The FDA is considering approval of “Ella”, a new morning after pill that works up to five days after sex, causing Right-To-Lifers to get all pissy pants (via). That’s funny, because this WHO study (via this menstruation blog) shows that the existing Plan B emergency contraception pill will stop most pregnancies in the five day window. Ella might be better, but what we have now is pretty good.
Plan B is the biggest unheralded loss that the Right-to-Lifers have suffered in the last few years. From their perspective, it’s an over-the-counter abortion in pill form. And look who’s using it:
It turns out in the study — published in the Journal of the American College of Obstetricians and Gynecologists — that most of the women who took the drug between two days and five days after unprotected sex were young, mostly between the ages of 18 and 25. And 60 percent were white. More than two-thirds had some college or were college graduates.
If Right-to-Lifers can’t force smart white girls to have unwanted babies, what’s a movement for? (Apparently to punish poor and minority women, but that’s not news to anyone who’s been paying attention.)
Ella is chemically related to RU-486, which is another big Right-to-Life loss. In 2006, the last year with statistics, it was responsible for 11% of abortions. I’d be surprised if that number hasn’t doubled by now.
Mr Furious
In 2006, the last year we have statistics, it was responsible for 11% of
abortionsterminated pregnancies.adolphus
I agree with Mr. Furious.
I refuse to admit these drugs are abortions. I don’t know Ella, but from what I know of the other two (and I am not medical man) they are not in fact abortifacients. You are enabling them by referring to them otherwise. Don’t cede that ground.
leo
Frankly, if it pisses off the Right-to-Lifers, even us guys ought to take the thing.
eemom
“menstruation blog”??
Bella Q
There is something to the point that the technical ground should not be ceded. These drugs (Ella and Plan B) are not abortifacients, and should not be referred to as such. I would suggest a different headline, but it’s not my blog.
mistermix
@eemom: It’s called “The Well-Timed Period”. The Internet is an awesome place.
Face
Menstration Blog is a great name for a band.
Morbo
@mistermix: Not to be confused with grammar blog “The Well-Placed Period”.
TooManyJens
The best available evidence suggests that Plan B (levonorgestrol) only prevents fertilization and not implantation. Unfortunately, that’s relatively recent research and by the time it was published, everyone had already gotten entrenched in the idea that it prevented implantation of an embryo, and they were just arguing over whether or not that constituted abortion.
I have no idea how ella works.
Mr Furious
@Bella Q: I’ve got NO problem with the headline. I think it’s an accurate, yet simplified, distillation of the debate.
But citing statistics of ABORTIONS related to the use of these pills is not semantics, it’s fucking bullshit.
(the venom in that statement is directed at the source, notsomuch mistermix)
mistermix
@Mr Furious:
Just to be clear:
RU-486 is an abortifacient. It causes the death and expulsion of an implanted embryo from the uterus. You can call that process by whatever name you’d like, but I don’t think it damages the debate to call it an abortion. The only abortion statistic I cited was that 11% of 2006 abortions used RU-486.
Plan B and Ella are emergency contraceptives. They do something to keep pregnancy from happening (stop implantation? delay ovulation?). The RTL crowd calls that an abortion. I don’t.
And: http://www.youtube.com/watch?v=S4qY22rR9tQ
Betsy
@adolphus:
RU-486 is in fact an abortifacient. It terminates pregnancies up to (I think) 8 weeks. Plan B, or emergency contraception, is just that – contraception. Because they’re both taken orally, and because of deliberate anti-choice rhetoric, there’s a lot of confusion about the differences between the two.
Edit: Oops, mistermix beat me to it!
Betsy
@mistermix:
LOL!! Excellent choice, sir.
Mr Furious
Fair point. I forgot the difference between RU-486 and emergency contraception—particularly that it’s effective that far along. I’d admit there’s a better case to be made for calling that “an abortion,” but not by me. As I said, you were just the messenger on that, not the recipient of my ire… :-)
In conclusion, if the right-to-lifers wants to fight this battle on the backs of bloody fetuses on posters and the horrors of crushing skulls and psychotic doctors, then I’m not counting a pill of any stripe as such.
