Plan B & ella - abortifacients?

[levinas12]

Can Plan B (the morning after pill) and “ella” (the week after pill), at least sometimes, function as abortifacients?

There seems to be a lot back and forth on this.

Some argue that recent studies show that these drugs do not interfere with implantation.

But others point out that some of the ingredients in these pills can thin the lining of the uterus.

This issue has become particularly pressing given Obamacare’s mandate and the recent decision by a federal judge that allows these drugs to be sold over the counter to a female of any age.

 

[rafarose]

On one pro life event on campus, a pro life physician suggested that such pills rarely cause abortion. But as you mentioned its not really clear, wondering the same thing

 

[Morwenna]

The manufacturers admit that these products may prevent implantation (which is another way of saying they cause chemical abortion).

For example from "ella"s website:
ella-rx.com/

How does ella work?

•  ella works to help prevent pregnancy by delaying ovulation (the release of an egg from the ovary) for 5 days
•  Works at certain stages of your cycle, even just before ovulation—the time you’re most fertile and likely to get pregnant
•  **ella may also work by preventing attachment to the uterus**

 

[TheWarriorMonk]

Can Plan B (the morning after pill) and “ella” (the week after pill), at least sometimes, function as abortifacients?

Plan B is reputedly no a abortifacient, and I believe there was an article published in a Catholic Health Journal to that effect. It is supposed to stop ovulation, and if you have already ovulated, expect to get pregnant.

Ella is also supposed to stop ovulation, but it can cause non-implantation of a fertilized egg.

 

[levinas12]

Thanks for the info.

Even if Plan B is not an abortifacient, and I’m still on the fence about this, is it potentially hazardous (especially if it sold over the counter - i.e., no medical exam, no physician oversight)?

It seems that “ella” may, at least sometimes, be an abortifacient. Does it involve a stronger dose - and could it be potentially injurious?

 

[_Abyssinia]

Plan B contains Ulipristal and levonorgestrel. A study on these drugs discovered:

Ulipristal has similar biological effects to mifepristone, the antiprogestin used in medical abortion

Source - G Bernagiano & H. von Hertzen, ‘Towards more effective emergency contraception?,’ 375 The Lancet 527-28 (Feb. 13, 2010), 527

Published in the Mayo Clinic Proceedings in 2006 said the amount of progestin in some low dose birth control pills for a month’s worth (i.e. 1.925 mg), is nearly equivalent to when a person takes Plan B, 1.5 mg of levonorgestrel within 12 hours

Chinese study on Levonorgestrel on page 673 says the drug

will be abortive

novapublishers.com/catalog/downloadOA.php?order=1&access=true&osCsid=5e9a553a1b1129fed10cc0ad3598a587

The most recent scientific study on Levonorgestrel, the essential component of the “morning-after pill” or “emergency contraceptive,” confirms that the drug does indeed have a third effect on users, which consists in preventing the implantation of a fertilized ovum in the womb of the mother.

catholicnewsagency.com/news/experts_confirm_abortifacient_potential_of_morningafter_pill

fertstert.org/article/PIIS0015028206047327/abstract

Plan B makers say:

Plan B® (levonorgestrel) may prevent pregnancy by temporarily stopping the release of an egg from a woman’s ovary, or it may prevent fertilization. It may also prevent a fertilized egg from attaching to the uterus. Plan B® One-Step may also work by preventing it from attaching to the uterus (womb).

go2planb.com/ForConsumers/AboutPlanB/HowItWorks.aspx%3Cbr%20/%3E

After fertilization, the pre-implantation embryo remains extremely vulnerable. The 'morning-after" pill, with its high estrogen content, alters the endometrium so that implantation fails to occur…

Source - Human Embryology and Developmental Biology, Bruce M. Carlson, M.D., Ph.D., 1994, page 110

World’s top authority on morning-after pill says women must be told it may cause abortions

 

[_Abyssinia]

Plan B contains Ulipristal and levonorgestrel. A study on these drugs discovered:

1. 
   *]
   

   Ulipristal has similar biological effects to mifepristone, the antiprogestin used in medical abortion

