Emergency Contraception (EC)
May 02, 2013
Emergency contraception (EC) is opposed by anti-abortionists because they are convinced it is an abortifacient.
However, it has yet to be shown that EC causes a change in the uterus to prevent a fertilized egg from implanting in the uterine wall. EC works by impeding sperm and delaying or blocking ovulation.
Breast feeding suppresses ovarian function which results in the thinning of the uterus, which would prevent implantation if there were an egg to fertilize.
No one objects to breast feeding, so why object to either artificially blocking ovulation or preventing implantation?October 2010
Emergency Contraception News
Emergency Contraception - Behind the Confusion and How it is Available in the Bathroom of 27% of All Women Using ContraceptionApril 25, 2003, Patrick Burns
Confusion among pharmacists and the lay public is widespread, and those in the family planning movement are at least partly to blame. Some incredibility is due to the fact that: in the early 1980s and 1990s, RU-486 (now called the abortion pill) was refered to as 'emergency contraception' and not abortion, leading to confusion as to what we now call 'Emergency Contraception' really is, which is OTC abortion. At the very same time that this was going on, there was little effort to educate women about the use of regular birth control pills as emergency contraception. RU-486 is new to the U.S., but taking massive doses of birth control pills is NOT new. The Yutzpe method (developed 20-25 years ago by Dr. Al Yutzpe), when using the most commonly available birth control pills in the U.S., are that two doses should be taken, 12 hours apart, and within 72 hours of having sex. Like the Dorothy in the Wizard of Oz, most women already have access to emergency contraception. Just as the shoes on her feet got Dorothy home, so too can the birth control pills already in her cabinet (or in her friend's cabinet) get her out of the trouble she is in if a condom breaks or she has a serious lapse of judgment. For more information, see: http://ec.princeton.edu/questions/ecpuse.html
Ella is a new morning after - or emergency contraception - pill that has been approved by the US Food and Drug Administration (FDA). It prevents prevents pregnancy if taken within five days after unprotected sexual intercourse.
The pill, comprised of ulipristal acetate, can be obtained by prescription only
The FDA stressed that people should not use Ella as a contraceptive.
Ella inhibits or delays ovulation. It has been sold in Europe since May 2009 under the name EllaOne.
Women don't use emergency contraception enough to make an impact on pregnancy or abortion rates, Dr. James Trussell of the Office of Population Research said.
Emergency contraception (EC), is not well known in India. To dispel the myths associated with it and provide information Cipla launched the "i-pill helpline" service.
The i-pill is the first single-pill emergency contraception available over the counter in the Indian market today.
Emergency contraceptive pills contain common female hormones, prevent pregnancy in the first place and so do not cause an abortion.
Cipla's i-pill prevents pregnancy by stopping or delaying release release of an egg), blocking fertilisation or preventing implantation by making the lining of the uterus inhospitable for pregnancy. It has to be taken within 72 hours or three days of contraception.
The i-pill contains the hormone levonorgestrel, and when taken immediately offers maximum protection against pregnancy. It can prevent pregnancy by up to 89% if taken within 72 hours of unprotected sexual intercourse and is available without a prescription at all chemist outlets.
Abortion Rate at Highest EverFebruary 08, 2007, Telegraph
A total of 5,992 abortions were carried out last month at the Marie Stopes nine UK clinics, a rise of 13% on the 5,304 figure for January 2005. The charity believes this increase could have been caused by Christmas drinking, leading to unprotected sex.
In total, 61,983 abortions were performed at Marie Stopes clinics in the UK in 2006.
We may be seeing the consequences of the festive season. The charity offered emergency contraception in an attempt to encourage women to keep emergency contraception at home.
Some family planning groups called it irresponsible.
MSI has called for a Government-funded education campaign to alert women and men to the importance of preventing unwanted pregnancies and STIs. The British Pregnancy Advisory Service (BPAS), has seen a higher than usual number of women for abortion treatment this January. Closure of family planning facilities, GPs and pharmacists during the holiday period means contraceptive access is reduced.
Making emergency contraception available over the counter has caused controversy.
Chile's president has signed a decree so that the morning-after contraceptive pill can be given to girls of 14 without their parents' consent.
The government says teenagers have 40,000 unwanted pregnancies a year.
The Catholic Church and opposition parties are against the move; they say it is a method of abortion, which is illegal.
President Bachelet's government announced that it would allow public health centres to give the morning-after pill to girls of 14 and older, even if they did not have the consent of their parents.
However, two weeks ago, the Court ruled that the health minister did not have the power to do so. The decree signed on Monday includes an amendment which requires teenagers to receive counselling when they are given the pill.
