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Controversy Over The New Emergency Contraceptive Approved By The FDA

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I recently wrote a post about the controversial proposal of making birth control pills available over-the-counter, and in even more controversial news, on Friday the FDA approved a new (prescription only) emergency contraceptive. This new emergency contraception is not the morning after pill, but it's not an abortion pill either.

From The New York Times:

Federal drug regulators on Friday approved a new form of emergency contraceptive pill that prevents pregnancies if taken as many as five days after unprotected intercourse.
. . .
Women who have unprotected intercourse have about 1 chance in 20 of becoming pregnant. Those who take Plan B within three days cut that risk to about 1 in 40, while those who take ella would cut that risk to about 1 in 50, regulators say.

The controversy surrounding emergency contraceptives comes mainly from the pro-life (or anti-abortion) community, which is confusing to me because there are hopes that these medications could someday reduce the need for clinical abortions. The main sticking point seems to be that this group of people believe that life begins the moment of conception (or fertilization), and that these emergency contraception medications "abort" a fertilized egg.

From the Catholic News Agency - Pro-life groups denounce new drug:

After the Federal Drug Administration recently approved the new drug ella, which is being marketed as emergency contraception, numerous pro-life groups reacted strongly to the move, claiming that the pill acts as an abortifacient.

However, not only are emergency contraceptives NOT abortion pills, but it's a misnomer that fertilization will have always taken place before the woman uses the medication.  Fertility experts are the best at explaining how this is possible, here is an excerpt from FertilityFriend that might help you understand when fertilization takes place.

Your fertile window is made up of the days in your menstrual cycle when pregnancy is possible. The length of this fertile phase is determined by the maximum life span of your partner's sperm and your egg. Sperm can survive a maximum of five days in fertile cervical fluid and your ovum can survive for up to one day. Your theoretical fertile window is thus six days long, comprised of the five days before ovulation and the day of ovulation. You only have a chance to conceive when you have intercourse on these days. This means that pregnancy is technically possible from intercourse on any of these six days.

Basically, a woman can become pregnant even if she doesn't ovulate until five days after intercourse.  Therefore, these emergency contraceptives are blocking the sperm from fertilizing the egg in the first place, just like other methods of birth control -- and NOTHING like an abortion.  Here is a quick video that talks about how this new contraceptive works...

In addition, even when women are trying to become pregnant, it is believed that up to 50% of fertilized eggs never make it to the implantation stage, and of the ones that do, about 30% will still be lost. Most of the time the woman does not even know she had been pregnant. So when it comes to emergency contraceptives, most of the time there isn't even a pregnancy to prevent -- it's just used as a precaution -- and of all the possible pregnancies that it does prevent, more than 50% would have ended even without the use of emergency contraceptives.

My personal opinion...Since you can't force a woman to want a pregnancy that she doesn't want, it seems the option of preventing one would be better than having to end one.

What do you think?  I would love to hear your thoughts in comments.

On a side note, if birth control pills become available over-the-counter, they can also be used as emergency contraception. This is from a post by Deborah Mitchell -- 5-Day Emergency Contraceptive Named Ella:

Birth control pills also can be used as emergency contraception when they are used as directed by a physician, as each type requires a different dose to be effective. These pills contain two hormones, progestin and estrogen. When started within 72 hours after unprotected intercourse, birth control pills reduce

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ClaireF21 5 pts

The last line of your argument untangles the whole thing. "...of all the possible pregnancies it does prevent..."

You are arguing that because many pregnancies result in miscarriages that aborting a cell dividing fetus should be fine. The news is: we are dividing cells from the moment we are conceived until the moment we die. It's our DNA that makes us human, not the number of cells we have. To give a base number of cells one must have to be human is a false argument based on faulty logic.

Exactly how many cells does one have to have to be a "viable" human being? How many cells exactly must I have to be a mature adult? What is the exact number? What if I fall below that number during my adulthood through a process like...liposuction or a tummy tuck? Am I no long an adult, or even a viable human being? What if I lose quite a lot of blood during an accident, and then they amputate my legs and part of a lung? Am I no longer a viable human being then? In reality, I am just a dividing cell mass all through out my life cycle.

