Wampum

Plan B

It has been said that the definition of a fanatic is one who, having lost sight of his objective, redoubles his effort. The American Life League qualifies under that definition.

Yesterday, two expert advisory committees to the FDA voted overwhelmingly to approve the emergency contraception pill known as “Plan B” for over the counter sale. Plan B is a “morning after” pill. Plan B consists of two large doses of the very same hormone contained in the usual birth control pill.

Plan B is very effective. It prevents pregnancy in 89% of the cases if taken within 72 hours of intercourse. Plan B was originally approved in 1999 but required a doctor’s prescription. That requirement prevented Plan B from being readily available when needed.

According to Barr Laboratories, who purchased the right to manufacture and sell Plan B, making Plan B available on an over the counter basis would prevent 1.5 million unwanted pregnancies per year and would reduce the number of abortions by 700,000 per year.

One might think that a reduction of almost three quarters of a million abortions per year would please the American Life League. One would be mistaken. The American Life League is adamantly opposed to Plan B being sold over the counter.

The controversy arises out of the mechanisms used by Plan B to prevent pregnancies. Reuters reports:

Plan B contains high doses of progestin, one of the hormones used in birth control pills, to interfere with ovulation or prevent fertilization of an egg, according to the manufacturer.

But some research has suggested the pills also stop a fertilized egg from implanting in a woman's uterus, which upsets some abortion opponents.

The Boston Globe reports that Plan B works “by preventing ovulation, preventing fertilization, and preventing implantation of a fertilized egg. It has no effect after an egg is firmly implanted in the uterine wall.”

The right to life groups have seized on the possibility of Plan B preventing a fertilized egg from being implanted to make their argument against over the counter sales. The American Life League believes that preventing a fertilized egg from being implanted in the uterine wall is the equivalent of an abortion. That position follows from the belief that life begins at conception.

The Times reports:

Judy Brown, president of the American Life League, said, "The pill acts to prevent a pregnancy by aborting a child." Ms. Brown added that while Plan B may be called emergency contraception "the emergency in this case is a baby."

In the cases in which Plan B works by preventing ovulation, no egg is ever fertilized, no conception occurs and, therefore, even by the American Life League’s standards, no life is ever created or destroyed. In the cases in which Plan B works by preventing fertilization, obviously no conception occurs and therefore no life is destroyed. It is only in the instance in which a fertilized egg is prevented from being implanted in the uterine wall that an egg has been fertilized, conception is achieved and, in their view, life has begun.

Let us assume for the purpose of discussion that the American Life League wants to minimize the number of abortions. What policy, from the American Life League’s point of view, is best suited to promote that goal?

In order to answer that question, we need to make some assumptions. First, let’s assume that Barr Laboratories is correct that over the counter sales will prevent 1.5 million unwanted pregnancies and 700,000 abortions a year. Let us also assume that the reported figure of 89% effectiveness is accurate.

Since we are looking at this from the American Life League’s point of view, let us assume that preventing a fertilized egg from being implanted is the equivalent of an abortion.

There are three possible mechanisms by which Plan B works. The key point is that the mechanisms work in sequence.

If Plan B works by preventing ovulation, there is no fertilized egg to prevent from being implanted. For Plan B to destroy a life, as defined by the American Life League, Plan B must first fail to prevent ovulation, and then fail to prevent fertilization. Only if both those failures occur does the possibility of preventing the implantation of a fertilized egg come into play.

Let’s do some math.

How many fertilized eggs would be prevented from being implanted (the equivalent of an abortion from the American Life League’s point of view) by over the counter sales of Plan B?

Assume that each of the three mechanisms work in 50% of the possible cases. I chose that figure because three sequential 50% chances to prevent a pregnancy will result in an overall effectiveness of 87.5%, very close to the reported 89% effectiveness of Plan B.

The first possibility is that Plan B works by preventing ovulation. Under our assumptions, that will occur in 750,000 of the 1.5 million cases. The second possibility is that Plan B will work by preventing fertilization. That only occurs in the cases in which Plan B fails to prevent ovulation. Thus, fertilization will be prevented in half of the remaining cases for a total of 375,000 additional cases.

Only when both ovulation and fertilization occurs will a fertilized egg be prevented from being implanted in the uterine wall. That is another 375,000 cases.

Thus, over the counter sales of Plan B will prevent 700,000 abortions and will result in fertilized eggs being prevented from implanting in the uterine wall 375,000 times.

The American Life League believes that life begins at conception. It also believes that both abortion and preventing a fertilized egg from implanting in the uterine wall is the equivalent of killing a baby. If we accept those views, then approval of over the counter sales of Plan B will prevent the killing of 325,000 babies. Nonetheless, the American Life League opposes over the counter sales of Plan B.

The American Life League has lost sight of its objective but has not diminished its efforts.

Posted by Dwight Meredith at December 17, 2003 01:47 PM | TrackBack