Abortifacent? Fine. Abortion. No.
Betsy
@Mr Furious:
Interesting. I respect your position on that, but come at from the opposite angle – I don’t want to let them own the term “abortion.” Abortion is NOT just the horror show that they get off on – it doesn’t have to be scary or grotesque. I believe in calling things what they are – and “abortion” is generally defined (by neutral parties) as the removal of an embryo or fetus from the uterus to end a pregnancy. That’s why Planned Parenthood and other pro-choice groups, along with doctors, refer to RU-486 as “medical abortion,” as opposed to “surgical abortion.” It’s NOT contraception, which is something that prevents a pregnancy. I feel like to call it that is to allow that “abortion” is an intrinsically bad or yucky thing.
I get really angry when right-wingers try to warp language to suit their cause. I don’t want to do the same thing.
Bella Q
@Mr Furious:
I see your point that the headline is fine. It’s just that the anti-choice crowd are going to call the emergency contraception meds “abortion medication,” even when the aren’t abortifacients, which RU 486 indeed is.
I’m perfectly fine with anyone who does not wish to terminate a pregnancy not doing so. But women who feel the need to do so should be permitted that choice about their bodies. We are people (now with voting rights, even) not incubators. And of course don’t even get me started about how much interest the anti-choice crowd has in those sacred fetuses once they cross the rubicon of the cervix.
Mr Furious
Betsy:
I fully concede that you (and Bella) are both making more rational arguments than me… When I’m pissed the keyboard takes over. You raise a compelling point about the “semantics” I dismissed earlier, and the language DOES matter. I think you are correct on the merits, but there is definitely a price to be paid in the court of public opinion with that terminology. I think it behooves the “reality-based” side of the debate to be as correct as possible, and let the other side do the hyperbole.
That said, I think taking the gruesome brutality argument from the right-to-life side and turning it around with, “all that can be avoided with this simple pill” is a convincing case with most people who might support a pro-choice position, yet be squeamish about traditional abortion.
—
Bella:
Yup. That’s way I said the headline, while correct in spirit, was indeed an oversimplification. Abortions are in my mind a medical/surgical procedure, morning after pills are contraception, and RU-486 is somewhere in between.
malraux
@Mr Furious: In that case, your mind is wrong. Any ending of a pregnancy is an abortion. RU-486 ends a pregnancy.
Uloborus
Just a note, but aren’t smart white girls the most important demographic to force to have babies? These are their daughters, after all. Certainly the natural immorality of the niggers requires careful policing, but it’s really important that white girls breed copiously within proper marriages. Young women who’re getting an education are at huge risk.
Actually, I’ve never quite understood the misogyny of the Christian Right, but that seems to be one big part of it. They go nuts about maximizing the number of good white Christian children being brought up. Possibly they’re trying to outbreed the rest of us.
Kirk Spencer
@malraux: Nobody disagrees about RU-486. The discussion is about Plan B and Ella. They are contraceptives. They prevent pregnancies, not end them.
IndieTarheel
@eemom: If it exists in the real world, there is a blog about it. No exceptions.
dj spellchecka
@ uloborus: not to go all pc here, but your choice of words, even in an obviously ironic sentence, is pretty jarring..
as for “smart white woman,” judging from their voting patterns, they are the group least likely to be members of the religious right…and polling shows that under 30’s in general are by far the least religious part of the american population
fucen tarmal
@mistermix:
didn’t they have a pregnant pause? or were the posts just late?
Mr Furious
@dj spellchecka: Yes. It was as if that was the only word in the comment and it was 48 pt and bold.
Mr Furious
@malraux: What Kirk said. And I already stated clearly that that position is my personal opinion and is regarding the commonly used language over the technically correct terminology.
fucen tarmal
whether or not plan b, or ella, is an abortion or not, the real benefit is much like the blank and the blindfold for a firing squad. it alleviates guilt for those so inclined by making it unclear.
if you take them anyway, you don’t necessarily know if you are having an abortion. so for practical purposes, it functions more on the basis of contraception, just after the sex….
and personally i think they should count as a topping on school lunch pizza.
ema
Bwahaha, I’ve mesmerized you with my menstruation blog!
