Our Bodies, Our Blog

Science Says: Emergency Contraception Does Not Block Implantation of a Fertilized Egg

By Rachel Walden |

Last week, in a post about how some types of emergency contraception are less effective or ineffective in women weighing more than 165 pounds, we mentioned that the European equivalent to Plan B One-Step was getting a new label that will note the problem.

Let’s take a look at the other reason for the label change: European health officials have determined — and want to make clear — that the drug “cannot stop a fertilized egg from attaching to the womb.”

This is a big issue, as abortion opponents have long opposed EC on the grounds that it might prevent a fertilized egg from implanting in the uterus. U.S. labels of levonorgestrel-containing emergency contraceptive pills, such as Plan B, don’t directly refute the possibility.

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But as The New York Times noted last year, recent science suggests that this is not the case; the pills work only by preventing ovulation and fertilization.

Last week, NYT reporter Pam Belluck noted how the FDA and other health agencies responded to the scientific studies:

References to the possibility of blocking implantation were then removed from the websites of the National Institutes of Health and the Mayo Clinic. And an F.D.A. spokeswoman, Erica Jefferson, said that “the emerging data on Plan B suggest that it does not inhibit implantation.”

On Tuesday, Ms. Jefferson reiterated that view. The drug agency has not moved to change the label, saying manufacturers must request a change. Plan B One-Step’s manufacturer, Teva Pharmaceuticals, declined to comment. It had previously said scientific evidence suggested that the pill did not disrupt implantation.

Although pregnancy is not medically considered to have begun until a fertilized egg has successfully implanted in the lining of the uterus, media coverage around this topic has often obscured this distinction and promoted a false idea that emergency contraception is the same thing as the abortion pill (RU-486) or abortion in general. Medical professionals generally assert that “emergency contraception is not effective after implantation; therefore, it is not an abortifacient.”

Effect on Lawsuits

Hobby Lobby is one for-profit corporation that filed suit to avoid complying with Obamacare coverage for contraception, claiming that forms of contraception that could interfere with the implantation of a fertilized egg are tantamount to abortion. The Supreme Court will hear the case, focusing on whether for-profit companies can be required to provide coverage that may conflict with the private religious beliefs of the business owners.

As Linda Greenhouse wrote in an op-ed about challenges to the contraception mandate under the Affordable Care Act, a coalition of medical groups, led by Physicians for Reproductive Health, filed a brief in the case, noting in part that “the weight of the scientific evidence establishes that the FDA-approved contraceptives and emergency contraceptive are not abortifacients.”

Read Greenhouse’s column for an excellent look at how the religious-based challenges represent a culture war on “modernity.” For more on the lawsuits, SCOTUSblog is a smart resource.

And we highly recommend the Emergency Contraception website for easy-to-understand fact sheets, such as this one: “Does emergency contraception cause an abortion?

Worried About the Effectiveness of Emergency Contraception Pills? Here’s An Alternative

By Rachel Walden |

Emergency contraception is tremendously important for women seeking to prevent pregnancy after unprotected sex. Activists and public health advocates have worked for years to make EC pills more readily available, and have been successful in getting pills such as Plan B available without a prescription or age restrictions. Emergency contraception pills containing levonorgestrel (including Plan B) may not be right for every woman and situation, however. Though the pills can be taken up to five days after unprotected intercourse, the pills are most effective (95 percent) when taken within 24 hours and become steadily less effective as more time passes. A different type of EC pill — Ella, containing ulipristal — is thought to keep a pretty high level of effectiveness for the full five days. News this week has raised another issue of emergency contraception effectiveness: EC pills with levonorgestrel seem to be less effective in women weighing more than 165 pounds, and lose their ability to work in women who weigh more 175 than pounds. Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowThis loss of effect happens regardless of whether women are considered overweight or obese according to BMI charts, … More

The Ultimate Guide to the Legal Battle Over OTC Access to Emergency Contraception

