Morning-after pills and other abortifacients

September 01, 2005

Morning-after pills and other abortifacients

How morning-after pills work
Morning-after pills can prevent or delay ovulation, thus preventing conception. Failing this, they can stop the successful implantation of the embryo by affecting the lining of the womb1. They are designed for use up to 72 hours after intercourse2.

Very few women will know precisely when they ovulate so, if they take the morning-after pill, they will not know whether it has prevented conception or caused an abortion.

Side-effects and dangers of morning-after pills
The standard dose of the Levonelle 2 morning-after pill comprises two tablets each containing 750µg of levonorgestrel that are taken as a single dose. Girls or women taking Levonelle 2 therefore receive 1,500µg of levonorgestrel in the course of a day. By contrast, the Norgeston daily mini-pill contains just 30µg of levornogestrel. Levonelle 2 thus delivers 50 times the daily dose of the mini-pill.

The summary of product characteristics for Levonelle 2, a type of morning-after pill, states that patients who have used this type of pill and who nevertheless become pregnant should be evaluated for ectopic pregnancy. Other sources3 confirm this, and ectopic pregnancies are a significant cause of maternal deaths4.

Other side-effects include nausea, vomiting and tenderness of breasts5.

Morning-after pills do not protect against sexually-transmitted diseases (STDs). The incidence of reported STDs among the under-20s increased by one third between 1995 and 19976 and such diseases can lead to infertility.

Morning-after pills and abortion
The UK government has claimed that the morning-after pill is not abortifacient because pregnancy only starts when an embryo implants in the womb7. However, when asked to name three established scientists who accepted that pregnancy only occurred once an embryo had implanted, the Department of Health could not do so8.

Implantation has been described as the fourth stage of human embryonic development9. A leading textbook on embryology10 states: "Human development begins after the union of male and female gametes or germ cells during a process known as fertilization (conception)." The Oxford Concise Medical Dictionary11 defines conception as: "The start of a pregnancy, when a male germ cell (sperm) fertilises a female germ cell (ovum) in the fallopian tube." An American public health leaflet12 states: "All the measures which impair the viability of the zygote [newly-conceived embryo] at any time between the instant of fertilization and the completion of labor constitute, in the strict sense, procedures for inducing abortion."

Contraceptive pills have been available free of charge since the mid-1970s. In addition, during recent years the numbers of morning-after pills prescribed has escalated to approximately one million packs annually13. Despite the continued availability of such substances, the trend in the total number of abortions, and in the rate of abortions, has been upwards14.

Morning-after pills and human rights
The World Medical Association has invited doctors to pledge themselves to the following commitment: "I will have the utmost respect for human life, from the time of conception; even under threat, I will not use my medical knowledge contrary to the laws of humanity."15 A leading pro-abortion gynaecologist has suggested that women and girls who ask for morning-after pills should be told how they work16. If morning-after pills become widely available through pharmacies, unscrupulous men could exploit vulnerable young women by saying: "you can always go to the chemist and get the morning-after pill."

How morning-after pills have been promoted
Marie Stopes International offered morning-after pills to millennium partygoers via the internet17. The Brook Advisory Centres wanted "everyone ready for the millennium party, party, party"18 and they planned to give partygoers "emergency contraception in advance"19. Brook is funded with public money20.

Supply through pharmacies
For some time, pharmacists were asking to prescribe antibiotic ointments for eyes and skin, yet permission was refused. Given their side-effects and dangers, morning-after pills are a very unsuitable choice as the first type of substance which pharmacists may prescribe. Morning-after pills were not the drug which pharmacists themselves most wanted to prescribe21.

If a girl or woman is prescribed morning-after pills by her general practitioner, the doctor can check her state of health and medical history for anything which might make taking such pills dangerous22. Pharmacists cannot check medical records, they may not be able to find out about patients' medical history in other ways, and they may not be able to tell if a girl is aged under 16. A patient's doctor will only be told that morning-after pills have been supplied to her if the patient agrees.

The pill is also being prescribed by Brook Advisory Centres and family-planning clinics, and these institutions do not usually tell their patients' GPs about what they have done. Indeed, Brook has said that it observes total confidentiality23. Brook's figures for 1994-5 show that more than 7,000 (11%) of their clients were under 16, of whom nearly 2,500 were given morning-after pills.

Footnotes
1 "[The PC4 morning-after pill is] primarily aimed to prevent implantation of the fertilised ovum in the endometrium." (Schering, the manufacturer of PC4)

2 A Consumer's Guide to the Pill and Other Drugs, John Wilks, BPharm, MPS, ALL Inc, Stafford, Virginia, 22555

3 Postcoital contraception-coping with the morning after, D Rabone, in Current Therapeutics, January 1990

4 Triennial Reports on Confidential Enquiries into Maternal Deaths, HMSO/The Stationery Office, United Kingdom

5 Expanding Access to Emergency Contraception in Developing Countries, C Ellertson, B Winikoff, E Armstrong, S Camp and P Senanayake, in Studies in Family Planning, 1995

6 Cases reported to clinics in England of STDs among those under 20 rose from 18,740 in 1995 to 24,981 in 1997 (Public Health Laboratory Service). Reported cases of chlamydia, an STD with minimal symptoms and which causes infertility, rose by 53% between 1995 and 1997 (Mail on Sunday, 28 February 1999).

7 "The medical and legal view is that a pregnancy begins at implantation in the endometrium, not when the egg is fertilised." (letter, Department of Health, 5 June 1995)

8 Letter to chairman of LIFE, 6 June 1995.

9 The Developing Human--Clinically Orientated Embryology, Keith L Moore MSc, 1976

10 Essentials of Human Embryology, Keith L Moore, Blackwell/Decker, 1988

11 1980

12 Leaflet 1066, US Department of Health, Education and Welfare, 1963:27

13 Pharmacy Magazine, February 2000

14 Abortion Statistics, 1998, Office for National Statistics, table 1

15 Declaration of Geneva, 1948

16 Peter Diggory, consultant gynaecologist (letter, The Independent, 2 May 1990)

17 http://www.mariestopes.org.uk/partypack_info_sheet.html in winter 1999/2000

18 Brook's "Get it sussed" campaign, Daily Mail, 12 November 1999

19 Brook's Dr Gillian Vanhegan, ibid

20 National government pays £100,000 towards running Brook's London headquarters and local authorities support its clinics.

21 Mrs Karen O'Brien, Community Liaison Pharmacist, Manchester Health Authority, Pharmacy Journal, 8 January 2000, p44

22 People with a family-history of thrombosis, high blood-pressure or strokes should not take the morning-after pill. Focal migraine and hereditary high blood-cholesterol are similarly excluded, as are pregnant women.

23 "Unless we can guarantee that we will see people in confidence, we won't see them.", Dr Fay Hutchinson, Belfast Telegraph, 19 June 1991.

from the web site of the Society for the Protection of Unborn Children