at all.”

The Obama administration’s FDA is expected to conduct the new review of the morning-after pill that the court ordered. Anti-birth-control advocates are out, scientists are in. There’s little doubt that the drug’s safety and effectiveness — the only considerations that were supposed to be taken into account in the first place — will hold sway.

Yet White House plans on abstinence-only education programs remain foggy. Its budget blueprint calls for financing “evidence-based” sex education that provides “medically accurate and age-appropriate information” to youths. This is the political code we’ve been forced to start using for giving teenagers the facts about pregnancy and birth control. But the president has also vowed to fund “faith-based efforts” to reduce teen pregnancy.

It takes a leap of faith, indeed, to see how these two objectives can be reconciled without sacrificing science — and the lives of girls and women who should be able to depend on it.

Marie Cocco’s e-mail address is mariecocco(at)washpost.com.

© 2009, Washington Post Writers Group