By Rachel Walden |

In the October issue of the journal Contraception, authors from Harvard Law School and Brown University’s medical school trace the legal and political battles over non-prescription access to emergency contraception. The authors date the legal dispute back to Jan. 21, 2005, when a coalition of organizations in favor of emergency contraception filed a lawsuit accusing the FDA of ignoring the science and safety and applying different standards to Plan B, a type of EC under review at that time, than the FDA applied to other drugs. Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowOf course, concern about access and the FDA’s process actually goes back further. Organizations had filed a Citizen Petition four years earlier asking the FDA to approve over-the-counter access. The FDA’s failure to respond to that petition, and rejection of the drug company’s application for OTC status, are what ultimately led to the 2005 lawsuit. The article in Contraception covers the legal battles and notes the various ways the U.S. government interfered in the FDA’s decision-making. You might recall that politically motivated delays under the Bush administration led Susan Wood, a former assistant FDA commissioner for women’s health and director … More

Emergency Contraception Can Be Free, But it Takes Planning – And a Prescription

By OBOS |

By Michelle Andrews, Kaiser Health News Women of all ages will soon be able to pick up emergency contraceptive pills at pharmacies and other stores without a prescription or proof of age. What many may not realize, however, is that they can get the pricey pills free under the Affordable Care Act. Doing so, however, may take time and forethought. “Women may be faced with a tradeoff between timeliness and coverage/cost,” says Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a reproductive health research and policy organization. Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowWhen it comes to emergency contraception, timing is important. The pills, which delay or inhibit ovulation, generally need to be taken within three days of unprotected sex or they lose their effectiveness. (One prescription-only pill now available is effective for up to five days after a sexual encounter.) Like other types of birth control, emergency contraceptives are required to be covered as a preventive benefit without cost sharing in health plans that aren’t grandfathered under the health law or don’t meet certain religious exclusions. But consumers can only receive reimbursement from their insurer for … More

Ask the FDA to Approve *All* Emergency Contraception Pills for OTC Access

By Rachel Walden |

Many readers are already aware of the developments over the past few months regarding prescription-free access to emergency contraception,  including the FDA’s recent approval of Plan B One Step with no age restrictions. While unrestricted access to Plan B One-Step is great news for women and girls needing timely access to emergency contraception, there are concerns that the cost — between $35 and $60 — puts it out of reach for many users. Unfortunately, the FDA’s approval focused specifically on that one product, and left out generic two-pill versions that would likely cost less. In his response to the FDA’s plan, U.S. District Judge Edward R. Korman noted that he “did not order the defendants to make the brand-name Plan B One-Step available over-the-counter without age or point-of-sale restrictions,” but instead instructed the FDA “to make levonorgestrel-based emergency contraceptives available without a prescription and without point-of-sale or age restrictions.” Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowKorman had allowed, however, that if the FDA believed there was a real difference between the newer one-pill and two-pill products, it could limit its approval to the one-pill form. The FDA did just that, citing the need for additional … More

Obama Administration Will Stop Trying To Block Some Emergency Contraception Access

By Rachel Walden |

Best news all day: “The Obama administration has decided to stop trying to block over-the-counter availability of the best-known morning-after contraceptive pill for all women and girls.” The administration is withdrawing its appeal of a ruling that requires emergency contraception pills to be made available without prescription, regardless of age. This is good news for access to the one-pill form of emergency contraception. In not-so-good news, the administration may still interfere with over-the-counter access to the two-dose form of the drug. Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowAlthough the previous ruling required that the two-pill form be made available even before the intended appeal was heard, the Justice Department’s letter indicates that it may still try to require additional data specific to safety of the often more affordable, generic two-dose form in younger adolescents before approving the change. As SCOTUSblog explains, “the FDA is interpreting Judge Korman’s April order as giving it permission to choose between Plan B One-Step and the two-pill version so that just one of them would be open without restrictions to women of all ages.” The Center for Reproductive rights, which has been heavily involved in the court … More

