Contraception - Chemical Methods / Hormonal Contraception / Emergency / Morning After Pill

Morning After Pill (EC/MAP): Increases Pregnancy & Abortion (2001)

No studies to date show that Emergency Contraception/MAP reduces unintended pregnancy rates (20) or lowers abortion rates.

In fact, studies show that morning-after pills increase rates of unintended pregnancy and abortion. After MAP was introduced on a widespread basis in Sweden, adolescent abortion rates increased from 17/1,000 to 22.5/1,000.(21)

The British Medical Journal found that teenagers whose pregnancies ended in induced abortion were more likely to have used the morning-after pill before conception. The study surmised that MAP use is an indicator of willingness to engage in "risk-taking" behavior.(22)

Still, the self-evident reality that life begins at fertilization, and that abortion can occur at any time after this point, should be revisited by America's medical establishment.


1. Task Force on Postovulatory Methods of Fertility Regulation, "Randomised Controlled Trial of Levonorgestrel versus the Yuzpe Regimen of Combined Oral Contraceptives for Emergency Contraception," The Lancet, Vol. 352:428-33, August 8, 1998.  Study sponsored by UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization.

2. Anna Glasier, Evert Ketting, V.T. Palan, "Case Studies in Emergency Contraception from Six Countries."  International Family Planning Perspectives. June 1996; 22(2) p.57-61.   

3. "Contraception, Not Abortion – An Analysis of Laws and Policy Around the World," Center for Reproductive Rights, April 2002, Item:  B012.

4. "Briefing Document:  Nonprescription Drugs and Reproductive Health Drugs Advisory Committee Meeting," Women's Capital Corporation, Plan B for Emergency Contraception Rx-to-OTC Switch, 14 November 2003, Appendix 1: Mechanism of Action. 
(To supports its claims that Plan B is not abortifacient, Women's Capital Corporation's Briefing Document included a Medical Bulletin from International Planned Parenthood Federation entitled, "Emergency Contraception Pills:  How Do They Work?"  According to the report, since it is never known whether MAPs were taken before or after ovulation and since no study could ethically or logistically make such determinations, "there is no direct evidence for or against the hypothesis that MAPs prevent pregnancy by interference with post-fertilization events."  The report discusses studies of endometrium alterations where endometrium biopsies were obtained.  The report states that "treated cycles in which the ovulatory process is believed to be abnormal or suppressed are excluded since endometrial development would reflect abnormal ovarian function rather than a direct effect of the EC pill."  However, where abnormal or suppressed ovulation occurs, consequent changes in endometrial development would be an indirect but still abortifacient effect of the morning-after pill.)

5. Dianne Irving, PhD., "New Drug Application 21-045 Levonorgestrel [Plan B, and Preven, Emergency Contraceptives] and Their Possible Abortifacient Effects," Letter to FDA Advisory Committee, December 5, 2003. 

6. Ibid., Irving.

7. Ibid., Briefing Document; FDA Transcript, Nonprescription Drugs Advisory Committee in Joint Session with the Advisory Committee for Reproductive Health Drugs Meeting, Food and Drug Administration, December 16, 2003, P. 288, 289.   Transcript.

8. Ibid., FDA Transcript.

9. Ibid.

10. Ibid.

11. Ibid.

12. Ibid., p. 269-271.

13. "Center for Reproductive Rights Petitions FDA Petitions FDA to Change Emergency Contraception from Prescription to Over the Counter," Center for Reproductive Law and Policy [now Center for Reproductive Rights], February 14, 2001. 

14. Rachel K. Jones, et al., "Contraceptive Use Among U.S. Women Having Abortions in 2000-2001," Perspectives on Sexuality and Reproductive Health, The Alan Guttmacher Institute, Vol. 34, No. 6, November/December
2002.  (The study reported that 46% of the aborting women were described as not using contraception in the month they became pregnant.)

15. Ibid.

16. Ibid. 

17. Ibid.

18. Ibid. (Interestingly, James Trussell, whose studies claim a 75% effectiveness rate for MAP, was a voting member of the December 16, 2003, FDA advisory committee which recommended OTC status for MAPs.)

19. Briefing Document.

20. Tina Raine, MD, MPH, et al., "Does Improving Access to Emergency Contraception Through Pharmacies Make a Difference in Unintended Pregnancy Rates?" American Public Health Association 2003 Annual Meeting, November 19, 2003, Abstract #70869. (It is unclear whether the results of this study have been published. This study was supported by a research grant from Women's Capital Corporation, manufacturer of Plan B.) 21. K. Edgardh, "Adolescent Sexual Health," Sexually Transmitted Infections, 19 July 2002; 78:352-356. 

22. Dick Churchill, et al., "Consultation Patterns and Provision of Contraception in General Practice Before Teenage Pregnancy:  Case-Control Study," British Medical Journal, 2000 August 19; 321 (7259): 486-489.

(c) 2001 Population Research Institute. Permission to reprint granted. Redistribute widely. Credit requested.