Given by Patrick Leahy, Student LifeNet.
Note: The speech has been amended for website usage.
The Basics:
There are two main types of Morning-after-pill, nicknamed ‘emergency contraception’ licensed in the UK: Schering PC-4 and Schering Levonelle-2. The latter is used more frequently because of its higher success rate. Levonelle-2 was made available without prescription to over-16s in 2001. It is also available to under-16s in some areas of the country without prescription and without parental or doctor knowledge.
It is to be taken within 72 hours of intercourse and it is composed of 2 tablets with the 2nd tablet taken 12 hours after the first.
How it works:
The morning-after-pill can work by preventing or delaying ovulation, slowing down the transmit time of sperm or an egg or by affecting the lining of the womb so that the embryo cannot implant.
The first 3 actions impede conception with the fourth being a form of early abortion.
Various research has suggested that the primary mode of action is the fourth (1). On the PC-4 product summary it states it is “primarily aimed to prevent implantation of the fertilised ovum in the endometrium” (2).
Levonelle-2 is thought to act more often as an abortifacient since it only contains progestogen whereas PC-4 contains both progestogen and oestrogen.
Why is it labelled contraception if it acts as a form of abortion?
The UK government has claimed that the morning-after pill is not abortifacient because pregnancy only starts when an embryo implants in the womb (3). However, when asked to name three established scientists who accepted that pregnancy only occurred once an embryo had implanted, the Department of Health was unable to do so (4).
It is scientific nonsense to talk about contraception after fertilisation has taken place. It should, at the very least, be described as a post-coital pill.
Success rate of Levonelle:
Table 1. Effect of Coitus-to-Treatment Interval on Efficacy of Levonelle (levonorgestrel 0.75mg)*
| Time taken after intercourse | Proportion
of pregnancies prevented |
24 hours
or less | 95% |
| 25-48 hours | 85% |
| 49-72 hours | 58% |
* Results from the WHO Task Force trial.
Usage of the morning-after-pill
Schering, unsurprisingly, will not release the official number of sales of the morning-after-pill.
However, the government has estimated that nearly a million courses of the morning-after pill were supplied to women in the UK in 2000 (5). Yet Schering states that “Emergency contraception is an occasional method. It should in no instance replace a regular contraceptive method” (6). This is particularly worrying when considering the dosage, side effects and rise in STDs (see below).
The government encourages its usage probably to save costs of surgical abortions on the NHS (and to cut down on teenage pregnancies). NHS abortions are quite expensive – particularly when 500 are being carried out daily. Unfortunately for the government, MAP usage does not seem to cut the number of surgical abortions (see below).
Dosage:
The standard dose of the Levonelle 2 morning-after pill comprises two tablets each containing 750µg of levonorgestrel that are taken within 12 hours of each other. Girls or women taking Levonelle 2 therefore receive 1,500µg of levornogestrel in the course of a day. By contrast, the Norgeston daily mini-pill contains just 30µg of levornogestrel. Levonelle 2 thus delivers 50 times the daily dose of the mini-pill.
Side effects:
The following side effects are taken from the 2000 edition of the ‘Levonelle-2 – Summary of Product Characteristics’:
| Effect | Percent of women with effect (n=977 women)* |
| Nausea | 23.1 |
| Low abdominal pain | 17.6 |
| Fatigue | 16.9 |
| Headache | 16.8 |
| Dizziness | 11.2 |
| Breast tenderness | 10.8 |
| Vomiting | 5.6 |
| | |
| All other undesirable effects | 13.5** |
*Lancet, 1998, 352, 428-433;
**mostly diarrhoea, irregular bleeding and spotting
The government issued at the beginning of February 2003, a warning about the risk of ectopic pregnancy from Levonelle-2. Ectopic pregnancy is one of the major causes of pregnancy-related deaths and it also causes infertility. According to government figures, there is a 6% chance of ectopic pregnancy if the patient becomes pregnant (7).
Furthermore, considering in many, if not most, cases a woman will not be pregnant, women will be merely receiving a dangerous jolt of hormones.
