What You Should Know About the Morning After Pill
On August 24, 2006 the U.S. Food and Drug Administration (FDA) approved the contraceptive drug Plan B for over-the-counter sales.* Plan B, manufactured by Barr Pharmaceuticals, is often called the “Morning After Pill” or “Emergency Contraception.” It is available over-the-counter to women 18 and older.** The drug remains available to women under 18, but by prescription only. 
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?
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 approved by the FDA for over-the-counter sales 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 an older type of MAP that uses a combination of hormones to achieve the same effect. 
What are the side effects of the MAP?
Possible side effects include: 
- 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
What about long term side 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? Did the FDA bow to political pressure rather than follow their normally stringent requirements for product approval?
How does the MAP work?
There are three ways that MAP can work. 
- Suppressing ovulation (female egg production in the ovary).
- Thickening mucous in the cervix which blocks sperm passage.
- 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 the 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” had 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 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.    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 directions (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?
Lets 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 liberal laws of our country call this the 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.
Can the MAP protect me from an STD?
No contraceptive or abortifacient can protect you from the growing epidemic of STDs (sexually transmitted disease). Neither can condoms provide complete protection from STDs or pregnancy. STD infection can occur in both males and females whether or not a condom is used. 
Sometimes it seems that there is a health care philosophy in America that assumes you are incapable of making choices that will completely protect you from STDs and pregnancy.
Why not tell the truth about how you can be completely protected?
The surest way to avoid pregnancy or any infection with a sexually transmitted disease is to practice sexual abstinence (abstain from any sexual contact) while single. If you marry, select a partner who is not infected with an STD and remain sexually faithful during marriage.
This is the only guaranteed, 100% effective way to avoid infection and pregnancy. All other methods leave you vulnerable. It’s your life and your decision. Make it a good one.
*Plan B has been available for some time in nine states – Washington, California, New Mexico, Alaska, Hawaii, Maine, New Hampshire, Massachusetts and Vermont to women of any age without a doctor’s prescription. It is felt by advocates of these pharmacy based programs that the recent FDA ruling will not change these programs since a pharmacist technically writes a prescription for the drug.
**Plan B in the new retail version is not expected to be available until the end of 2006. Associated Press, August 24, 2006, as reported on MSNBC found at: http://www.msnbc.msn.com/id/14497678/, accessed 8-30-06.
***The Partial Birth Abortion Ban Act has been successfully challenged in the courts. Recently, at the urging of the Bush administration, the Supreme Court agreed to review a lower court ruling that has blocked enforcement of the ban during the next Supreme Court term beginning October 2006.
- ^ U.S. Department of Health and Human Services, Food and Drug Administration, FDA News, August 24, 2006, found at: http://www.fda.gov/bbs/topics/NEWS/2006/NEW01436.html, accessed 8-29-06.
- ^ A Brief History of Emergency Contraception, Planned Parenthood Affiliates of California, Inc., Health Center, found at: http://www.ppacca.org/site/pp.asp?c=kuJYJeO4F&b=139489, accessed 8-29-06.
- ^ The Morning After Pill, What You Need to Know about Emergency Contraception, found at: http://www.morningafterpill.org/mapinfo1.htm, accessed 8-29-06.
- ^ Reardon, D. “The Best Kept (ugly little) Secret in America.” The Post Abortion Review 6(4) Sept.-Dec. 1998, found at: http://www.afterabortion.info/PAR/V6/n4/birthcontrol.htm, accessed 8-29-06.
- ^ O’Rahilly R and Müller F, Human Embryology and Teratology (New York: Wiley-Liss, 1994).
- ^ William J. Larsen, Human Embryology (New York: Churchill Livingstone, 1997.)
- ^ Carlson B, Human Embryology and Developmental Biology (St. Louis, MO: Mosby, 1994.)
- ^ Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2004. Atlanta, GA: U.S. Department of Health and Human Services, September 2005, found at: http://www.cdc.gov/std/stats/trends2004.htm, accessed 8-29-06.
- ^ Kahlenborn C, Stanford J, Larimore W, “Postfertilization Effect of Hormonal Emergency Contraception”. Annals of Pharmacotherapy 2002; 36:465-70.