Students seeking emergency contraception will soon no longer have to go to Pickens Health Center "the morning after," due to Student Health Services' decision to prescribe the pills in advance.
Director of Student Health Services Bill Christmas said that although anticipatory prescription of the morning-after pill is not ideal, it may be necessary.
"In the end, it's the person's choice...," Christmas said. "If someone was to use emergency contraception six or eight times a year, I don't think that's a very damaging thing. Basically, it's a handful of birth control pills."
But Steve Hong, president of Duke Students for Life and a Chronicle columnist, argued that the morning-after pill is not just another form of contraception.
"Providing the MAP preemptively puts it on a similar value level with a condom if you can keep both in your purse 'just in case,'" Hong wrote in an e-mail. "The morning-after pill is unlike any other ordinary form of contraception. It prevents the fertilized egg from implanting in the uterus."
Emergency contraception-in the form of a kit including eight LoOvral oral contraceptive tablets, two Phenergran tablets to prevent nausea and detailed instructions-is currently available at Pickens for $7.79. Between September 1999 and September 2000, the clinic dispensed 248 kits.
Junior Carrie Johnson, coordinator of Students for Choice, applauded the decision by Student Health. "[Taking the pill] is not an easy thing for the body to go through," she said. "It's not something women would want to be subjecting their bodies to on a regular basis.... [The decision] has the proper precautions for women being able to use that option instead of maybe having to use a surgical abortion or RU-486 later down the line."
Christmas emphasized that the protocol for the prescription has not been established yet, but that it would likely involve counseling for women who repeatedly use the pill, something Student Health already does.
"We really encourage them to make an appointment with one of the doctors and talk about contraception," said Jean Hanson, assistant director of Student Health. "Sometimes, when people come back and it looks like a method of contraception, it's time to talk to them about what's really going on."
But the side effects associated with taking the morning-after pill, namely nausea, can be quite severe and may deter students from using it on a regular basis. Also, health advocates point out that the morning-after pill does not prevent sexually transmitted diseases.
"Having protected sex prevents unwanted pregnancies in addition to protecting both partners from possibly contracting many STDs that reside on Duke's campus," Shannon Johnson, program coordinator at the Women's Center, wrote in an e-mail.
A similar policy is being considered at Harvard University, but Dr. Christopher Coley, chief of the medical department at Harvard University Health Services, said the service is more useful at schools that lack accessibility.
"The concern is that people don't get the kind of counseling [we prefer to offer]," Coley said. "If we offer this... it would dilute the ability to tether people into our system and link them up to primary care providers."
Health officials at the University of Virginia said they have offered the advance prescription, as it has been requested in the past. At Vanderbilt University, student health physicians have not received any requests for the morning-after pill in advance but would consider prescribing it if someone asked.
The effort to provide the service to Duke students was initiated by third-year medical student Shaheen Wirk. He said that there is no empirical proof that students have unprotected sex more often even if anticipatory emergency contraception is available.
"People who have used emergency contraception [in the past] are much better at taking precautions ahead of time," said Ray Rodriguez, coordinator of student health promotion.
Some students said they were glad the service will be offered. "What students do now is not going to change.... [Advanced prescription] will be a lot more effective and will hopefully keep some people from becoming pregnant," said senior Luzmarina Lalli.
But most thought that providing the pill in advance would condone irresponsible behavior. "We're all big kids. We should all know what we're doing," said sophomore Julie Cooper.
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