It happens every day. Somewhere in Maine, a woman realizes that something went wrong. The sex might have been a spur-of-the-moment thing. It could have been forced. Perhaps a condom simply failed.

In any event, the women fears she could be at risk of an unwanted pregnancy.

Soon, she’ll have an option that could be as close as her nearest drugstore.

Nearly 150 Maine pharmacists took the first step earlier this month toward offering emergency contraception – commonly called the “morning-after pill” – by completing a training program endorsed by the Maine Pharmacy Association, physicians, the state and the Family Planning Association.

Once they finish a few more steps, they’ll be able to dispense emergency drug therapy to customers without prescriptions.

“I don’t know if anyone is actually doing it yet,” said Stan Tetenman, a pharmacist who lives in Poland and works in Oxford. “I’m hoping to be able to shortly.”

Tetenman was one of the pharmacists who took the initial round of training during an April 1 workshop in Portland.

He has also completed an on-line course sponsored by a national pharmacists’ organization. Now he’s lining up a local doctor – the authorized prescriber – to collaborate with in offering emergency contraception drug therapy.

The therapy – also sometimes called “Plan B” – uses some of the same medication as regular birth control pills.

Plan B progestin-only pills are the only dedicated product specifically used for emergency contraception. They have an effective rate of 89 percent if taken promptly. Guidelines note they work best if taken within three days of unprotected sex, although evidence shows effectiveness for up to five days.

A fact sheet offered by the Maine Board of Pharmacy also notes that off-label higher-than-usual doses of estrogen/progestin pills also can work as emergency contraceptives, with effective rates of 75 percent.

Both therapies are designed to prevent pregnancy.

“It’s not an abortion pill,” Tetenman was quick to point out.

Nevertheless, allowing pharmacists to offer emergency contraception has become something of a lightning rod in certain conservative circles. In some states, laws either allowing or prohibiting the pharmacy-based therapy have led to firestorms of controversy, largely based on religious beliefs.

Maine has so far avoided such a brouhaha by making its emergency contraception program completely voluntary.

Anne Head, director of the state’s Office of Licensing and Registration, said she’s heard virtually no complaints about the original legislation that is now allowing pharmacists to distribute morning-after pills.

Pharmacists who object to it simply don’t take part in the training or form collaborative agreements with doctors or nurse practitioners, she said.

Tetenman said he knows of some pharmacists who are opting out of the program for reasons other than religion as well.

“It’s a very busy profession,” he said. Some pharmacists don’t want to take the time to get the training or have to deal with associated paperwork and reporting requirements.

The morning-after pill has been available for decades from community health organizations such as Family Planning. This month, 53 clients at Tri-County Health Care received the contraceptive. The agency charges a sliding fee of between $15 and $10 for it – less for indigent clients. Doctors, nurse practitioners and clinics have also been dispensing the emergency contraception.

Tetenman said he’s hoping some of the larger drugstore chains develop protocols that will give pharmacists an incentive, beyond the simple desire to help customers, to get the training. Consultation fees that could be charged in addition to the cost of the medication might provide that incentive, he noted.

Sue McPhee, a spokeswoman for the Maine Family Planning Association, and Cheryl Daggett, who oversees the MFPA’s emergency contraception therapy program, both said they’re pleased with the level of participation by the state’s pharmacists in the initial training session, and glad that another source of emergency contraception will be available.

Given the number of calls to her agency’s hot line seeking guidance for morning-after pills, Daggett said she expects pharmacists will find their help being welcomed by Maine women.

Daggett said the hot line gets 30 to 40 calls a month, peaking during the summer and around holiday weekends.

That’s also a time when many doctor’s offices are closed for vacations, making emergency contraception harder to get, she noted.

“There’s absolutely a need for this,” said Daggett.

For now, at least.

Head said the Food and Drug Administration is continuing studies to determine if Plan B medication could be taken off the prescription drug list and offered over the counter.


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