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Emergency Contraception (EC)
Information
Sponsored link.
About Emergency Contraception:
There will always be a need for such post-coital medication to prevent pregnancy -- at least for women who wish to regulate their fertility. Condoms can tear; women sometimes forget to take their birth control pills; diaphragms will occasionally slip; rape and forced incest happens. Sometimes, in the rush of the moment, people will not use a condom. As one physician stated: "as people's sex drive goes up, their IQ goes down."
Types of emergency contraception:
 | An emergency contraceptive pill (ECP), a.k.a. the Yuzpe regimen. This contains an elevated dose of oral contraceptives containing estrogen (ethinyl estradiol) and a progestin (levonorgestrel or norgestrel) is taken within 72 hours of unprotected intercourse. This is followed by a second dose 12 hours later. This method has been in use for over 20 years. Gravol pills are often given in addition to the ECP, to reduce nausea -- a common side-effect. |
| An alternative ECP contains a high dose of either estrogen or a progestin alone, without estrogen. There is less clinical experience with this medication. |
| An intra-Uterine Device (IUD) is sometimes inserted within 5 days of unprotected intercourse. The IUD changes the environment of the uterus in ways that are not entirely clear; the result is that a fertilized ovum will not be able to attach itself to the endometrium, the lining of the uterus. |
Emergency contraceptives have been approved for use as a regular post-coital method in over 20 countries - including Canada, England, New Zealand, the Netherlands, and the United States. Research is ongoing by the World Health Organization, the Population Council. In 1997-FEB, it was declared safe and effective by the US Food and Drug Administration. The pills are sold specially packaged for emergency use in some countries.
How the pills work:
| If an ovum has not been recently released from an ovary, the medication will usually prevent it from being released. |
| If an ovum has recently been released, ECP may prevent it from being fertilized. |
| If the ovum has already been fertilized, it is believed that the pills will "alter the lining of the uterus inhibiting the implantation of the embryo. 1 The exact mechanisms of the latter two processes have not yet been proven by research. |
| If pregnancy has begun (i.e. the ovum has developed into a embryo which has already attached itself to the uterine wall), researchers report that the pills will have no effect. The pregnancy will continue normally. |
There are two common and unpleasant side-effects to these pills. About 50% of women develop nausea; 20% vomit. Some women experience headache, dizziness, cramping, tender breasts, and/or irregular bleeding. These do not generally last more than a day. "Advocates argue that the side effects are minor compared with the consequences of the estimated 2.7 million unwanted pregnancies every year in the United States." 2
In the very unlikely chance that a woman takes the pills and still remains pregnant, one source states that "there is no reason to suspect that one time emergency use of the pills would be associated with birth defects." 7
Self Medication:
Unfortunately, some women have learned the exact dosages of birth control pills required for emergency contraception, and are engaging in self-medication. The New York Times published an article in 1997 containing precise ECP dosages using various contraceptive pills. The Feminist Women's Health Center currently publishes a dosage and color of regular birth control pills to take in order to have similar results to EC pills. 17 This is not a safe technique. The procedure should be taken under the direction of a physician or pharmacist because of the slim possibility of serious side-effects.
Impact on abortions:
One source, the Alan Guttmacher Institute estimates that there are about 6.3 million unintended pregnancies each year. 3 The FDA predicted that if doctors and women adopt ECP, emergency contraception could prevent up to 2.3 million of these pregnancies every year in the U.S., and thus prevent up to one million abortions. This change would reduce the level of abortions to a small fraction of their present levels. A conference in India indicated that ECP could make a major impact at reducing that country's 11 million legal and illegal abortions each year. 4
Some argue that schools, public health agencies etc. should undertake a massive educational program promoting EC in the event of contraceptive failure or lack of use. The goal would be to reduce accidental pregnancies and the subsequent abortions. Some suggest that pharmacies make EC freely available to persons aged 16 and older without prescription. This would make it easier for people to obtain EC on evenings and weekends, and thus be able to take the pills within 72 hours of unprotected sex. However, Dr Gene Rudd, associate executive director of the Christian Medical Association, a pro-life group, suggested that if EC is available to teens then they might skip regular visits to their gynecologist. He said: "They're not going to get their pap smears; they're not going to get screened for sexually transmitted disease." 14
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Effectiveness:
Various sources indicate that their efficiency is 74% or more; one study found 89% effectiveness. However, most women who take emergency contraceptive pills would not have become pregnant anyway. The number of women who take the pills and still become pregnant is only about 2%. One essay quotes a study which showed a pregnancy rate of only 1.2% for ECP, if the treatment is started within 12 hours of sexual intercourse. 5 Effectiveness rates of 99.4 and 99.9% have been reported for the two main IUD types. 15
Safety Considerations:
The medication appears to be safe when taken by active (i.e. not bedridden) women. 6 The Consortium for Emergency Contraception suggests that women who are:
"... at risk of stroke, heart disease, blood clots, or other cardiovascular problems -- should not use combined oral contraceptives on a regular basis. [However] medical experts believe one time emergency use of birth control pills does not carry the same risks." 7
The "progestin only" pills might be a better choice for such women. No deaths or serious complications have been reported in the approximately 25 years that the pills have been used. The World Health Organization, International Planned Parenthood Federation, and the U.S. Food and Drug Administration have all found ECP to be safe and effective.
