New Hampshire has begun a program to allow dispensing of EC without prescription by pharmacists who have taken a two-day special training. This is not quite the same thing as OTC availability (and finding yet another way to make EC availability dependent on pharmacists’ cooperation, though a positive step in some ways, is not completely a step forward). However, it is a major advance in making this medication available at the time of need.

Six months after Gov. John Lynch signed a bill that would make “morning-after” pills available to women hoping to prevent unwanted pregnancies, about 200 pharmacists have received training in dispensing the drug.

The law allows pharmacists who have volunteered for the training to provide women with an elevated dose of birth-control hormones without a doctor’s prescription. The drug, if taken within 72 hours of unprotected sex, can cut a woman’s chance of pregnancy by up to 89 percent. . . .

Two training sessions for pharmacists were held this past weekend. Once trained, pharmacists need to partner with a doctor or nurse practitioner to be able to prescribe the pill.

One problem with this approach is that, by putting the responsibility on pharmacists to dispense this medication, it unavoidably puts on them the responsibility to deal with issues that are fundamentally the woman’s concern alone:

The training sessions address such issues as a pharmacist’s personal views on emergency contraception and the medical side effects or liability that comes with dispensing the drugs.

Part of the protocol is to prescribe the pill first, then ask questions afterward, said Don Downing, a pharmacist and associate professor at the University of Washington School of Pharmacy.

Any woman, regardless of her age, can have the pill if she’s had unprotected sex in the past five days and has had her period in the past four weeks, which means she’s not pregnant. She must also sign a consent form.

If a pharmacist suspects that a woman has been raped, he or she can refer the woman to a hospital or to one of the state’s 14 crisis centers.

It is not mandatory that the pharmacist report the assault unless the woman is under 18. If that is the case, Downing suggested that a pharmacist dispense the drug, then tell the girl about his or her intention to call authorities.

“You never hold them hostage,” he said. “They’ve just been held hostage.”

Though this training seems to have been designed to be as empowering of women as possible, questions about the pharmacists’ personal views, whether the medication will be dispensed, who must be notified, and whether notification will be conducted against the woman’s wishes would not arise if states could just trust women to make their own decisions about their own bodies, with a medication that has proven to be highly safe and effective for all age groups. There is no reason for pharmacists to “address” these issues at all, let alone allow them to stand as explicit – or even implicit – barriers to women’s healthcare. European practice, and the studies resulting in a near-unanimous approval for OTC sale of Plan B by the FDA’s scientific advisory panel, show that women can use this medication safely on their own initiative, without submitting their decisionmaking to someone else’s review.

New Hampshire is to be commended for taking a large step toward increasing availability of Plan B, but it would be much easier, and better for the women, if the FDA would simply let women have what they need without anyone else’s intervention.