The argument surrounding Emergency Contraception's finally being available over the counter has led to a strong debate among pro- and anti-choice people.
What is Emergency Contraception & How Does it Work?
EC (also known as Plan B), by definition, is a type of postcoital birth control that is intended to prevent a pregnancy.
Emergency postcoital contraception, a method used to prevent pregnancy after unprotected sexual intercourse, is a highly effective but underutilized birth control option. Two hormone regimens, ethinyl estradiol (100 ?g) with levonorgestrel (0.5 mg) or high-dose levonorgestrel (0.75 mg), given within 72 hours of intercourse and repeated 12 hours later, are available for this purpose? Emergency postcoital contraception should be considered as a primary prevention health service to women of childbearing age. (American Family Physician 2000;62:2287-92) [Emphasis my bold]
More recently, doctors who prescribe EC are suggesting that the 2 pills can be taken together if the patient does not get nauseous easily.
Both pro- and anti-choicers claim their main goal is to prevent and end abortions, and as such, it seems to logically follow that every person should be ecstatic with the news that this type of drug will be available over the counter in November.
But some anti-choicers are not, and they?re screaming it from the tops of their soapboxes (bring your earplugs).
The Disinformation
If proponents of the so-called 'pro-life' ideology want to eliminate abortion, surely they would support greater availability of EC; however, the loudest (and sometimes more influential) seem to think EC, available OTC, will have negative effects on the public.
A variety of people who claim to be anti-choice have been spouting the disinformation that EC is an abortifacient and that it promotes (or will promote more) promiscuity among teenagers and adults.
In a June CBS report, Cardinal Egan of New York was quoted as stating that EC may cause "a chemical abortion." The report also discusses the concerns of David Hager, a gynecologist from Lexington, KY. He states, ?One of the mechanisms of action can be to inhibit implantation, which means that it may act as an abortifacient.?
This basic argument resides in their belief that life begins at conception, when sperm fertilizes an egg. If Plan B is taken once the egg has been fertilized, but it has not implanted in the uterus, implantation may be prevented. The fertilized egg could be expelled from the body. This is, to anti-choicers, an abortion.
Some pharmacists have also voiced their moral opposition to EC.
Deirdre McQuade, the anti-choice spokeswoman for the U.S. Conference of Catholic Bishops, stated here, ?Making this powerful, abortifacient drug available without a doctor's oversight could place women and their newly-conceived children at risk."
Wendy Wright, president of Concerned Women for America, opposes the wider availability of Plan B because, she thinks, adult men who have sex with (read: rape) minor girls could force them to take the pills. Donned in her metaphorical red dress and pearl necklace, she stated, ?The FDA's irresponsible action today takes those rights out of a parent's hands and gives them to ill-intentioned perpetrators.?
The other common argument against Plan B is that it will catalyze a rise in sexually transmitted infections, including HIV/AIDS. Because it removes this major ?negative consequence? of having sex with a variety of partners, conservatives argue women will be freer with whom they choose to have sex, and thus put themselves in harm?s way.
The Accurate Information
The first question we must ask ourselves is: Why do people think EC may induce a chemical abortion? And second: Why do some consider it to be an abortifacient?
Here are some applicable definitions that need to be used in the debate (from http://www.m-w.com/) before we can go further:
Abortion: The termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus as a spontaneous expulsion of a human fetus during the first 12 weeks of gestation [or] induced expulsion of a human fetus.
Abortifacient: An agent (as a drug) that induces abortion.
Pregnant: Containing a developing embryo, fetus, or unborn offspring within the body.
Pregnancy: The state of being pregnant.
To state it more succinctly, an abortion is the natural (often referred to as a miscarriage), surgical, or chemical expulsion of a pregnancy, and an abortifacient is the agent that causes an abortion.
A chemical abortion is predominately induced in the United States through the use of a combination of Mifeprex (more widely know as RU-486) and Cytotec. Mifeprex, when taken alone, does not have a high efficacy rate of inducing an abortion. A second drug, a prostaglandin, usually Misoprostol (its brand name is Cytotec), should be used 48 hours later. Misoprostol causes uterine contractions to help expel the pregnancy.
Plan B is not the same as RU-486. There are completely different drugs, drug interactions, and purposes for each.
