Steve Chapman

We all know that every day, people in Mexico come across the border in pursuit of something they can't find in their country. What you may not know is that every day, people in the United States go across the border to Mexico for the same reason. They aren't looking for jobs. They're looking for birth control pills.

Why would that be? After all, Americans can get the pill without leaving their country. The reason is that in Mexico, they don't need a prescription. They don't have to see a doctor and present a scrip to a pharmacist.

They can just walk into a store and buy what they want. The cross-border alternative is cheaper, and they don't even have to go themselves -- a friend or relative can pick them up.

Last week, the Obama administration gave up its transparently political effort to enforce an age restriction on over-the-counter purchases of Plan B, the "morning-after pill" that can prevent pregnancy after sex. This helpful development creates an anomaly: Women and girls will be able to get emergency contraceptives without a prescription -- but not the regular oral contraceptives that would make them unnecessary.

It's like saying we'll treat you if you come down with the flu, but we won't give you a flu vaccine so you don't get it in the first place.

There is no obvious explanation why something used safely over half a century by hundreds of millions of women should remain so restricted. In most countries, it's not. But the U.S. government presumes that women are incapable of making this decision without the approval of a doctor.

This outmoded paternalism can't be justified by the health risks of oral contraceptives. Plenty of over-the-counter medicines are considerably more dangerous. "Nonsteroidal medicines kill far more people than birth-control pills," Dr. Eve Espey, a professor of obstetrics and gynecology at the University of New Mexico, referring to painkillers like Advil and Motrin, told The New York Times.

Oral contraceptives are not entirely devoid of danger. They can slightly raise the risk of certain cancers, while lowering the risks of others. They can slightly increase the incidence of heart attack and stroke, particularly for women who are over 35, have high blood pressure or smoke. But they are safe enough that doctors often prescribe them even for patients who are chaste as nuns -- to alleviate acne, severe cramps and heavy menstruation.

Steve Chapman

Steve Chapman is a columnist and editorial writer for the Chicago Tribune.

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