The government often claims that there are ‘no serious side effects’ to the morning-after-pill. But there is some ‘spin’ involved here since they are relying on the reported side effects from pharmacies supplying the drug over-the-counter. If the "morning-after" pill is given to women without their
doctors' knowing, of course the doctors will not report any side-effects, because they will not know if any have been caused! Without a prescription, no proper records are kept or collated.
Furthermore, although pharmacies encourage women to return for a check-up (to see if the drug has worked), the woman does not have to turn up. Furthermore the emphasis on the check-ups is to see if the drug has worked – not if there have been any problems.
Morning-after-pills and sexually transmitted diseases (STDs):
Morning-after pills provide no protection against sexually transmitted diseases (STDs) and increased reliance on them could well result in an increase in the incidence of such diseases. STDs are already spreading fast. In England between 1998 and 1999, cases of uncomplicated gonorrhoea rose among teenagers by 39% in males and by 24% in females (8). Between 1995 and 1998, the number of diagnoses of chlamydia in England among 16 to 19-year-olds rose on average by 28% per year (9).
Dangers to the well being of those under-16 year olds:
Schering states on its product summary that “Levonelle-2 is not recommended in children” and “Very limited data are available in women under 16 years of age” (6).
The side-effects listed above are likely to be even more dangerous in young women.
Furthermore, without parental knowledge the girl is less likely to receive proper care and support. It is also wrong to not inform parents who will be understandably concerned about the well being and sexual activity of their child.
Availability to under-16s can only encourage unscrupulous men to exploit young women. If girls as young as 11 are obtaining the morning-after-pill (10), then it is likely paedophilia is occurring.
Dangers with supplying the morning-after-pill over the counter:
Without a prescription there is no way pharmacists can check the medical records of patients. They therefore have no knowledge about whether the patient is in a high-risk category. Neither will they know whether the patient has taken the morning-after-pill several times before.
As a result, pharmacists may find themselves legally liable for any negative outcome of supplying the drug.
Without prescriptions, under-16s will be able to obtain the drug easily (even in areas where it is not supplied to under-16s without prescriptions) either by deception or through carelessness on the part of pharmacists.
Patients will also be able to obtain the morning-after-pill 72 hours after sexual intercourse.
Pharmacists will also not be able to ensure adequate after-care for the patient.
For some time, pharmacists were asking to prescribe antibiotic ointments for eyes and skin, yet permission was refused. Why then are morning-after-pills allowed to be sold over the counter?
Doesn’t the morning-after-pill lead to a drop in the number of teenage pregnancies and surgical abortions?
Setting aside the fact that the morning-after-pill can destroy the embryo, the 1990s saw a five-fold increase in prescriptions of morning-after pills yet the overall rate of abortion and teenage pregnancy also rose.
In 2001, the morning-after-pill was legalised over the counter. Yet, in the same year the abortion rate actually rose on previous years’ rates.
There are better ways of cutting the number of pregnancies and surgical abortions. For instance Minnesota’s 1981 law requiring parental consent for abortion led to a large cut in the number of teenage pregnancies. In Holland teenagers get treatment on their parents’ insurance which means the parent has to be informed. This too reduces the teenage pregnancy rate.
Even if the morning-after-pill did lead to a drop in the number of teenage pregnancies and surgical abortions, this would not justify its usage for the reasons stated in the article.
HOWEVER, statistics may actually show a drop in the number of teenage pregnancies. This is because the morning-after-pill conceals conception rates. Obviously, there is no way of knowing whether a woman taking this drug is pregnant at the time, and so any conceptions that have occurred are not included in government statistics (thus making it appear as though the number of teenage conceptions has been lowered when in fact they have not).
This is believed to be one of the core reasons explaining why the government is promoting its usage. Since it is not regarded as a form of abortion by the government it may statistically lower abortion rates too.
The Politics of the morning-after-pill
Why it is important to oppose:
The morning-after-pill is becoming very widely used and consequently many embryos would have doubtlessly been destroyed. It’s the easiest form of abortion to get hold of (since the government doesn’t consider it to be abortion for the reasons stated above, there is no need for doctor approval to obtain the drug).
