Summary
On August 24, 2006, the U.S. Food and Drug Administration approved an application by Barr Laboratories to sell the morning-after pill “Plan B” (so-called “emergency contraception”) without a prescription in pharmacies to persons 18 years of age and older. Under the ruling, girls 17 and younger continue to need a physician’s prescription to purchase the pills.

New York State law requires hospitals to offer these drugs to victims of sexual assault. New legislative proposals are anticipated that would further expand access to the morning-after pill, including one that would make it available to persons of any age without a doctor’s prescription.

Conference Position
The United States Conference of Catholic Bishops opposed the “Plan B” application approved by the FDA. The New York State Catholic Conference opposes legislative efforts to further expand access to the morning-after pill.

Rationale
Powerful drugs containing high doses of hormones identified as the “morning-after pill” or “emergency contraception” should be used only by qualified physicians to respond to urgent cases of sexual assault. The act of rape is a violent, unnatural act of aggression, and the Church encourages a woman to defend herself against such an act by seeking immediate treatment. To preserve Catholic teaching on the sacredness of human life and to avoid further victimizing a sexual assault victim who may be pregnant, Catholic health facilities will conduct appropriate testing to ensure there is no evidence conception has occurred, prior to offering the morning-after pill.

Pending legislative proposals seek to expand access to the morning-after pill beyond victims of sexual assault to all sexually active women, regardless of age. The pill is being promoted by family planning and abortion advocates as a “back-up” to regular birth control. This concept dramatically changes the morning-after pill from a crisis response into regular birth control/abortion, at a very high cost to women’s health. The morning-after pill consists of high doses of hormones; clinicians recommend the pill can be taken up to 72 hours after unprotected sexual intercourse. Medical experts, including those at the FDA, agree that the pill can work in one of three possible ways, depending upon where a woman is in her fertility cycle. The drugs can:

1. inhibit ovulation, meaning the egg will not be released; or
2. inhibit fertilization, meaning the sperm will not reach the egg; or
3. alter the lining of the uterus so that an already-fertilized egg will be unable to implant.

If the drugs act to prohibit the implantation of an early embryo (as in (c) above), they are acting in an abortifacient manner and destroying an innocent human life.

Thus, the suggestion by some that easy access to emergency contraception will decrease the numbers of unintended pregnancies and abortions is untrue, and is not borne out by the research. A three-year study published in July 2005 in the British Medical Journal found that making the morning-after pill available without a prescription in the United Kingdom did not lead women to alter their behavior. The findings reveal that the same percentage of women use the morning-after pill before and after legalization of over-the-counter use. Additional studies in Scotland, Sweden, California and Washington State reach similar conclusions – no impact on pregnancy and abortion rates, belying the notion that easier access to these drugs will somehow diminish the incidence of abortion.

At the very least, women must be afforded appropriate informed consent and be adequately counseled about the possible abortifacient effects of these drugs.

A 2001 study published in the Journal of Family Planning and Reproductive Health Care on morning-after pill use in the United Kingdom reveals "high levels of repeat use" among all age groups, with 25% of women using the morning-after pill three or more times. Since the morning-after pill has been made available over-the-counter in Washington State, cases of chlamydia have increased by 56%. This increase is a dramatic reversal of a steadily downward trend in chlamydia before over-the-counter availability of the morning-after pill.

There are additional safety concerns for women who use Plan B repeatedly. An FDA post-marketing Safety Review yielded 116 adverse events, including convulsions and 28 cases of ectopic pregnancy. Emergency contraception proponent David Grimes, MD, explains: “Repeated use of emergency contraception wreaks havoc on a woman’s cycle, so the resulting menstrual chaos acts as a powerful deterrent to using this method too often.”

For all of these reasons, the Conference opposes expanded access to the morning-after pill.