The impact of over-the-counter availability of "Plan B" on teens' contraceptive decision making

Soc Sci Med. 2008 Aug;67(4):618-27. doi: 10.1016/j.socscimed.2008.04.016. Epub 2008 Jun 5.


In ruling on the over-the-counter status (OTC) of the emergency contraceptive, "Plan B", the US Food and Drug Administration (FDA) questioned whether younger adolescent females could adequately self-select and self-medicate. That determination requires a judgment of fact, regarding how increased emergency contraceptive availability would affect adolescents' behavior, and a judgment of values, regarding the acceptability of different outcomes. We present a general approach to such problems, using analytical and empirical methods grounded in behavioral decision research. We illustrate it with findings from 30 in-depth interviews and follow-up surveys, with adolescent females aged 13-19 in the Pittsburgh area reporting how Plan B availability would affect three decisions (having sex, choosing contraceptives, using Plan B). Although the FDA expressed concern about younger teens using Plan B as their primary form of contraception, neither younger nor older teens revealed such an intention. However, teens preferred easier availability, should emergency contraceptive be needed. Incorporating an understanding of teens' decision-related perspectives can make such policies more predictable and transparent.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Adult
  • Contraception Behavior*
  • Contraceptives, Postcoital / supply & distribution*
  • Decision Making*
  • Female
  • Humans
  • Levonorgestrel / supply & distribution*
  • Nonprescription Drugs / supply & distribution*
  • Public Policy
  • Sexual Behavior


  • Contraceptives, Postcoital
  • Nonprescription Drugs
  • Levonorgestrel