New Developments in OTC Emergency Contraception Court Case

By Rachel Walden |

First, a quick refresher: A couple of months ago a judge ordered that emergency contraception pills (like Plan B) be made available over the counter (OTC) without age restrictions. The U.S. Justice Department appealed that ruling, and asked for a stay so that OTC access wouldn’t take effect during the appeals process. Around the same time, the FDA approved Plan B One-Step emergency contraception pills for purchase without a prescription for teens ages 15 and older. Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowOn Wednesday, the Second Circuit Court of Appeals denied the stay for two-pill types of emergency contraception. This means that two-pill regimens should become available without prescription to women and girls of all ages even before the government’s appeal is resolved. The Court allowed the stay for one-pill variants of emergency contraception (e.g. Plan B One Step), and stated that the appeal process would be expedited. Women’s health advocates have been fighting for more than a decade to make OTC emergency contraception a reality. Nancy Northup of the Center for Reproductive Rights called Wednesday’s order “a historic day for women’s health,” adding: “Expanding access to this safe and effective … More

One Step Forward, Two Steps Back: The Week in Over-the-Counter Emergency Contraception

By Rachel Walden |

What a frustrating week in the ongoing battle over evidence-based health policy. To the surprise and disappointment of women’s health advocates, the U.S. Justice Department on Wednesday filed an appeal to prevent girls under age 15 from gaining over-the-counter access to emergency contraception. Approaching the date U.S. District Judge Edward Korman’s order making levonorgestrel-based emergency contraceptive pills (such as Plan B and Next Choice) available without restrictions would go into effect, the Obama administration also requested a stay pending appeal, meaning the judge’s order would not be implemented according to schedule. Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowThe judge’s ruling last month was in response to the Center for Reproductive Rights’ renewed lawsuit seeking over-the-counter access to the morning-after pill. Responding to the appeal, Nancy Northrup, CRR president and CEO, said in a statement: Women who urgently need emergency contraception have been delayed in getting it or denied access entirely for more than a decade because of the political maneuverings of the last two presidential administrations. The federal court has made clear that these stalling tactics were based purely on politics, not science. We are deeply disappointed that just days after President Obama … More

The Long Political History of Increasing Access to Emergency Contraception

By Rachel Walden |

Last week, a judge ordered the FDA to make emergency contraception pills available over the counter, with no age restrictions, capping a long and frustrating legal battle to increase access. Versions of levonorgestrel-based emergency contraceptive pills (such as Plan B and Next Choice) are expected to be made available without restriction within 30 days, but it’s not clear whether there will be some administrative interference. The FDA might decide on new labeling or to limit the forms of emergency contraception made available. There is also the possibility that the decision will be appealed. OTC access for all ages is essential because most emergency contraception pills are most effective when used as soon as possible, and time, distance, money, and privacy can be serious barriers, especially for teenagers, to obtaining and filling a prescription in time to prevent pregnancy. Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act NowThe push to make emergency contraception pills (also known as morning-after pills) available to all ages without a prescription suffered a major setback in 2011, when HHS Sec. Kathleen Sebelius blocked the FDA’s decision to remove the age barrier. Since 2009, emergency contraception has been available without a prescription for … More

Sign on to Support Native American Women’s Access to Emergency Contraception

By Rachel Walden |

Native American women are subjected to much higher levels of sexual violence than other women in the United States; the Department of Justice estimates that more than 1 in 3 Native American women will be raped in their lifetime, and they are often denied access to justice. According to a new report, Native American women are also denied access to emergency contraception through the Indian Health Service (IHS). The report, from the Native American Women’s Health Education Resource Center, includes the personal experiences with sexual assault and the perspectives of women of a diverse number of Tribes. It describes the barriers Native American women face when attempting to access emergency contraception and outlines steps that should be taken in order to provide them with on-demand access to emergency contraception. According to the organization’s 2009 research: Like what you’re reading? Our Bodies Ourselves needs your support to continue providing trusted health info!Act Now1) Only 10% of IHS unit pharmacies surveyed have Plan B available over the counter (OTC); 2) 37.5% of pharmacies surveyed offer an alternative form of emergency contraception; and 3) The remaining have no form of EC available at all. At Change.org, a petition has been created to ask … More