OK, it’s not really a period blog; it’s an Ob/Gyn blog with a focus on contraception. (Forgive the name of the blog, I was new to the Internets when I picked the name.)
Now, to the issue at hand.
Briefly, RU-486 is a 1st generation progesterone receptor modulator. Depending on dosage and regimen, it has different mechanisms of action. It can act as either a contraceptive (prevents the establishment of a pregnancy by acting on ovulation or implantation) or an abortifacient (terminates a pregnancy by acting on the uterus).
Bottom line, if you’re talking about a specific RU-486 regimen/dosage, it’s correct to refer to that as an abortifacient. However, the drug itself is not an abortifacient, rather it’s a progesterone receptor modulator with different mechanisms of action. (Contrast that to a drug like misoprostol, and abortifacient. Its only mechanism of action is labor induction.)
Ulipristal acetate (ellaOne) “is the first representative of a new therapeutic class, selective progesterone receptor modulators, and is the first molecule to have been specifically designed and developed for use as an oral emergency contraceptive.” This drug prevents pregnancy (inhibition/delay of ovulation*) and there’s no evidence it has any effect on an established pregnancy.
*One study found that UPA altered the uterine lining, but whether this change would inhibit implantation is unknown.
Levonorgestrel ECP brands (Next Choice, Pan B One-Step, i-Pill, and Levonelle One Step) are contraceptives that work on ovulation. There’s no evidence they work on fertilization or implantation.
Last, but not east, Plan B is no more. It’s been discontinued and replaced with Plan B One-Step (a 1 pill brand). The generic for Plan B, Next Choice (a 2-pill brand is still available.)
(More on emergency contraception; a bit of medspeak but not too bad.)
Zuzu's Petals
The RTLers lost that argument years ago, when the IUD – which IS an abortifacient – came into wide use. Heck, even my pastor’s wife used one back in my fundie days.
Of course, some birth control pills also act as abortifacients.
TooManyJens
@Zuzu’s Petals:
Again, this is often asserted, but not actually known.
ellaesther
Hmm. I’m torn on this. I’m all for Plan B contraception in its many forms, but I’m not sure I want one named after me. “Oh God, my condom tore!” “That’s ok, honey, I’ll just get ella in the morning.” You see the problem. At least it’s not the ellaesther.
Also, this? Ella might be better – what are you talking about? Of course I’m better.
But also, this in its entirety (and on a more serious note)? Ella might be better, but what we have now is pretty good. I’m one of the minority of women for whom “what we have now” didn’t work (though it was in the distant past, I don’t think that “what we have now” is appreciably better than what we had then), and thus I wound up having a full-on abortion when a few more weeks had passed and we could determine that I had, in fact, conceived. It was a terrible few weeks, and if we can get something better than that, I think that that’s a good thing.
TuiMel
This was my thinking, as well. I understand my thinking is medically irrelevant, but is it not true that at the time any of these medications would be taken, it is impossible to know whether or not a pregnancy exists? Again, I acknowledge that my POV means nothing to pharmacists who do have objections to dispensing “abortions.” But not every pill taken = the termination (or prevention) of a pregnancy. It is taken for the termination of the possibility…
Uloborus
@dj spellchecka:
Yes. Actually, all of that was part of my point. Smart white women are, in their eyes, the prodigal daughters who must, must, must be brought back into the moral fold to continue the breeding project.
And I’m pretty unPC. Growing up a Jew most people thought was gay in the South I realized I didn’t give a rat dropping what people called me if they didn’t mean it hatefully, and was much more pissed off if they called me something nice but *did* mean it hatefully.
Svensker
A miscarriage is technically a “spontaneous abortion.” That’s what goes on your medical chart if you miscarry.
ema
@Zuzu’s Petals:
The IUD is an abortifacient and some BCPs act as abortifacients? How so? The [Cu] IUD is spermicidal; it prevents fertilization and, likely, implantation, and BCPs work manly by inhibiting/delaying ovulation. They have no effect on pregnancy.
