Tuesday, December 26, 2006

Parsing the emergency contraception bill HB 23

North Texas made headlines in 2004 when a pharmacist in Denton, Texas refused to fill a prescription for emergency contraception for a rape victim. Since that time, the FDA has debated the merits of the emergency contraception pill in an approval process noteworthy more for its political posturing than its scientific merits. Nonetheless, the agency finally approved the drug for use without a prescription for women over the age of 17 in August of this year.

Wouldn't you think that all of those "family values" legislators would welcome a pill that...
....was responsible for approximately 43 percent of the decrease in the number of abortions from 1994 to 2000. If more widely available, EC could prevent 1.7 million unintended pregnancies and 800,000 abortions each year in the United States alone.
Apparently not. Frank Corte, R-San Antonio, has introduced legislation which deals with emergency contraception. Corte has been dubbed the energizer bunny of anti-choice legislation for his prolific attempts at curtailing women's reproductive rights, and nothing in this legislative run-up contradicts that. Vince Leibowitz at Capitol Annex posted an in-depth analysis of several bills that have been filed by Corte, including HB 23. Vince's post has an extended excerpt of the bill, which is a doozy, and he does a great job of highlighting the complete absurdity of the logic behind the proposed bill.

After a short holiday hiatus, it seemed like a good time to point out an issue with Corte's bill that hasn't had too much discussion and deals specifically with the wording of the warning to be posted in the pharmacy.

But first, it might help to mention what emergency contraception is and is not. Emergency contraception usually refers to the brand name, Plan B, a synthetic hormone approved for use over-the-counter by the FDA. It should not be confused with RU486, the abortion pill. Plan B uses progestin, the same hormone used in daily birth control pills, but in a higher dosage.

From an Austin Chronicle op-ed on the HB 23:

....Corte's front-running legislative stinker would define emergency contraceptives as drugs that "prevent pregnancy by preventing fertilization of an egg or preventing implantation of an egg in a uterus," conveniently leaving out the third way EC can work, by preventing ovulation altogether.

Let's clarify this even further. Consider this statement from the FDA.

Plan B works like a birth control pill to prevent pregnancy mainly by stopping the release of an egg from the ovary. It is possible that Plan B may also work by preventing fertilization of an egg (the uniting of sperm with the egg) or by preventing attachment (implantation) to the uterus (womb), which usually occurs beginning 7 days after release of an egg from the ovary [emphasis mine]. Plan B will not do anything to a fertilized egg already attached to the uterus. The pregnancy will continue.

Preventing ovulation isn't just a third way that Plan B works - all evidence suggests that it is its primary mechanism of action. The reference to fertilization and implantation are speculation, but scientists, being a cautious lot, won't rule it out.

"....researchers will probably never be able to prove for certain whether or not emergency contraceptive pills have an effect after fertilization."

Of course, Corte doesn't want anyone to know that, because by emphasizing implantation, he wants us to equate emergency contraception with abortion. The Austin Chronicle article distills the logic behind this, quoting Corte staffer Kathi Seay:

"If you know, up front, that [Plan B] is preventing the implantation of an egg, and you're fine with it, [then] go for it."

So this then is the purpose of the bill: to misrepresent the science in order to confuse potential users, and if that doesn't work, then to stigmatize anyone who still insists on access to the drug.

And if all this seems a bit confusing, imagine how it must seem to young adults who haven't even had the benefit of comprehensive sex education.

View the text of HB 23 here.

1 comment:

Bradley Bowen said...

This post was great... thanks for clearing up some misconceptions I had!