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President Barack Obama supports requiring girls younger than 17 to see a doctor before buying the morning-after pill to help prevent unwanted pregnancies. But fighting that battle in court, after a new decision makes the pill available without a prescription, comes with its own set of risks.
A federal judge ordered the US Food and Drug Administration to lift age restrictions on the sale of emergency contraception - ending the current requirement that buyers show proof they're 17 or older if they want to buy it without a prescription.
The ruling accused the Obama administration of letting the president's pending re-election in 2012 cloud its judgment when it set the age limits in 2011.
"The motivation for the secretary's action was obviously political," US District Judge Edward Korman wrote in reference to Health and Human Services Secretary Kathleen Sebelius, who made the decision. The FDA had been poised to allow over-the-counter sales with no age limits when Sebelius took the unprecedented step of overruling the agency.
Obama administration appealed the ruling
If the Obama administration appeals the ruling, it could re-ignite a simmering cultural battle over women's reproductive health, sidetracking Obama just as he's trying to keep Congress and the public focused on gun control, immigration and resolving the nation's budget problems.
"There's no political advantage whatsoever," said Democratic strategist Hank Sheinkopf. "It's a side issue he doesn't need to deal with right now. The best idea is to leave it alone."
Still, Obama has made clear in the past that he feels strongly about the limits..
"As the father of two daughters, I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine," Obama said in 2011 when he endorsed Sebelius' decision.
The Justice Department said it is evaluating whether to appeal. The White House said Obama's view on the issue hasn't changed since 2011.
"He supports that decision today. He believes it was the right common-sense approach to this issue," White House spokesman Jay Carney said Friday.
Unwanted pregnancies in the US
Half the nation's pregnancies every year are unintended. Doctors' groups say more access to morning-after pills - by putting them near the condoms and spermicides so people can learn about them and buy them quickly - could cut those numbers.
Appealing the decision could anger liberal groups and parts of Obama's political base that are already upset with his forthcoming budget, which includes cuts to long-protected programs like Medicare health aid for the aging and Social Security pensions. But currying favour with conservatives who want the ruling to stand also is unlikely to do much to help Obama make progress on his second-term priorities.
Also weighing on Obama is the unpleasant memory of previous battles over contraception, including an election-year fight over an element of Obama's health care overhaul law that required most employers to cover birth control free of charge to female workers as a preventive service. That controversy led to a wave of lawsuits and anger from Catholic and other faith-based groups.
When Obama offered to soften the rule last year, religious groups said it wasn't enough. Obama proposed another compromise on the rule in February, to mixed response.
If the court order issued Friday stands, Plan B One-Step and its generic versions could move from behind pharmacy counters out to drugstore shelves - ending a decade-plus struggle by women's groups for easier access to these pills.
Women's health specialists hailed the judge's ruling, dismissing concerns that it could encourage underage people to have sex.
But social conservatives, in a rare show of support for Obama's approach to social policy, said the ruling removes common-sense protections and denies parents and medical professionals the opportunity to be a safeguard for vulnerable young girls.
"The court's action undermines parents' ability to protect their daughters from such exploitation and from the adverse effects of the drug itself," Deirdre McQuade, spokeswoman for the US Conference of Catholic Bishops.
Absent an appeal or a government request for more time to prepare one, the ruling will take effect in 30 days, meaning that over-the-counter sales could start then.
