Reducing the abortion rate
Emergency contraception (EC)
a.k.a. the "Morning After Pill"
EC (emergency contraception) medication, if taken shortly after unprotected sexual
intercourse, will generally prevent a pregnancy from starting. However, some pharmacies
refuse to stock this medication and some individual pharmacists
refuse to dispense it because of the owner's or pharmacist's personal moral or religious beliefs.
The Roman Catholic document Dignitas Personae, issued in late 2008, considers EC to fall "within
the sin of abortion." At the time, the mechanisms by which EC works was not firmly established and many physicians believed that EC might sometimes prevent a zygote (a fertilized ovum) from implanting itself in the wall of the woman's uterus. Since the Church teaches that human personhood begins at conception and must be protected from that time onwards, the use of EC was banned for Catholics. A concensus has now been reached among almost all researchers that EC only works by delaying ovulation or preventing conception. Thus, it is a true contraceptive. But Dignitas Personae has not yet been updated. As a result, many Catholic hospitals deny EC to
women worldwide and sometimes -- as a matter of policy -- refuse to refer women to places where they can obtain EC.
There are many hurdles that women may encounter while trying to obtain EC in
some communities. Some women who feel that they might
need to obtain this medication in the future because of the possibility of rape or contraceptive failure might wish to determine, in advance of
need, the nearest pharmacy which will supply them with the medication.
They might also wish to obtain a prescription from
their physician, if needed, and perhaps even purchase the medication to have it
on hand for immediate use. "The American College of Obstetricians
and Gynecologists has urged its members to offer prescriptions for
emergency contraception during patients' regular checkups."
As of 2013-MAR, in the U.S.:
- "Plan B" is available at pharmacy counters without a prescription for women of all ages .
- "Next Choice One Dose" and "My Way" is becoming available to persons 17 years-of-age or older with proper identification.
- "ella" requires a prescription.
You should ask the pharmacist what the medication's shelf life is if it is stored at room temperature or alternately in a refrigerator or freezer, and mark the box with this data.
A pharmacy lookup for each U.S. zip code at:
Cedar River Clinics in Washington State provide a chart suggesting how prescription birth control pills can be used as a substitute if EC is not available. The clinic states that: "They are less effective and cause more nausea and vomiting." 3
Research in the UK during 2011 indicates that EC is less effective among heavier women. The European manufacturer, Norvelco, has decided to add a warning to the label stating:
"In clinical trials, contraceptive efficacy was reduced in women weighing 75 kg or more and levonorgestrel was not effective in women who weighed more than 80 kg."
The identical drug in the U.S. and Canada is Plan B One Step, manufactured by Teva Pharmaceuticals. 75 kg is equivalent to 165 pounds; 80 kg is equivalent to 176 pounds. For heavier women who have experienced unprotected sex, the insertion of a copper IUD within seven days might be an effective backup option. 4
About this section:
Since this essay was originally written, many information sources have expanded the meaning of "emergency contraception" (EC) to include not only EC medication but the insertion of an inter-uterine device, a.k.a. IUD. These essays will deal entirely with EC medication.
When these essays were written, the methods by which emergency contraception (EC) worked were not clearly known. It was generally accepted that EC mainly acted as a contraceptive. It could inhibit ovulation -- the release of an ovum from an ovary -- and thus terminate any chance of fertilization and pregnancy. It was also agreed that EC will inhibit fertilization -- again terminating any chance of fertilization and pregnancy. But it was unclear whether EC could work in a third way: to interfere with the implantation of the blastocyst -- the products of conception -- in the wall of the uterus. In fact, the Food and Drug Administration (FDA) requires Teva Pharmaceuticals, creators of Plan B to have a warning label stating that the drug:
"... may inhibit implantation by altering the endometrium" [the inside lining of the uterus]."
Teva has repeatedly asked the FDA for permission to remove the warning because there is no scientific evidence to support it.
Many pro-life groups concentrated on this third path; some even implied that it was the only way in which EC worked. Some still do. Under the definitions of terms that many pro-life groups used, pregnancy starts at conception. By interfering with implantation, this would have made EC into an abortifacient -- a medication that caused an abortion.
Subsequently, medical research revealed that this third path was extremely unlikely and probably impossible. But many pro-life groups continued to routinely refer to EC as an abortifacient. Unfortunately, their followers often believe that pro-life groups hold to a high standard of reporting accuracy, and accept their statements as valid.
EC (emergency contraception) has unfortunately become popularly known as "the
morning after pill." This is a poor term. Many people believe that women have
only a small interval of time to take the medication:
|Some people have concluded that a woman has to wait for many hours before taking the
pill - perhaps until the next morning.|
||Others believe that the treatment is no longer effective if a woman waits past the next
Neither is true. The most popular types of EC are "Plan B" and "ella." They can be taken immediately after unprotected intercourse,
or at any time up to about 72 hours later for Plan B and 120 hours (4 days) for ella. Some studies indicate that they are effective even later. However, its efficacy seems to be reduced as
time after intercourse increases, so it is important that, if it is going to be taken, that it be taken
as quickly as possible.
Topics included in this section:
Information about EC (How it
works, side effects, impact on abortion, safety, etc.):
||Awareness of EC
||Access to EC
Can EC or regular hormonal birth control pills prevent implantation? (That is, are they contraceptives or abortifacients?
||Does EC reduce or increase the number of
||EC Developments during:
Since 2007, EC has become available "over the counter" to U.S. women of all ages if they have proper identification. We do not expect many new
developments in the near future, as the use of EC has become largely routine in North America.
||Roman Catholic instructions in bioethics,
2008 "Dignitas Personae"
- Lawrence Morahan, " 'Morning-After' Pill Available at Some DoD
Clinics," CNSNews.com, 2002-JUN-3, at:
- "Doctors: Have emergency birth control Rx on hand," Associated Press,
- "Plan B One Step Emergency Contraception (pill)." Feminist Women's Health Center, at: www.fwhc.org/ This is a PDF file.
- Molly Redden, "New Warning: Morning-After Pill Doesn't Work for Women Over 176 Pounds," Mother Jones, 2013-NOV-25, at: http://www.motherjones.com/
||"Back up your birth control" campaign is a coalition uniting hundreds of
national and local medical organizations and women's health advocacy groups
to promote EC awareness. See: http://www.backupyourbirthcontrol.org/
||Fact sheets are online from the following medical organizations:
||Fact sheets are online from the following advocacy organizations:
||A personal story:
Copyright © 1999 to 2013 by Ontario Consultants on
Originally published on 1999-JAN-13
Latest update and review: 2013-JUN-12
Author: B.A. Robinson