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Tuesday, June 29, 2010

Well, this promises to be exciting.

Rumor (and by "rumor" I mean "the New York Times") has it that there's a new, and better, morning after pill that may come on the market. Better how, you ask? Well, read for yourself:

A federal advisory panel voted unanimously Thursday that federal drug regulators should approve a medicine that could help prevent pregnancy if taken as late as five days after unprotected sex.

The pill, called ella, sprang from government labs and appears to be more effective than Plan B, a morning-after pill now available over the counter to women 18 and older that gradually loses efficacy after intercourse and can be taken at latest three days after sex. Ella, by contrast, works just as well on the fifth day as the first after sex.

So that's all good news because, really, I'm pretty much always in favor of providing people with more reproductive options. Unfortunately, however, there is most certainly going to be a debate over this medication, particularly since its mode of action is not completely understood:

The dispute is whether the drug works by delaying ovulation (as the pill’s manufacturer claims) or by preventing a fertilized egg from implanting itself in the uterus (as anti-abortion advocates say).

Dr. Jeffrey Bray, a pharmacologist at the Food and Drug Administration, said that ella may do both. And Dr. Scott Emerson, a committee member and professor of biostatistics at the University of Washington, said any drug that can prevent pregnancy if taken five days after unprotected sex must do more than simply delay ovulation.

Animal studies showed that ella had little effect on established pregnancies, suggesting it acts differently than RU-486. Dr. David Archer, a professor of obstetrics and gynecology at Eastern Virginia Medical School who spoke on behalf of ella’s maker, said ella was not an abortion pill. “I just don’t think there is any element here that would allow me to say that this has an abortifacient activity,” Dr. Archer said.

In other words, if you think that an unimplanted blastocyst is a person, then this drug might qualify as an abortifacient. I say "might" because, again, we don't know precisely how it works. If you don't view said blastocyst as a person, then it's definitely a contraceptive. And speaking personally, I find it relatively reassuring that it doesn't impact already implanted embryos, though in certain circumstances that could be viewed as a drawback.* Still, amidst the debate that is sure to erupt, I think we may have a little misunderstanding. The Times article suggests that this pill could reduce the number of unplanned pregnancies, but then goes on to make a rather bizarre little assertion:

Even though ella is somewhat more effective and can be taken later than Plan B, the new drug would, if approved, probably do little to solve this epidemic of unplanned pregnancies. Plan B has been available without a prescription since 2006 for women 18 and older, but abortion and unintended-pregnancy rates have remained largely unchanged.

If you're not sure what I think is so bizarre, you should direct your attention to that whole "Plan B has been available without a prescription since 2006" bit. Do we not remember the pharmacists who make decisions for us? Or the jail guard who refused to permit a rape victim to ingest Plan B? What about doctors who won't prescribe it? And how about states where it is de facto unavailable? Yeah, call me crazy, but I don't really think we can base speculations about the effectiveness of this new drug based on Plan B.

Buckle up, kids, cause this is liable to get interesting.

* You know, given that women who are victims of rape or incest don't always get to seek out contraceptives on their preferred time table.

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