Access to Plan B

Biting Beaver‘s recent post regarding her struggle to obtain Plan B reminded me of my own story, so I thought I’d share it here.

I live in Canada, and like, I think, many Canadians my age (mid-20s) I had grown a little complacent about access to contraception. Degrassi High (the show that all Canadian youth both watched and mocked) had an episode about abortion, and although the characters went through their moral and emotional struggles, actual physical access to the abortion was guaranteed. I always assumed that obtaining Plan B would far simpler even than that, given that it was supposedly available over the counter from pharmacists in British Columbia since 2000.

For years now my primary form of contraception has been the Fertility Awareness Method (FAM), which works very well for me and my male partner. For ourselves, we chose never to have penis-in-vagina intercourse during my carefully and casually tracked fertile times. This was part of an evolving continuum of choices we made about our contraception, and it changed gradually as we became more comfortable and confident with FAM. 

Other people choose other things, including using barriers during fertile periods, and these are all very individual choices. This is part of the appeal for me of FAM: I as a woman get to choose my own level of comfort and risk-taking in my sexual choices.

In December of 2003 I returned from an 8-week trip to Australia with family. My partner had not accompanied me and we had missed each other greatly. Because I had been travelling my fertility cycle was a little disrupted, and although I hadn’t had any signs that I was likely to ovulate I knew that the timing was generally right for that sort of thing to occur soon. For once, we chose to use barriers rather than to avoid intercourse altogether. Of course, in the midst of our passionate reunion, we weren’t as conscientious (i.e., freakishly paranoid) as we would ordinarily have been and discovered only after the act was completed that our barrier had slipped off and was lying uselessly on his stomach.

When I realized this I just got dressed and we drove over to the 24-hour pharmacy about five blocks from my house. Inside the pharmacist politely explained that although Plan B was technically available over the counter, it had to be dispensed by a specially trained pharmacist and the only one they had on staff wouldn’t be in until late in the morning the following day. Sorry, nothing they could do. Besides, it didn’t really matter, I just had to take it within three days for it to be effective.

Now, while it’s true that there is a three-day window for Plan B, taking it as soon as possible is important. The sooner the better, in fact, which was why I was at a 24-hour pharmacy at 1 in the morning. Of course, if I didn’t live in the middle of the second largest metropolitan area in Canada I probably wouldn’t be as close to a 24-hour pharmacy and would have had to wait until morning, so… fine. Wait until morning.

I decided that since the pharmacist wouldn’t be in until later in the morning I’d go to the drop-in clinic at my workplace to get a prescription as soon as it opened in the morning. Because I live in Canada all office visits are fully covered by Medical Services Plan, so I didn’t have to worry about whether or not I could afford to go to the doctor. When I got to the clinic only one doctor was on duty. He was a young man, possibly in his late 20s. I explained what I wanted and he then quizzed me for a while on what my usual birth control was and so on before announcing that he didn’t prescribe the “morning after pill” for ethical reasons.

“What??” I said. At the time I’d never heard of such a thing. I asked what ethical reasons those were exactly and he refused to explain. I asked if there were any other doctors on staff that I could see and he said that there weren’t any. I just sat and looked at him. He looked at me. I said, “Look, I didn’t do anything wrong. In fact, I’m trying to do everything right. I get the feeling that you’re passing some kind of judgement on me here and I don’t like it.” He shrugged uncomfortably and opened the door to indicate that it was time for me to leave. I left.

I went up to a different walk-in clinic close to the pharmacy. I didn’t really like this one because it was often crowded and busy and the doctors had always seemed quite indifferent to me, but I figured it was better than nothing. I waited my forty minutes to get in to see a doctor and when I did I ended up with a crusty older man. I explained what I wanted. He just sat there and looked at me. By this point I was starting to feel almost… defensive about what I was trying to do, so I said something along the lines of having used a condom but that it had broken (a lie, of course, it just came off without our noticing, but I felt guilty for what I perceived to be a rookie mistake that should never have happened).

“You don’t have to explain.” he said chidingly, “That’s none of my business. I’ll write you the prescription. Ask them to give you some gravol with it because it often makes you feel quite nauseous.” And he wrote me the prescription. I went back to the pharmacy and had no difficulty filling it. I got home and took my first dose along with a gravol just over 12 hours after having what turned out to be unprotected intercourse.

Now, in the end, did I get the prescription I wanted? Yes. Was it really that hard? I suppose not. And I realize now just how lucky I was in some respects. After all, of the four medical service providers (two doctors and two pharmacists) that I interacted with, only one of them really felt strongly that I should just get pregnant as a result of a mistake whether I wanted to or not. It only took me 12 hours and three unsuccessful attempts in the second largest city in Canada to get my hands on emergency contraception.

Really, we can do better than that.

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