Testimony on Pending Legislation: Assembly Bill 343
Before Assembly Committee on Family Law
May 26, 2005
Testimony of Kathleen Poi, MS, RN
Executive Director of University Health Services
University of Wisconsin-Madison
Good morning/afternoon Chairman Owens and committee members. Thank you for the opportunity to speak to you.
My name is Kathleen Poi. I am the executive director of University Health Services at the University of Wisconsin-Madison. Representing the Madison campus and my organization, I am here to speak to you in opposition to AB 343, the proposed legislation that would prevent the campuses of the UW System from advertising, prescribing or dispensing emergency contraception.
Access to emergency contraception (EC) is a medically appropriate preventive service currently widely available in the United States. It is offered by most primary care providers in Wisconsin. Used to prevent, not terminate, unplanned pregnancy, its availability through a campus health service is an important factor in eliminating unplanned pregnancy as a factor interfering with a young woman’s ability to complete her education. Provision of this service at the health services of UW system campuses and the actual cost of the medication are not funded by state tax dollars. Funding is through fees paid by the students in the form of segregated fees and fee-for-service.
Student Health Services at the campuses of the UW System are the primary providers of health care services for the students at these campuses. To discriminate against the health care providers of these organizations by not allowing them to offer this service is not only inappropriate, it is particularly troublesome in that it prohibits the student from receiving this needed service from the provider most accessible to them and with whom they have an established relationship.
Dialogue and debate regarding this legislation has revealed a number of misconceptions. I would like to address some of these areas of misunderstanding.
The emergency contraceptive pills do not trigger an abortion or adversely affect an established pregnancy. Emergency contraception is not “the abortion pill” the slang name for RU-486 or mifepristone. Mifepristone is not available for contraceptive use in this country.
Ready availability of EC does not lead to promiscuity or increased high risk sexual behavior by the women who use it. Published research data also show that EC is not being used instead of other more standard forms of contraception. It is most often used when other forms of contraception – particularly barrier contraception such as condoms – fail. The form of EC primarily prescribed by college health providers is called Plan B. The name is self explanatory. When plan A fails, go to plan B. Few women want to use EC more than once. Most will review the reliability of their primary form of contraception and make appropriate decisions.
EC, particularly in the form of Plan B, is safe. The prescribed dose of the hormone, progestin in Plan B is the equivalent of less than the monthly dose of progestin that a woman using Alesse, a common progestin based oral contraceptive, takes. In December 2003, the FDA’s advisory committee overwhelmingly recommended that Plan B is safe and effective enough to be approved for over-the-counter sale. The FDA, to date, has not chosen to follow the advice of its advisory committee. Plan B is available over-the-counter in Canada.
Information issued recently by Rep. LeMahieu’s office suggests that campus health services shouldn’t be allowed to prescribe EC to young women seeking it following a sexual assault because the young woman will simply be given a prescription and not receive the appropriate supportive services. This assertion couldn’t be further from the truth. College health services are particularly sensitive to the sensitive medical and psychological issues around sexual assault and will either directly provide the needed services or connect the young woman with appropriate community resources. On the Madison campus, we actually provide office space for our local rape crisis program as well as providing both medical and counseling services ourselves. We are part of a campus-community coalition addressing the complex issues of sexual assault and relationship violence. Preventing our providers from offering one of the important components of treatment following a sexual assault does a great disservice to the student assault victim by fragmenting their care.
The underlying mission of every student health service in the UW system is the provision of those services needed to help a student be successful in the university unhindered by health issues. Providing services including EC that help young women prevent unintended pregnancy is important. The bill author states that he does not intend to restrict access to oral contraceptives, only EC. So does access to EC really make a difference? We think so. Our health service began prescribing Plan B in 2001, shortly after it became available. During the past four years, we have seen the percent of pregnancy tests performed in our clinic that are positive decrease by 43%. The primary variable that changed during this time period is the availability of Plan B.
The decision to use EC should be made by the woman herself. She should have access to information about its use and timely access to the necessary prescription. For college women, both can be best acquired directly or indirectly through their college health service.