Despite having some of the most restrictive anti-abortion laws in the world, it is estimated that in Chile 35% of all pregnancies are terminated illegally.
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The Food and Drug Administration said that it would allow Plan B One-Step emergency contraception to be offered on drugstore shelves next to other family planning products such as condoms and pregnancy tests. -- but only to those age 15 and over.
Consumers will be required to show proof of age at the register. Many of those under age 17 may not have a photo ID if they do not yet have a driver's license.
Emergency contraception contains high doses of the female hormone progestin and needs to be taken within three days of unprotected sex to prevent pregnancy; it's currently available without a prescription to those age 17 and over but is kept behind a pharmacy counter and dispensed only when the pharmacy is open.
The FDA said that women age 15 and older "understood that the product was not for routine use and would not protect them against sexually transmitted diseases" and could be used safely without a doctor's supervision.
Under the Affordable Care Act, contraception coverage without cost to women is required as part of basic health care coverage. However, despite overwhelming evidence that the ability to plan and space pregnancies critically impacts a woman's health and the health of her children, many employers are suing the federal government, claiming that the requirement to cover contraception violates their personal religious beliefs, one of which is that emergency contraception, the "morning-after pill," is the same as abortion.
Abortion foes believe what isn't true when they equate contraception and emergency contraception with abortion. They don't believe what is true when they fail to see that the best way to prevent abortion is to provide reliable birth control.
After unprotected intercourse, sperm can live in the woman's reproductive system for up to five days, waiting for the egg to be released. But the morning-after pill works by preventing the release of the egg, thereby preventing fertilization and pregnancy. It decreases the likelihood of pregnancy by about 80%.
The product descriptions for the two available medications state that blocking implantation of an embryo is a possible mechanism for these medications, but newer studies dispute this. Neither medication interrupts an established pregnancy, so the idea that emergency contraception equates to abortion is false.
Rape victims and women who have a contraceptive failure have a vital need for access to emergency contraception.
The medical practice has always helped people recover from the consequences of their lifestyle choices. We provide emergency care to people injured from risky behavior and cardiac care to patients who develop heart disease from their diet and exercise habits, and we treat lung cancer patients who smoke.
50% of U.S. pregnancies are unplanned, and 25% end in abortion. Data from the U.S. and other countries shows us that making abortion illegal does not prevent its occurrence.
A study of no-cost contraception provided to women in the St. Louis area showed that, without cost as a determining factor, more women chose the very effective long-acting methods of contraception, and had 75% fewer abortions than other women in the same region. The teen pregnancy rate in study participants was 6 per 1,000 teens compared to 34 per 1,000 for the region.
Emergency Contraception: Have We Come Full Circle?August 21, 2009, RH Reality Check
Two decades ago, Dr. Felicia Stewart began her campaign to let out of the closet "America's best-kept secret" - emergency contraception twenty years ago.
Many providers thought the method was "not effective enough," or would lead women to use it "too much" - in place of using other more effective methods.
Dr. Stewart and other women's health advocates pushed to make emergency contraception more public and more available because they saw the need for a method that could be used after sex and one that was safe enough to provide without the barrier of a medical interface. They believed that women could learn to use the method appropriately, and that women had the right to this important option.
After twenty years there are many dedicated emergency contraception products now available worldwide, women's awareness and use of EC has been increased, and, in the U.S., the direct to consumer marketing of EC by a pharmaceutical company. Also the method is popular.
Recently it has been shown that emergency contraception is not as effective in reducing unwanted pregnancy rates at a level for which we once hoped, which has slowed funding, and women are using it repeatedly instead of switching to other more effective methods. Also, by providing it directly to women we are missing opportunities to provide women with a full range of reproductive health services.
However, it should be remembered that emergency contraception fills a unique and important role in the mix of available contraceptive methods; it is effective enough to be promoted as a contraceptive option; and women's use of the method contributes in a positive way to every woman's significant challenge of how to avoid unplanned pregnancies over her lengthy fertile years.
Emergency contraception is the only method a woman can easily use post-coitally, important not only for women who have had no control over their exposure to sex, as in the case of sexual violence, but also for couples who find themselves in need of contraception after sex. Also the method is convenient compared to other methods because it can be used without having to see a doctor or health care provider.
Women are willing to pay more for emergency contraceptive pills than for a month of oral contraceptive pills. This should tell us something about what women want.
While EC did not produce the hoped-for level of pregnancy prevention, the fact is that women with enhanced access to emergency contraception do not always use it when they need it - individual women have a right to use the contraceptive method that best suits them, not the one that best contributes to overall demographic indicators.