   Source - G Bernagiano & H. von Hertzen, ‘Towards more effective emergency contraception?,’ 375 The Lancet 527-28 (Feb. 13, 2010), 527
   
   *]
   

   Published in the Mayo Clinic Proceedings in 2006 said the amount of progestin in some low dose birth control pills for a month’s worth (i.e. 1.925 mg), is nearly equivalent to when a person takes Plan B, 1.5 mg of levonorgestrel within 12 hours

   *]Chinese study on Levonorgestrel on page 673 says the drug
   

   will be abortive

   novapublishers.com/catalog/downloadOA.php?order=1&access=true&osCsid=5e9a553a1b1129fed10cc0ad3598a587
   
   *]
   

   The most recent scientific study on Levonorgestrel, the essential component of the “morning-after pill” or “emergency contraceptive,” confirms that the drug does indeed have a third effect on users, which consists in preventing the implantation of a fertilized ovum in the womb of the mother.

   catholicnewsagency.com/news/experts_confirm_abortifacient_potential_of_morningafter_pill
   
   fertstert.org/article/PIIS0015028206047327/abstract
   
   *]Plan B makers say:
   

   Plan B® (levonorgestrel) may prevent pregnancy by temporarily stopping the release of an egg from a woman’s ovary, or it may prevent fertilization. It may also prevent a fertilized egg from attaching to the uterus. Plan B® One-Step may also work by preventing it from attaching to the uterus (womb).

   go2planb.com/ForConsumers/AboutPlanB/HowItWorks.aspx%3Cbr%20/%3E
   
   *]
   

   After fertilization, the pre-implantation embryo remains extremely vulnerable. The 'morning-after" pill, with its high estrogen content, alters the endometrium so that implantation fails to occur…

   Source - Human Embryology and Developmental Biology, Bruce M. Carlson, M.D., Ph.D., 1994, page 110
   
   *]World’s top authority on morning-after pill says women must be told it may cause abortions

 

[_Abyssinia]

CBS News notes ella’s “chemical similarity” to RU-486 (which will not be “free” under Obamacare). The New York Times describes it as being RU-486’s “chemical relative.” The Washington Post describes it as being RU-486’s “close chemical relative.” WebMD says that it works to prevent the implantation of a fertilized egg — in other words, as an abortifacient. Dr. Justo Aznar writes that between 50 percent and 70 percent of the time, ella “will act by an abortive mechanism.” The European Medicine Agency acknowledges that the drug has the “ability to delay maturation of the endometrium likely resulting in prevention of implantation.”

Far from denying that ella can prevent implantation of the fertilized egg in the womb, the FDA observes that it could potentially cause an abortion even later. It notes that there “are no adequate and well controlled studies in pregnant women” pertaining to ella, while the drug has been found to cause abortions in pregnant rats and rabbits: “Embryofetal loss was noted in all pregnant rats and in half of the pregnant rabbits,” the FDA declared.

Jeanne Monahan of the Family Research Council writes that, like RU-486, ella not only works to prevent implantation but also causes embryos to be aborted post-implantation. She writes, “Plan B can prevent an embryo from implanting in the uterus, thereby causing its demise. However, Plan B cannot terminate an already implanted embryo… Ella can cause the demise of an embryo that is already implanted in its mother’s womb, in addition to preventing implantation after fertilization.” Dr. Rich Poupard of the Life Training Institute (who doesn’t think that Plan B likely acts as an abortifacient) says that “ella is basically RU-486.” He explains that both drugs act to block implantation, and, if implantation does occur, they act to prevent progesterone from adhering to the uterine lining, thereby denying the embryo the nutrients it needs to survive.

weeklystandard.com/blogs/obamacare-mandates-coverage-abortion-drug_581969.html?nopager=1

Ella as it is known in America or EllaOne as it is known in Europe, contains Ulipristal acetate which has been studied by the European medicines agency and this is what they discovered:

Page 8

Due to its mechanism of action, ulipristal acetate has an embryolethal effect in rats, rabbits (at repeated doses above 1 mg/kg) and in monkeys

ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/001027/WC500023670.pdf

Progesterone prepares the endometrium for implantation and pregnancy which Ulipristal acetate prevents

Page 8

Ulipristal acetate prevents progesterone from occupying its receptor, thus the gene transcription normally turned on by progesterone is blocked, and the proteins necessary to begin and maintain pregnancy are not synthesized

Page 16

As expected, ulipristal acetate is embryotoxic at low doses, when given to rats and rabbits in repeated doses at gestation days 6-17 or 6-18 respectively

Page 17

In vivo pharmacology results show that ulipristal acetate has antiprogesterone activity shown as inhibition of progesterone induced endometrial glandular proliferation….

ema.europa.eu/docs/en_GB/document_library/EPAR_-_Public_assessment_report/human/001027/WC500023673.pdf

 

[manualman]

You have to be REALLY careful of sophistry when reading medical jargon these days.

On claims that Plan B isn’t abortive, I have questions. The medical definition of pregnancy starts with implantation, not conception. Thus, in medical terminology it is technically true (if deceitful) to say without asterisk that a drug that prevents implantation is NOT abortive if it won’t cause the destruction of an abryo already implanted in the uterine wall.

See the trick? Pro-lifers don’t care about the distinction between before or after implantation. We just want to know if the drug results in the death of an embryo.

I still can’t tell the truth from what I’ve read. As best I can tell, it looks like Plan B has the theoretical possibility of preventing implantation, but it’s primary function is to prevent ovulation. Some argue that it’s like taking your kids on a car ride in a snowstorm: the primary function is to get to Grandma’s house, but a genuine potential side effect that might occur is dying in a nasty car crash along the way.

Are those two scenarios (risk of preventing implantation of an embryo vs. risk of death in a car crash) similar in morality?

In most situations, the point is moot since Plan B is a contraceptive and immoral to use anyways. But most catholic moral theologians (decent ones, not just the Charles Curran wannabees) think that a rape victim with reason to believe that she hasn’t ovulated yet can morally use Plan B to prevent ovulation even though there is some risk of breakthrough ovulation and subsequent failure to implant. They’ve concluded that it’s OK to take the kids to Grandma’s house even if there is some risk due to the nature of car travel on the way.

The reason the HHS mandate on this stuff and recent efforts to make it sold like aspirin is that there are serious side effects and health risks associated with them that should be evaluated by a doctor first. It’s absurd that one needs a prescription to get a modestly potent ointment for psoriasis, but any fool can buy massive doses of hormones without any competent advice. If it were any subject other than sexual license, the government would be regulating it to death.

 

[TheWarriorMonk]

If you’re interested in an article from a Catholic source, see below.

chausa.org/subjectindex.aspx?year=2010

It’s under the “Analysis” section, article titled “Plan B How It Works”

 

[manualman]

An excellent article, thank you. It does clearly address the question about the potential for blocking implantation, a relief for sure.

However, the article raises another question implicitly that is never resolved. The author claims that the two primary mechanisms by which Plan B prevents pregnancy are:

1. Prevent ovulation
2. Greatly degrade sperm motility by changing the mucus physical characteristics.

As an NFP guy, I can tell you that fertile mucus is very wet and slippery. It’s functionally a liquid. After fertility declines, that mucus thickens greatly before drying up. The sperm are reliant on the liquidity and quantity of that mucus for movement. Here’s my question: If Plan B thickens or eliminates that mucus to prevent sperm travel, won’t it have the SAME effect on the new zygote that needs to travel to a suitable implantation spot within the uterus? If the zygote cannot travel because the mucus has thickened up or dried out, perfect uterine wall implantation conditions won’t do a bit of good. The embryo will still essentially starve to death if it, like the sperm loses its ability to travel to a viable implantation site. I wonder if there might even by an increased risk of ectopic pregnancy?

I’m not saying the above is true, I’m just raising the question. I find it odd that if a non-medical guy like me sees the potential why it isn’t addressed in the article. Surely she thought of that possibility as well??

