Editor’s Note: The editors present this series (read part 1, part 3, part 4, part 5, part 6) on the recent furor over Plan B as an opportunity for our fellow pro-lifers to slow down, step out of activist mode, and enter into the conversation in a prayerful and thoughtful way.
The Church encourages conversation among faithful scientists and theologians as new science comes to light and as we deepen ethical reflection. Typically such conversations occur in academic settings, but since the recent furor pushed the issue into the open, causing much confusion and scandal, we felt it important to present the latest science and moral reflection in a context of faithful discussion.
We offer this series in a spirit of obedience to the Magisterium, and as an opportunity for faithful Catholics and people of good will to come to a greater understanding of the nuances of the Church’s teaching and the complexities of the science and art of medicine in the difficult situations involving the treatment of women who have been raped. There has been no (and will be no) revision in the Church’s teaching concerning direct abortion or contraceptive sexual acts between spouses. Both are morally illicit without exception.
As with all Truth and Charity Forum articles, opinions belong to the author alone and do not necessarily represent the official position of Human Life International.
The decision by the Catholic bishops of Germany to approve the use of morning-after pills (MAP) for victims of rape who present themselves at a Catholic hospital has generated much controversy. Critics have vehemently opposed this decision because they argue that all morning-after pills are inherently abortifacient.
Some morning-after pills are certainly abortifacients. For instance, there is scientific evidence that shows that the morning-after pill, ulipristal acetate, sold as ellaOne throughout the world, is a bona fide abortifacient. Several lines of evidence suggest that it has a post-fertilization mechanism of action that leads to the death of the human embryo.
Another pill called mifepristone (RU486) is routinely used as a chemical abortifacient that can end a pregnancy if it is taken within forty-nine days of the start of a woman’s last menstrual period.
Clearly, some drugs are abortifacients. However, as I have described in more detail elsewhere, there are scientific studies that show that at least one morning-after pill, the drug levonorgestrel that is sold as Plan B, does not have a post-fertilization effect. In other words, it is not an abortifacient: It neither prevents the implantation of a human embryo nor undermines the life of an embryo that has already implanted himself in his mother’s womb.
Why do I think that it is unlikely that Plan B is either an interceptive or an abortifacient?
There is no better summary of the scientific evidence than the statement of the International Federation of Gynecology & Obstetrics (FIGO) and the International Consortium for Emergency Contraception (ICEC) on the mechanism of action of Plan B.
In their statement, these two organizations summarized the published evidence demonstrating that Plan B is neither an interceptive nor an abortifacient as follows:
- Two studies have estimated effectiveness of LNG ECPs [levonorgestrel-only emergency contraceptive pills like Plan B] by confirming the cycle day by hormonal analysis (other studies used women’s self-reported cycle date). In these studies, no pregnancies occurred in the women who took ECPs before ovulation; while pregnancies occurred only in women who took ECPs on or after the day of ovulation, providing evidence that ECPs were unable to prevent implantation.
- A number of studies have evaluated whether ECPs produce changes in the histological and biochemical characteristics of the endometrium (the lining of the uterus where the embryo implants). Most studies show that LNG ECPs have no such effect on the endometrium, indicating that they have no mechanism to prevent implantation. One of these studies found that following administration of double the standard dose of LNG, there are only minor or no alterations in endometrial receptivity. One study found a single altered endometrial parameter only when LNG was administered prior to the LH surge, at a time when ECPs inhibit ovulation.
- One study showed that levonorgestrel did not prevent the attachment of human embryos to a simulated (in vitro) endometrial environment.
- Animal studies demonstrated that LNG ECPs did not prevent implantation of the fertilized egg in the endometrium.
- Two studies of women who became pregnant in cycles when they took LNG ECPs found no difference between pregnancy outcomes of women who had taken LNG ECPs and those who had not. Variables included miscarriage, birth weight, malformations, and sex ratio, indicating that LNG ECPs have no effect on an established pregnancy even at very early stages.