Emergency Contraception Pill:

Plan B is the new Plan A

The emergency contraception pill, aka "Plan B" or the "morning after pill," may seem like the best thing since sliced bread. But women who use this method of "protection" as their preferred form of birth control may be headed for an unpleasant surprise.

Now that it has been approved for over-the-counter use, we need to ask ourselves how it will shift incentives regarding sexual behavior, including how it may increase the spread of Sexually Transmitted Diseases (STD’s). (Frankly we should have asked this question BEFORE it was approved.)

We know that contraceptive failure is a function of age, income and marital status. Younger women, unmarried women and poor women are more likely to experience a contraceptive failure. Consider the failure rate of oral contraceptives for poor married women:

  • 13% for poor married women under the age of 20
  • 5.7% for poor married poor women over 30

The failure rate is even more dramatic for poor couples living together who are unmarried and who use oral contraceptives:

  • 48% for poor cohabiting women under age 20
  • 10.8% for poor cohabiting women over age 30

The failure rates for condom use are similarly correlated with age, income and marital status.

  • 23% poor unmarried women under the age of 20
  • 6% for poor married women over the age of 30

For couples living together who are unmarried:

  • 72% for poor unmarried women under the age of 20

The pills and condoms are failing because the poor women aren’t using them correctly. Married women, more mature women, and higher income women are more likely to take their pills regularly and use condoms consistently. The high failure rates for cohabiting women occur because cohabiting women have more sex than other unmarried women.

What does this tell us about the likely impact of the emergency contraception pill? For those women who rely on birth control pills for contraception, it will probably not change their behavior, so the spread of STDs won’t change much for this crowd. But for people who primarily rely on condoms, "Plan B" may become become Plan A, the birth control method of first choice. Imagine a likely dialog among the under 20 crowd: "Oh honey, stop, we’ve got to put on a condom." "Don’t worry, baby. I’ll get you emergency contraception tomorrow." (Let’s not even get into a discussion about how predatory this might be towards the young woman.)

What's to stop people from using this as their primary contraception? Here is some information taken directly from the Plan B One Step website:

"Plan B One-Step® should only be used in emergencies, but there is no medical reason why you can't use it more than once."

I won’t be surprised to see an increase in sexual activity, as people believe themselves to be "safe" from pregnancy, due to the availability of the emergency contraception pill. But being "safe" from pregnancy isn’t the same as being "safe" from STD’s.

Look for an increased rate of STD infections, particularly among those who typically rely on condoms.



Plan B One-Step® is a registered trademark of Women's Capital Corporation.



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