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In Europe, large segments of the population began to use various methods to regulate conception, pregnancy, or births in the latter part of the eighteenth century. During the nineteenth century, the widespread desire for more forms effective means of controlling the number of births resulted in the development of numerous devices and or medications that provided both men and women with opportunities to use contraceptives. With the increased demand and practice of contraception, the medical community needed to provide the population with the best means possible for each individual to prevent conception. For this reason, medical science has in the past few years has made significant advances in the different areas of birth control. The discovery of emergency or postcoital contraceptives was a breakthrough in the treatment of early-unwanted pregnancies. This particular method of preventing conception has actually existed for many years in the United States and throughout the world. The currently approved method and dosage is 0.10 mg ethinyl estradiol (estrogen) and 0.50 mg levonrgestrel (progestin) taken within 72 hours of intercourse and another dose 12 hours later (Emergency). This is a modified or off-label use of the oral contraceptives normally prescribed for women and is perfectly legal, but not officially approved. The Food and Drug Administration (FDA) just recently officially approved the use of oral contraceptives as postcoital contraceptives at the doses listed above (Federal). Recently, the French abortion pill RU486 (mifepristone) was also approved for use in the United States as both a postcoital contraceptive and as an alternative to surgical abortion. The estrogen/progestin and RU486 both accomplish pregnancy prevention by not allowing a fertilized zygote to implant on the uterine walls and grow to development. However, the methods behind the drugs differ. The estrogen/progestin regiment prevents pregnancy in three different ways depending on the time taken. It can prevent ovulation, inhibit fertilization, or alter the endometrium (uterine lining) thereby stopping implantation, but it cannot affect an implanted zygote (Federal). However, the effects of RU486 vary considerably. It alters the endometrium so that no implantation can occur, and if implantation has already occurred, a spontaneous abortion or miscarriage will occur (Piaggio, et al.) Therefore, RU486 is both a postcoital contraceptive and an abortifacient-agent that causes abortion. With the emergence of these two forms of birth control, many groups have begun to re-evaluate the actions and implications of all postcoital contraceptive agents. The controversy is rooted in whether the administration of these types of medications is the solutions to “unprotected sex” or a quick, unsafe form of abortion. Participants in this heated debate come from the medical and the pro-life/pro-choice factions of the political community. Most physicians and governmental agencies support the ideas of postcoital contraceptives because they feel that these methods/medications allow people to prevent unwanted pregnancies in potentially harming sexual situations. Opponents of emergency contraception primarily belong to the pro-life sector of the abortion debate. They state such means of birth control to be early forms of abortion. These individuals refer to various textual definitions to form grounds for their arguments. Family planning agencies may also have objections to emergency contraception, stemming from the economic impact of replacing their older forms of contraceptives with newer/costlier ones. Though both sides of this controversy possess strong counter arguments, some members from each side are commonly concerned about postcoital contraceptives promoting promiscuity. The views held by all the persons involved this debate provide grounds for analysis of the justifications backing their arguments. The consequences, whether good or bad, stemming from the real actions of emergency contraceptives· are at the center of the debate over their use. The main directives in each portion of either the proponents’ or opponents’ opinions come from the societal, economic, and medical implications of the benefits and or harms of this means of birth control. Criterion established by each faction shows how emergency contraception affects all areas of the world population. The most important effect that these drugs present is the potential for postcoital contraceptives to replace conventional contraceptives that are currently used by family planning organizations. This outcome is an even more possible reality because of the medication used for emergency contraception. The drugs prescribed for emergency contraception are the same as those used for conventional birth control; therefore, women who have been prescribed traditional birth control can take them after intercourse instead of regularly as prescribed. This poses a major economic problem for governmental health agencies because they would have to allocate additional funds to offer such drugs. In case they were able to do so, the increased usage of emergency contraceptive agents could promote unsafe sex, causing more diseases and more occurrences of sex in the population. Based upon the potential harms toward the entire population, these consequences, developing from the economic/medical/societal impact of these medications, define the criterion in which health organizations find valid grounds to oppose the use of these particular preventatives of conception. The supporters of emergency contraceptives state that the purpose of postcoital contraceptives is to “prevent unwanted pregnancies of women who have been raped, experienced contraceptive failure, or engaged in unprotected sex” (Center). Therefore, supporters look at this type of contraceptive as a safety net for those women who have been the victim of some type of misfortune. This view shows how proponents feel that postcoital contraception benefits people in unfortunate sexual encounters in such areas as health and appropriations of funds. For this reason, one can decipher that their argument is founded by the long-term ways in which these medications will make the population act. They feel that such types of people will not suffer the health risks of pregnancy and the economic heartaches associated with bearing children. This will result in content individuals who can plan to have families when they are emotionally and economically ready, causing children to actually live in a less stressful/sound environment. Future generations can then reap the social benefits that are derived from stable and well to do families. In order to emphasize the need for such treatments proponents cite studies that illustrate the number of unwanted pregnancies that occur each year. Case in point, according to the National Survey of Family Growth reports that 3.04 million