Emergency Contraception Finally Available Through All IHS Facilities
Mary Annette Pember
American Indian and Alaska Native women can now access the emergency contraception pill, Plan B under the same circumstances as their non-Native U.S. sisters. The Indian Health Service finalized their policy late last week making the over the counter pill available at its clinics to women of any age with no questions asked in keeping with federal law for all U.S. women.
“We have been fighting for this for over five years,” said Charon Asetoyer, director of the Native American Women’s Health Education Resource Center (NAWHERC) in Lake Andes, South Dakota.
The updated policy was released after more than two years since a 2013 federal court ordered the Food and Drug Administration to approve Plan B as an over-the-counter drug for women of all ages without a prescription.
The NAWHERC has published several surveys exposing a lack of coordinated policies among Indian Health Service Clinics regarding dispensing the pill. Some clinics, according to the surveys, required women to be at least 18 years old, required a doctor’s prescription or did not offer the medication at all.
Citing U.S. Justice Department statistics that one in three Native women is raped in her lifetime, Asetoyer said, “Given the statistics on rape, Indian Health Service should be doing everything they can to reduce the residual trauma of sexual assault.”
IHS clinics are required to provide health care and medication, including plan B, free of charge to Native Americans in the U.S.
According to Asetoyer, Micha Bitsinni, a Native women’s health care advocate has made it a habit over the years to occasionally ask for the Plan B pill at her IHS pharmacy.
“Just 2 weeks ago I was at IHS and decided to ask for Plan B with my prescription. They made me fill out a form and wait 4-5 hours. So I left and came back. They lost the form. Fill it out again. Wait a couple of hours and at the end of the day they told me I needed a doctor’s appointment and a pregnancy test,” reported Bitsinni of the Navajo Nation; she currently works as an Academic Writing Teacher at Native America Community Academy. She previously worked at First Nations Community Healthsource in Albuquerque.
If their local IHS clinic refused to dispense the pill, Native women had the option to purchase the drug, which is often over $50 at commercial pharmacies.
According to an October 16 press release from the American Civil Liberties Union, “For some Native American women, if emergency contraception is unavailable at their IHS facility, the next alternative may be hundreds of miles away. However, emergency contraception is most effective the sooner it is taken, with effectiveness decreasing every 12 hours. The distance and potentially insurmountable transportation costs make timely access to emergency contraception difficult, if not impossible, for many women.”
The ACLU joined Amnesty International and NAWHERC in efforts to convince IHS to standardize policies related to Plan B.
U.S. Senator Barbara Boxer (Democrat-California) also conducted a survey in March 2015 exposing lack of access for Native women to Plan B and urged Health and Human Services to improve access to emergency contraception for Native women at IHS facilities.
According to Asetoyer, IHS had left the decision regarding dispensing the pill up to individual service units. “You can’t do that with federal policy; it needs to be standardized,” she said.
“This policy is way overdue. Denying equal access to health care for Native women is a violation of human rights,” said Asetoyer.
Susan Karol, chief medical officer for IHS told the Associated Press that urban and tribally operated health programs are not required to follow IHS policies. On Friday, however, she said that IHS policy now has clear expectations that Plan B, or a generic equivalent be stocked in pharmacies so it’s easy for Native women to get.
IHS posted the new policy on its website.