March 3, 2006

MGH caregivers take a stand for patients' rights

When retail giant Wal-Mart announced Feb. 14 that it would begin to stock Plan B — the so-called morning-after pill — at its 44 Massachusetts pharmacy stores, it did so in part as a result of the efforts of two MGH staff members who were concerned about their patients' rights to have access to the medication.

Julie Battel, CNM, a nurse midwife with the MGH Vincent Memorial Obstetrics and Gynecology Service, and Rebekah Gee, MD, MPH, an obstetrics and gynecology resident in the MGH/BWH combined residency program, were two of the three plaintiffs who brought a lawsuit against Wal-Mart Feb. 1. Under Massachusetts law, all pharmacies in the state are required to stock all "commonly prescribed medicines in accordance with the usual needs of the community." Plan B, which delivers a high dose of the hormone progesterone to prevent a fertilized egg from implanting in a woman's uterus, has been available in the United States since 1999. Since that time, Massachusetts women have been able to obtain the medication at all major pharmacy chains with the exception of Wal-Mart.

In December, Gee and Battel, along with the suit's third plaintiff, Katrina McCarty, attempted to fill prescriptions for Plan B at three separate Boston-area Wal-Marts. All three were turned away. While the women approached Wal-Mart as part of a planned action coordinated with the Planned Parenthood League of Massachusetts and other abortion-rights advocacy groups, they wanted to bring attention to this issue for women who might patronize a Wal-Mart pharmacy for Plan B without realizing that the medication is broadly available elsewhere. They filed suit because they believed Wal-Mart's position was in violation of state law — and because, Battel says, "it simply was the right thing to do for Massachusetts women."

"Emergency contraception is critical to women's health care," says Gee. "Delay in receiving this medication could result in a preventable unintended pregnancy."

In light of the importance of timely access, legislation was passed last year in Massachusetts that mandates hospital emergency rooms to offer Plan B to all rape victims and allows patients to obtain Plan B at a pharmacy directly without a doctor's prescription. "The ready availability of this medicine, which is a safe and effective form of emergency contraception, is very important to our patients," says Michael Greene, MD, director of MGH Vincent Obstetrics. "We are very proud of Rebekah and Julie for their willingness to take a stand on what is best for their patients."

Battel and Gee's actions may help more women than they expected. Prior to the suit, Wal-Mart carried Plan B only in Illinois, where it was required by law. Following the decision in Massachusetts, the retailer is considering carrying the medication in all 50 states, a change that would affect approximately 3,700 pharmacies.