The only choice a woman has is whether or not she will use contraception and be reproductively responsible BEFORE there is a possibility of conception. The next step is sharing her body with another person. Whether modern women want to admit this fact or not, that is how life is created for humans, or mammals if you want to be technical. We share, and it is on the female to do it. Sorry ladies, there is no socio-political movement that will get you out of this one. It's called personal responsibility before hand and after. And you don't have to raise him or her, there is always adoption.

Claire F. came from intergenerational debt and is transitioning into wealth. She lives by the motto: Life is easy when there is buck in the bank and a boy in the bed! Follow her at www.buckinthebank.blogs ( http://www.buckinthebank.blogspot.com )

Catherine Morgan 5 pts

Are you saying that a woman shouldn't "jog" after unprotected sex because she may "abort" a potentially fertilized egg? I can't imagine there is any scientific information backing a statement like that?

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

crashtestdoll 5 pts

Absolutely agreed. EC is also a good and practical solution to women and girls who can't afford an abortion either (I actually had a friend whose sister had a baby because she couldn't come up with the $900 at the time and her pro-life family refused to help her. Obviously she can't afford the baby either so it essentially is now raised by her parents who still somehow manage to blame her for having unprotected sex).

crashtestdoll 5 pts

Exactly! Thank you for being a voice of reason!

"The pill makes the uterine wall become thinner, which can hinder implantation. And if the embryo cannot implant and dies, to some folks that means it’s aborted."

Essentially, anything that you do that is less than creating a perfect environment for pregnancy is considered abortion. If life begins at the very moment of conception, you really shouldn't be jogging during that window before the egg implants, otherwise you just aborted your baby and ended a life.

crashtestdoll 5 pts

I think that is kind of redundant. There is no way to know if the egg is fertilized or not, thus there's no way to know if you are preventing the sperm and egg from joining or preventing the "baby" from getting you pregnant.

If fertilized egg = life, don't take the pill. Simple as that. You will never know at which point it prevented pregnancy so it's pretty obvious you shouldn't take the pill and hope the egg wasn't already fertilized, because then you just committed murder.

I kind of see it as trying to have it both ways, trying to be pro-life and still squeak by ending a "life" by the narrowest margin. Why would you do that to yourself?

Pro-life groups already came out against ella, could a pro-life woman sincerely tell her pro-life group that ella only prevented the union of sperm and her egg but did not prevent her fertilized egg from implanting in her uterus, without being intellectually dishonest? I think both the pro-life and pro-choice groups would look at her as trying to pull a fast one.

crashtestdoll 5 pts

"Is a fertilized egg bouncing around in there suddenly not considered a baby?"

It never was considered a baby and there is nothing sudden about it.

You can argue "well, but to me PERSONALLY, it is my OPINION that it's a baby," fine. But that still doesn't change that a fertilized egg is not a baby.

There is a difference between FACT and OPINION. You can argue your opinion until the cows come home, but it doesn't make a lick of difference in the fact.

And the fact is that a fertilized cluster of cells is not a baby. When you have in vitro done, you don't say "I have babies in me" and you don't go buy diapers. You wait until the eggs implant first. You are wrongly putting the "baby" ahead of being pregnant. There is no possible way by any stretch of the imagination that those cells can constitute a baby without the process of pregnancy, unless you want to write a sci-fi novel.

That's why THE LAW does not recognize those cells as a "baby." Do you even think about the far-sighted consequences of your bloviating and obfuscating? ALL the "fertilized babies" sitting in cryogenic suspension now have a right to be born. Even if they are YOUR fertilized babies. People are not property, and just like you can't murder a newborn just because it's "yours," you do not have ownership of those fertilized cells by your definition. So someone could come along and implant your fertilized eggs, and there is nothing you could do because no one can own another person.

Here's a better idea: since YOU have a definition of "abortion" different than the FDA, yes, it is up to YOU to research the issue for yourself. The FDA can't have a patchwork of words that are up for negotiative interpretation ("So what exactly do you mean by 'causes sleeplessness'? Does that mean insomnia? What does sleeplessness even MEAN? What does SLEEP even mean?! Are we talking REM-stage true sleep or just dosing off?").

