Women today seek answers and help via Internet searches when they think they may be pregnant or have had unprotected sex. Therefore, the websites of Pregnancy Resource Medical Clinics (PRMCs) are critical in reaching those women before they seek others, such as Planned Parenthood, that will steer them toward abortion and other unhealthy lifestyle choices.
PRMCs owe women information that is evidence based and accurate. Emergency contraception (EC) is also known as Plan B One Step (Morning-After Pill). Other methods of emergency contraception, such as the copper IUD and a high dose of birth control pills containing both estrogen and progestin, are not addressed.
PROMOTES THE IDEA
OF SEXUAL ACTIVITY
With FDA approval in 1999, EC has become widely available and can be purchased in pharmacies without a prescription by women over 18. (If they live in Alaska, California Hawaii, Maine, Massachusetts, New Hampshire, New Mexico, Vermont and Washington, they can get it even earlier). EC's proponents have made great claims of its effectiveness. The Feminist Majority, a pro-abortion advocacy organization states: "Is EC safe and effective? When taken within 24 hours of unprotected intercourse, EC can be up to 95% effective. Overall, EC lowers a woman's risk of becoming pregnant by 75-88%."1 (NOTE: This "fact" claim on their website does not have a medical reference supporting its conclusion.)
Many PRMC websites offer FAQs regarding emergency contraception. Of great concern is that most referenced material regarding EC comes from information claiming high rates of EC effectiveness. PRMCs must be very careful that the facts are accurate and evidence based. Claims of EC's effectiveness of 84 percent might appear to be an actual promotion or endorsement of its use to patients. We must not promote EC, as it undoubtedly acts as an abortifacient — preventing implantation of a fertilized ovum, which biologically is the early life of the unborn. Further, promotion of EC tends to promote sexual activity without consequence.
A research article appearing in the American College of Obstetricians and Gynecologists (ACOG) journal refutes the claims of EC's effectiveness based upon a meta-analysis.2 In this study, the authors "systematically reviewed data on effects of increased access to emergency contraceptive pills on pregnancy rates and use of the pills." They extracted research data from 23 studies, involving 13,654 women in 10 countries — a large analysis. This study states:
"A recent analysis has confirmed that the levonorgestrel regimen (EC, as defined above), which is the form of emergency contraceptive pills most commonly used worldwide, is significantly more efficacious after a single coital act than no treatment. . . analysis suggested that we can be 95% confident that it reduces pregnancy risk by more than 23%. But just how much more remains poorly defined; the published efficacy figures calculated from currently available data on this regimen— on average, approximately 80%—may overstate actual efficacy, possibly quite substantially." (Emphasis added.)
The ACOG article further references a study from Sweden which actually shows an increased availability (over the counter) of emergency contraceptive pills (ECP) was coincident with rise in number of abortions.3
Finally, note the ACOG study's important conclusion:
"Increased access to emergency contraceptive pills enhances use but has not been shown to reduce unintended pregnancy rates."
One reference in this above study states this conclusion: "Making emergency hormonal contraception available without prescription has improved services to women who need them, but these improvements are quantitatively minimal, preventing only five additional pregnancies per 10,000 users."4 Again, this is a far cry from the boasts of ECPs' promoters.
Why is ECP promoted in spite of its ineffectiveness?
Perhaps the almighty dollar answers this question. Planned Parenthood's websites tout ECP's effectiveness and offer it for $10-70. It is clearly a source of revenue for them. Of note: Victor Gonzalez, former CFO of Planned Parenthood's Los Angeles branch, exposed through a federal lawsuit that some California clinics purchased birth-control pills at discount prices, then billed both self-pay clients and federally funded state programs inflated prices. Through its dozens of affiliated "health centers" over several years, Gonzalez estimates, Planned Parenthood had profited over $180 million from overbilling.5
Even though EC has not proven to be effective, the ACOG authors offer this statement in its defense:
"Ultimately, emergency contraception may contribute its greatest public health benefit indirectly, by providing an opportunity to encourage women who may be in a particularly receptive frame of mind to adopt a more effective contraceptive method or to use their current method more correctly and consistently."
In other words, EC must be defended even though it is truly ineffective.
One final study, produced this year in Great Britain again confirms what numerous others have found,
"Although improved accessibility of EC has clearly led to increased use, it does not appear to have had any public health benefit in reducing unintended pregnancy rates."6
In addition to being ineffective, the use of EC provides another health concern. In India there has been a steady rise of ectopic pregnancy. This has been correlated to the increased use of EC:
"A 10-year study to evaluate the time trends of ectopic pregnancy showed a gradual but steady rise of incidence from 1/179 to 1/108. Reproductive failure constituted the major bulk but contraceptive failure is gradually increasing. Interestingly, failure of emergency contraception has emerged as another risk factor in recent years."7
NIFLA recommends that the research herein should be examined and provided to those who look to the PRMC as a trusted source of information. Review your client literature and website for accuracy in light of actual evidence-based research. Those who have financial gain from the use of EC use should be suspect as sources of reference because the basis of their claims has proven to be false.
Thomas A. Glessner is President of NIFLA (www.nifla.org) and can be contacted at (540) 372-3930 or NIFLA@aol.com. Audrey Stout is the national NIFLA nurse manager consultant.
1. "Emergency Contraception: Get the FACTS." Feminist Majority Foundation. Accessed November 15, 2012 from: www.feministcampus.org and www.overthecounterEC.org
2. Raymond, E, Trussell, J, Polis, C. "Population effect of increased access to emergency contraceptive pills: A systematic review." Obstetrics & Gynecology. Vol. 109, No. 1, January 2007.
3. Tyden T, Aneblom G, von Essen L, Haggstrom-Nordin E, Larsson M, Odlind V. "No reduced number of abortions despite easily available emergency contraceptive pills. Studies of women's knowledge, attitudes and experience of the method" [in Swedish]. Lakartidningen 2002; 99: 4730-4732, 4735.
4. Killick SR, Irving G. "A national study examining the effect of making emergency hormonal contraception available without prescription." Human Reproduction. 2004 Mar;19(3):553-7. Epub 2004 Jan 29. Accessed November 15, 2012 from: http://www.ncbi.nlm.nih.gov/pubmed/14998950.
5. Zahn, D. "Court tosses Planned Parenthood to legal 'bounty hunter'." World Net Daily, 7/03/2010. Accessed November 15, 2012 from: http://www.wnd.com/2010/07/174065/.
6. Glasier A. "Emergency contraception: clinical outcomes." Contraception. 2012 Oct 4. pii: S0010-7824(12)00786-X. doi: 10.1016/j.contraception.2012.08.027. Accessed November 15, 2012 from: http://www.ncbi.nlm.nih.gov/pubmed/23040128
7. Bag TS, Saha DP, Dasgupta N, Sarkar M, Mandal SK, Mondal T, Saha SK. "Time trends in ectopic pregnancy over a decade--a retrospective hospital-based study." J Indian Med Assoc. 2011 Oct;109(10):727-9. Accessed November 15, 2012 from: http://www.ncbi.nlm.nih.gov/pubmed/22482318