Estimates of the effectiveness of emergency contraceptive pills range from 59% to 94%, but it is more effective than doing nothing. While it was found that the typical effectiveness of condoms and pills was much lower than their theoretical effectiveness, we did not push women to stop using them in favor of more effective IUDs or towards sterilization because it has the highest level of real effectiveness.
Providing access to a wide variety of contraceptive methods is an effective approach to helping a diverse range of women meet their reproductive needs and desires.
Women (and men), when considering contraception methods, prioritize effectiveness, but also may consider other factors, like convenience, privacy, insurance coverage, avoiding hormones, and the reputation - accurate or not - of the method. These factors change over the course of a woman's life, explaining why the average woman uses between three and four different contraceptive methods during her lifetime.
U.K.: Morning-After Pill the Choice for 50% of Young WomenMay 2, 2009, Daily Mail
The morning-after pill is the contraceptive of choice. A survey of 500 students found nearly half used the pill. 7 in 10 of those who took it did so because they hadn't used any other form of precaution.
The drug was advertised last month and is on sale online as well as pharmacies.
Critics claim easy availability of emergency contraception will encourage women to have unprotected sex.
The latest study was carried out among students in their late teens and early 20s in SW London.
A fifth said they had had more than one sexual partner in a week and one in ten claimed to have slept with at least two women in one day.
A third said they did not regularly use condoms, leaving them at risk of sexually transmitted infections.
When the morning-after pill was first approved for use in the UK, assurances were given that it would be used only in exceptional circumstances and under the control of doctors.
The morning-after pill is lulling young women into a false sense of security, exposing them to increased risk of sexually transmitted infections. Sex education isn't getting through to people.
Conservative officials in Chile are threatening the emergency contraception (EC) policies with a lawsuit that would ban EC. Under the President Michelle Bachelet's administration, all forms of birth control have been free for women over 14 at public clinics since 2006.
Conservatives argue that the policy violates the Chilean ban on abortion based on the misconception that EC is a form of abortion. Despite the Catholic influence on Chile, 49% of Chileans believe that women should have the right to access EC.
President Bachelet's administration is battling pharmaceutical companies to force them to keep emergency contraception in stock. President Bachelet has enforced legislation to ensure birth control's availability.
Morning-after Pill Not Linked to Drop in Unplanned PregnancyApril 18, 2007, Press Association (UK)
Women who receive an advance supply of the "morning after pill" have an equal chance of becoming pregnant as women who do not. This is based on studies of more than 6,000 women in the US, India and China.
EC use was higher among women given an advance supply of the birth control pills, but that did not translate to a drop in pregnancy.
We don't know if women were using EC at the times when they were at risk for pregnancy. Marie Stopes International disputed the findings. If someone has an accident and is prepared, the quicker they take emergency contraception, the more effective it is.
The British Pregnancy Advisory Service urges women to keep the pill ready at home in case they risk pregnancy.
The findings should not prevent easier access to emergency contraception. Women deserve the chance to protect themselves from unintended pregnancy. The presence of EC does not lead to an increase in promiscuity. There was no difference in sexually transmitted infection rates between the two groups, unprotected sex, condom use or changes in use of other contraception.
When Chilean President Michelle Bachelet announced that the country would provide emergency contraception to "everyone who requires it" she was aware of the storm that would ensue.
Six years ago, as health minister, Bachelet proposed giving sex abuse victims access to the emergency contraceptive pill, at drugstores by doctor's prescription.
A flurry of lawsuits, counter suits, injunctions, and constitutional challenges have pitted pro-life forces led by the Catholic Church against Bachelet's government, backed by women's rights organizations and health professionals.
Before the Supreme Court overturned a lower court ruling and banned the sale of Postinal, considering it abortifacent, the governmental drug licensing agency had already approved a second product, Postinor-2.
Even though Postinor-2 has the same components as Postinal, the Santiago Court of Appeals ruled that the plaintiffs could not represent unborn babies and that scientific or ethical determinations about when life begins are out of the court's realm of competency.
Bachelet signed into law the Regulations on Fertility that permit women over 14 to obtain Postinor-2 without parental consent.
Chilean law enacted in recent years lowered the statutory age at which minors may be tried as adults and the age of informed sexual consent to 14 years of age from 16.
Mayors of the Independent Democratic Union party, influenced by traditional Catholic doctrine, vowed to block the distribution of emergency contraception in public clinics in their municipalities, while congressional advocates have filed protective orders against these mayors. A final ruling from the Constitutional Tribunal is expected later this year.
