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The Emergency Contraception Debate

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Updated March 06, 2014

The Emergency Contraception Debate

Plan B One-Step and Plan B

Photo © 2009 Dawn Stacey
Though emergency contraception (EC) is not a new idea to society, it is still igniting many debates just as it did when it was first introduced to the United States. The controversy stems from people's beliefs about whether or not Plan B One-Step (the main brand of emergency contraception), Plan B One-Step's generic alternatives (Next Choice One Dose or My Way), or Next Choice (the generic equivalent of Plan B) terminates a pregnancy.

Emergency contraception continues to be a highly emotional and controversial issue, both for advocates who believe EC will lower the number of unintended pregnancies and abortions, and for opponents who believe that using EC amounts to an abortion. The controversy fueling this debate centers around one of the ways that emergency contraception works. Although the exact mechanism of action is not clear, emergency contraception basically works in the following ways (depending on where a woman is in her monthly cycle and when the EC is taken):

  • It can prevent or delay ovulation

  • It can affect the movement of the egg or sperm (making them less likely to meet)

  • It can interfere with the fertilization process
However, many individuals, including pro-life organizations, have taken the stance that Plan B One-Step prevents implantation of a fertilized egg. This mechanism of action is included on Plan B's product labels, yet research has demonstrated that this emergency contraceptive has no impact on implantation. Nonetheless, those who buy into this notion are quick to debate its use and have labeled this type of contraceptive as an abortifacient (something that causes pregnancy to end prematurely and causes an abortion).

The belief that emergency contraception causes abortion has created a barrier to the access and use of Plan B One-Step. Women with religious backgrounds may not even inquire about EC because they have been told that it causes abortions. Many pharmacists even refuse to dispense Plan B One-Step because of moral or religious objections. There are even instances of hospital emergency rooms refusing to provide emergency contraception to women who have been raped.

Current Status

Emergency contraception is often viewed synonymously with the early abortion pill, RU486. This view has lead to many people confusing Plan B One-Step with the abortion pill (also referred to as M&M, Mifeprex, RU486, mifepristone or medical abortion). These two medications serve two different purposes and work completely different from one another. The following information is intended to explain exactly what The abortion pill is.

The Abortion Pill (marketed under the brand name Mifeprex by Danco Laboratories), was first used safely in Europe, and was approved by the Federal Food and Drug Administration (FDA) on September 28, 2000, for sale in the United States. Also known as, mifepristone, it is an early abortion option for women who are 7 weeks pregnant or less. A woman is given a series of pills to take which results in an abortion due to the combination of the medications, mifepristone and misoprostol. mifepristone blocks the hormone progesterone, which is needed to maintain a pregnancy. Once this hormone is blocked, the uterine lining begins to shed, the cervix begins to soften and bleeding may occur. Twenty four to 72 hours later, the woman takes misoprostol. This causes the uterus to contract, and the result is a miscarriage. When used in combination, mifepristone and misoprostol are 95 to 97 percent effective in terminating a pregnancy.

Emergency contraception, on the other hand, is not the same as an abortion and will not cause an abortion.

  • The Abortion Pill results in a termination of a pregnancy and is only used after pregnancy is established (and no more than 49 days since a woman’s last menstrual period)

  • Emergency Contraception, also known as the morning after pill or Plan B One-Step, is used to prevent pregnancy when taken within 5 days after unprotected intercourse. It will not harm an existing pregnancy.

Background

EC originated in the 1960s as treatment for rape victims to prevent unintended pregnancy. Doctors would prescribe a high dose of regular birth control pills after a rape.

Although emergency contraception has been available via prescription since 1999, this contraceptive received more attention in 2005 when Commissioner Lester M. Crawford of the FDA passed the Plan B action, which announced that "until unresolved regulatory and policy issues" could be reviewed, Plan B would not be available over the counter and would remain a prescription drug. Then Assistant FDA Commissioner for Women's Health and Director of the Office of Women's Health Susan Wood resigned in protest.

On August 24, 2006, the FDA publicized that Plan B would become available without a prescription for women ages 18 and older whereas those younger than 18 would still need a prescription to obtain Plan B. Then, on April 22, 2009, the FDA announced that Plan B could be purchased by 17-year-olds without a prescription. These actions caused emergency contraception to find its way back into the spotlight.

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