EDITORIAL: Emergency contraception is not the 'abortion pill'

Our View: Political debate over scientifically inaccurate emergency contraception claims shows our scientific progress should be influencing our social and political debates – not the other way around.

Hobby Lobby filed suit Wednesday in the Western District of Oklahoma to waive a requirement in the federal health care law that must provide contraceptive medication and services to their employees with no co-pay, along with other preventative medicine.

If the Oklahoma City-based company does not comply with the Jan. 1 deadline in the health care law , it could face millions of dollars in fines.

According to the lawsuit, the self-insured company does not object to providing all contraceptive medicine, only what the suit calls "abortion-causing drugs and devices," i.e. emergency contraception like Plan B and Ella.

This is a medically inaccurate description of emergency contraception and its effects. Neither medication affects nor terminates an existing pregnancy, as the real abortion pill RU-486 does.

Other companies have objected to the reach of the new health care law or to the requirement to cover contraception at all, but those debates have no bearing in this case. Because Hobby Lobby has decided to sue over a misguided understanding of emergency contraception, it's time the company faced some facts.

The two drugs that make up the vast majority of the market for emergency contraception are Plan B and Ella. Plan B uses levonorgestrel, a hormone used in weekly hormonal birth control. The only difference is that Plan B utilizes higher doses.

Ella contains ulipristal, which is a non-hormonal drug that blocks the effects of certain hormones. This is a similar drug as the one used in RU-486, but in such lower doses as to have a significantly different effect.

These drugs work best if taken within a certain time frame (72 hours after unprotected sex for Plan B, five days for Ella) because their primary effect is to stop the release off eggs from the ovaries. In this way, they stop sperm, which can stay active in the body for up to five days, from fertilizing the egg.

Those who would call it an abortion pill point to a description on the labeling for these drugs that explains they also may stop the implantation of an egg onto the uterine wall. If implantation fails, the egg never becomes viable.

It is this effect that has encouraged some to label them abortion pills: If the fertilized egg is alive even before implantation, then stopping it from implanting would kill it.

But the science contradicts this speculative statement on the packaging, which was added to the labeling for Plan B by the Federal Drug Administration during the approval process for the drug in 1999.

The New York Times reported that nowhere in the hundreds of pages of approval documents is there any mention of proof for the claim that Plan B affects implantation. This claim is merely included in a list of many other speculations on how the drug might prevent pregnancy.

Sources in the FDA told The New York Times it is common during the approval process, when the focus is on the safety of the drug and potential side effects, for little to be known about exactly how the drug works.

But now, more than a decade since the drug was first approved, there is more conclusive data to be found. A 2007 study, not the first to have such results, showed that eggs exposed to the hormone in Plan B did not have trouble implanting on uterine tissue in a lab setting.

In that same year (and again in 2009 and 2010), coordinated research in Australia and Chile showed that women who took the pill before ovulation had no pregnancies, while women who took the pill after ovulation became pregnant at about the same rate as women who are not using contraception.

If emergency contraception had an affect on implantation, not just ovulation, you would expect to see fewer pregnancies in the women who took the pill after ovulating as well.

Based on these and other studies, doctors and health experts have called for the labeling of emergency contraception to be changed to reflect what is now known about the real effects.

Despite scientific and medical consensus, anti-abortion rights groups and some religious groups still object to the use of emergency contraception and, as Hobby Lobby has illustrated, still get away with calling them abortion pills.

It is dangerous to allow important political debates to be grounded on guesswork and assumptions. We never will find the truth or the right path by ignoring reality.

It goes to show that our scientific progress should be influencing our social and political debates — not the other way around.

The Editorial Board

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