If you are that pro-life, it would probably be better if you played it safe and didn't take ella; if there's already this much hand-wringing from you over debating an already settled word, the anguish that would come after taking ella increases exponentially and I'd hate to see this level of confusion multiplied intensely.

oviedostyle 5 pts

I am not against abortion, but I don;t think they are a great thing either. Emergency contraceptives on the other hand are necessary in our society.

We live in a world with millions of uneducated people with free will and we also have to deal with the problems of overpopulation.

EC's are a good thing. Unwanted children and parents who are unable to afford their care is a bad thing.

Leah Oviedo - Micro Grants & Free Resources, http://iiwomen.com ( http://iiwomen.com/New/index.htm )

lauracarroll 5 pts

With all that is out there on this, I have read that the pill most often works to prevent ovulation, and thicken cervical mucus to make it harder for sperm to reach the egg (if ovulation has occurred).

But if the woman does ovulate, and the sperm does happen make it to the egg, conception occurs. The pill makes the uterine wall become thinner, which can hinder implantation. And if the embryo cannot implant and dies, to some folks that means it’s aborted.

Some docs say the pill’s primary effect is inhibiting ovulation, and the bulk of the evidence says it does not affect implantation. Others say that if the woman ovulates, the uterine lining responds and thickens, not thins, thus not making the pill an abortifacient.

So it seems the pill can hinder implantation, but it’s not a given. Women who believe life begins at conception in particular would want to know this.

Claiming the pill works as an abortifacient really depends on when you think life begins. At conception? Implantation? 1st trimester? 2nd trimester or when the embryo could potentially survive on its own? At birth?

People may need to be more fully informed about how the pill works, and if you believe life begins at conception, you may very well view the pill as a potential abortifacient.

Laura
Families of Two
http://lauracarroll.com

Catherine Morgan 5 pts

Thanks AV. I totally agree...It's wonderful to be part of a community that understands we can disagree without being disrespectful.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

avflox 5 pts

When I saw this post had comments, I braced myself for the adrenaline that would no doubt overtake my body the moment I laid eyes on them.

I have never seen a discussion on the matter occur in a civilized fashion, with both sides presenting actual data and looking for a conclusion.

I was astonished to find that this one was one such discussion. Now I feel as though I've encountered some sort of mythical being and I haven't the words to express my own opinion -- simply awe that this community knows how to have discussions and does it in a civilized and enriching fashion.

Thank you all for having this conversation. I think it's a giant step toward the sort of discourse this nation needs as it regards these topics.

AV Flox is the editor of Sex and the 405 ( http://sexandthe405.com ) -- what your newspaper would look like if it had a sex section.

Catherine Morgan 5 pts

Thanks Elisa. Yes, we would find common ground, I would find that 100% acceptable.
I'm only against the word "abortion" used to describe the action of this contraceptive.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

SewSweetStitches 5 pts

Taken straight from http://www.accessdata.fda.gov/drugsatfda_docs/labe...

"In addition, it may inhibit implantation (by altering the endometrium)."

Elisa Camahort 5 pts

...it's not about listing another side effect, but rather putting this disclosure line in as prominent a position as the side effect:

"ella is thought to work for emergency contraception primarily by stopping or delaying the release of an egg from the ovary. It is possible that ella may also work by preventing attachment (implantation) to the uterus."

Catherine, if my understanding is correct, would you object...and if not, have we then just found common ground?

:)

Elisa Camahort Page
BlogHer
elisa@blogher.com
My BlogHer profile truly shows you everything I do online...Check it out!!

Catherine Morgan 5 pts

I'm sorry, I'm still confused...What would the danger or side effect be listed as?

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

SewSweetStitches 5 pts

Oh no, I'm not saying they should be labeled as abortion pills at all! No matter what you believe about exactly when life begins, it would be false to say this pill ALWAYS causes an abortion.

I would be satisfied if the one line about inhibiting implantation was brought forward and stated obviously. Like (for example) how medication commercials very carefully state the dangers and side effects in open, clear terminology.

Catherine Morgan 5 pts

Hi SewSweetStitches, I totally understand how emotions can cloud intentions (it happens to me all the time).

