November 17, 2005
Why The Morning-After Pill Is Pro-Life
By Steve Chapman
If you want to locate the dividing line between what is morally accepted and what is morally controversial in modern America, you can often find it at Wal-Mart. The retail giant declines to stock unrated movies, CDs that carry parental advisory warnings, and raunchy magazines such as Maxim and FHM. It does carry birth control pills -- but not morning-after pills.
Why is that? Because most Americans are far more comfortable with birth control than they are with abortion. The pro-life movement has long opposed the morning-after pill as abortion in disguise, not the "emergency contraception" it is supposed to be. Anti-abortion groups argue that by preventing implantation of a fertilized egg, it destroys a fetus.
That reputation has made many people justifiably leery of it. And that reputation apparently has been enough to deter the Food and Drug Administration from approving an application to allow over-the-counter sales of the medication known as Plan B.
But it turns out the reputation is groundless. The best scientific evidence we have indicates that the morning-after pill serves to block fertilization, while having no effect on implantation. That makes it contraception, not abortion.
As a longtime pro-lifer, I think anti-abortion groups had solid grounds to oppose the morning-after pill when its function was unclear -- as I did. But given what we now know, it's a grave mistake to keep opposing it. In fact, there are grounds for celebration: A drug once believed to produce abortion is found to prevent abortion.
For almost two years, the FDA has delayed making any final decision on the application -- ignoring the advice of its own medical experts, who said it should be sold without a prescription. In August, Susan F. Wood, head of its Office of Women's Health, quit in protest, saying she could "no longer serve when scientific and clinical evidence, fully evaluated and recommended for approval by professional staff here, has been overruled."
This week, the Government Accountability Office, an investigative arm of Congress, released a report that gave a withering critique of the agency's handling of the issue. It concluded that high-level FDA officials decided against Plan B before the scientific review had been done, as part of an approach the GAO described with such adjectives as "unusual," "novel" and "unprecedented" -- a polite, bureaucratic way of saying "outrageous."
Many groups that oppose abortion have no use for Plan B. The American Life League says, "Plan B aborts children and hurts women." Concerned Women for America opposes it partly because of its "abortifacient potential."
But they're aiming at the wrong target. The data that have been compiled on the morning-after pill in recent years make a convincing case that if you oppose abortion, you have no quarrel with Plan B.
In June, Chicago Tribune reporters Judy Peres and Jeremy Manier reported a surprising consensus among experts that "there is no scientific evidence the pills prevent implantation -- and considerable evidence they work mainly by blocking the release of an egg from the woman's ovary, so no embryo is formed."
They cited a study by the Karolinska Institute in Stockholm which found that the pill's effects "involve either blockade or delay of ovulation . . . rather than inhibition of implantation." Dr. David Archer, director of clinical research at the Contraceptive Research and Development Program of Eastern Virginia Medical School, said "there's no evidence scientifically" that Plan B is an abortifacient.
The GAO report agrees. The drug, it concluded, can prevent pregnancy by impeding sperm and by delaying ovulation, but it has "not been shown to cause a post-fertilization event -- a change in the uterus that could interfere with implantation of a fertilized egg."
There is no way to be 100 percent sure that emergency contraception never interferes with implantation. But the mere possibility of an adverse event is a poor reason to reject its use.
After all, breast-feeding is known to cause uterine changes that can prevent a fertilized egg from being implanted. No one in the pro-life movement would say mothers should therefore abstain from nursing. Just as nursing is morally and ethically permissible because it advances worthy purposes, so is the morning-after pill.
If emergency contraception were widely and easily available, it could prevent a lot of pregnancies that would otherwise end, tragically, in abortion. That's reason enough for the FDA to approve over-the-counter sales. For anyone who believes in the sanctity of life from the moment of conception, Plan B is not an enemy but an ally.
Copyright 2005 Creators Syndicate