Emergency Contraception (EC)

Information: Part 2
Concerns, misinformation & later developments

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This is a continuation from Part 1

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. They apparently reject medical evidence that shows that EC is purely a contraceptive. They regard EC as a potential abortifacient because they believe that 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" and then only if one rejects medical research that indicates that it is extremely unlikely or impossible for EC to interrupt the implantation process.
	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. The nausea symptoms would make it very unlikely that a woman would use EC in this way.
	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. Studies have indicated that no negative effects occur.
	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. Other groups look on the increase in the use of EC favorably, because it prevents unwanted pregnancies, about 40% of which would have been terminated by abortion. 1

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.

Other groups 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.

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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 medical definition of the word "pregnancy" states that it begins at implantation, these doctors define pregnancy as beginning at conception. They also reject medical research and believe that EC can prevent the blastocyst from implanting in the womb. Thus 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.  ₂

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." 3 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. 3

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. As expected, there was no response to either.

Future developments in EC:

	Research: Studies are underway to determine: If the interval of time over which EC is considered effective can be increased from its current limit of 72 hours to 120 hours. "...several recent studies have found that the pills are effective when the first dose is started up to 5 days (120 hours) after unprotected intercourse. " 4 If the second pill(s), taken 12 hours after the first, can be eliminated without reducing the effectiveness of the treatment. whether an antiemetic drug "meclizine" (Dramamine II, Bonine) will reduce some of the unpleasant side-effects of EC. whether one levonorgestrel pill, followed by a second identical pill 12 hours later is as safe, effective as the conventional medication. The two-pill method appears to generate fewer side effects. 5
	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, some 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. 6
	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." 7 A FDA panel recommended this step to the FDA which has since been approved for women 17 years-of-age or older. Some Republican Congress members had threatened to cut the FDA's budget if the agency allowe women under the age of 17 to obtain the drug without a prescription. In late 2011, an FDA panel supported a policy of allowing broader over-the-counter access to emergency contraceptives for women under the age of 17. This decision was supported by the FDA Commissioner Margaret Hamburg on 201-DEC-06. However, Health and Human Services Secretary Kathleen Sebelius too the very unusually step of overruling both the Commissioner and expert panel by keeping non-prescription access only to women 17 years-of-age and older. This is an important decision, because the average age at which youths become sexually active is 16. Making emergency contraceptive more difficult to obtain will increase unwanted pregnancies of which 40% are terminated by abortion. Sibelius issued a statement on DEC-07 saying: "It is commonly understood that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age, which I believe are relevant to making this determination as to non-prescription availability of this product for all ages." NARAL Pro-Choice America said in a statement: "We expected this kind of action from the Bush administration, so it’s doubly disheartening and unacceptable that this administration chose to follow this path." Rep. Henry Waxman (D-CA) said: "I think it’s very unfortunate the secretary made the decision that she did. The FDA is a scientific agency, and they gave her their recommendation based on the science, and I think she should have followed it." 8

References used:

The following information sources were used to prepare and update the above essay. Many of these URLs are no longer accessible.

1. "The Morning After Pill (MAP)," Canadian Physicians for Life, undated, at: http://www.physiciansforlife.ca/
2. "Peruvian doctors reject morning-after pill, calling it an illegal abortifacient," Catholic News Agency, 2006-MAR-22, at: http://www.catholicnewsagency.com/
3. A "Provider Attitudes towards ECPs" survey was at: http://www.path.org/
4. Emergency contraception website, at: http://ec.princeton.edu/
5. Christine Dinsmore, "Women's Health: A casualty of hospital merger mania,"  MS magazine, 1998-JUL/AUG
6. 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/
7. "California to sell morning-after pill Jan 1," Japan Today, was at: http://www.japantoday.com/e/
8. Sam Baker, "Sebelius overrules FDA, blocks access to morning-after pill," The Hill, 2011-DEC-07, at: http://thehill.com/
9. "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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Copyright © 1999 to 2011, by Ontario Consultants on Religious Tolerance
Originally published on 1999-JAN-13
Latest update: 2011-DEC-07
Author: B.A. Robinson

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