- The Washington Times - Wednesday, January 2, 2002

The poster shows a waist-down photo of a person standing in a pair of blue jeans.
The blunt caption appears over the jean's zipper: "Emergency contraception. Use within 3 days of opening."
Emergency contraception, or EC, has been around for decades health workers at rape-crisis centers and campus clinics have long known to give women double doses of certain kinds of birth-control pills within 72 hours of unprotected sex to prevent pregnancy.
If EC was widely used, half of unwanted pregnancies and thousands of abortions could be avoided each year, say groups such as Advocates for Youth (AFY), Planned Parenthood Federation of America and the National Abortion and Reproductive Rights Action League.
But many Americans remain unaware of the power of this approach, they say, which is why they are planning a major EC education campaign early this year.
A top goal is to get the Food and Drug Administration (FDA) to make EC pills and kits available over the counter.
"If we are truly interested in teen pregnancy prevention, this is something to become knowledgeable about," said Tamarah C. Moss, who runs the Emergency Contraception Initiative at AFY.
Teen pregnancies each year number as many as 900,000, of which 80 percent are unintended, recent studies have found.
Half of these unintended pregnancies could be averted with ECs, said Ms. Moss, citing a 1992 study published by the Alan Guttmacher Institute.
EC pills are not only for people who have had unprotected sex, but for those who suspect their birth control has failed or who have been sexually assaulted, Ms. Moss said at a recent AFY workshop on emergency contraception.
Emergency conception kits "should be in every emergency room," she added.
EC opponents include many pro-life groups who see emergency contraception as "emergency abortion." Fertilization and life can begin within 30 minutes of intercourse, many pro-life advocates say.
Since the EC pills can prevent a fertilized egg from implanting in the womb, its effect "is to kill a tiny human being," said Dr. John C. Willke, president of the Life Issues Institute in Cincinnati. "It is a very, very early abortive drug."
Judie Brown, president of the American Life League, maintains that medical groups are wrong when they say pregnancy begins after implantation in the womb.
Pregnancy begins at fertilization, "not some other arbitrary point," said Mrs. Brown. "Any 'treatment' that destroys the living human being at any point after fertilization is abortion, and all true pro-lifers must oppose any method that could act in this manner," she said.
More than 100 doctors have signed a statement questioning federal designation of EC as "contraception."
Calling these pills "contraception" when they work only when taken after sexual intercourse is a rejection of what is known about biological science, says the statement, which appears at www.morningafterpill.org.
Rep. Melissa A. Hart, Pennsylvania Republican, says distributing EC pills to minors in schools violates parental rights.
"Students can receive a pill to abort a pregnancy but can't even get an aspirin without parental permission. This is inconsistent and inappropriate," Miss Hart said in October when she submitted an amendment to block federal funding to schools that distribute EC pills and kits to minors. The amendment was part of the appropriations bill for the departments of Health and Human Services, Education, and Labor.
Miss Hart said that according to the Congressional Research Service, more than 180 schools now offer emergency contraception in their clinics.
"The role of our schools is to educate and nourish our children as they grow, not to act as family-planning counselors," she said.
Miss Hart later withdrew her anti-EC amendment, but she planned to introduce the legislation again soon, an aide said before the congressional recess in December.
Supporters of EC pills say their use and application are widely misunderstood. Emergency contraception, they say, doesn't encourage sexual activity or cause infertility, and it is not RU-486 or mifepristone, which are used to chemically abort a pregnancy in the first trimester.
But the biggest message EC proponents want to get across is their view that EC pills do not cause abortion.
EC pills may do one of three things: delay ovulation, prevent fertilization or prevent implantation, Ms. Moss said at the December AFY workshop on emergency contraception.
Most people consider implantation of the fertilized egg to be the beginning of a pregnancy, she said. Because it takes longer than 72 hours for a fertilized egg to implant, EC pills don't cause abortion, she said.
Moreover, EC pills don't prevent pregnancy if the woman is already pregnant, which is why many medical professionals and EC kits include pregnancy tests, Ms. Moss said.
Proponents of EC have made headway in some areas: A national hot line was established in 1996 to provide information on the pills; current hot line numbers include 1-888-NOT-2-LATE and 1-877-99-GO-4-EC in Maryland.
The approach also has been helped by the FDA, which in February 1997 confirmed that double doses of six kinds of birth-control pills taken soon after unprotected sex could prevent pregnancy.
"The best-kept contraceptive secret is no longer a secret," FDA Commissioner David Kessler said at the time.
In 1998, the FDA approved the sale of Preven, the nation's first designated EC kit, and in 1999, another EC kit called Plan B, was introduced.
Still, EC use remains small. According to a 2000 Kaiser Family Foundation survey, 2 percent of women ages 18 to 44 had ever used EC pills.
Surveys show that teens and young adults don't know how to obtain EC pills or kits, AFY workshop participants said. Males were especially unlikely to know about ECs.
The 72-hour window for use is another barrier, EC advocates said. ECs are not believed to be useful if taken later than 72 hours after unprotected intercourse, but many medical clinics require appointments to dispense them, Ms. Moss said.
Also, many pharmacies are unlikely to stock ECs or sell them without prescriptions, said Tom Croce of the American Pharmaceutical Association.
ECs are "not on most pharmacists' radar screens," he told the AFY workshop. He added that it's a Catch-22 because pharmacies won't stock ECs if they don't get calls for it, but they won't get calls for ECs unless they stock them. Furthermore, industry "conscience clauses" allow pharmacists to opt out of dispensing products they morally oppose, he said. EC pills fall under that clause.
Still, EC supporters are heartened by laws in Washington state and California that allow pharmacies to dispense ECs without prescriptions. "We've just got to make emergency contraception part of the discussion," said Marnie Wells, a Minnesota EC advocate.


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