POSTED: Wednesday, June 6, 2012 - 6:33pm
UPDATED: Thursday, June 14, 2012 - 6:04pm
Is the morning-after pill also an abortion pill? That's seems a continuing question. If you read some of the labels, the morning-after pills work primarily by "stopping (or delaying) the release of an egg from the ovary." But the controversy has been -- and continues to be -- whether taking the morning-after pill is tantamount to abortion.
Ella, Plan B and Next Choice (the generic version of Plan B) are morning-after pills currently all currently available in the United States. All three labels indicate the drugs work by preventing the release of an egg from an ovary. If the egg is never fertilized, there's nothing to abort.
All three labels also indicate that the pills may prevent the attachment of a fertilized egg to the uterus, which has been interpreted by some to mean it causes an abortion.
A New York Times article Wednesday looked at the science and mounting data that morning-after pills do not cause abortions and whether election year politics is fueling the debate.
Dr. Jim Breeden, President of The American Congress of Obstetricians and Gynecologists says even though the line of thinking that morning-after pills cause abortins has not gone away, the data is irrefutable.
"We've been saying that all along. It's an important distinction that the morning-after type pills prevent pregnancy by stopping ovulation so there is no fertilization," Breeden said. "I think it doesn't go away because there was some uncertainty many, many years ago as to how the method actually worked, so there was speculation that it might have impacted implantation. But nobody knew that-- there was no research that showed that."
Plan B, first approved by the FDA in 1999 for emergency contraception use, was originally manufactured by Barr Pharmaceuticals. It contains a hormone the company says has been used in birth control pills for more than 35 years. Today, it's made by Teva Pharmaceuticals who bought Barr. In 2006 the agency approved Plan B for over-the-counter use in women aged 18 years and older. It's now available over-the-counter for women 17 and older. The pill can be used up to 72 hours after unprotected sex to prevent a pregnancy.
Ella, made by Watson Pharmaceuticals was approved in 2010. It blocks progesterone, a female hormone produced by the ovaries. Watson spokesman Charles Mayr says people often confuse emergency contraception pills used to "prevent" pregnancy, with abortion pills like RU-486, also known as mifepristone.
"Ella is not an abortion pill. Ella is a contraceptive product for use within 120 hours of unprotected sex or contraceptive failure. It is used to prevent pregnancy. We recognize that people have different opinions about contraceptives and emergency contraceptives," Mayr said. "And a product that can be used to prevent an unintended pregnancy that results from a contraceptive failure or unprotected intercourse is an important option that we believe women should have. Ella has been determined to be safe, it's determined to be effective. We believe it's a valuable option but it is not an abortion drug. This drug does not terminate a pregnancy."
When asked whether the FDA would consider revising the labels of morning-after pills by dropping the implantation reference, FDA spokesperson Erica Jefferson told CNN: "Labeling of a drug may change as more becomes known about a drug after it is approved, usually at the request of a company to reflect new information from clinical trials or other scientific sources."
Asked what would help put the controversy to rest, Breeden said: "Reasonableness would be good. Actually studying the literature and trying to put pre-conceived concepts aside and actually looking at what the data and research show."
Politics, he says, is at play here. "We have been pushing very hard to make this go away, to make contraception easily assessable. We have the highest unintentional pregnancy rate in the world -- about 49%. That's 3 million pregnancies a year that are unplanned, unwanted, unintended and unfortunately, many of them end in abortion. If we had good contraceptive access we would not have so many unwanted pregnancies."
Breeden says today's literature and research shows that if these pills did prevent implantation there wouldn't be as many cases where they failed to prevent pregnancy.
He says with all the science showing that these pills work by preventing ovulation and not by interfering with implantation, a label change might go a long way toward putting some of these concerns to rest.