There's a difference between the drugs that induce a medical abortion and those used in emergency contraception, or the morning-after pill, an Oklahoma City doctor said this past week.
“Emergency contraception, first and foremost, is not an abortifacient,” Dr. Andrea Palmer, an obstetrician-gynecologist at Lakeside Women's Hospital, said. “It is not going to dislodge or disrupt an already implanted pregnancy. It's not something that is going to cause an implanted pregnancy to no longer be implanted or to abort.”
Whether emergency contraceptive pills can cause abortions has been a contentious fight since the pills first came onto the market.
Emergency contraceptive pills have been around since the 1970s, according to a study published in the Association for Voluntary Surgical Contraception journal. Plan B and ella are two examples of emergency contraceptive pills currently available in the U.S.
Challenging the act
The issue has recently been brought to the forefront in Oklahoma City. The Green family, who owns Oklahoma City-based Hobby Lobby and Mardel, filed a lawsuit in September that challenges part of the Patient Protection and Affordable Care Act, also known as Obamacare.
They said a provision dealing with insurance coverage for certain types of contraception, including the morning-after pill, the week-after pill and some intrauterine devices, went against the family's beliefs. The Greens believe those types of contraception could cause abortions.
Meanwhile, the American Association of Pro-Life Obstetricians & Gynecologists argues that, for example, the emergency contraceptive drug named ella is an abortifacient.
The association argues this because taking ella “may result in death of a new human being by preventing implantation, thus is abortifacient.”
The Mayo Clinic has said that morning-after pills do not end a pregnancy that has implanted.
“Depending on where you are in your menstrual cycle, morning-after pills may act by one or more of the following actions: delaying or preventing ovulation, blocking fertilization, or keeping a fertilized egg from implanting in the uterus,” according to the clinic. “However, recent evidence strongly suggests that Plan B One-Step and Next Choice do not inhibit implantation. It's not clear if the same is true for ella.”
How the pills work
Palmer said what emergency contraceptive pills do is different from what abortion-inducing drugs do.
Sperm can live inside a woman's body for up to 72 hours. Sperm must travel from the vagina, through the cervix, through the uterus, out the fallopian tube, where the sperm meets the egg outside the uterus near the end of the fallopian tube, Palmer said.
The fertilized egg is taken back inside the fallopian tube, and it must travel down the fallopian tube and implant itself into the uterus, she said.
Meaning, a woman doesn't necessarily become immediately pregnant after intercourse.
“If you think about how tiny sperm (are) and how fast they move and the distance that they have to travel, it's not a one-hour kind of ordeal,” Palmer said. “It's a process of many hours that it takes for the sperm to reach its destination and find that egg.”
Ovulation is the time period when an egg is released from the ovaries. During ovulation, the egg cell will either be fertilized by sperm or will dissolve if fertilization does not take place, according to the U.S. National Library of Medicine.
“Why emergency contraception can work is that it can prohibit that ovulation from happening,” Palmer said. “And if you have already ovulated and the sperm get out there, it's probably not going to be effective.”
Emergency contraception cannot dislodge or end a pregnancy. If a woman is pregnant by the time she takes the pills, she will remain pregnant, Palmer said. This is the same for intrauterine devices, Palmer said.
Contributing: Don Mecoy, Business Editor