Why this pharmacy does not sell the 'morning-after' pill.

John Wilks
February 18th 2004
Reproduced with Permission

Why this pharmacy does not sell Postinor-2; the 'morning-after' pill (MAP).

1. Scientific studies have provided strong evidence indicating that for many women the 'morning-after' pill (MAP) does not stop a pregnancy from occurring. Researchers have said that this drug acts in at least two ways to end a pregnancy that began at fertilization:

• By damaging the lining of the womb so that implantation of the human embryo - the unseen patient - cannot occur.1
• Research in mice has also indicated that if an embryo attaches to the womb, the body reabsorbs it, thereby ending the embryos life.2

Because the MAP can act via these two methods, it must be classified as an abortifacient - a drug that can cause an abortion.3 The fact that the MAP reduces the expected pregnancy rate by 87% supports the claim that it frequently acts to end the life of a human embryo.4

Therefore, due to the danger to the health of the human embryo caused by the MAP, my Code of Professional Conduct, parts 1.1 and 1.2 forbids me from selling this drug.5

2. The 'morning-after' pill is also very dangerous to a woman's health. Scientific reports have proved that:

• The 'morning-after' pill causes an increase in the incidence of ectopic pregnancies (lodgement of the human embryo in the Fallopian tube rather than in the womb.)6 In one of these cases the affected Fallopian tube had to be surgically removed. As a result these women have a greatly reduced possibility of a future pregnancy.
• The 'morning-after' pill can also have serious interactions with prescribed medications. The British Medical Journal has reported that the 'morning-after' pill can interfere with warfarin medications.7,8
• Dr. Ellen Grant, writing in the Lancet (2001) has expressed the concern that "... 5% of women have a genetic susceptibility to thromboembolic disease (blood clots)." When these women take the 'morning-after' pill - which is equal in strength to taking 50 regular birth control tablets - a blood clot might form.9
• There is concern that the very high dose of hormone taken in the 'morning-after' pill might 'kick-start' cervical cancer if a woman is already infected with human papilloma virus.10

In summary, because of these dangerous medical consequences associated with the 'morning-after' pill and my professional duty-of care responsibilities, we do not sell Postinor-2.

John Wilks B. Pharm., MPS, MACPP
Consultant Pharmacist.
February 18th 2004

Endnotes

1 Ugocsai G, Rozsa M, Ugocsai P. Scanning electron microscope (SEM) changes of the endometrium in women taking high doses of levonorgestrel as emergency postcoital contraception. Contraception. 2002;66:433-437 [Back]

2 Shirley B, Bundren JC, McKinney S. Levonorgestrel as a postcoital contraceptive. Contraception. 1996:52(2):277-81 [Back]

3 Moore KL, Persaud TVN. The Developing Human: Clinically Orientated Embryology (6th edition. Philadelphia: W.B. Saunders Company 1998) [Back]

4 Wellbery C. Emergency Contraception. Arch Fam Med 2000; 9:642-64 [Back]

5 Policy - Code of Professional Conduct. Pharmaceutical Society of Australia. Endorsed by National Council March 1998. [Back]

6 Sheffer-Mimouni G, Pauzer D, Maslovitch S et al. Ectopic pregnancies following levonorgestrel contraception. Contraception. 2003;67:267-269 [Back]

7 Ellison J, Thomson AJ, Greer IA. Apparent interaction between warfarin and levonorgestrel used for emergency contraception. BMJ. 2000;321:1382 [Back]

8 Richards D. An Important drug interaction - an alternate mechanism. BMJ Rapid responses. 22 December 2000 [Back]

9 Grant E. Adverse reactions and emergency contraception. Lancet. 2001;357:1201 [Back]

10 Chen Y-H, Huang L-H, Chen T-M. Differential effects of progestins and estrogens on long control regions of human papillomavirus types 16 and 18. [Back]

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