What you should know about 

THE MORNING AFTER PILL

Take a pill and my worries are over?

After an unexpected sexual encounter, a young woman comes home, takes a pill before bed and another late the next morning.  No more pregnancy.  What’s the matter with this picture?

Recent developments in medicine have brought new dilemmas to the abortion debate.  In December, 2003, a panel of advisors recommended to the FDA (Food and Drug Administration) that the “Plan B” morning after pill be made available over the counter without prescription.  The FDA generally follows these recommendations, and in 2009, Plan B was reformulated and renamed Plan B One-Step. It is now taken in a single-dose tablet. A two-dose generic form is also available. 6

If you are a sexually active woman, or are thinking about becoming sexually active, you need to educate yourself about this subject.

What is the morning after pill?

The Morning After Pill is called MAP for short.  The version of MAP being considered by the FDA is called “Plan B”.  It consists of 2 tablets of levonorgestrel (progestin) taken 12 hours apart, generally within 72 hours of intercourse.  The Yuzpe regimen is another type of MAP that uses a combination of hormones to achieve the same effect.

What are the side effects of MAP?

Possible sides effects include: 1

• Nausea and Vomiting (especially in the Yuzpe regimen)
• Irregular and unpredictable menstrual periods (especially on multiple uses)
• Ectopic (tubal) pregnancies, which can be life-threatening
• Breast tenderness
• Infertility

What about long term effects?

In the rush to make MAP available, studies to determine the risks of long term and repeated use were not carried out.  The FDA has the responsibility of regulating these drugs and normally requires extensive testing of any drug it approves.

The chemicals used in MAPs are much like those in birth control pills.  Because of known health risks, the FDA requires a doctor’s prescription for birth control Pills.  Yet MAP pills have a much higher dosage of these chemicals.  Why shouldn’t a doctor’s prescription be required for this new high-dosage pill?  Although it would be irresponsible of the FDA to make MAP an over the counter item, it remains to be seen what happens.

How does MAP work?

There are three ways that MAP can work. 2

• by suppressing ovulation (female egg production in the ovary)
• by thickening mucous in the cervix which blocks sperm passage
• by making the lining of the uterus hostile to implantation and causing an abortion

It is, of course, the last point that is of the highest concern, especially for people who value human life.  Which leads us to a very important question:

Is MAP contraception or abortion?

Women who choose to use MAP will never know which has happened, because MAP can be both.  If a woman has not yet ovulated, MAP works as a contraceptive by suppressing ovulation.  However, if she has become pregnant, but the embryo has not yet implanted, the use of MAP is an abortion.  Chemicals such as these that cause abortion are called “abortifacients”.

Do Planned Parenthood and the FDA say it’s not an abortifacient?

Yes on both counts.  However, in order to say this, “when life begins” has to be redefined to fit the purpose.  In an effort to make MAP more acceptable to the general public, the well known truth about when life begins is simply ignored.  If you “change the rules” and say life begins not at conception (fertilization), but implantation (7-10 days later), now MAP is not an abortifacient drug.  But is this true, or just changing the truth to fit the situation?

When does human life begin?

Actually, it’s a simple biology question.  Any good text on embryology can tell you. 3 4 5  The sperm and ovum, neither of which can sustain life or direct growth by itself, come together at fertilization.  For the first time the new life has all 46 chromosomes and all the direction (DNA) it needs for the rest of life.  The sex of the baby, the color of the hair, everything is already fixed.  The only additional things required before a person dies of old age is shelter, nutrition and love.

Then when is abortion OK?

Let’s work back to the beginning.  Is abortion moral and ethical during the first 3 days after birth?  Believe it or not, James Watson, who won a Nobel prize for his part in discovering the structure of DNA, wrote this in Prism magazine at the time abortion was legalized in the United States:

“If a child were not declared alive until three days after birth, then all parents could be allowed the choice only a few are given under the present system.  The doctor could allow the child to die if the parents so choose…”

Of course, even the laws of our country call this murder of an innocent human being.  How about an abortion where all but the baby’s head is delivered and then the baby killed?  This barbaric practice was actually legal just a short time ago.  Not until November, 2003, was it made illegal when President Bush signed the Partial Birth Abortion Ban Act.

Or maybe an abortion a month before birth wouldn’t be killing a human being.  Or two months, or three months, or four.  Maybe abortion would be OK when the baby doesn’t look so cute, or when she is very small…

The fact is, nothing is really different about the human life inside the womb when you trace growth all the way back to fertilization.  Life is a continuous development from conception to birth and even until the time we die.

Sources and Resources

1.  http://www.morningafterpill.org/mapinfo 1.htm accessed 1-23-04.

2.  Reardon, D.  “The Best Kept (ugly little) Secret in America.”  The Post Abortion Review 6(4) Sept.-Dec.  1998.

3.  O’Rahilly R and Muller F, Human Embryology and Teratology (New York: Wiley-Liss, 1994)

4.  Willaim J. Larsen, Human Embryology (New York: Churchill Livingstone, 1997)

5.  Carlson B, Human Embryology and Developmental Biology (ST. Louis, MO: Mosby, 1994.)

Kahlenborn C, Stanford J, Larimore W, “Postfertilization Effect of Hormonal Emergency Contraception”.  Annals of Pharmacotherapy 2002:36:465-70.

6. Watson Pharmaceuticals Receives FDA Approval for Generic Plan B For Over-the-Counter Use; August 28, 2009: http://ir.watson.com/phoenix.zhtml?c=65778&p=irol-newsArticle&ID=1325502