The Population Council published a study in May 2005 that explained how Plan B works. Page three reads, ??the drug [levonorgestrel] had no effect on fertilization or implantation when it was administered shortly before or after mating or before implantation.? This means Plan B?s primary method of preventing pregnancy is not inhibiting implantation; rather, Plan B inhibits ovulation. In the event ovulation has occurred, Plan B prevents a sperm and egg from uniting as a secondary method. The third, which is under debate, is if conception has occurred, implantation may be inhibited.
Plan B?s homepage also issues this statement: "Remember that Plan B is not RU-486 (the abortion pill). Because Plan B is used to prevent an unplanned pregnancy, it will not work if you?re already pregnant. If you take Plan B and are already pregnant, it will not affect your existing pregnancy."
In other words, you cannot have an abortion without first having a pregnancy.
The American Medical Association and the American Academy of Pediatrics also stated that they favor non-prescription sales, citing studies that there is no evidence to support conservatives' claims that easier access to the drug leads (or would lead) to an increase ?sexual promiscuity.? STIs are a real threat to a person?s physical, sexual, social, and emotional health, and since EC does not protect against STIs, people won?t use it for protection in that respect.
One study published last year in the Journal of the American Medical Association found no change in sexual behavior or birth control habits when EC was available (search for the document res_hod443_a04). This is plausible because EC is $25?$40, while condoms and/or other means of contraception are significantly cheaper and more effective. Making EC available over the counter is not going to stop the use of other methods. EC is meant as a back-up method in the events that either the primary method fails or there was no contraception used.
To briefly address concerns involving rapists purchasing EC and forcing their victims to take it, EC has been available for quite some time in certain states without a prescription, and through most private women's clinics in all states. EC is given when survivors of rape request it. Fearing a male rapist may give the woman he raped EC is not addressing the underlying issue of rape, but rather looking at a rare abuse of Plan B and attempting to argue with logical fallacies by detracting from the issue at hand.
What's the Real Issue Here?
It is safe to say, at this point, that conservatives are not arguing whether the use of EC is the moral and legal equivalent to having an abortion. It clearly is not. Assuming, in the slight chance Plan B would work to inhibit implantation, a fertilized ovum cannot be considered ?life? because its lacks essential attributes of life. The essential step of implantation needs to occur in order for the zygote to develop into an embryo. Without implantation, a fertilized ovum is nothing more than cells that will be washed away with menstruation. (We could say the process of life begins at conception, but life, by definition, cannot begin until implantation since a zygote cannot be sustained without implantation occurring.)
The real issue here is whether women need to remain at the mercy of their reproductive anatomy. Conservatives seem to think that a woman?s reproductive system should remain completely untouched by natural or chemical contraceptives, which, of course, leads to the logical conclusion that they want pregnancy (and the fear of pregnancy) to dictate women?s lives.
People against Plan B?s presence seem to want unintended pregnancies to be: (a) a punishment for sex; (b) a fear that controls women?s choices about with whom they engage in intercourse; and (c) the overall deciding element that dictates women?s careers, finances, social goals, and emotional states, thus keeping women in a constant state of fear and subjugation.
Equating inhibiting implantation of a fertilized ovum to a chemical abortion (and thus employing the moral charges associated with abortion) with Plan B shows the desperation of the right and the lengths they?re willing to go to dispense their disinformation in order to politicize issues that further their underlying agendas.
Conclusion
Dr. Susan Wood, who headed the FDA?s Office of Women?s Health, was one of the scientists inside the agency who argued that Plan B should be available without a prescription. ?If it's safe, and it is, and effective, it's more effective the quicker you have it. This is why it needs to be over-the-counter."
Women need the tools to control their reproductive freedom in order to keep their autonomy and live a quality life. The use of responsible planned parenting is not only good for the women of American society, but also for the collective. Women can?t be responsible and productive people when they?re under the ?thumbs? of their uteruses. We have to trust women to make the best decisions regarding their reproductive health, and Plan B's OTC availability is one step in that direction.
Pregnancy should not decide anything?pregnancy should be decided and desired.
Kelly Gorski is an editor and proofer for a national organization as well as a former high school teacher and options counselor. She can be reached at kellygorski@gmail.com | |
