The EC Debate

Although the controversy surrounding emergency contraception (EC) has largely been put to rest by medical experts (such as the Federal Food and Drug Administration (FDA), the National Institutes of Health, and the American College of Obstetricians and Gynecologists) and research, the debate surrounding EC lingers on.

The Controversy

At the heart of the EC controversy is the belief by some people that Plan B One-Step (the main brand of EC) and Next Choice (the generic version of Plan B) sometimes works not as a contraceptive, thereby preventing pregnancy from occurring, but rather as an abortifacient, thereby ending pregnancy by causing an abortion. This debate, in turn, stems largely from the fact that the exact mechanism of how EC works remains unclear.

How EC Works

Depending on the point a woman is at in her menstrual cycle when she takes EC, EC (popularly known as "the morning after pill") is thought to work in one of the following ways to prevent pregnancy from occurring:

•- prevents or delays ovulation (prevent the egg from leaving the ovaries and traveling via fallopian tubes)

•- interferes with transport of sperm such that the sperm and egg don't meet

•- blocks hormones necessary for fertilization

•- prevents implantation of a fertilized egg

It is the latter function that has caused an uproar by some religious groups and pro-life advocates who argue that life begins with the fertilization of an egg, and since Plan B One-Step creates a hostile environment within the uterus and prevents the implantation of an egg, they consider this end result as equivalent to an abortion.

On the other side of the debate are scientists and medical experts who assert that a pregnancy is not established until a fertilized egg has implanted in the lining of the uterus. Therefore any drugs or contraceptives such as EC that act before implantation occurs are agents that prevent pregnancies from occurring, and not agents which terminate pregnancies.

Emergency Contraception vs. the Abortion Pill

Another reason for the EC debate is the erroneous equation of EC with the early abortion pill, RU486 (also known as M&M or the combination of Mifeprex and Mifepristone).

The abortion pill was approved by the FDA in the year 2000 as the means of an early abortion option for women seven weeks pregnant or less. The purpose and end result of the abortion pill is to terminate a pregnancy that has already been established (the medications work to block progesterone, a hormone necessary to maintain a pregnancy, thereby causing the lining of the uterus to shed, the uterus to contract, and finally the woman to miscarry).

EC, on the other hand, (originally prescribed as a treatment to help rape victims prevent an unplanned pregnancy) prevents a woman from becoming pregnant if taken within five days of unprotected sex, and in no way affects an already existing pregnancy.

Current EC Status

Federal policy is in accordance with the opinion of the medical community. Plan B and Next Choice are considered safe and effective methods for women to prevent a suspected unintended pregnancy (and in fact have actually decreased the number of abortions that could have taken place without them). Plan B One-Step and Next Choice can be obtained at most pharmacies without a prescription for women over the age 18, while individuals under age 18 require a prescription.


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