I'm just not sure exactly what more can be added to the labeling of these drugs that would be acceptable to you? I could never support the idea of adding the word "abortion" to the description of what this medication does...It seems that would be even more misleading (if not total deception) due to the fact that no medical or scientific definition is even remotely similar to the actions of this medication (that is taken only 1-5 days after unprotected sex).

I'm just wondering if you would only be satisfied if the word "abortion" was used in the description of these medications? If that's the case, I really don't know what else I can say.

Thanks for commenting. And although I don't share your belief system, I do respect it, and I hope my comments are not coming off as disrespectful in any way.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

Catherine Morgan 5 pts

Hi Elisa. I am totally FOR full disclosure, I just don't believe the word "abortion" should be added to the labeling of emergency contraception. By definition, these contraceptives are not even close to an abortion...

Abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus or embryo, resulting in or caused by its death.

I'm not trying to be disrespectful to anyone's belief system about when life begins (and I hope I am not coming off as disrespectful), I just think that any reference to these medications being "abortion pills" is totally misleading and not at all accurate.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

Jill Miller Zimon 5 pts

Thanks for the time you're investing in this.

(Btw, I don't consider my not looking up the info the way you do - I don't expect the gov't to do everything for me at all - I check a gazillion resources for everything, and I'd be shocked if a woman considering this medication would NOT do some research - esp if she is a woman who is like you in terms of seeing the gravity of the med's implications.)

If I've missed it, my bad, but could you please re-state, then, the exact single line of information you say you want that you believe is currently missing?

I'm reading your comments to mean that you want the word "abortion" used, and not the medical terms for what medically speaking actually happens with our anatomy and from a medical perspective (as opposed to the subjective - well, what you previously called subjective). But maybe I'm wrong in that. I just find your comments to be a lot about saying what you don't like but not saying a lot about what exactly you believe would fix the situation.

Thanks.

Jill Writes Like She Talks ( http://www.writeslikeshetalks.com )

In The Arena: Jill Miller Zimon, Pepper Pike City Council Member ( http://jillmillerzimon.blogspot.com )

SewSweetStitches 5 pts

Do you mean, does what is already included satisfy me? (I might be misunderstanding your question.) If that is what you mean, then no it does not. I already had that information before visiting this discussion, but only because I went digging for it.

That's exactly what I shouldn't have to do. Just because my standards differ from the FDA's, (as the standards of many women do,) I shouldn't have to research the fine print to determine if what they're saying about the pill not terminating pregnancies is true.

All advertisements for medication include a disclaimer at the end about side effects. This used to be a rushed auctioneer-style statement like a car sales ad. Now it's very prominent, spoken slowly and in common terminology. It's impossible to miss.

Why can't this be the same? I'm positive there are millions of women out there who share my views and consider that one little tiny sentence in the fine print to be of utmost importance, life or death.

I realize I'm not going to win over any opinions that this shouldn't be touted as an alternative to abortion. But I stand firm that hiding a very important fact in a mile of fine print terminology is misleading to a large portion of consumers.

Jill, the fact that you weren't willing to go on a research venture to find the FDA's exact language proves my point. While all women should behave with a measure of responsibility for educating themselves about their bodies, they shouldn't have to dig to find the information they need.

And they shouldn't be presented with the opinions of one medical professional (a nurse in this case) as pure fact without any other information to support alternative viewpoints, especially on a website/network established to support women.

Jill Miller Zimon 5 pts

And if not, why not?

(Denise - can we saint you while still alive? I thought about "if only I could SEE the exact language" but I honestly wasn't going about finding it - thank you!)

Jill Writes Like She Talks ( http://www.writeslikeshetalks.com )

In The Arena: Jill Miller Zimon, Pepper Pike City Council Member ( http://jillmillerzimon.blogspot.com )

SewSweetStitches 5 pts

I understand what you're saying. I feel like that's a little inconsiderate to people who don't happen to share the FDA's view of when life begins.

