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Debate: Emergency contraception

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Should the morning-after pill be banned?

Background and context

Emergency contraception, often called the ‘morning-after pill’, reduces the chance of pregnancy following unprotected sexual intercourse. It consists either of an increased dose of certain conventional oral contraceptive pills or (not a ‘morning-after pill, but still an effective emergency contraceptive) the use of an intra-uterine device, or IUD. Emergency contraceptive pills work best when taken within 120 hours of unprotected vaginal intercourse; if taken within 72 hours they reduce the risk of pregnancy by between 75 and 89 percent. Emergency contraceptives such as Levonelle are legal in the US and UK; in the UK they can be bought over the counter from pharmacists by over-16s. In the US, there are complaints that many religiously affiliated hospitals, especially Catholic hospitals, do not provide emergency contraceptive advice to victims of sexual assault. Anti-abortion groups continue to argue that post-intercourse, potentially post-fertilisation methods of preventing pregnancy are forms of abortion, and to campaign against emergency contraception on that basis. Many of the arguments for and against emergency contraception are therefore the same as the arguments for and against abortion. These are not rehearsed here; refer to the ‘Abortion’ topic and related links.

Contents

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Abortion-like? Is emergency contraception like a form of abortion? If so, is abortion wrong?

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Yes

  • Emergency contraception is a form of abortion: It works by preventing a fertilised egg - fertilisation can occur as soon as 15 minutes after intercourse wiki.idebate.org in the uterus. A fertilised egg is, in effect, a human being, because it contains within itself all that is necessary for a child to develop. Emergency contraception differs from forms of contraception which prevent conception from happening in the first place, and which therefore do not kill conceived human beings.[1]
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No

  • Emergency contraception is not equivalent to abortion: Precisely how such contraceptives work depends on the stage of the menstrual cycle at which they are taken, but they can delay ovulation, inhibit the tubal transport of egg and sperm, interfere with fertilisation or alter the lining of the uterus to prevent the implantation of a fertilised egg. At the stage when the contraceptive is effective, there is no viable pregnancy so there can be no abortion. If a woman is already pregnant, a morning-after pill will not induce an abortion. In any case, if abortion is legal then arguing that emergency contraception is a form of abortion is not a compelling argument against it.[2]
  • Even if emergency contraception can be considered abortion, abortion is ok:
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Side-effects? Do emergency contraception drugs have serious, harmful side-effects?

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Yes

  • Emergency contraceptive pills can have serious, harmful side-effects: These can include nausea, vomiting, infertility, breast tenderness, ectopic pregnancy and blood clot formation. There are no long-term studies into whether women are at risk of permanent damage or diseases such as cancer as a result of exposure to such high doses of dangerous chemicals.[3]
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No

  • Serious side-effects from emergency contraception are extremely rare: Nausea and vomiting, while unpleasant, do no long-term damage and would be considered by women who choose to use emergency contraception to be a price worth paying for avoiding an unwanted pregnancy. Citing a lack of investigation-based evidence for long-term damage is not a good argument that there may be long-term damage.[4]
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Affecting protection choices: Does the availability of emergency contraception cause people to rely on it as an alternative to safer approaches?

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Yes

  • Emergency contraception may be seen by some as an alternative to safer forms of contraception: Its widespread easy availability would encourage women to have unprotected sex. This increases their risk of getting or passing on sexually transmitted diseases which are prevented by barrier contraceptives such as condoms but not by emergency contraceptives which are taken after sex.[5]
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No

  • Only completely mis-informed individuals would rely solely on morning after pill for protection against pregnancy and STDs: Given the existence of the various unpleasant side-effects discussed, nobody would sensibly choose the morning-after pill over other forms of contraception, or risk unprotected sex on the grounds that they can take a morning-after pill afterwards. Emergency contraceptives are for use in emergencies - and emergencies really do happen, and really do need to be dealt with.[6]
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Effect on sexual behavior: Does the availability of emergency contraception lead people to engage in more risky sexual behavior?

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Yes

  • Emergency contraception encourages irresponsible sexual behavior: If you have unprotected sex, you should accept the chance that, if you are a woman, you may get pregnant as a result. If you don’t want to get pregnant, you should use contraception or avoid having sexual intercourse altogether, rather than taking action after the event.[7]
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No

  • Whether intentionally or otherwise, people do sometimes have unprotected sex without wanting to get pregnant: When this happens, emergency contraception enables women to ensure that they are not pregnant, without the stress, uncertainty and increased health risk caused by waiting until a pregnancy can be confirmed and then, if desired, having an abortion.[8]
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Prescription required? Should emergency contraception be made, if anything, a prescription drug?

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Yes

  • There are significant harms arising from selling the morning-after pill through pharmacies: Doctors are not informed of their patients’ over-the-counter purchases, but a patient’s previous use of a drug as powerful as the morning-after pill may be something they need to know about to make good future medical decisions. Pharmacists cannot check medical records to find out whether there is anything in the customer’s medical history which might make taking the pill dangerous. They have no way of telling whether their customer is over 16.[9]
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No

  • There are good reasons for making the morning-after pill a non-prescription drug: It can take time to get a prescription from a doctor, and in cases of emergency contraception speed is very important. Some patients may be embarrassed to tell their doctor about their sexual behaviour, and consequently be put off seeking a prescription. The restriction of emergency contraception to over-16s makes no sense in any case; a girl under 16 who has had unprotected sex may well need emergency contraception.[10]
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United Kingdom: Should emergency contraception be banned within the rubric of UK law?

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Yes

  • UK-specific argument: Even though abortion is legal, emergency contraception is not covered by the terms of the 1967 Abortion Act: Abortion is regulated by the 1861 Offences Against the Person Act; the 1967 Act creates a defence for doctors against the criminality of abortion, by deeming it lawful for them to authorise an abortion on certain grounds. The 1861 Act prohibits the supply of "any poison or other noxious thing" with the intent to cause miscarriage; the circumstances under which emergency contraception is supplied to women - over the counter, without a pregnancy test and without consulting a doctor - do not meet the exception criteria of the 1967 Act.[11]
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No

  • UK-specific argument: This argument is irrelevant because emergency contraception does not cause miscarriage: Miscarriage can only occur after the implantation of the fertilised egg into the uterus - and once this has happened, emergency contraception does not work anyway. This interpretation was upheld in 2002 following a case brought by the Society for the Protection of Unborn Children and opposed by the Department of Health. The possibility of making the argument at all, however, does expose the inadequacy of the 1967 Abortion Act, which does not enshrine a woman’s right to abortion but creates certain exceptions to the state’s basic, continued right to control her fertility.[12]

See also

External links and resources

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