Other EC considerations:
Some groups claim that if the ECP were generally available, that some women would stop using her regular birth control technique and rely on the ECP instead. This is unlikely, because:
| EC costs much more than regular birth control pills, |
| They are less convenient, since they require a trip to the doctor or pharmacist each time they are used |
| They produce unpleasant side effects. |
| EC is much less reliable than some other contraceptive methods. |
| EC is useless at preventing the transmission of sexually transmitted diseases (STD) |
A study in Finland showed that "No respondents reported using emergency contraception as their only contraceptive method." 8
Concerns about EC by the pro-life movement and religious conservatives:
In an undated essay, Canadian Physicians for Life (CPFL) express concern about the use of EC. Their Statement of Principle defines human personhood as beginning at conception. Thus they regard EC as a potential abortifacient because it can sometimes prevents the implantation of a fertilized ovum in the uterus.
Some of their concerns:
| Referring to the Morning After Pill (MAP) as emergency contraception hides the fact that it is an abortifacient. But it is only an abortifacient according to their definition of "pregnancy." Physicians generally define pregnancy as beginning at implantation. After implantation, EC cannot induce an abortion. |
| Since EC contains a multiple-dose of conventional contraception medication, CPFL is concerned about side effects and health risks to the woman, particularly if she takes them repeatedly. A recent study in Pennsylvania shows that very few women, if any, use EC repeatedly as a contraceptive. |
| They are concerned about the effects that a high dose of contraceptives will have on a pre-embryo which has implanted itself in the lining of the womb. |
| They are concerned about increased use of EC. They cite an 83.5% increase in "EC clients" at Planned Parenthood The interval over which this increase occurred is not stated. Others look on the increase in the use of EC favorably, because it prevents unwanted pregnancies, many of which would have been terminated by abortion. 13 |
Many conservative religious groups strongly promote and value celibacy outside of marriage. They assert that the availability of EC will cause some unmarried couples to become more comfortable with the use of condoms as their prime birth control method, because EC would be available as a backup. Thus, unmarried couples might be more likely to become sexually active. Without such a backup contraceptive technique, some couples might be so frightened about the possibility of pregnancy that they might decide remain celibate.
Some conservative religious groups also point out that young people are often not prepared with contraceptives when they first decide to become sexually active. If EC were not available, then the possibility of pregnancy might have a chilling effect on their desire for sexual intercourse.
Others have pointed out that fear has historically been shown to be an ineffective way of reducing sexual activity.
Some conservatives are concerned that teens will be able to obtain EC and still keep their sexual activity secret from their parents.
Misinformation on the Internet:
With the increase in use of EC, misinformation and disinformation seems to be keeping track:
| 2006-MAR-22: The Catholic News Agency published an article about a statement by some doctors in the College of Medicine in Peru. Although the regular definition of the word "pregnancy" states that it begins at implantation, these doctors define pregnancy as beginning at conception. Since, under some circumstances, EC can prevent the blastocyst from implanting in the womb, they believe that EC can act as an abortifacient under some circumstances. They refer to studies: |
"that relate use of the [morning-after pill] with ectopic pregnancies, which can lead to the death of the mother. In all of the scientific studies, it has been shown that the rate of side effects is between 25-35%. Therefore it cannot be said that it is harmless."
Most readers would probably interpret this statement as implying that ectopic pregnancies occur in about 30% of the time that EC is used. In reality, the side effects to which they appear to be referring are nausea and vomiting, which are at least partly controlled by Gravol -- a medication that is often given along with EC. 16
| 2006-JUN-12: The Catholic News Agency published an article about the use of EC in the Galicia region of northern Spain. Some doctors are concerned that some young women are taking EC as many as seven times a month to prevent pregnancy. The article states that "The morning-after pill is equivalent to 25 regular birth control pills and its frequent use can seriously affect a woman’s health." 17 This is not accurate. According to the Feminist Women's Health Center, a morning-after pill is equivalent to from 2 to 5 of one color of pills of all of the common birth control pills; the exact number depends on the brand. The only known exception is for a very weak pill, Ovrette, of which 20 are equivalent to an EC pill. 18 |
One problem with publishing incorrect information of this sort is that young women will become needlessly concerned about their health if they take EC. But a more serious result may be that some women will incorrectly associate 25 of their birth control pills with one EC pill, and end up taking a massive overdose. We are not medical experts, but it is possible that If this action were repeated often enough, over a sufficiently long time, their health could be endangered.
