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Emergency birth control

SINCE THE late 1990s, women in need of a ''morning after" emergency contraceptive have been able to get one by doctor's prescription. But the pill -- actually a short series of high-dose birth control pills -- loses effectiveness with any delay. Access would be much better if the Food and Drug Administration accepted a proposal -- endorsed by the FDA's own experts -- to make emergency contraception available over the counter. Since political pressure has kept the FDA from doing so, there is need for state legislation that makes Plan B, as the treatment is called, somewhat more available until the FDA sees fit to allow over-the-counter sales.

Under a bill pending in the Legislature, pharmacists would be allowed to sell Plan B without prescriptions if they undergo special training set up by the state Department of Public Health and establish a relationship with a doctor who would oversee how the pill is dispensed. Such arrangements are already in place in six other states, including Washington and California. The training in Washington has focused on Plan B's side effects (nausea and breast tenderness) and informed consent issues. The bill would also require that all hospital emergency rooms in Massachusetts offer emergency contraception to the victims of rape or sexual assault. Most emergency rooms in the state already do so. The bill deserves the support of the Legislature and Governor Romney.

Plan B prevents 89 percent of pregnancies when it is taken within 72 hours of intercourse, either by interfering with ovulation or by blocking fertilization. In some cases, it might also work by keeping a fertilized egg from implanting in a woman's uterus. This has kept some opponents of abortion from supporting use of Plan B. Supporters of Plan B say that easier access to it would reduce the number of unplanned pregnancies and abortions. The legislation has won support from organizations representing women, the medical profession, and pharmacists.

Morning-after pills are far from ideal as a means of birth control. Their effectiveness rate is lower than that of other measures, and they do not prevent sexually transmitted diseases, as condoms do. But they should be a readily available option for women.

Last year the state Senate passed an emergency contraception bill, but the former House speaker, Thomas M. Finneran, blocked action on it in that chamber. With Finneran departed, advocates of the bill hope that it will pass both houses. As a candidate for governor in 2002, Romney answered ''yes" to a questionnaire from the Planned Parenthood League of Massachusetts that asked him whether he supported ''efforts to increase access to emergency contraception." The Legislature should pass the bill and, if it does, Romney should sign it.

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