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

Statement Of Canadian Physicians For Life; The Morning After Pill

The Morning After Pill (MAP/EC)
The MAP is a multiple dose of an oral contraceptive. The MAP may prevent ovulation or, if fertilization has occurred, it may ruin the implantation of a newly conceived human being. It is important that the potential for post-fertilization effects be communicated to patients and health-care providers, as many consider human life to be present and valuable from the moment of fertilization.
The common description of the MAP as emergency contraception fails to accurately describe its abortifacient action and is misleading the public. The confusion is aggravated by the current attempt to re-define pregnancy as occurring after implantation. It is a basic fact of human embryology that life begins at conception.

The common description of the MAP as emergency contraception fails to accurately describe its abortifacient action and is misleading the public. The confusion is aggravated by the current attempt to re-define pregnancy as occurring after implantation. It is a basic fact of human embryology that life begins at conception.

Impact of MAP Use

Manufacturers have greatly reduced the hormone content of oral contraceptives due to serious side effects and health risks. Now women are being encouraged to use these same pills, in multiple doses, as post-coital “contraception.” The potential long-term impact of these high hormone doses, especially when used repeatedly, is worrisome and not being adequately addressed. The effect of the drug on children who survive is also a cause for concern.

The policy to make the morning-after-pill available without a doctor’s prescription puts women and girls at higher risk for disease and sexual health problems. Physical and clinical examination by a physician are essential to good healthcare: to counsel patients and determine sexually-transmitted diseases, abusive relationships and related health issues.

Obviously increased access to MAP will increase use. The 1998-99 annual report of Planned Parenthood Federation of America showed an 83.5% increase in “emergency contraception (EC) clients”. Seventy-eight of its 132 affiliates “offered EC kits to keep at home ‘just in case’.” Manufacturers stress that the MAP is not intended for repetitive use but offer no realistic plan to prevent this. In Asia, repetitive MAP use (and health consequences) have become commonplace, and health authorities there have become

Conscience Rights

A related issue raised by increased MAP demand is that of conscientious objection. Our recent correspondence with provincial Colleges of Physicians and Surgeons indicates that, in general, regulating bodies agree that physicians do not have a professional obligation to refer a patient for an abortion. This principle must also apply to the prescription of abortifacients, where referral would violate the conscience and medical good judgement of the physician.

Canadian Physicians for Life affirms the Hippocratic tradition in medicine.
We are dedicated to the respect and ethical treatment of every human being, regardless of age or infirmity. Those who hold these principles must not be pressured to act contrary to them as they are foundational to the integrity of our profession and the trust of the public.

Informed Decision Making

Any policy that morally troublesome issues need only be referred to a colleague is oblivious to the principled objections of pro-life physicians. Pro- life practitioners are not merely refusing to prescribe a type of medication but are dedicated to helping patients make fully informed decisions about their health.

The Code of Ethics of the Canadian Medical Association requires physicians to “inform a patient when their personal morality would influence the recommendation or practice of any medical procedure that the patient needs or wants.” We suggest that doctors should be required to inform patients when pro-abortion beliefs may bias their approach to a pregnancy, reflecting the same principles expected of pro-life doctors. In other words, doctors who rank unborn human lives as disposable and who believe that abortion does not cause unacceptable harm to women should be expected to inform the patient of this bias during the counseling process.

II.  Morning After Pill (MAP) (Emergency Contraception)

IF breakthrough ovulation has taken place, and IF fertilization has taken place, then these pills COULD be abortifacient. The following was investigated, documented to be true and accurate, and because of this, the Philippine government withdrew its sale of Posnitor (an “emergency” contraceptive):

“Inhibition of Implantation: The administration of relatively large doses of estrogens (“morning-after pills”) for several days, beginning shortly after unprotected sexual intercourse, usually does not prevent fertilization but often prevents implantation of the blastocyst. Diethylstilbestrol, given daily in high dosage for 5 to 6 days, may also accelerate passage of the dividing zygote along the uterine tube [Kalant et al, 1990].  Normally, the endometrium progresses to the secretory phase of the menstrual cycle as the zygote forms, undergoes cleavage, and enters the uterus. The large amount of estrogen disturbs the normal balance between estrogen and progesterone that is necessary for preparation of the endometrium for implantation of the blastocyst.   Post-conception administration of hormones to prevent implantation of the blastocyst is sometimes used in cases of sexual assault or leakage of a condom, but this treatment is contraindicated for routine contraceptive use. The “abortion pill,” RU486,  also destroys the conceptus by interrupting implantation because of interference with the hormonal environment of the implanting embryo.
“An intrauterine device (IUD) inserted into the uterus through the vagina
and cervix usually interferes with implantation by causing a local inflammatory reaction. Some IUDs contain progesterone that is slowly released and interferes with the development of the endometrium so that
implantation does not usually occur.” (p. 58)

— [Question Chapter 2, #5 for students:]
“#5. A young woman who feared that she might be pregnant asked you about the so-called “morning after pills” (post-coital birth control pills). What would you tell her? Would termination of such an early pregnancy be considered an abortion?” (p. 45)
— [Answer #5 for students:]

“Chapter 2
#5. Post-coital birth control pills (“morning after pills”) may be prescribed in an emergency (e.g., following sexual abuse). Ovarian hormones (estrogen) taken in large doses within 72 hours after sexual intercourse usually prevent implantation of the blastocyst, probably by altering tubal motility,
interfering with corpus luteum function, or causing abnormal changes in the endometrium. These hormones prevent implantation, not fertilization.
Consequently, they should not be called contraceptive pills. Conception occurs but the blastocyst does not implant. It would be more appropriate to
call them “contra-implantation pills”. Because the term “abortion” refers to a premature stoppage of a pregnancy, the term “abortion” could be applied to such an early termination of pregnancy.” (p. 532)

— [Question chapter 3, #2 for students]:
“Case 3-2. A woman who was sexually assaulted during her fertile period was given large doses of estrogen twice daily for five days to interrupt a possible pregnancy.
— If fertilization had occurred, what do you think would be the mechanism of action of this hormone?
— What do lay people call this type of medical treatment? Is this what the media refer to as the “abortion pill”? If not, explain the method of
action of the hormonal treatment.
— How early can a pregnancy be detected?” (p. 5
— [Answer Chapter 3, #2 for students:
“Chapter 3-2 (p. 532)

Diethylstilbestrol (DES) appears to affect the endometrium by rendering it
unprepared for implantation, a process that is regulated by a delicate balance between estrogen and progesterone. The large doses of estrogen upset this balance. Progesterone makes the endometrium grow thick and succulent so that the blastocyst may become embedded and nourished adequately. DES pills are referred to as “morning after pills” by lay people. When the media refer to the “abortion pill”, they are usually referring to RU-486. This drug, developed in France, interferes with implantation of the blastocyst by blocking the production of progesterone by the corpus luteum. A pregnancy can be detected at the end of the second week after fertilization using highly sensitive pregnancy tests. Most tests depend on the presence of an early pregnancy factor (EPF) in the maternal serum. Early pregnancy can also be detected by ultrasonography.” [Keith Moore and T.V.N. Persaud, The Developing Human: Clinically Oriented Embryology, 6th ed., Philadelphia: W.B. Saunders Comp. 1998, pp.45, 58, 59, 532; Nancy Valko, R.N.; Dr. Diane Irving (college professor Ph.Ds in philosophy & in  bioethics) regarding the ethics director of CHA’s comments that there is a lack of conclusive evidence on the ‘morning after’ pill]