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Medical and Ethical Dangers of "Morning-After Pill"

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U.S. Bishops' Aide on Plan B

WASHINGTON, D.C., FEB. 19, 2004 (Zenit) - The Food and Drug Administration commissioner's verdict on the newest "morning-after pill," a substance strongly opposed by the U.S. bishops' conference, is expected in the next few months.

Cathy Cleaver Ruse, spokeswoman for the bishops' Pro-life Secretariat, decried Plan B in December after two FDA advisory committees recommended that it be made available over-the-counter. "American women and children do not deserve this reckless experiment on their lives," she said.

Cleaver Ruse shared why Plan B, a levonorgestrel-only pill, is bad policy and bad medicine -- and detrimental to both women and their unborn children.

Q: How does Plan B work?

Cleaver Ruse: Morning-after pills such as Plan B are intended for use after sexual intercourse. They are marketed and advertised as emergency "contraception" but that label is highly misleading.

Plan B can work before or after conception. It works before conception to delay ovulation or interfere with sperm capacitation, and it works after conception by impeding the movement of the new embryo through the fallopian tube and by interfering with the process of implantation.

In fact, an extensive review of the literature on morning-after pills suggests up to 11 possible modes of action for the drug, seven of which work after conception.

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Q: Why do proponents of Plan B say that it doesn't cause abortions?

Cleaver Ruse: It comes down to the definition of "pregnancy."

It used to be universally acknowledged that "pregnancy" began when human life began. That is, when a human egg was fertilized by a human sperm somewhere in the vicinity of the ovary, before the tiny growing embryo began the weeklong journey through the fallopian tube and into the uterus to burrow into the endometrium, a nourishing temporary home.

But the IUD changed all that. Not the process, of course, but the definition. Promoters of intrauterine devices in the 1960s lobbied successfully to "delay" the official start of pregnancy by 10 days, to the point of implantation, so that the IUD, which works post-fertilization, could still be labeled a "contraceptive."

Thus, while new human life begins when it always began, "pregnancy" is sometimes said to begin a week-and-a-half later, depending on what you're reading.

The morning-after pill pushers are taking this confusion to the bank. Supporters of Plan B claim that it doesn't cause abortion because it doesn't interfere with pregnancy as they have decided to define it. And there's no mystery why Plan B's distributor says it's just a contraceptive and doesn't cause abortion -- it wants to sell as many drugs to women as possible.

But preventing human life from beginning is not the same thing as destroying life that has already begun, and to many women it is a distinction that makes all the difference. Women deserve to know the truth about drugs that are marketed to them.

Q: What about the claims that Plan B would reduce abortions by as many as half?

Cleaver Ruse: Putting aside for a moment the obvious rejoinder that an abortion drug won't reduce abortions, there simply is no evidence to support this claim.

In fact, abortion numbers have not been significantly affected in areas in the country where the drugs have already been made more widely available. Washington state, for example, removed the need for a prescription in 1998, but its abortion numbers kept pace with prior state and national rates, all of which were falling marginally year by year.

Q: What are the ramifications of the current proposal to make Plan B available to women and girls without a prescription?

Cleaver Ruse: Recently the distributor of Plan B, a for-profit drug company, petitioned the FDA to allow its drug to be sold over-the-counter without a prescription.

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Two FDA advisory committees -- the Nonprescription Drugs Advisory Committee and the Advisory Committee for Reproductive Health Drugs -- voted 23-4 in favor of the switch. The final decision rests with the commissioner of the FDA, Mark McClellan.

Putting Plan B on the shelves of a drug store is a very bad idea. First, there is the enormous problem that women are being misled about what this drug really does. But beyond that, this powerful drug has been associated with a heightened risk of ectopic pregnancy, a potentially fatal condition.

While initial clinical trials did not show a risk, experience with the drug in the United Kingdom and New Zealand has revealed the danger and prompted medical authorities to issue warnings to physicians. The UK's Committee on Safety of Medicines recently found 12 ectopic pregnancies out of 201 pregnancies following use of the drug.

What's more, the common side effects of the morning-after pill -- nausea and abdominal pain -- are also symptoms of ectopic pregnancy. Eliminating a doctor's involvement would leave women and girls particularly vulnerable to a potentially fatal condition.

If the FDA approves the pending proposal, it will begin a reckless experiment on the lives of women. This drug, with its serious risk of life-threatening consequences -- for the woman or girl taking it and for her developing child -- does not belong on the shelf of a drug store and at the reach of a frightened teen-ager.