On March 31, 2005, an article appeared in the Toronto Star in which N. Jane Pepino et al. advocated the sale of 'Plan B', a 'morning after' pill (MAP), without either a prescription or the need to consult a physician or a pharmacist. The article claimed that 'Plan B' (levonorgestrel) when used as an MAP does not abort, reduces the rate of surgical abortions, and is medically safe. These claims are not correct.
'Plan B' can act as a contraceptive. It can also act to prevent an embryo from implanting in the uterus 5 to 7 days after it has come into existence. This is an abortion which surreptitiously kills the embryo before the mother is even aware that she has conceived. Human embryologists everywhere agree that a human being, a human person, comes into existence at fertilization. This is an objective scientific fact, known to embryologists for over one hundred years. Yet strange to say, it is either unknown or conveniently ignored today by many physicians, research scientists, and pharmaceutical companies who may have a conflict of interest.
On December 16, 2003, the U.S. Food and Drug Administration (FDA) review committee questioned 'Plan B's manufacturer whether MAP users understood that it has an abortion-inducing effect. Dr. Joseph Stanford of the review committee referred to the 'Plan B' Label Comprehension Study, which tabulated answers to the question what is 'Plan B' used for? 'Plan B's manufacturer included as correct answers: an abortion type of thing if you think you are pregnant and an abortion type of thing for the day after.1
Despite the claims of the Canadian Medical Association Journal2, 'Plan B' does not decrease the number of surgical abortions. A study in 2004 from Nottingham University in Scotland confirms that teens who have access to the MAP engage in higher rates of sexually promiscuous behaviour, contract more sexually transmitted infections and have higher rates of abortion than do teens who do not have such access.3
A Swedish study in 2002 showed an increase in the adolescent abortion rate from 17/1000 to 22.5/1000, despite widespread use of the MAP.4 A British Medical Journal study found that teenagers whose pregnancies ended in abortion were more likely to have used the MAP.5 A study in Glasgow, Scotland, where MAP prescriptions increased 300% from 1992 to 1997, showed that the number of abortions did not decrease.6 In Lothian, Scotland, where schools handed out condoms and sent pupils to clinics for the MAP, teenage pregnancies among 13-15-year-olds jumped 10% in one year.7 A study by David Paton of Nottingham University, has shown that between 1998 and 2001 in England, increase in family planning services and availability of the MAP without a physician's prescription was associated with an increase in the rate of sexually transmitted infections from 93.08 to 119.27. The incidence of chlamydia infection and of gonorrhea increased by 24%. This suggests that easy access to the MAP may encourage young people to engage in risky sexual activity.8
Despite claims by the World Health Organization, the Canadian Public Health Association, and the Canadian Society of Obstetricians and Gynecologists, that the use of 'Plan B' is safe, there is no proof that the use of 'Plan B' as an MAP is safe over the long term. There is a lack or absence of scientific studies on the MAP's long- term effects; repeated usage of the drug; effects on adolescents and the effects of high hormone dosage. On May 6, 2004, the FDA rejected a plan to allow the MAP to be sold over the counter at American pharmacies, citing concern that it might be unsafe for girls under the age of sixteen. On May 7, 2004, the FDA decreed that levonorgestrel ('Plan B') could not be sold over the counter until more studies are done.
It should be noted that levonorgestrel is the active principle in both 'Plan B' and Norplant (an oral 'contraceptive'). When used as a regular 'contraceptive', Norplant can occasionally cause weight gain, depression, gall bladder disease, increase in blood pressure, blood clots, and blindness. Physicians recommend that levonorgestrel should not be used as an oral contraceptive if a woman is pregnant, or has a history of unexplained vaginal bleeding, allergy to the drug, blood clots, breast cancer, pelvic inflammatory disease, or active liver disease.
The governments of British Columbia, Saskatchewan and Quebec have made 'Plan B' available by delegating authority to pharmacists to write prescriptions. How is the pharmacist expected to assess the medical history and status of his clients with any degree of accuracy? Ms. N. Jane Pepino et al., the Canadian Womens' Health Network and Health Canada want to go a lot farther however. They want 'Plan B' to be made available without the assistance or intervention of either a physician or a pharmacist. This, they claim, would reduce "needless barriers" to access and would respect a woman's privacy. They ignore the fact that this use of 'Plan B' (levonorgestrel) will rule out the proper medical counseling of many of those who engage in promiscuous sexual activity. The result will inevitably be a sharp increase in the rate of known sexually transmitted infections and other, as yet unknown, health risks to women, as well as the unrecorded killings of countless innocent newly conceived human beings. As so often happens, we will learn only too late about the devastation wrought by the morning after pill.
1 Briefing Document: F DA Transcript, Non Prescription Drugs Advisory Committee in Joint Session with Advisory Committee for Reproductive Health Drugs Meeting, Food and Drug Administration, Dec. 16, 2003, p. 288, 289. Transcript. [Back]
2 Editorial: Canadian Medical Association Journal, March 29, 2005; 172(7), doi: 10. 1303/cmaj.050260. [Back]
3 Action on teenage sex backfiring, Edinburgh News, 5 April, 2004. This study was presented at the Royal Economic Conference, Swansea, by David Paton, Professor of Industrial Economics, Nottingham University Business School. [Back]
4 K. Edgardh, Adolescent Sexual Health, Sexually Transmitted Infections, 19 July, 2002 78: 352-356. Available here. [Back]
5 Dick Churchill, et al., Consultation Patterns and Provision of Contraception in General Practice Before Teenage Pregnancy: Case Control Study, British Medical Journal, 2000 August 19; 321 (7259): 486-489. Available here. [Back]
6 Susan E. Wills, "Deconstructing Rosie". The National Review, March 28, 2002 [Back]
7 Graham Grant, "Birth Control of Teens So Pregnancies Go Up 10%" Daily Mail (London), 1 December, 2003. E D_ Sci. p.10. [Back]