Sex and Public Policy

By MOLLY IVINS

Creators Syndicate

AUSTIN -- Sex has the most unfortunate effect on people's ability to think clearly, as you have doubtless noticed.

When this problem gets to the level of public policy, it is, of course, written rather large. Here we are once more trying to deal with the societal consequences of the fact that people like to have sex. And not doing very well at it.

The latest wrinkle is called Preven, the first prepackaged emergency contraception kit. Preven was approved by the Food and Drug Administration last September, and 1.3 million packages were sold in its first three months on the market, indicating quite a need for it.

Actually, post-coital contraception has been around for some time, but not many people knew about it. Two doses of certain oral contraceptives taken within 72 hours of intercourse act as contraception after the fact. Had this been widely publicized, it might have prevented 1.2 million unplanned pregnancies and 800,000 abortions annually. But we don't think very clearly about sex in this great nation.

Now comes an approved pill that does the same thing and is not an abortifacient, meaning something that causes an abortion. Unlike RU-486, the "abortion pill," which can be used up to the seventh week of pregnancy, Preven does not end a pregnancy. It prevents implantation of the fertilized egg, which The Nation calls "the generally accepted medical definition of the beginning of pregnancy."

Just how generally accepted is the problem. According to The Nation, the National Right to Life Committee apparently recognizes the distinction and has given tacit approval since it has not opposed Preven. However, Wal-Mart has.

Wal-Mart is the second-largest drug retailer in the United States and has announced that it will not carry Preven. This is the first time that Wal-Mart has done this with any legal drug. According to pro-choice groups, this is a taste of the boycott pressure that anti-abortion groups will bring against RU-486 if it is approved.

In addition, some pharmacists are refusing to fill Preven prescriptions, claiming a right not previously recognized by the profession to refuse to fill a prescriptions they find "morally objectionable."

Arthur Kaplan, the noted health ethicist, says that emergency contraception is "a tremendous health advance" and should be readily available to all fertile women. It has long been known that about half of all abortions are sought because of contraception that did not work, and this finding was confirmed by a pilot program in Washington state that is dispensing Preven without a prescription.

Wal-Mart's decision will have a disproportionate effect on women in rural areas. Wal-Mart has more than 2,400 stores and is dominant in many rural areas and small towns. The phenomenon of Wal-Mart having driven competitors out of business all over the country is well-documented and has often been rehashed.

And the usefulness of Preven depends on fast, no-hassle pharmaceutical access. It works up to 72 hours -- and is most effective if taken within 12 hours -- after intercourse.

It is likewise in rural areas that women are most affected by the increasing shortage of doctors who will perform abortions -- some have to go to other states. And it is these same women who are the most adversely affected by the innumerable niggling laws passed by various state legislatures concerning notification, waiting periods and the like.

Jessica Moser, spokeswoman for Wal-Mart, said the chain made "a bottom-line decision." That's ridiculous, given the product's sales record.

Also contending for the "help-I-can't-think-straight award" is our new presidential contender, George W. Bush. Bush, who seems to be campaigning for national rector, has favored us with the news that he will "emphasize chastity" if elected. That means chastity for teenagers rather than birth control or certainly rather than abortion. Which would be fine if we had any reason to believe that teen-agers would give up sex.

Helpful perspective on all this is provided by Thomas Hine's new book, "The Rise & Fall of the American Teenager."

You will be consoled to know that adult Americans have been complaining about their teen-agers, and particularly about their lack of morals, since Colonial days. Until about 1900, adulthood was assessed in terms of physical maturity instead of age: If a boy was strong enough to work, he was considered a man; if a girl could bear a child, she was a woman.

Now, hormone-driven physical and sexual maturity occurs at ever younger ages. No one claims that this makes a 11-year-old girl emotionally ready for sex, but there it is.

Hine, most helpfully, rather likes teen-agers and suggests that we consider them "beginner adults" rather than incompetent, troubled, half-mad and dangerous victims of "raging hormones." He offers perspectives rather than prescriptions, but his mercifully calm perspective does suggest some useful things we can do about teen-agers to make their lives better. That does not include barring their access to birth control and abortion.


Molly Ivins is a columnist for the Fort Worth Star-Telegram.