For example, if I was allergic to peanuts, I would trust the label of a food product to tell me whether or not it was ok to eat that food. Not only would the label say, "contains peanuts", it would also say "made in a factory that manufactures foods with peanuts." So even if it didn't TECHNICALLY have peanuts in it, they're not pretending that it isn't possible peanut traces could be there for the sake of selling more product. Who's to say what a peanut trace is? What level of peanut trace actually makes a peanut trace? Not the point! I shouldn't have to google the food factory to make sure there aren't going to be any peanut traces.

The point is the disclosure up front, JUST IN CASE, to satisfy everyone. That's a pretty far-out example, but no farther than comparing an unfertilized chicken egg to a fertilized cell.

SewSweetStitches 5 pts

Sometimes I let my emotions cloud my intentions. This is something I feel strongly about- A matter of life and death. Further assertions that I should comfort myself with the idea that terminating a cell is somehow less horrifying than terminating a baby adds to my vexation.

What Elisa said is exactly how I feel, emotions aside.

I don't feel that women are given enough information to make their own educated decisions.

Thank you, Elisa, for digging through my ramblings to find the heart of the matter :)

Mom101 5 pts

I am also for disclosure, but what I'm seeing from SewSweetStitches is: The wording used with these medications is deceptive. It says that it will not abort a pregnancy, yet it says it will "inhibit implantation by altering the endometrium." Is a fertilized egg bouncing around in there suddenly not considered a baby?

In other words, let's change the medical and scientific definitions of "baby" and "abortion." Let's treat cells as babies and call the inhibition of implantation, an abortion.

Is that disclosure? Or is that semantic shenanigans, hoping to advance a particular agenda?

Making millions at Mom-101 ( http://mom-101.com )

Denise 9 pts moderator

I totally agree, there should be a disclosure about how ella works so that women who do not want to delay ovulation or prevent implantation can make an informed choice.

And the ella prescribing info ( http://www.accessdata.fda.gov/drugsatfda_docs/labe... )(Pdf) does disclose this information:

ella is thought to work for emergency contraception primarily by stopping or delaying the release of an egg from the ovary. It is possible that ella may also work by preventing attachment (implantation) to the uterus.

~Denise
BlogHer Community Manager
Life. Flow. Fluctuate.

Jill Miller Zimon 5 pts

Though I think what you suggest would be fine with me, I didn't read her comments to suggest that that's what she would like.

I would ask SewSweetStitches: What exactly DO you want the FDA language to say, specifically? Would you be satisfied with Elisa's suggestion?

Jill Writes Like She Talks ( http://www.writeslikeshetalks.com )

In The Arena: Jill Miller Zimon, Pepper Pike City Council Member ( http://jillmillerzimon.blogspot.com )

Julie Ross Godar 5 pts

I don't see what's wrong with disclosure on the FDA policy. It seems like a gimme. And I too am 100% pro choice.

Elisa Camahort 5 pts

...disclosure, not to ban the pill.

For people who believe that a fertilized egg=life, whether or not it implants, this pill can indeed end the existence of that fertilized egg. And shouldn't those women know that?

So, what's the harm in that disclaimer? The vast majority of people who would take such a pill won't care, but perhaps some folks walk that fine line where the birth control pill is fine, but this pill crosses their personal line. All incendiary language could be avoided, and if true, it could simply say that the pill may prevent a fertilized egg from implanting. If that's true, why not divulge it and let the woman decide how comfortable she is with it?

I'm 100% pro-choice, and I'm not sure I see a problem with making it 100% clear for people who are less black and white than me.

Elisa Camahort Page
BlogHer
elisa@blogher.com
My BlogHer profile truly shows you everything I do online...Check it out!!

Rita Arens 7 pts

I'm glad you feel if a woman wants to have an abortion it should be her right to choose the pill. However, I do think a woman who wants to prevent a pregnancy should also have the right to use the pill. This pill seems like a very, very, very good thing -- and in my mind no different than the birth control pill.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Jill Miller Zimon 5 pts

So, some pro-life people were willing to say that what Scott Roeder did was not murder - he was instead saving lives. So in this sense, murder is also subjective, right?

Consider: Would you say that women who use this FDA-approved product are committing murder the same as Scott Roeder? Or murder the same as what some pro-life advocates consider is murder if all abortion is considered murder? What should the penalty be - is the FDA sanctioning murder -should they be tried too in each case?

