IHS Expands Access to Plan B for Native Women

Native American women seeking emergency contraception at Indian Health Services facilities managed by the federal government now can get it without a consultation or prescription.

The agency had come under fire from women's health advocates who said it needed to make the morning-after pill more accessible to American Indian and Alaska Native women. IHS has no retail pharmacies, and critics said Native women faced long wait times for Plan B because they had to compete with all the other patients seeking emergency care at clinics, urgent care centers or at emergency rooms.

IHS said more than a year ago that it was finalizing a policy to provide the drug directly to patients. That policy hasn't been released, but the agency told The Associated Press that all IHS facilities run by the federal government are now under a verbal directive to provide Plan B to women 17 years and older at pharmacy windows without a prescription.

"I want to reassure you that we have taken this issue seriously, and the IHS has, on several occasions this year, confirmed access to FDA-approved emergency contraceptive products in all IHS federally operated facilities with pharmacies," the agency wrote in response to questions from the AP.

The verbal directive to IHS area directors came as welcome news and a sign of progress to the Native American Women's Health Education Resource Center in Lake Andes, S.D., and to U.S. Sen. Barbara Boxer of California. The resource center said it is moving forward with educating women on misconceptions about the morning-after pill and how to access it, focusing on South Dakota, Oklahoma and New Mexico.

Meanwhile, women's health advocates are pushing IHS to issue a written policy on emergency contraception.

"A verbal directive can be rescinded at any time," Boxer said through a spokeswoman. "We need a permanent policy that says that all IHS facilities, including those that serve Alaska Natives, shall carry and offer emergency contraceptives consistent with law."

IHS said it is working to update its pharmacy policy but would hold all employees accountable for following the verbal directive on medication.

Charon Asetoyer, resource center director, said she's also looking to IHS to provide unrestricted sales of the Plan B One-Step morning-after pill. The U.S. Food and Drug Administration in June lifted all age limits on the emergency contraception after months of back-and-forth legal battles. The Obama administration promised a federal judge it would take that step after women's health advocates pushed for easier access for more than a decade.

"We've made some progress, and we have to acknowledge that, but there's still more," Asetoyer said. "They're still violating our rights to access by denying women who are age 16 and under. ...We have to ask, why are we being treated differently?"

Quick, easy access to emergency contraception is crucial considering the prevalence of domestic abuse and rape of Native women, Asetoyer said. One-third of all American Indian and Alaska Native women will be raped in their lifetime, and nearly three of five had been assaulted by their partner, the U.S. Department of Justice has said.

The IHS said Plan B One-Step would be available without a prescription for all ages once products with the FDA labeling are available.

While Native women can go to any pharmacy at a federally managed IHS facility and get Plan B without a prescription, the rules can be different at facilities run by American Indian tribes. More than half of the IHS budget is administered by tribes through self-determination contracts or self-governance contracts.

The medication is free for Native women because of the federal government's trust obligation to provide health care to them. Any woman 17 and older can buy Plan B from behind the counter at retail pharmacies.