Princeton Plan B

In the winter of her freshman year, Veronica ’12 had sex for the first time, with a senior boy the week after Dean’s Date. They used a condom, but “we were messing around afterwards,” she said, “and I had heard horror stories about getting pregnant.”

So Veronica went to the CVS store on Nassau Street to buy emergency contraception.

In a recent survey by The Daily Princetonian, 23.5 percent of 575 female undergraduate respondents said they had used Plan B, the “morning after” pill, at least once in their lives. Emergency contraception includes all types of contraception that can be taken after sex to help prevent pregnancy.

Students who need quick access to Plan B on campus have two options: McCosh Health Center or CVS. At McCosh, the morning after pill is offered at a subsidized rate, and some students said they had positive experiences at McCosh. But others said they were more comfortable going to CVS, where the contraception cost more than twice as much but the process was simpler and quicker. (The names of students interviewed for this article, including Veronica's, have been changed to protect their privacy.)

Though emergency contraception is offered by University Health Services (UHS) for $19, both Veronica and Sarah ’10 purchased Plan B from CVS, where it can cost between $40 and $50.

Sarah said she decided to go to CVS instead of McCosh because she thought the health center was closed on Sundays, adding that she had heard that the people at McCosh were “kind of moralistic” and likely to lecture students about safe sex when asked for the morning after pill.

But Maya ’10 said she had a positive experience purchasing Plan B from McCosh. “You talk to a nurse, and she just wants to know what the timeframe is, if you’re on any medication, etc.” she said. “I was pretty uncomfortable going in. But the nurse was fabulous ... She made me feel totally comfortable about it and a whole lot better.”

Maya added that she chose to go to McCosh instead of CVS because she wanted to talk to someone about the medication, even though she’d heard it was cheaper at the pharmacy.

“UHS views health care visits as opportunities to inform students about best healthcare practices so students can make good decisions,” UHS Director John Kolligian said in an e-mail. “In the emergency contraception area, questions are routinely asked about proper condom use, pregnancy status and alternative birth control methods, usually only if the student has been seen regularly for emergency contraception.”

Veronica, who said she has used Plan B five times since coming to Princeton, has only ever gotten the medication at CVS.

“I had a friend who had to go to UHS to get [emergency contraception], and she told me that the nurse who asked her questions seemed judgmental and prying in a not nurturing or friendly way,” Veronica explained.

“As part of any good consultation, our clinical staff ask questions, sometimes detailed and sensitive ones, and our staff in our Sexual Health and Wellness (SHW) service pride themselves on doing so in a clear yet caring manner,” Kolligian said. Sexual Health and Wellness, he added, has consistently received very high satisfaction ratings on UHS student surveys.

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Before providing Plan B, a health professional at McCosh will typically ask a student a series of questions about the unprotected sex, including whether or not alcohol was involved, whether the intercourse was consensual and whether there is any possibility of already being pregnant, according to one student who visited the health center to purchase emergency contraception.

“Our clinical staff will inquire about whether a student’s need for post-coital contraception represented, say, a non-consensual encounter,” Kolligian said.

“While some students might be taken aback by this question, a student’s response to this and other questions has important implications — by asking, we are less likely to miss opportunities, if needed, for students to consult our SHARE office,” he added. “This approach is in the best interest of our students, and we stand by it.”

UHS does not release data about how many students have purchased Plan B at McCosh “because of general privacy concerns that form the basis of disclosure policies relating to clinical data,” University spokeswoman Cass Cliatt ’96 said in an e-mail.

Sarah said the pharmacists at CVS were very businesslike. They ask for ID to check that the customer is at least 18 years of age and then offer instructions if needed, she said.

But Veronica noted that she did have one awkward experience at the pharmacy.

“The only bad experience I had was when apparently I asked for [the morning after pill] too quietly,” she said. “The pharmacist asked me if I could say it a little louder, which was uncomfortable because there was an older man standing behind me.”

Sarah has used Plan B twice, like 29.5 percent of those respondents who reported using emergency contraception. Another 48.5 percent said they had used the morning after pill only once, and 21.2 percent reported using it three to five times. Only 0.8 percent of respondents who had used emergency contraception said they had taken it more than five times.

Both Veronica and Sarah said alcohol consumption had occasionally played a role in the circumstances leading up to their needing emergency contraception.

The first time Sarah used Plan B, “I didn’t remember what I’d done the night before, and I wasn’t sure if I’d had sex or not, so I took it just in case,” she explained.

Veronica explained that the most recent time she needed emergency contraception, she was using a condom, but it came off before her partner ejaculated. It was a mutual decision that she would get the morning after pill, she said, also noting that since she brought it up the first time, her partner assumed she would get it after subsequent encounters.

“I think that [the girl and her partner] should at least split the cost,” Veronica said of emergency contraception. “If you don’t wear a condom without the girl’s permission, you need to pay for all of it.”

But Sarah said she decided to get Plan B on her own, adding that she wouldn’t want her partner to contribute to the cost.

“I think that a guy giving money would imply that it was in some way his decision whether or not I used emergency contraception,” she said. “I think that choice is mine and mine alone.”

For many female students, the morning after pill is just one tactic for pregnancy prevention. In the ‘Prince’ survey, 44 percent of sexually active respondents said they always used condoms when having sex, while 31.6 percent said they “usually” used condoms and 24.4 percent reported using condoms only rarely, or never.

Additionally, 34.4 percent of female respondents said they regularly use an oral contraceptive.

Both Veronica and Sarah said they usually use other forms of birth control. Sarah said she regularly takes a birth control pill, and she once took a multiple dosage of that pill as another form of emergency contraception. She added that she almost always uses condoms, but once had to use Plan B when a condom broke during sex.

Veronica said she had been on the pill, but because of health concerns, her doctor advised her to stop taking it during the summer before her sophomore year.

“Now, I try to use condoms,” she said. Most of her sexual partners, she explained, do not mind that form of contraception, except for “one partner, who is the ‘Mr. Magic No Condom’ man.”

Though there are other risks associated with unprotected sex, Veronica said pregnancy was her biggest fear.

“I think I’m more scared of getting pregnant than getting a disease, because most are curable,” she said. “But because I knew the person I was having sex with, I was less nervous about it.”

Roughly 1 percent of female respondents to the ‘Prince’ survey said they had been pregnant, and of those, 84 percent had gotten an abortion.