October 19, 2015 — Indian Health Services last week finalized a written policy requiring IHS-run facilities to provide emergency contraception to Native American women of all ages without a prescription, according to AP/U.S. News & World Report (Fonseca, AP/U.S. News & World Report, 10/16).
Although women ages 17 and older can legally purchase EC from behind the counter at retail pharmacies, IHS does not operate any retail pharmacies. Previously, women in federally recognized tribes who sought to obtain EC had to visit a clinic, emergency department or urgent care facility for a consultation before receiving a prescription.
IHS Chief Medical Officer Susan Karol in May 2012 announced that the agency was developing a policy aimed at making EC available without a prescription. In 2013, IHS issued a verbal directive ordering its facilities to offer EC without a consultation or prescription for Native American women ages 17 and older. However, the directive did not conform to FDA guidelines, which permit EC to be provided without age restrictions. (Women's Health Policy Report, 9/20/13). Women's health advocates noted that without a written policy, the order could have been rescinded easily.
According to AP/U.S. News & World Report, EC is provided at no cost to Native American women because of a federal trust that offers health care to Native Americans and Alaska Natives.
Written Policy Details
Karol on Friday said the new process meets FDA's guidance on EC access and should ensure that Plan B One-Step or a generic EC option is stocked in pharmacies to facilitate access for Native American women.
Karol noted that there are no requirements that health programs in urban or tribally operated areas follow IHS policies.
Asetoyer said EC access for Native American women is particularly important because of the high rates of domestic violence and sexual assault against Native American women. According to the U.S. Department of Justice, one-third of all American Indian and Alaska Native women will be raped over the course of their lifetime, and about three-in-five will experience domestic violence.
Alexa Kolbi-Molina, an attorney with the American Civil Liberties Union, said, "Just because you rely on the federal government for your health care doesn't mean you should be subjected to a different standard that makes access more difficult." She added, "Native American women are finally going to be getting the health care they're entitled to and deserved all along" (AP/U.S. News & World Report, 10/16).