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Leading the charge for the morning-after pill

After graduating from the University of Massachusetts at Amherst in 2002, Annie Tummino of Middleborough spent a year working as an abortion and information counselor at Planned Parenthood of Western Massachusetts, where she regularly dispensed the morning-after pill.

''I saw firsthand how ridiculous it was that women had to get off work on short notice, drive long distances, and pay $50 for an office visit just to get the morning-after pill in a timely manner," she says. ''My clinic was closed on the weekends, which made it even harder for women to get the pill when they needed it. I felt angry that there were so many unnecessary obstacles to getting this safe and effective form of birth control."

Not long after leaving her position at the clinic, Tummino found herself facing the very same obstacles.

''I went away for a long weekend and got a couple of days behind on my daily birth control pills," she says. ''Taking the pill is part of my routine, and when I am on vacation it is easier to forget, because I am out of my normal routine. I had sex with my boyfriend a couple of days after I got back. We are used to having sex without condoms, and afterwards I realized I could be in trouble. I needed the morning-after pill, but I didn't have it at my fingertips."

Working at a small business with only one other staff person, Tummino was not able to take the day off to ''wait in a clinic for hours to be seen." She considered asking friends who might have an extra package of morning-after pills or a prescription with refills left. Even then, she knew she would have had to wait until after work to get to a friend's house. ''The clock was ticking," she says. But Tummino knew about a website through which she was able to get a doctor to call in a prescription on her behalf. One hour later she had the pill in her hands.

The morning-after pill, also called Plan B, is dispensed by Barr Laboratories, which tried unsuccessfully in 2003 to get it approved for over-the-counter status. Though the Food and Drug Administration's official rejection stated that the pill had not been tested on enough girls under 16, reproductive-rights organizations and activists -- including Tummino -- assert that the real reason the FDA rejected over-the-counter status was pressure from the Bush administration.

''The FDA is allowing right-wing politics to trump science," says Tummino, who is now vice chair of the Women's Liberation Birth Control Project in New York. ''The FDA's own medical advisory committee voted unanimously that Plan B is safe for over-the-counter sales. Clearly, the FDA is failing to fulfill their mandate to advance public health. This is a dangerous precedent."

The FDA declined to speak with the Globe about the morning-after pill, issuing a statement that says the agency ''cannot comment on a pending application." White House spokesman Ken Lisaius also declined to comment.

An early activist
Tummino has never been one to swallow what she considers injustice. In ninth grade she decided she needed more educational freedom, so she picked up a copy of ''The Teenage Liberation Handbook," got a job at Holt Associates in Cambridge (the company that published Growing Without Schooling magazine), and home-schooled herself until college.

''Most of the classes [at Middleborough High School] were taught in a very traditional lecture format, with lots of busywork," recalls Tummino, who is 26. ''I knew that I enjoyed learning, especially reading and writing, but I didn't feel like I was encouraged to think critically at school. I felt that kids and teenagers should be able to have more of a say in what and how we were learning. I also wanted to read more books by women! I remember in my ninth-grade English class, only one book assigned was written by a woman. And I wanted to learn more about politics and social change."

At UMass-Amherst, Tummino majored in both women's studies and social thought and political economy; got heavily involved in the fight against budget cuts to higher education, the global economic justice movement, and antiwar activism; and spent her summers interning at the National Organization for Women in New York. It should come as no surprise, then, that Tummino cofounded the Morning-After Pill Conspiracy, a national group demanding that the FDA make Plan B available to women and girls of all ages.

''A lot of women have to conspire to break the law to get this pill," says cofounder Stephanie Seguin of Gainesville Women's Liberation, ''so the day after Valentine's Day in 2004, we decided to do an action where we publicly would give the pill to our friends." She giggles at the memory. ''We thought it was kitschy."

Over the next two years, the group undertook many similar actions, culminating in a Jan. 7 demonstration and press conference in front of the FDA building in Maryland. Barr had re-petitioned the FDA to make the morning-after pill available over the counter for women and girls 16 and over. Though the FDA was not scheduled to decide on Barr Laboratories' new petition until Jan. 21, Tummino says, ''the FDA sometimes ruled earlier in the past. We wanted to put pressure on them, to make a difference before they made their decision."

Following the demonstration, police arrested nine leaders, including Tummino. Two weeks later, on the date it was scheduled to announce its response to Barr's second petition, the FDA released a statement indefinitely postponing its decision on the status of the morning-after pill.

Making waves
Immediately following the FDA's nondecision, Simon Heller, a lawyer at the Center for Reproductive Rights, filed a lawsuit against the FDA, with leaders of the Morning-After Pill Conspiracy listed as plaintiffs; Tummino was the lead plaintiff. ''We felt that it was important to have an individual activist as the lead plaintiff," Heller explains. In addition, he says, Tummino ''was willing to take on the heightened public exposure resulting from having a case named after her."

''Annie is really resilient, really strong," says Kelly Mangan, another plaintiff in the case and the chair of the Florida NOW Young Feminist Task Force.

Publicity from the case may not have shaken Tummino, but it has sent waves through the halls of Congress. Senators Hillary Rodham Clinton of New York and Patty Murray of Washington, both Democrats, have pledged to block President Bush's formal nomination of Lester Crawford, the acting commissioner of the FDA, to the post of commissioner.

''I'm prepared to hold it for as long as it takes to get a decision made," Clinton said in a prepared statement after a meeting with Murray and Crawford on April 6. ''From everything we're able to determine, the agency has substituted politics and ideology for science and facts."

''The treatment of Plan B is a very visible example of a lack of independent leadership," Murray said in an interview with the Globe. ''I am very concerned about the ideological reasons for holding up Plan B. I believe this is symptomatic of a shift in the public health debate that is turning contraception into the new abortion."

Tummino alleges the FDA's delay on the morning-after pill is ''part of a larger anti-birth-control campaign" by the Bush administration that has included abstinence-only education programs, the rollback of health insurance coverage for birth control for federal employees, and rules that allow pharmacists in some states to refuse to fill birth-control prescriptions out of moral objections.

Those in power, Tummino says, ''would like us to believe that American women are the most liberated in the world. In fact, we are behind in many areas, but we are kept in the dark about this. . . . Women in many other industrialized nations have universal access to programs like health insurance, child care, paid parental leave, and elder care. . . . It's rare to hear these international comparisons, because if women realized what we were missing, we would demand more."

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