A federal judge has ruled that the government must make the most common morning-after pill available over the counter for all ages, instead of requiring a prescription for girls 16 and younger.

The decision, on a fraught and politically controversial subject, comes after a decade-long fight over who should have access to the pill and under what circumstances. And it counteracts an unprecedented move by the Obama administration’s Health and Human Services secretary, Kathleen Sebelius, who in 2011 overruled a recommendation by the Food and Drug Administration to make the pill available for all ages without a prescription.

In a decision in a lawsuit filed by advocates, the judge, Edward R. Korman of Federal District Court, ruled that the government’s refusal to lift restrictions on access to the pill was “arbitrary, capricious, and unreasonable.”

Judge Korman ordered the F.D.A. to lift any age and sale restrictions on the pill, Plan B One-Step, and its generic versions, within 30 days.

THIS IS REALLY IMPORTANT AND AWESOME NEWS. However, we still have questions: 

• What does this ruling mean for “morality clauses” that allow pharmacists to not dispense Emergency Contraception on religious or moral grounds? Will they still apply even for OTC medications? (ETA: even though plan b is currently OTC for people 17+, FDA rules require it be kept behind the pharmacy counter, making the pharmacist the gatekeeper.)
• Will insurance cover this? EC is expensive, often running $50+ a box. If insurance doesn’t cover it, will the price go down? 

If you have insight into either of these questions, hit us up. Also remember that just because this ruling happened doesn’t mean there won’t be a ridiculously long and drawn out appeal process. In the meantime, check out the PSA for Emergency Contraception we wrote around the time that HHS struck down the FDA’s recommendation to make EC available OTC.

The sex ed textbook used by the Clovis Unified School District in Fresno, Calif., “does not mention condoms at all, even in chapters about HIV/AIDS and on preventing STDs and unintended pregnancy,” according to a press release from the American Civil Liberties Union, which is representing the parents, along with local doctors, in the suit. Instead, the textbook recommends preventing STDs through self-respect, group hangouts, abstinence and, um, “plenty of rest.” Who wrote this thing, Todd Akin?

Charmingly, the curriculum compares “a woman who is not a virgin to a dirty shoe” and explains that “men are unable to stop themselves once they become sexually aroused,” says the ACLU.

Economic Opportunity is Better than SexEd at Preventing Teen Pregnancy:

The study authors say teenagers in high-inequality areas may have kids at a young age essentially because they might as well — they may be told to wait, finish school and get a good job, but if they don’t believe they can really achieve a better life that way, they may choose to have a child instead. They write that high birthrates in high-inequality areas reflect “a decision among a set of girls to ‘drop-out’ of the economic mainstream; they choose nonmarital motherhood at a young age instead of investing in their own economic progress because they feel they have little chance of advancement.”

And Levine and Kearney argue that for many low-income teens, having a child really is to some degree a choice, not an accident. Though most teenagers say their pregnancies were unintended, another study found that 20 percent of older teens who were having unprotected sex eschewed birth control either because they wanted to get pregnant or they didn’t care. That’s ten times the number who said they couldn’t afford birth control, and the second-most common explanation for unprotected sex (the most common was the frustratingly vague response “other reason”).

Levine and Kearney also think that sex ed (abstinence-only or otherwise) has little effect on the teen birthrate. In a separate study, also published this year, they found that neither form of sex ed played any observable role in the recent drop in births to teens. Improved access to family planning services had an effect, but only a small one.

Really, they say, teen pregnancy is more of a social problem than a sexual one. And the best way to solve it isn’t to target pregnancy directly, as sex education programs try to do, but rather to improve girls’ lives as a whole. Their research doesn’t show that sex ed is useless — it may still help kids protect themselves from STDs or learn to communicate with partners. But for preventing pregnancy, says Levine, the best programs are actually those that give girls more opportunities, such as by helping them go to college.

If you are 17 or older, you can get Plan B without a prescription. If the pharmacist or pharmacy tech says you can’t, they are wrong. If you live in Alaska, California, Hawaii, Maine, Massachusetts, New Hampshire, New Mexico, Vermont, or Washington, some pharmacists can prescribe and dispense EC even if you are under 17. Call your local pharmacist to see if they are licensed to do this.

There are some states (Arizona, Arkansas, Georgia, Idaho, Mississippi, and South Dakota) where pharmacies/pharmacists can refuse to dispense Plan B on “religious or moral grounds.” If you live in one of these states (or even if you don’t) this document from the National Women’s Law Center has great information on what to do if you are refused EC or BC.

It’s not a bad idea to keep a box or two of EC handy, even if you live in a state that’s  generally liberal about EC dispersal. EC is expensive (it runs $50-$60 OTC in New York), but if you have health insurance and get an advance rx from your doctor or from a clinic like Planned Parenthood, it’s often covered by your insurance like any other prescription. Having EC on hand also stops you from having to deal with power tripping pharmacists and from stressing out about getting to a pharmacy in time.

For more info on Plan B, including safe use, pharmacy & clinic locators, and rates of effectiveness, click here.