Don’t get me wrong, I get that some people believe pregnancy is defined as sperm going down the penile urethra, etc. But we mustn’t perpetuate the myth that personal belief is equivalent to medical fact.
dj spellchecka
@Uloborus
still not goin all pc on your ass…but you’re ok with typing n****g, but won’t say rat’s shit?
[artie johnson voice]” verrrrrrry interesting”
cheers
dj
DBrown
You say “it was responsible for 11% of abortions.”
WTF?! Thos pill does not cause an abortion – it prevents a cell from sticking to the wall. This is not a fetus so it is not an abortion. Please, stop following these peoples incorrect words/phases – this pill prevents a pregnancy from occuring it does not cause an abortion. Thanks.
Xenos
@Uloborus:
It is all about the patriarchy, which is what they mean by ‘family’. No need to bring race into it, because relatively few fundies are conscious racists.
TEL
@ema: Hey, you’re speaking my language (sciencese)! Thank you for the information. I’m definitely going to check out your blog.
conumbdrum
Check out the “pissy-pants” right-to-lifer (I refuse to capitalize it) article about this Ella making-Jebus-cry pill: the author was hitting the keys so frantically (no doubt blinded by tears for the unborn) that he spelled the word as “abrotion” in the damned headline.
The article is hysterical in more than one sense of the word. “It’s exactly like RU-486! Exactly the same!” That’ll get the unborn baby fetishists to the barricades, by cracky!
Anne Laurie
@Uloborus:
During an historically brief halcyon period, say from the mid-1920s until Dr. Rock’s invention and Roe v Wade got some social traction, god-fearing middle-class white couples with fertility issues had access to a reliable supply of healthy white newborns at relatively modest costs. Now that young white
sluts“girls who get caught” have alternative choices, extending even to drugs allowing them to dispose of the evidence of their unsanctioned sexual activities, people like Justice John Roberts can still buy adorable blond babies in the global marketplace, but his less prosperous fellow Chamber-of-Commerce members are reduced to scouring Third World orphanages for kids that don’t look too “ethnic” or too damaged. Never underestimate those members of the anti-choice movement who are frustrated would-be parents… combining the ‘procreational urge’ with the fury of thwarted consumerism creates something very toxic.Glen Tomkins
Actually, sex causes abortions
Morning after strategies, Plan B or this “Ella” make use, largely, of implantation failure to achieve contraception. You need that qualifier, “largely”, because it is possible that in some cases it works by preventing fertilization, it hinders motility and makes it difficult for sperm and ovum to get together. Even the literal morning after, much less 5 days later, is mostly, but certainly not always, too late to prevent fertilization.
Of course, to the “human life begins at conception (by which they mean “fertilization”)” crowd, anything that kills the fertilized egg is murder, so preventing pregnancy by hindering embryo motility or implantation is simply murder.
Now, this also means that Plan A, plain old vanilla birth control pills, sometimes work by “murder”. Mostly BCPs prevent ovulation, but they also hinder egg and sperm and fetilized egg motlility, and they encourage implantation failure.
Sometines you see women’s rihgts advocates object to this idea, and denounce any airing of the notion that BCPs work by anything but ovulation failure, out of concern that the wingnuts not be given any ammo to use to ban BCPs.
But this is a short-sighted objection, quite aside from it not being a good idea to shape your views of the real world to ideological convenience. Because, you see, ordinary procreational sex also results frequently in such “murder”. There is no way to know just how frequently natural implantation failure, implantation failure in the face of no medical intervention, causes such “murders”, but it is thought to be a quite common phenomenon. It pretty clearly causes much of the infertility associated with uterine abnormalities, and more speculatively, some percentage of single, as opposed to multiple, gestations. A successful implantation immediately triggers changes designed to make the uterus inhospitable to any further implants. There wouldn’t be any need for this feature unless it were not at all uncommon for each insemination to produce more than one fertilized egg. To put it another way, this sort of “murder” of spare embryos must account for enough of the absence of fraternal twinning that we observe, to have made it worthwhile for this trait, whereby embryos trigger changes on implantation that make further implantation impossible, to have developed. That would have to be a pretty hefty butcher’s bill.