Midwives or doctors at public health clinics administer Postinor-2, prefaced by counseling on birth control methods.
Family planning programs in Chile began in the mid-1960s, when an average 550 women died annually due to complications related to childbirth. During the same period, and with therapeutic abortion still legal in Chile, an estimated 300 women died each year as a consequence of illegal abortions.
Then-President Eduardo Frei Montalva a devout Catholic, put aside his personal beliefs to initiate free distribution of birth control methods to save women's lives. The 1973-1990 dictatorship of Augusto Pinochet maintained this family planning practice, but a lack of consensus within the Junta on penalties delayed the banning of therapeutic abortion until Bishop Jorge Medina interceded to urge the regime to enact the prohibition in September 1989, six months before the inauguration of the first democratically elected government in 17 years.
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Low-income communities have the highest teen pregnancy rates in the U.S., yet researchers from Boston Medical Center found that pharmacists in poorer areas were more often misinformed about the law and mistakenly were denying 17-year-old girls access to Plan-B. The study was published in the Journal of the American Medical Association.
Plan B, or levonorgestrel, prevents a fertilized egg from attaching to the wall of the uterus, if taken within 72 hours of unprotected sex. The drug, unlike RU-486, cannot be used to terminate a pregnancy.
In 2006, Plan B became available for purchase by adults in the U.S. without a prescription. In 2009, the age at which Plan B could be dispensed without a prescription was lowered to age 17.
"There is a lot of misinformation about emergency contraception," said senior auther Dr. Tracey Wilkinson, a pediatrician at Boston Medical Center. Box labels on the contraception -- as well as the advertising -- may not be clear, and may be contributing to the problem.
In the study, graduate assistants posed as 17-year-old adolescents and called over 900 pharmacies throughout the U.S. to see if pharmacists would dispense the morning-after pill to teens. 19% of all pharmacists and 23.7% of pharmacists in low-income neighborhoods, said they could not obtain the pill under any circumstance.
Given the controversy surrounding the drug, and the changes in the rules and guidelines surrounding access, it's "not really surprising that it permeates everywhere," Wilkinson said.
Whatever the reason for the misinformation, whether it's a problem with staff education in the pharmacies, high turnover, the relative rarity of teens asking for the drug, she said, "at the end of the day, it puts adolescents in poor neighborhoods at a disadvantage," she said.
Another problem is that a 17-year-old may be asked to prove she is 17 and she may not have a license since she isn't driving.
Susan Wood, director of the Jacobs Institute of Women's Health said emergency contraceptives should be compared to and accessible as condoms, tampons and pregnancy tests.
Even though the maker of Plan B received approval from the FDA to sell Plan B over the counter, which would make it available to all consumers regardless of age andsafety studies that show that women of all ages can take the drug safely and effectively, U.S. Department of Health and Human Services defied the FDA and prevented the drug from becoming available for sale over the counter in December.
Recently the FDA approved a new, more effective emergency contraceptive called Ensure. Quick to react, the Family Research Council started a new campaign to "encourage" pharmacists to refuse to dispense the new drug. Not surprising since they are doing the same thing with all birth control. Rep. Carolyn Maloney (D-14th/NY) and Sen. Frank Lautenberg (D-NJ) have introduced the Access to Birth Control Act (ABC Act--H.R. 5309/S. 3357) in the U.S. House and Senate.
This Act simply requires pharmacists to fill valid prescriptions for contraception and to dispense over-the-counter emergency contraception when asked, or to provide a referral to another store. Pharmacists do not have a right to interfere with a woman's private medical decisions, or to substitute their moral judgment for hers.
Last March, a United States District Court made emergency contraception (EC) for 17-year-olds available over the counter, as it is for adult women.
Russell Turk, M.D., an OB/GYN in Connecticut, made the argument to make it available to girls as young as 13. The EC pill is safer than the alternative. "Widespread availability of the morning-after pill has the potential to prevent unplanned pregnancy and abortion - both of which pose far greater risk and hardship to teen girls."
The longer a woman waits to get the pill, the less effective it will be. Therefore the more hurdles we put between EC pills and the young women that need them, the more likely it is for a young teen girl to be faced with the choice of abortion or risky pregnancy.
It is ironical that once a girl is pregnant, she's legally considered an ‘emancipated minor' - which means she can make medical decisions of a much more serious nature without adult supervision. And yet we can't trust her to make a decision that will keep her from getting pregnant?
U.S.: Take Realistic Approach Toward ContraceptionMarch 26, 2009, Des Moines Register
America's teenage birth rate is among the highest in the developed world. So it is good news that a federal judge's order that the FDA make the Plan B morning-after birth-control pill available without a prescription to women as young as 17.