We have sent a form to the Catholic News Agency asking that they print a prominent retraction on their web site. We have also sent an Email to LifeSite. net who provide a link to the article. There was no response to either.
Future developments in EC:
| Research: Studies are underway to determine:
| ||||||||
| Simplified dispensing: “Collaborative drug therapy agreement” programs are underway or being developed in some states. These allow pharmacists to dispense EC without a prescription, under the direction of a physician. | ||||||||
| Restrictions on availability: The Roman Catholic church is now the largest private health care provider in the U.S. They have achieved this status recently through mergers with secular hospitals. Catholic hospitals restrict or eliminate fetal tissue research, in vitro fertilization, and women's access to reproductive health care, including birth control counseling. They generally do not allow the use of EC. Frequently, they will not even refer clients to places that will provide these services. This has led to "parking lot dispensing" where employees of the hospital secretly meet women in the parking lot or at some neutral location on or near hospital grounds, and covertly give out pills. The percentage of hospitals which are operated by the Roman Catholic church appears to be increasing. This seriously restricts the availability of EC in some areas. This restriction is expected to continue to increase in the future. 10 | ||||||||
| Increases in availability: Legislation in some western states now allow pharmacists to dispense EC to customers, along with an information sheet. "Earlier this year, more than 60 medical, public health and women's groups signed a petition urging the US Food and Drug Administration (FDA) to switch emergency contraception pills to nonprescription status." 11 A FDA panel recommended this step to the FDA. |
References used:
Many of these URLs are no longer accessible.
- A "Provider Attitudes towards ECPs" survey was at: http://www.path.org/
- Paul Koring, "Drug gets go-ahead for sale in the U.S.," Globe and Mail, Toronto ON, 1998-SEP-3
- Julie Severens Lyons, "Law makes morning-after pill available without prescription: PHARMACIES WILL BE ABLE TO DISPENSE EMERGENCY CONTRACEPTIVES," The Mercury News, 2001-OCT-16, was at: http://www0.mercurycenter.com/
- Report of a national meeting on emergency contraception held in Lucknow, India in 1996-DEC, was at: http://www.path.org/
- Jo Ann Rosenfeld, "Post-Coital Contraception," was at: http://www.wwilkins.com/
- "Emergency Contraceptive Pills" at: http://opr_princeton.edu/ec/ecp.htm gave an overview of ECP.
- "Questions and Answers for Decision Makers," by the Consortium for Emergency Contraception website was at: http://www.path.org/
- Reports on Britain and Finland were at: http://www.path.org/
- Christine Dinsmore, "Women's Health: A casualty of hospital merger mania," MS magazine, 1998-JUL/AUG
- Julie Severens Lyons, "Law makes morning-after pill available without prescription: PHARMACIES WILL BE ABLE TO DISPENSE EMERGENCY CONTRACEPTIVES," The Mercury News, 2001-OCT-16, was at: http://www0.mercurycenter.com/
- "California to sell morning-after pill Jan 1," Japan Today, was at: http://www.japantoday.com/e/
- Emergency contraception website, at: http://ec.princeton.edu/
- "The Morning After Pill (MAP)," Canadian Physicians for Life, undated, at: http://www.physiciansforlife.ca/
- Martha Irvine, "FDA weighs morning-after pill for teens," Yahoo! News, 2004-OCT-18, at: http://news.yahoo.com/
- "More Women Opting For IUD Contraception. IUDs Improved Substantially Since Dalkon Shield," WXII12, at: http://www.wxii12.com/
- "Peruvian doctors reject morning-after pill, calling it an illegal abortifacient," Catholic News Agency, 2006-MAR-22, at: http://www.catholicnewsagency.com/
- "Morning-after pill spreading out of control in Spanish schools," Catholic News Agency, 2006-MAY-30, at: http://www.catholicnewsagency.com/
- "Emergency Contraception (also known as The "Morning After" Pill or "Plan B")," Feminist Women's Health Center, at: http://www.fwhc.org/
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Site navigation: Home > "Hot" topics > Abortion > Reducing abortion > EC menu > here |
Copyright © 1999 to 2007, by Ontario Consultants on
Religious Tolerance
Originally published on 1999-JAN-13
Latest update: 2007-MAY-25
Author: B.A. Robinson
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