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Reducing the abortion rate

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Emergency contraception (EC)
a.k.a. the "Morning After Pill"

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Important information:

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." 1,2

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: http://www.planbonestep.com/

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

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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]."

Section of handout supplied with Plan B

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.

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Terms used:

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:

bulletSome people have concluded that a woman has to wait for many hours before taking the pill - perhaps until the next morning.

bullet Others believe that the treatment is no longer effective if a woman waits past the next morning.

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.

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Topics included in this section:

bullet

Information about EC (How it works, side effects, impact on abortion, safety, etc.):

bullet Awareness of EC

bullet Access to EC
bullet The FDA approval process of non-prescription status for EC

bullet Denial of service by WalMart

bullet Access to EC and EC information in Roman Catholic Hospitals
bullet EC administered in Connecticut Catholic hospitals

bullet EC is available without prescription in Canada

bullet Attempts to deny students' access to EC in Wisconsin

bullet Bill introduced in Congress to require pharmacists to dispense birth control & EC

bullet Will Catholic hospitals make EC available to rape victims?

bullet Making EC available to military servicewomen
 
bullet Making EC readily available to younger teens: Part 1: 1998 to 2011-APR.  Part 2: 2011-APR until now:

bullet

Can EC or regular hormonal birth control pills prevent implantation? (That is, are they contraceptives or abortifacients?

bullet Does EC reduce or increase the number of abortions?
 
bullet EC Developments during:
bullet 1998
bullet 1999
bullet 2000
bullet 2001
bullet 2002
bullet 2003
bullet 2004
bullet 2005
bullet 2006
bullet 2007 and later

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.

bullet Roman Catholic instructions in bioethics, 2008 "Dignitas Personae"

References used:

  1. Lawrence Morahan, " 'Morning-After' Pill Available at Some DoD Clinics," CNSNews.com, 2002-JUN-3, at: http://www.cnsnews.com/
  2. "Doctors: Have emergency birth control Rx on hand," Associated Press, 2006-MAY-08, at: http://www.cnn.com/
  3. "Plan B One Step Emergency Contraception (pill)." Feminist Women's Health Center, at: www.fwhc.org/ This is a PDF file.
  4. 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/

Information sources:

bullet "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/

bullet Fact sheets are online from the following medical organizations:
bullet American Medical Women's Association
bullet Association for Reproductive Health Professionals
bullet Family Health International
bullet Planned Parenthood Federation of America
bullet PATH - InformaciĆ³n clave sobre la AnticoncepciĆ³n de Emergencia (Espanol)

bullet Fact sheets are online from the following advocacy organizations:
bullet Advocates for Youth
bullet Advocates for Youth Teen pamphlet (English)
bullet Advocates for Youth Teen pamphlet (Espanol)
bullet Center for Reproductive Rights
bullet NARAL Pro-Choice America
bullet National Family Planning and Reproductive Health Association
bullet National Latina Institute for Reproductive Health (English)
bullet National Latina Institute for Reproductive Health (Espanol)
bullet Sexuality Information and Education Council of the United States

bullet A personal story:
bullet Dana L's difficulties: obtaining EC and later abortion

Site navigation:

Home > Abortion > Lowering rate > here

Home > "Hot" religious topics and conflicts > Abortion > Lowering rate > here

 Home page > Sex > here

 Home page > "Hot" topics > Sex > here

 Home page > Christianity > Christian history, belief... > Beliefs > Sex > here

or Home page > Christianity > History, practices... > Christian practices > Sex > here

or Home page > Religious Information > Basic data > Sex > here

Copyright © 1999 to 2013 by Ontario Consultants on Religious Tolerance
Originally published on 1999-JAN-13
Latest update and review: 2013-JUN-12
Author: B.A. Robinson

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