The FDA must review whether to make the emergency contraceptive available without a prescription for women of all ages.
Critics claim making Plan B available will promote promiscuity. Yet many teenagers have sex before they are mature enough to make such a decision. What's needed is to better educate them about how this can affect their lives so they wait until they are older.
The Centers for Disease Control says it's not that U.S. teens have more sex than teens in other countries; it's that they are less likely to use contraception. In 2002, French officials allowed minors to obtain emergency contraceptives - with counseling - from a pharmacy at no cost, and without a parent's permission.
U.K.;: Women to Be Able to Get Pill on Demand at Local PharmacyDecember 13, 2007, Guardian (London)
Women will be able to get the contraceptive pill from their chemist under new plans revealed by the government.
They will be able to walk into the chemist's and obtain the pill after a discreet conversation with the pharmacist.
It had not yet been decided whether girls under 16 would be able to get the pill without their parents being informed. The morning-after pill is already available to women including under-age girls from a pharmacist, if he or she is satisfied that they are competent to make the decision to take it and are in good health.
Any woman getting the pill would involve a questionnaire about her health and other medication she might be taking. It could also mean that the pharmacist would take her blood pressure.
Pharmacists will be given extra training. The move towards pharmacy availability is intended to make life easier for women. Pharmacies could play an increased role in the provision of contraception and other sexual health services because of their accessibility and convenient opening hours.
For the change to come about, strategic health authorities must issue instructions called patient group directions, permitting pharmacists to prescribe specific medicines to specific groups of people.
Not only the morning-after pill but also cholesterol-lowering statins are available from pharmacists, who carry out checks to ensure the drugs are suitable for those who request them. The Department of Health wants to increase the range of medicines available this way.
US Wisconsin;: Rape Victims Advocate Requiring Morning-after Pill at HospitalsApril 26, 2007, Associated Press
Rape victims testified in support of a bill that would require Wisconsin hospitals to provide Plan B. Opponents likened taking the pill to having an abortion but supporters argued that it only stops a pregnancy from occurring.
The bill is needed because a majority of hospitals do not offer the pill to rape victims.
About a third of the state's hospitals are affiliated with the Catholic Church and those hospitals give rape victims emergency contraception if a test shows no pregnancy has already occurred. The Catholic Conference will not oppose the bill as long as it allows hospitals not to administer the pill to women who tests show they are pregnant, but the bill does not define when pregnancy begins.
Any action that destroys a fertilized egg is akin to an abortion, said Pro-Life Wisconsin. And because it is difficult to determine whether fertilization has occurred when the drug is given, the potential for causing an abortion exists.
The committee took no action on the proposal, which has been pushed unsuccessfully three times in recent years.
US Oregon;: After 14 Years, Time Could Be Now for Contraception BillFebruary 25, 2007, Associated Press
Bills that would require private insurers to cover the costs of prescription birth control have been around the Oregan Capitol since 1993, only to die quietly.
But 14 years on, it looks like the proposal has some real traction. Twenty-six other states have moved to establish such coverage.
Oregon opponents have included the influential Catholic lobby, and private health insurers, who tend to bristle at any talk of government mandates.
Supporters were encouraged that both parties signed off on a bill mandating that insurers fully cover mental health treatments, suggesting that they're open to some government-imposed requirements on private insurers.
It is much cheaper to cover the cost of the prescription birth control than the cost of labor and delivery for an unplanned pregnancy. Nationally, figures from a reproductive rights organization show that about 50% of traditional fee-for-service health plans offer no coverage for contraceptives.
HMOs offer more complete coverage, while newer types of managed care plans offer a bit less coverage.
Offering coverage of the most-used contraceptive methods would cost an average of $1.43 per month per employee. The bill requires that Oregon hospitals must inform victims of sexual assault about emergency contraception, and dispense the pill if women ask for it. In 2003, Oregon lawmakers established a fund, fed by private donations, to pay for emergency contraception for sexual assault victims but not every hospital is making use of the funding.
The Oregon Association of Hospitals and Health Systems are evaluating the mandate to offer emergency contraception.
Most of the state's largest hospitals have been regularly reimbursed from the fund for emergency contraceptive costs for sexual assault victims. Smaller hospitals have not sought reimbursements over the last two years. Missing from the proposed legislation is any clause that would allow hospitals or doctors to opt out of providing emergency contraception. Although 18 states allow employers and insurers to refuse to cover birth control, the Oregon proposal contains no such language.
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