It is also a drug which inflicts much harm on the well-being of women. It additionally aids in spreading STDs.
Problems with opposing the MAP:
We have to be especially careful not to sound like we are anti-contraception since this would deter those we are trying to win over. We have to make it absolutely clear that the morning-after-pill can act as a form of early abortion and not contraception therefore.
For that reason it is worth re-asserting that we do not campaign against REAL forms of contraception.
Another problem with opposing the morning-after-pill on pro-life grounds, is that it brings about debate of ‘when life begins’. Resultantly, one obviously needs to be well equipped on arguments about why all life from conception should not be killed.
Some tactics/arguments:
It is often better to highlight other more popular arguments which appeal more to the non-pro-life public.
The availability of the morning-after-pill to under-16s seems to be a concern shared by many parents and some newspapers. Surely parents know what is best for their child and not a government? It also severely undermines the parent-child relationship and is an affront to parental rights and responsibilities.
Additionally, if girls as young as eleven are obtaining this pill then cases of paedophilia are likely to be involved. The morning-after-pill allows unscrupulous men to continue exploiting young girls without the fear of childbirth resulting and the male being ‘found out’ or being held partly responsible for the upbringing of the child. See above for more information/arguments on the MAP and under-16s.
Women may also be worried about the health risks associated with the morning-after-pill. As stated above, the side effects are frequently occurring.
The morning-after-pill is also being used regularly (see ‘Usage of the morning-after-pill’ above) – even though Schering state that it should not become a regular method of “contraception”. It may therefore be causing great damage on the well-being of women. Additionally – if it is being used regularly then it must be leading to a rise in STDs.
Also see information on “Dangers with supplying the morning-after-pill over the counter”.
It’s also worth playing up the fact that the morning-after-pill is fifty times the strength of a contraceptive ‘mini pill’ (see: “Dosage”). No woman would ever dream of swallowing 50 contraceptive tablets at once! Yet this is exactly what is occurring over one million times a year.
Challenging the law:
The Society for the Protection of Unborn Children (SPUC) has already attempted to change the law regarding the distribution of the morning-after-pill.
To put it in simple terms, SPUC argued that since the morning-after-pill can impede implantation it is a form of abortion and therefore it should be subject to the controls set out in the 1967 Abortion Act.
SPUC also argued that the supply of the morning-after-pill constituted a criminal offence under the Offences against the person act 1861. The 1861 act prohibited the supply of ‘any poison or other noxious thing…with intent to procure the miscarriage of any woman, whether she be or be not with child’.
The judge threw the case out on the grounds that pregnancy did not begin until implantation!
However, if at any stage pro-lifers are successful in getting the morning-after-pill covered by the 1967 Abortion Act, the drug would become very difficult to get hold of. Not only would a woman have to book an appointment to see her doctor, but she would also need approval. Since the drug has to be taken within 72 hours this would severely restrict a woman’s ability to take it. This would help avoid harm to women’s well-being, curb the rise of sexually transmitted diseases and avoid destruction of the early human embryo.
References:
(1) See Grou in the American Journal of Obstetrics and Gynaecology, 1994; 171:
1529-34: “… this mode of action could explain the majority of cases
where pregnancies are prevented by the morning-after pill.”
(2) Schering, product summary for PC4
(3) letter, Department of Health, 5 June 1995
(4) letter to chairman of LIFE, 6 June 1995
(5) Source: Mail on Sunday, 18 March 2001
(6) Levonelle-2 – Summary of Product Characteristics
(7) www.doh.gov.uk/cmo/cmo_35.htm#20
(8) Public Health Laboratory Service – New cases of acute sexually transmitted
infections seen in genitourinary medicine clinics: England 1999 (provisional
data). Summary statistics updated on 30 July 2000
(9) Public Health Laboratory Service – New Cases seen at genitourinary medicine
clinics: England 1998. (CDR Supplement, volume 9, Supplement 6,
December 1999).
(10) “472 girls as young as 11 have received the abortifacient morning-after
pill from school nurses in Oxfordshire” (Daily Telegraph, 17th November 2002).