While I respect the right for you to have and express this viewpoint, I find your argument untenable because it purposely stretches the common sense and scientific boundaries of logic in order to prevent all women from having choice.

Nothing prevents you or other pro-life individuals from educating women about what you see as how they may want to define abortion and avoid this product. But information you want to impart has nothing to do with the FDA approving and providing mainstream-based explanations of how something that they regulate functions.

You want to say not having sex is also abortion? Go for it. But the FDA and the NIH and the CDC sure don't have to. They function with my tax dollars too and I don't see this contraceptive as being equivalent to abortion and would never support them counseling women that use of this particular item is in fact abortion.

Jill Writes Like She Talks ( http://www.writeslikeshetalks.com )

In The Arena: Jill Miller Zimon, Pepper Pike City Council Member ( http://jillmillerzimon.blogspot.com )

Mom101 5 pts

An egg is not a baby, no more than your omelet is a chicken.

Abortion by definition is the expulsion of an embryo or fetus, and a cell division is neither of those. So you can call it an abortion, and lots of people may believe it's an abortion, but that doesn't make it so.

I would have to side with Catherine who thoughtfully suggests that eliminating a cell division is preferable to eliminating an embryo and I'm pleased that we have increasingly more choices as women in terms of controlling our reproductive health.

Clearly you disagree. I accept that. But if we can stick to facts, and avoid statements like "an egg is a baby" I think the discussion will be more productive.

Making millions at Mom-101 ( http://mom-101.com )

SewSweetStitches 5 pts

We could go round and round all day trying to determine when life actually begins, but you cannot deny that many people DO believe that life begins at the moment of conception. Scientists have battled this topic for over a hundred years, so at this point it is a question of opinion.

Although my opinion obviously favors that of sperm + egg= human life, I do not doubt that there are countless others who agree with me. Shouldn't these women have the right to choose as well?

With the FDA wording as it stands, it leads consumers to believe that this pill will absolutely not cause abortion. That statement is subjective to what a person considers abortion to be. Just because the FDA has agreed that abortion only includes implanted eggs, that does not make it fact.

If a woman has already made up her mind that she doesn't have a problem with abortion, then fine, it is her choice to use the pill. However, if a woman is against abortion, she should have the choice to decide what is and is not abortion. Removing the blanket statement that this pill absolutely will not abort a pregnancy would be fair.

Catherine Morgan 5 pts

Thank you for your comment, but I have to respectfully disagree. A fertilized egg has a "potential" to become a baby (and statistically most of them will not), it is not a baby. A fertilized egg is a process of cell division, this is what a fertilized egg looks like...

( http://women4hope.files.wordpress.com/2010/08/huma... )

And again...If a woman does not want to have a baby, wouldn't it be better for her to prevent it at the stage of cell division than wait twelve weeks and have a clinical abortion? Life doesn't always provide us with a perfect solution, but preventing a pregnancy at the point of fertilization seems like a better solution than waiting until you are three months pregnant.

I'm not advocating that every woman be forced to use emergency contraception, I'm advocating for them to be able to have the choice.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

Catherine Morgan 5 pts

"Which brings me back to why I'm interested in seeing at least some options for daily birth control become available over the counter. I believe that having a more effective method of birth control on the shelves next to condoms will help de-stigmatize contraception and will increase the chances that couples are using some kind of protection if they don't want to run the risk of pregnancy."

Thanks for your comment...I totally agree.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

SewSweetStitches 5 pts

Medications like Plan B CAN result in abortions! A fertilized egg is still a BABY, whether it has accomplished implantation or not. The wording used with these medications is deceptive. It says that it will not abort a pregnancy, yet it says it will "inhibit implantation by altering the endometrium." Is a fertilized egg bouncing around in there suddenly not considered a baby?

So, a baby has been conceived but now it will die because it cannot implant. That's abortion.

Obviously, there's no way to tell if the medication has done the duty of a regular birth control pill or if it has gone farther and stopped the fertilized egg from implanting. So it would be a true statement that the medication does not ALWAYS cause abortion. To say that it doesn't cause abortion AT ALL is just plain misleading.

