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Morning-After Blues

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Pill Promises Not Kept

By Father John Flynn

ROME, JAN. 23, 2007 (Zenit) - The debate continues in many countries over the use of the so called morning-after pill. In Chile, after many months of conflict over the issue, the government gave the go-ahead to the distribution of the pill last September. On Jan. 12, however, Chile's Constitutional Court voted 6-4 to halt the pill.

According to an Associated Press report that same day, the judges invalidated the program under which the pill is distributed because it was authorized by an administrative decree, rather than by a presidential decree or a parliamentary law.

The halt to the pill's distribution may well be short-lived. The government responded to the decision by announcing that Chilean President Michelle Bachelet would issue a decree to overcome the technical fault found by the court.

The Catholic Church in Chile strongly objected to the program implemented by the government. In a declaration Sept. 7, the episcopal conference pointed out the possible abortive effects of the pill if conception had occurred.

The bishops also criticized the program for undermining the role of parents. The government's program foresees the distribution of the morning-after pill to girls as young as 14, without the need for parental approval. This deprives parents of their legitimate authority in educating and guiding children, the bishops stated.

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The continuing debate in Chile comes when doubt is rising over the effectiveness of programs involving the widespread distribution of the morning-after pill. Long claimed by its promoters as necessary to help reduce abortions, in practice there is no evidence that it has any such effect.

A review of 23 studies on the different types of "emergency contraceptives," published in the January issue of the journal Obstetrics and Gynecology, finds no evidence that use of the pill lowers pregnancy or abortion rates.

In its Jan. 8 report on the journal article, the Washington Times commented that in 2005, researchers at the Guttmacher Institute, a research organization connected to abortion provider Planned Parenthood, published a report arguing that the use of the pill and other "emergency contraceptives," had prevented 51,000 abortions in 2000.

Such arguments continue to be repeated. "It should be a no-brainer that we increase access to contraception, and in particular make the morning-after pill available over the counter," argued New York Times editorial page columnist Nicholas Kristof, in an article May 2.

More pills, more abortions

Another report, published Jan. 8, confirmed the failure of the morning-after pill to reduce abortion. A Spanish Web site, Forum Libertas, analyzed what had happened in the country since the pill's introduction. In 2000, the year before the pill was introduced, there were 60,000 abortions, a rate of 7.5 abortions for every 1,000 women under 20.

By 2005, fewer than 506,000 morning-after pills were distributed. At the same time, however, the number of abortions that year had risen to 91,000, and the rate of abortion for women under 20 rose to 11.5 abortions for every 1,000 women.

Similar findings were reported in Britain last year. The Sept. 15 issue of the British Medical Journal published an editorial authored by Anna Glasier, director of a National Health Service unit in Edinburgh, Scotland.

Glasier wrote: "Emergency contraception has been heralded as the solution to rising abortion rates." "Some authors have suggested that almost a million abortions could be prevented in the United States annually if every woman used emergency contraception every time she needed it."

"Yet, despite the clear increase in the use of emergency contraception, abortion rates have not fallen in the United Kingdom," the article continued. In fact, wrote Glasier, they have risen from 11 per 1,000 women aged 15-44 in 1984 (136,388 abortions) to 17.8 per 1,000 in 2004 (185,400 abortions). She added that increased use of emergency contraception in Sweden has not been associated with a reduction in abortion rates.

Concerns had already been raised over the use of the morning-after pill in Scotland. In a report published in November 2005 by the Scottish Council on Human Bioethics, Dr. Anne Williams observed that the morning-after pill "is wrongly and misleadingly labeled 'emergency contraception' by medical and government bodies."

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"It is misleading because it conceals the fact that it may work, not by preventing conception, but by preventing further survival and development of an already existing embryo," the report explained.

The term contraception is insufficient to describe the full effect of the morning-after pill, wrote Williams. In fact, the pill may act to prevent implantation (attachment of the embryo to the wall of the uterus), which occurs approximately seven days after conception has taken place. Contraceptives prevent conception, not implantation. "Acts which are post-conceptive cannot reasonably be included in the definition of contraception," she stated.

Health concerns

The report also observed the lack of adequate and in-depth research on the short- and long-term safety implications of the morning-after pill. This is particularly of concern when it comes to women who repeatedly use the pill.

The report cited evidence from seven family planning clinics, showing that more than half the women had used the morning-after pill at least once that year, and 25% had used it three or more times. Tracking health problems due to frequent use of the morning-after pill will also be problematic due to the nature of programs implemented by some governments, which include free distribution without a need for medical prescriptions.

Williams also argued that diminishing the fear of pregnancy through recourse to the morning-after pill may bring about a casual approach to entering a sexual relationship, with little excuse for a young woman to refuse. Greater sexual activity could well contribute to higher levels of sexually transmitted diseases.

Concern over the health effects of the pills were also raised by Susan Wills, associate director for education at the pro-life office of the U.S. bishops' conference. Plan B, one brand of the morning-after pill, and other methods of "emergency contraception" are the equivalent of taking from four to 40 times the daily dose of various oral contraceptive pills in a 12-hour period, she noted in an article published Aug. 15 on the Web site National Review Online.

Negative effects of the morning-after pill include severe disruption to the menstrual cycle, convulsions, and an increased risk of ectopic pregnancies. In spite of these dangers, last year the U.S. Food and Drug Administration, eased rules on Plan B, allowing women to buy it without a prescription.

Promoters of the pills continue to press for its evermore frequent use, to the point of advocating it should be present in every woman's bathroom medicine cabinet, reported the British newspaper the Telegraph on Dec. 14.

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In December the British Pregnancy Advisory Service said women should treat the pill as they would aspirin. "We are trying to make the morning-after pill as normal as Nurofen," a spokesman told the newspaper.

Norman Wells, the director of the Family Education Trust, criticized this attitude as "very irresponsible." Wells argued that its frequent use could have negative effects in the long term. He also commented that when the morning-after pill was first approved for use in Britain, it was proposed as something to be used only in exceptional circumstances. Now, however, it is marketed as if it were as insignificant as an aspirin. A move that should raise doubts over the priorities of some organizations.