The first post in this series can be found here.
Last time I looked at a couple literature reviews about the methods of action of Plan B emergency contraception (levonorgestrel, LNG). This time I’m presenting On the the mechanisms of action of short-term levonorgestrel administration in emergency contraception (Durand, et al., 2001)
The mode of action of [emergency contraception, EC] has become he subject of heated debate in North America and in several Latin American and Caribbean countries. The main question is centred on whether or not EC prevents pregnancy by interfering with post-fertilization events. This issue is of importance for many people who consider that a new human life begins at the time that fertilization is completed. Accordingly, interference with post-fertilization events would lead to loss of human life. In spite of a lack of scientific evidence to support a post-fertilization effect, this possibility is used as an argument to turn legal, political and religious constituencies against the availability and use of EC. (Ortiz, et al, 2004)
In order to satisfy my own curiosity and my critics, I’ve reviewed recent scientific literature related to the question of whether or or not Plan B is abortifacient. I do not wish to appear to be in any way “rooting” for Plan B and/or its supporters. I am not. However, I have been very frustrated by the way that many of my fellow pro-lifers have repeatedly stated confidently that Plan B sometimes acts after fertilization and is therefore abortifacient. I do not believe such confidence is supported by scientific evidence. The goal of this literature review is to present a fair appraisal of the likelihood of postfertilization effects caused by Plan B to the pro-life community.
For the most part my analysis will proceed in chronological order, but I’ll begin with a newer article (Croxatto, Ortiz, and Müller, 2001) that provides an brief primer on the relevant reproduction science. Continue reading
When Karina at Netscape.com linked to yesterday's post about Plan B, she lumped me in with those whose "buzz on this ruling is overwhelmingly positive". While I do not believe that Plan B is abortifacient, and therefore needn't be fought by pro-lifers as such, that does not mean that I think over-the-counter access to it is a good idea.
First of all, it's only going to worsen the already pervasive and pandemic contraceptive mentality in this country. However, that alone would be unsufficient grounds for banning Plan B or restricting access to it. If our opposition to Plan B is really based on its contribution to the culture of licentiousness, we'd be lobbying for condoms, the Pill, and various other prevalent forms of contraception, which I think we'd find difficult to justify or achieve in our pluralistic society. If we wish to counter the contraceptive mentality, we need to do so through leading by example. "They will know we are Christians by our love." That love should be so abundant and effusive that those outside of and weaker members within the Body of Christ should marvel at it and weep at its absense in their lives. Furthermore, that love should be so superabundant that in order to be fully expressed and nurtured it must become flesh and be born as our beloved children.
Getting back to the matter at hand, I would certainly not classify my reaction to wide availability to Plan B as "overwhelmingly positive". Nor would I characterize my sympathizers' reactions as such. I do not rejoice in the popular pursuit of sexual pleasure and gratification as ends unto themselves, divorced from their proper place in sacramental marriage. However, my primary discomfort with OTC availability of Plan B has more do with medicine and Hippocratic concerns than sexual morality.
"[M]ake a habit of two things – to help, or at least to do no harm." I'm not certain it won't do harm, especially if its administration cannot be monitored by health professionals. The birth control pill, aka the Pill, of which Plan B is a very large dose, requires a prescription. Providing Plan B over-the-counter seems an odd decision in that light. Also, offering it OTC to those over 18 while requiring prescriptions for minors seems unpracticable. If it's really important to restrict minors' access to the drug, there should be more concern that adults will purchase it OTC and give it to minors. Most serious, though, is how little is known about the long-term effects of taking Plan B once, let alone multiple doses. I worry that Plan B will become a frequent and commonplace fail-safe for when primary means of contraception fail or are not used – either carelessly or deliberately – rather than a rarely used emergency remedy. We just don't know what repeated use would do to a woman's health, and that worries me. I pray that Plan B doesn't kill people like RU-486 has.
In sum, while I do not believe Plan B is a form of chemical abortion that should be fought by the Culture of Life, I am certainly not overjoyed by the prospect of it being available without prescription.
As any regular reader of this blog is well aware, I’m strongly pro-life. However, I’m ticked off at my own movement right now because of crap like this [emphasis mine]:
"President George Bush shocked the pro-life movement with his support for over-the-counter access to abortion-drug Plan B, also known as the morning-after pill, for adults. However, Plan B ‘ought to require a prescription for minors,’ he said.
[…]
"’President Bush’s implied support of over-the-counter status for the abortion-causing drug Plan B is a betrayal of the pro-life principles he claims to support,’ said Stephen Peroutka, Esq., chairman of the National Pro-Life Action Center."
Let’s get with the program, people. Plan B is not abortifacient. Repeating "abortion" and "Plan B" in the same sentence over and over won’t make it so. As a devout Catholic, I’m no more a fan of Plan B than I am of condoms (or any other form of contraception), but since neither kill unborn children, there’s no just reason for banning them. Unless someone can provide evidence that Plan B causes abortions, I suggest we stop saying it does and move on to other matters. This is a poltical albatross.
[cross-posted at RedBlueChristian]
Update: Apparently, someone at Netscape.com saw fit to link to me as one of the "pro-life advocates [who] acknowledge that use of Plan B is not akin to abortion". I’m flattered by the publicity, but I really hope the inane and fruitless "conversation" going on in the comments over there doesn’t come here. I haven’t read such consistently belligerent and vapid comments since the last time I stopped by Eschaton. I don’t always agree with my readers, but I’m almost always appreciative of them and their ability to discuss matters reasonably and intelligently in the comboxes.
Update: Let Publius know whether you think I’m a "[d]ebunker of [a] commonly-held misconception or [an] advocate of netkookery".
Addendum: Serge at LTI Blog has begun a series of posts about Plan B.
Read Part I of "Mangling, Mishandling, and Misrepresentation of Science in the Plan B Debate"
In all my searching, I have found no studies that support the notion that Plan B acts as an abortifacient. The only two proven methods of action are thickening of the cervical fluid and prevention of ovulation. The manufacturer of Plan B states that it may interefere with implantation, but I strongly suspect that they’re just covering their ass…ets.