Kirsten Moore 5 pts

Hi Katherine - thanks for tracking reproductive health options so closely and for providing the link to a straightforward blurb about ella.

The label "morning after pill" was always a bit of a misnomer as even the original regimen which involved varying combinations or regular birth control pills was known to work for several days after unprotected sex or contraceptive failure. That's why public health experts came up with the admittedly unsexy name of "emergency contraception" - a term which referred to any option a woman could use after sex. This included Preven (the first FDA approved dedicated product in the US), Plan B (and now Plan B One Step and Next Choice) and ella. As you point out all these options are used after sex to reduce the risk of becoming pregnant.

As someone who spent a chunk of my professional career as a women's health advocate lobbying for over the counter access to Plan B in hopes that it could reduce the rate of unintended pregnancy I have to say that real world experience hasn't justified that hope. For one thing, there is a LOT of unprotected sex happening every day. Experts estimate more than 1 million acts of unprotected intercourse every 24 hours (I know!!). Women are using EC but not enough of it to make a dent in that statistic.

Which brings me back to why I'm interested in seeing at least some options for daily birth control become available over the counter. I believe that having a more effective method of birth control on the shelves next to condoms will help de-stigmatize contraception and will increase the chances that couples are using some kind of protection if they don't want to run the risk of pregnancy.

Melissa Ford 5 pts

Actually, not having sex is also a problem because it means the loss of all those unfertilized eggs. Sperm can't get to eggs if it's not in the body. So I say more sex! And no vitamin C.

Melissa writes Stirrup Queens ( http://stirrup-queens.com ) and Lost and Found ( http://lostandfoundandconnectionsabound.blogspot.c... ). Her book is Navigating the Land of If ( http://thelandofif.blogspot.com/ ).

Catherine Morgan 5 pts

Thanks for your comments, you are both very funny.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

Suzanne 5 pts

I did not know that, but I am glad that I do now. I will immediately begin advocating to ban the sale of Vitamin C to women. Womenare are essentially pre-pregnant at all times, and I would not want to do anything to let them control their destinies and do things like choose whether or not they should reproduce and when. Boycott the vitamin C industry and the fascist manhating women who run these businesses! :)

And Catherine, great post, as always.

Suzanne also blogs at Campaign for Unshaved Snatch (CUSS) & Other Rants ( http://cussandotherrants.com ) and is the author of Off the Beaten (Subway) Track ( http://offthebeatensubwaytrack.com ).

Ku963 5 pts

I do not understand this either-why it's so controversial. It is not an abortifacient. It does not kill a developing fetus.
If pro-lifers want to talk about banning/limiting emergency contraceptives acting as an "abortifacient" as they claim this new Ella pill is doing (which it isn't), they might as well make noise about Vitamin C. That's right. Did you know Vit C can act as an abortifacient?

Catherine Morgan 5 pts

Thanks for your comment, I agree completely.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

JennaHatfield 9 pts

I don't understand the controversy. At all. It angers me.

Jenna Hatfield (@FireMom ( http://twitter.com/FireMom )) is a Moms & Family Contributing Editor for BlogHer. She blogs at Stop, Drop and Blog ( http://stopdropandblog.com ) and The Chronicles of Munchkin Land ( http://thechroniclesofmunchkinland.com ). She is a freelance writer and newspaper photographer.

traceesioux 5 pts

I'm with you. I believe emergency contraception has the potential to DRASTICALLY reduce abortions, as will all women having access to health care.

I hate the idea that one must choose Pro-Life or Pro-Choice. I'm Pro-Choice and still the idea of a second term abortion or even a later first term abortion makes me sad -it rubs up against my feminine/maternal nature. It makes me sad for the women, not just the baby.

Emergency contraception - it seems to me - is the perfect ground for compromise between the two extremes. It will drastically reduce the abortion rate, even if you just look at the odds of an egg implanting - it may or may not have. Likely not.

It's the perfect compromise between the very valid and legitimate legal right for women to maintain jurisdiction over their own bodies, and the very valid and legitimate social good of a reduced abortion rate.

Five days seems like a legitimate amount of time for women to make a choice about what they want: what they're ready for and what they're not.

The Girl Revolution ( http://www.thegirlrevolution.com )