Tuesday, January 18, 2005

Plan B, the 2nd time around

What if there were a way that we could safely and effectively reduce unwanted pregnancies and therefore reduce abortions as well? Well, there is a way, but access to it right now is prescription only as a result of some unfounded arguments by opponents of the drug.

Although the FDA initially rejected the application to make Plan B an over the counter drug, Barr pharmaceuticals is trying again.

Turns out, the arguments against the drug were bunk:
"Our findings were that women don't change their sexual behavior when the drug is easily available, but rather that they're more likely to use it if access is easier," said lead author Tina R. Raine of the Center for Reproductive Health Research and Policy at the University of California at San Francisco.

So, considering a scientific study now proves the obvious (that women aren't going to change their sexual behavior as a result of the availability of a drug that is relatively expensive if used frequently, not 100% reliable, and causes physical discomfort), I'd be interested to see where this goes. I for one, like the editorial staff at WaPo sincerely hope that social conservatives and liberals alike can look at the science and potential of this drug and realize that it has the power to affect enormous social good.

Edit>> Please see a discussion on some controversial aspects of this drug by Dr. Drew Pinsky that I also mention in my comment as his views have heavily influenced mine on this issue, and he is more qualified to speak on such items than I.


At 12:49 AM, Blogger Nick said...

Strictly speaking, what is considered the moment of conception? More specifically, do social conservatives consider it fertilization or implantation? If Plan B sometimes works by "inhibit[ing] implantation," as that link you provide states, then anyone who considers life to begin at fertilization is probably going to have a beef with this drug. This is only an issue, of course, if social conservatives do believe life to begin at fertilization, a subject on which I'm ignorant - anyone out there know?

Also, keep in mind that a number of denominations (Catholicism, first and foremost) continue to regard even contraception as a sin and thus would find this drug anathema.

I would think the combination of those two factors could create a decent amount of political opposition to this drug should the FDA ever legalize its over-the-counter sales.

At 1:09 AM, Blogger Chris said...

Good points all Nick. I was rushed while writing the post and didn't address them even though I should have.

My understanding is as follows: the drug functions much like a birth control pill (ortho tricyclen.) In fact, chemically that's essentially what it is: an extra strong dose of the birth control drug that uses hormone manipulation in order to prevent conception and any further release of eggs.

I'll quote Dr. Drew Pinsky M.D. here as saying that Plan B "DOES NOT PREVENT IMPLANTATION" (he would consistently say this back when I used to listen to him on the radio...on hfs actually) Also, nice Discussion by Dr. Drew here on his position on the drug. Money Quote:

"It turns out that the morning after pill -- or emergency contraception -- works exactly the same way as the daily birth control pill. There is really no difference whatsoever. The morning after pill is basically a double dosage of contraception used within 72 hours of unprotected intercourse. The daily contraceptive pill that many women take suppresses an egg from being released by an ovary. Hence, there can never be fertilization. However, there is a small risk that an ovulation could occur, and if it does, there is also a small risk that the pill could impede implantation of that fertilized egg."

He goes on to argue that this statistically insignificant risk of preventing fertilization would also mean that to be philosophically consistent, the conservatives railing against the drug would have to campaign against all forms of oral contraception. Oh, and apparently Vioxx and Celebrex (obviously this article predates the whole Vioxx fiasco), but that CERTAINLY was not one of the arguments I ever heard against Merck for the recent problems with Vioxx.

The main point here is, well over 99% of the time it doesn't even present the problem of preventing implantation and therefore ALMOST NEVER (IF EVER) DESTROYS A LIFE BY ANY STRECH OF THE DEFINITION OF WHEN LIFE STARTS.

Plus, we have to make real life moral tradeoffs, and so even assuming a small number of recently conceived zygotes are prevented from being implanted in the uterus (which, interestingly enough is the point at which Mormons believe life starts-- i think), the availability of this drug would prevent A LOT of unintended pregnancies and thus significantly reduce abortions. For that reason it really surprises me why anti-abortion activists aren't also picketing for easier access to Plan B.

At 9:42 PM, Anonymous Anonymous said...

Hey guys, this is Tencia - I know Nick and Jesse, but I believe I've never met the other two of you...I do not understand Dr. Drew's explanation of how the drug works. My understanding (from 5th grade health, but nevertheless I've never heard differently) is that a woman conceives almost immediately after having sex, assuming that an ovum has already been released. If no ovum has been released, she does not conceive, and if one does, then it has already been fertilized by the "morning after" and is simply awaiting implantation. Thus by my understanding the "morning after" pill, if it works after the fact, HAS to impede implantation if it is going to actually prevent a pregnancy. This doesn't make a lot of sense.

^ The fertilization process takes up to twenty minutes, and after that it is a zygote. But then again, this is Wikipedia.

At 10:05 PM, Blogger Chris said...

Actually, conception can take several days:

From Wikipedia: "Emergency contraception's only proven mechanism of operation is preventing ovulation in the same way as the normal birth-control pill, so that fertilization never occurs. This would explain why the morning-after pill is not effective all of the time, and why its effectiveness increases the sooner it is taken after intercourse. It is a common misconception that fertilization always occurs immediately during intercourse. There is only about a 24-hour window for fertilization in each menstrual cycle, so sperm have the ability to stay alive for several days after intercourse, waiting for an egg to be released."


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