Pregnancy Prevention or Abortion? New Emergency Contraception Pill Walks the Line

More than a "morning after pill", a new emergency contraceptive pill, ellaOne, can prevent pregnancy for up to five days after unprotected intercourse.

While it is not yet available in the United States, the new pill may one day offer American women yet another option for preventing pregnancy. But critics of the drug say that it is not so much emergency contraception as emergency abortion.

"This is a thinly-veiled attempt to get an abortion drug over-the-counter," said Dr. Donna Harrison, president of the American Association of Pro-Life Obstetricians and Gynecologists.

Because fertilization of egg and sperm can only be prevented within 24 hours of intercourse if the woman has just ovulated, Harrison says, any emergency contraceptive that is effective five days after sex most likely works by preventing the fertilized egg from implanting in the uterus. And if one believes pregnancy begins with fertilization, that action would be considered abortion.

"To label this as emergency contraception when it's clearly an abortive action is dishonest," said Harrison.

But according to Dr. Lauren Streicher, clinical instructor in Obstetrics and Gynecology at Northwestern Medical School, thinking that emergency contraception is equivalent to an abortion "is a big misconception."

It takes five to seven days for the fertilized egg to implant in the uterus and begin to grow, she says. She argues that if one interrupts the process before this implantation takes place, pregnancy never begins.

"There are many people who are reluctant to take emergency contraception because they think it's abortive, but it's apples and oranges," she said. "With emergency contraception, it's really to stop a pregnancy of occurring."

Not surprisingly, these differing opinions hinge on the same definitional controversy that has plagued the abortion debates for decades: at what point does pregnancy begin -- when the egg is fertilized, or when it implants in the uterus?

Because these two events can occur up to a week apart, emergency contraceptives, especially ellaOne, with its five-day window for use, walk the line in this controversy.

New Drug Revives Old Debates

Available by prescription in Europe since September, ellaOne is 50 percent more effective -- and effective for 48 hours longer -- than the "morning-after pill" or Plan B, according to new research published Friday in the Lancet.

In the study of nearly 1,700 women aged 16 to 36 who sought emergency contraception, women who took a morning-after pill had a 2.6 percent chance of becoming pregnant, while women who took ellaOne had only a 1.8 percent chance, and five-day window of opportunity to take the pill.

Researchers noted that all forms of emergency contraception are more effective the sooner after intercourse they are taken, but ellaOne was found to be even more effective -- two thirds more -- than Plan B if taken within 24 hours of intercourse.

For those who support the use of emergency contraceptives, ellaOne is an important and vital innovation that will provide more reliable pregnancy prevention.

"This is great news [because] the need for emergency contraception is so great," Streicher said, pointing out that 50 percent of pregnancies are unplanned. Among those, she said, half involve couples using contraceptives that either malfunctioned -- like a condom breaking -- or were insufficient, like a diaphragm without spermicidal foam.

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