 

[choose_to_love]

The zygote isn’t traveling through cervical mucus, though; it’s traveling through the fallopian tube. Are you questioning whether the active ingredients in the drugs also affect or degrade the fallopian tube environment and potentially impede the blastocyst/embryo’s progress to the uterus to implant? Or am I not understanding the extent of the mucus?

 

[levinas12]

How fast acting are these drugs with respect to: (1) suppressing ovulation, (2) thinning the lining of the uterus, and (3) thickening cervical mucus?

 

[levinas12]

Some argue that recent studies show that these drugs do not interfere with implantation.

But others point out that some of the ingredients in these pills can thin the lining of the uterus.

I should add that people have said that these drugs might thicken the mucus in the fallopian tubes (as well as in the cervix). This obstruction, if it were to occur, might interfere with the passage of the fertilized egg into the uterus.

I would like to know if this is also possible.

 

[CopticChristian]

Plan B is reputedly no a abortifacient, and I believe there was an article published in a Catholic Health Journal to that effect. It is supposed to stop ovulation, and if you have already ovulated, expect to get pregnant.

Ella is also supposed to stop ovulation, but it can cause non-implantation of a fertilized egg.

Sifu,

women.webmd.com/guide/plan-b

Plan B is birth control

Depending upon where you are in your cycle, Plan B or Plan B One-Step may work in one of these ways:

It may prevent or delay ovulation.
It may interfere with fertilization of an egg.
It is also possible that this type of emergency birth control prevents implantation of a fertilized egg in the uterus by altering its lining.

Ella is birth control

webmd.com/sex/birth-control/news/20100813/new-morning-after-pill-ella-wins-fda-approval

The two emergency contraceptives work differently:

Plan B contains levonorgestrel, a progestin hormone used in lower doses in many birth control pills.
Ella contains ulipristal, a non-hormonal drug that blocks the effects of key hormones necessary for conception.
Plan B should be taken as soon as possible after sex. It may work for up to 72 hours after sex.
While emergency contraception should not be delayed, Ella’s effectiveness does not fade for 120 hours (five days) after sex, regardless of whether the hormonal surge has occurred.

 

[CopticChristian]

If you’re interested in an article from a Catholic source, see below.

chausa.org/subjectindex.aspx?year=2010

It’s under the “Analysis” section, article titled “Plan B How It Works”

BY SANDRA E. REZNIK, MD, PH.D.
Emergency contraception, that is, any of a number of methods to prevent
pregnancy after coitus, has become more effective and certainly easier to
obtain in recent years.

Emergency, Late, intentional, or whatever you put in front of the word…

Contraception does not change the fact that this is contraception, abortifacient or not…

 

[levinas12]

Emergency, Late, intentional, or whatever you put in front of the word…

Contraception does not change the fact that this is contraception, abortifacient or not…

Agreed. But if these drugs are also abortifacients, that’s significant in terms of the public debate.

 

[CopticChristian]

Agreed. But if these drugs are also abortifacients, that’s significant in terms of the public debate.

So I may understand the debate…tell me…

The Church teaches that abortion and birth control are not moral…

what is the debate?

 

[levinas12]

So I may understand the debate…tell me…

The Church teaches that abortion and birth control are not moral…

what is the debate?

The debate is not internal (within the Catholic Church). Rather, I am referring to the larger public debate.

There are really a number of public debates, e.g. (1) should Plan B/ella be available over the counter to girls of any age; (2) should the government be able to force employers to cover Plan B/ella in their health insurance plans (Obamacare); and (3) should every hospital/provider be forced to give Plan B/ella to rape victims regardless of whether ovulation has taken place?

If Plan B/ella are, at least sometimes, abortifacient (as well as contraceptive), this fact could be used to persuade people to oppose bad “public” policies.

 

[manualman]

For catholics, there is no debate (or shouldn’t be one).

But in the secular public discourse, non-catholics want to know why this shouldn’t be sold like aspirin. Moral arguments about contraception damaging the very nature of marital intimacy aren’t going to carry any weight there. Moral arguments about killing people still carry a bit more weight, even in secular culture (so far) .