Monday, January 8, 2007

Sexually active women are more likely to use “emergency contraception” (EC) pills if they can easily get them, but there is no evidence that widespread use of the pills lowers pregnancy or abortion rates, researchers say in a new report.

A review of 23 studies on EC “demonstrate convincingly that greater access [to the pills] increases use,” Dr. Elizabeth G. Raymond, James Trussell and Chelsea B. Polis said in their article in this month’s issue of Obstetrics & Gynecology.

But predictions that easier access to EC would produce “a direct, substantial impact … may have been overly optimistic,” they wrote, calling for more research “to explain this finding.”

“To date, no study has shown that increased access to this method reduces unintended pregnancy or abortion rates,” the authors concluded, adding that while some of the 23 studies taken individually have deficiencies, “the consistency of their primary findings is hard to ignore.”

The benefits of widespread use of EC have been touted for years by its supporters. Advocates for Youth, for instance, has cited studies predicting that if women — especially teens — could “back up their birth control” with EC, the number of unwanted pregnancies could be cut in half and 70 percent of abortions could be prevented. In 2005, researchers at the Guttmacher Institute, the research arm of Planned Parenthood, issued a report suggesting that EC alone prevented 51,000 abortions in 2000.

But EC opponents said the new Obstetrics & Gynecology article is just the latest example of overblown claims about EC’s benefits.

Mr. Trussell has for years “harshly criticized” the Bush administration and the Food and Drug Administration (FDA) for “allowing politics to trump science,” said Wendy Wright, president of Concerned Women for America. “Now we will see if ideology and abortion politics will trump science.”

In August, after a protracted battle, the FDA approved Plan B, the nation’s only EC product, for adults-only purchase in retail stores with pharmacists. Girls age 17 and younger still must have a prescription to buy Plan B, which is manufactured by Barr Laboratories.

Plan B is a set of birth-control pills intended to be taken by women within 72 hours of sexual intercourse. EC prevents pregnancy by preventing ovulation, preventing fertilization of the egg or preventing implantation of the fertilized egg in the womb.

Some pro-life activists oppose EC because they say life begins at conception, and since EC can prevent implantation, it could be an abortifacient. Pro-EC activists counter that pregnancy starts with implantation and EC cannot be an abortifacient because it doesn’t affect implanted embryos.

In their new study, Mr. Trussell and his colleagues found that women who used EC contraception were more likely to become serious about using reliable birth control.

“Ultimately,” they wrote, “emergency contraception may contribute its greatest public health benefit indirectly” by prodding women “to adopt a more effective contraceptive method” or use their current method “more correctly and consistently.”

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