If you believe that human life, with all the rights of a person, begins at conception, and that’s that, no qualifications, then engaging in procreative sex is simply murder. It cannot be defended. The Kansas AG needs to start bringing murder charges agaiinst all those women in his state who have given birth to children, because each and every one of those blessed events was made possible by the cold-blooded murder of legions of the unborn.
The only way to have sex at all without such murder, is to do so in a way that absolutely prevents any chance of conception. Carefully and consscientiously used barriers are close, but not quite infallible. The only sure way is for one or both partners to have had preventive surgery; oohorectomy, hysterctomy, orchiectomy or vasectomy.
There is no way, at present, to have children without “murder”. Perhaps we might someday develope a way to rescue embryos that have failed to implant, but it’s hard to see even that speculative technology working except in the setting of IVF. Even if you were able to identify and extract from the vaginal effluent these failed implants, unless you’re applying this solution right after an attempt to implant artificially, you pretty much have to have the surveillance going 24/7 for all the years a women is trying to be fertile.
At any rate, for now it is clear that fertility equals “murder”. By the Catholic Church’s reasoning in that famous case in which they excommunicated a nun for approving an abortion needed to save the mother and the fetus, which was way too premature to have any hope of surviving the mother. The evil of “murder” is not allowed, even to prevent two deaths. The Church clearly needs to announce that fertility is now a mortal sin, and will result in instant excommunication.
Shakers, move over. The Catholic Church wants to join you in demograpohic suicide. Okay, they should want to join you if it were consistent, so I guess we can call off the sucide watch.
Mayken
@Anne Laurie: I love most of what you write and never would have pegged you for one of the anti-choice/adoption conspiracy theory nuts.
As an (soon to be) adoptive parent, I have lived my life for the last 5 years steeped in the community of the adoption triad (because I believe in seeing the issue from as many perspectives as possible.) Granted I don’t have numbers to show you but the adoptive parents and prospective adoptive parents I have had contact with run the gamut of pro-life to pro-choice. And the most virulently anti-choice people in this world have NOT been touched by adoption in any way (Justice Roberts is a VERY rare exception.) Nor do they have plans to do anything even close to helping women who “choose life” whether they choose to parent or choose to make an adoption plan. And far from scouring orphanages in other countries, these are usually the same people with 6 or more bio kids telling me I’m irresponsible to adopt from another country when “so many kids” need homes in this country.
Blarg! Sorry, but you touched a nerve. My husband and I just received our referral from China for our son this week. Having gotten such an amazing reception of our boy from a wide range of family, friends and acquaintances, it was a cold dash of water to see someone who I normally respect circulating such horrible ideas about a subject so close to my heart.
TooManyJens
@Glen Tomkins:
Wrong. Please try again.
ema
@TEL
My pleasure. I’ll try to put up a more detailed post on the mechanism of action of ellaOne and RU-486 but the bottom line is that there’s no evidence for a post-fertilization effect for ellaOne.
Mnemosyne
@Glen Tomkins:
The most current science (as in within the past 5 years) seems to indicate that it’s the other way around: Plan B works primarily by preventing ovulation but doesn’t do anything to prevent an already-fertilized egg from implanting.
Changing the subject slightly, one of the biggest successes of the forced birth movement has been in convincing people that pregnancy begins at fertilization instead of implantation even though, medically, you ain’t pregnant until the fertilized egg implants. (I mean, think about it — what’s this weird vision they have of the fertilized egg magically growing from a zygote to an embryo to a fetus without ever actually attaching to the uterus?!)
LongHairedWeirdo
I’ll add agreement to those who say that the pills do not induce abortion, but I’m going to be all ugly and liberal and and use facts in my defense. An “abortion” refers to the premature ending of a pregnancy – reference, “aborting” a mission which refers to the same idea, stopping it before it has come to its normal stopping point. If the woman isn’t pregnant, she *can’t* be getting an abortion.
Zuzu's Petals
@ema:
I’ll take your and TooManyJens’ word on the pill. My last (and only experience) with IUDs was back in the ’70s, and that was the information then. So I’ll defer to your more recent information.