The Emergency Contraception Debate
By Maya
Emergency contraception (EC) -- also known as the morning after pill, post-coital contraception, and Plan B® -- has had a turbulent history. The debate over this product was in the spotlight in 2005 when Commissioner Lester M. Crawford of the Food and Drug Administration (FDA) passed the Plan B action, which announced that for the time being, Plan B® would remain a prescription drug, and would not be available over-the-counter at pharmacies.[1] Susan Wood, then the assistant FDA commissioner for women's health and director of the Office of Women's Health, resigned in protest of this action.
EC was in the headlines again in 2006 when the FDA announced that Plan B would become available without a prescription, but only to women ages 18 years and over. Young women under 18 still need to get a prescription to obtain Plan B®.[2] Emergency contraception remains a highly emotional and controversial issue, both for advocates who believe EC will reduce the number of unintended pregnancies and abortions, and for opponents who believe that having EC easily available encourages teenage promiscuity and constitutes an abortion.
EC was originally developed in the 1960s as treatment for rape victims to prevent unintended pregnancy. Doctors prescribed a high dose of regular birth control pills after the rape had occurred. Several decades elapsed before the first pre-packaged emergency contraception was approved for consumers in 1998.[3]
Today, packed as Plan B, EC must be taken with 5 days (120 hours) of unprotected sex to decrease the chance of pregnancy. Emergency contraception: 1) delays or inhibits ovulation (the release of the egg from the ovary); 2) may inhibit fertilization (the union of the egg and sperm); and 3) may possibly inhibit implantation (the attachment of the fertilized egg to the uterine wall) of a fertilized egg. EC is up to 89 percent effective at preventing pregnancy, depending on: 1) how promptly after unprotected sex a woman uses it; 2) when during her cycle she had sex; and 3) the kind of EC she takes. EC does not protect against sexually transmitted infections (STIs), including HIV.[4} EC does not cause an abortion and will not terminate an already established pregnancy. It has been estimated that EC could prevent 1.65 million unintended pregnancies and 800,000 abortions per year. [5]
Opponents of wide access to EC routinely state that emergency contraception is a form of abortion. Many people may believe this, but it simply isn’t true. Emergency contraception, as stated in the previous paragraph, prevents ovulation and may prevent fertilization and implantation. But major medical organizations like the American Medical Association agree that pregnancy begins after implantation. You cannot terminate a pregnancy that hasn’t started yet.
Although Plan B is safe, it also comes with some side effects that users should be aware of. Fifty percent of women who use emergency contraception get nauseated and 20 percent of them vomit. Other temporary side effects may include breast tenderness, weight gain or loss, and depression. If you do not get your period by three weeks after taking the pill, it is important to schedule a follow up visit with a physician. [6]
The belief that EC causes abortion has created an obstacle to access and use of EC. Women who come from religious backgrounds may not even ask about using EC because they have been told the pills cause abortions. Some pharmacists may refuse to provide EC because of moral or religious objections. Some hospital emergency rooms even refuse to provide EC to women who have been raped.
Another conservative argument against emergency contraception is that young people may not know how to use the pill correctly and that it will encourage them to be promiscuous. But we know that forty-seven percent of adolescents are sexually active by 12th grade. [7] In a country where we already know that abstinence only programs do not work, we should focus on complete sexual health education and prevention. Why would we take away from any young woman a way to prevent a pregnancy she doesn’t want and isn’t prepared for?
Make your voice heard!!! Emergency Contraception should be made available to ALL women without a doctor’s prescription. To learn more and to get involved, click here.
References
- U.S. Food and Drug Administration. “FDA Takes Action on Plan B.”
- U.S. Food and Drug Administration. “FDA approves over-the-counter access for Plan B for women 18 and older.”
- “A Brief History of Emergency Contraception.” Planned Parenthood.
- Feijoo, A. “The Facts: Emergency Contraception – A Safe and Effective Option for Teens.” Advocates for Youth, 2005.
- Kahn JG et al. Pregnancies averted among U.S. teenagers by the use of contraceptives. Family Planning Perspectives 1999; 31:29-34
- Office of Population Research at Princeton University, Association of Reproductive Health Professionals. Twenty-one Brands of Oral Contraceptives that Can Be Used for Emergency Contraception in the United States. Princeton, NJ: Author, [2004]
- Kann L et al. Youth risk behavior surveillance, United States, 1999. CDC Surveillance Summaries 2000;49(SS-5):1-94.
>> Related Article: Emergency Contraceptive Pills—An Emergency Option for Preventing Pregnancy after Sex: A Brochure by and for Young Women
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