women unintentionally become pregnant with 47% ending in abortion (Office of Population Research). Because of this large number of pregnancies and abortions, supporters are using their resources to further the public awareness and use of emergency contraceptives as an alternative to abortions. The FDA, the regulator of drugs in the United States, agrees with supporters and is actively enhancing the use of these drugs. As mentioned earlier, the FDA recently approved the use of estrogen/progestin as a postcoital contraceptive. In addition, the FDA approved Gynetics corporation to produce a prescription estrogen/progestin kit for the purpose of emergency contraception. This kit, called the Preven Emergency Contraceptive Kit, contains a home pregnancy test and two 0.25 mg levonrgestrel and two 0.05 mg ethinyl estradiol pills, one of each pills for the two doses (West). The purpose of this kit is to encourage women who experience unprotected sex to contact their doctor to obtain a kit instead of waiting, becoming pregnant, and having an abortion. All the actions taken by the advocates of postcoital contraceptives again illustrate their need to root their arguments in the potential economic, medical, social benefits to all countries. They truly feel that the development of various medications will actually prevent possible harms to women. The pro–life faction of the abortion debate do not view postcoital contraceptives the same way as its supporters view it. Anti-abortionists believe that emergency contraceptives as abortifacients and therefore the administration of these drugs is a form of early abortion. In an attempt to support this view, they cite references that define terms favorable to their argument. For example, according to the Signet/Mosby Medical Encyclopedia conception is “the beginning of pregnancy, this is usually taken to be the instant that the sperm enters an egg” (146). In addition, the World Book Dictionary defines contraception as “the use of … drug, … to prevent conception or pregnancy (451). Therefore, when the drugs acts to prevent a fertilized ova from implanting, it is not acting as a contraceptive because conception has already occurred, according to these definitions. Finding textual evidence to provide foundations for their claim, this group of people opposes this form of birth control by saying that it is morally unjust. In other words, one who uses such methods to prevent conception is committing a morally unjustified act. Their criterion is developed through the moral relevance this topic holds to numerous religious beliefs. In contrast to the definitions that give support to pro-life individuals, proponents believe that there is little evidence that emergency contraceptives act as abortifacients. The supporters of emergency contraceptives, upon discovering the view of this drug treatment as an abortion agent, countered those claims. The counter-argument is two fold. The first part is medical research on the drug. Numerous supporters with medical background have written articles in respected journals such as the New England Journal of Medicine. For instance, Dr. Phillip Stubblefield, M.D. states that emergency contraceptives cannot be considered an abortion agent, medically speaking, because as illustrated by in vitro fertilization pregnancy cannot begin until implantation occurs. Therefore, since emergency contraceptives act before this point they are not abortifacients (Stubblefield 41). In addition, research indicates that oral contraceptives do not affect early stage fetuses (Federal). The other front that supporters defend their opinion on is on legal grounds. Their legal backing comes from examination of abortion laws throughout the world. For example, the Center for Reproductive Law and Policy complied a study of various abortion laws and found that even in countries with strict abortion laws emergency contraceptives are approved medical therapy (Center). Those who oppose these medications and even some supporters are concerned about the temptation of people to replace traditional, time-tested contraceptive with a quick two-dose treatment after intercourse. They cite three primary risks of replacing traditional birth control with emergency birth control. The first is reduced use of barrier devices, such as condoms, will increase the chances of contacting a STD. In addition, reports, like the one from the FDA, contain statements indicating the effectiveness of postcoital contraceptives is less than the effectiveness of standard birth control. Another concern that anti-abortionist have regarding these medications is that it will lead to long term medical problems in women if taken on a regular basis. The entire core of these common arguments stems from the social and medical ramifications of postcoital contraceptives. Some members from both groups believe that society will view that the practice of casual sex to be normal, making more persons in engage it. Health hazards associated with taking postcoital drugs will then harm a woman’s body for a long range of time. Those who think that emergency contraceptives are safe and will be used properly cite their own evidence. They appeal to the common sense of people to realize that this type of therapy is not for routine use. In addition, they cite the side effects like nausea and vomiting will deter routine use of the drugs (Office of Population Research). The controversy over the use of emergency contraceptives is rooted in the multiple views and definitions that are present in our society. The supporters, many of whom are medical professionals, view to the concept as a safety net for responsible women who experience unwanted sex. Those whom oppose the concept do so because they view it as a form of early abortion or as an excuse for unprotected sex. After through analysis of the multiple views on this subject, I can only say that emergency contraceptives pose many consequences to society. They benefit and harm the population at the same time, making it hard for me to develop a clear opinion on this matter. For this reason, I feel that the government, various factions of the abortion debate, and the medical community need to establish the proper criterion needed to define the impact of emergency contraceptives in the world. Bibliography: Center for Reproductive Law and Policy. “Contraception, Not Abortion: An Analysis of Laws and Policy Around the World.” Center for Reproductive Law and Policy. February 1999. 27 October 1999. “An Emergency Contraceptive Kit.” Medical Letter on Drugs and Therapeutics 40.1038 (23 Oct 1998): 102-103. ProQuest. Online. 28 October 1999. Food and Drug Administration. “Prescription Drug Products; Certain Combined Oral Contraceptives for Use as Postcoital Emergency Contraception; Notice.” Federal Register 62.37 (25 February 1997): 8609-8612. 28 October 1999. Office on Population Research, Princeton University. “Emergency Contraception.” Office on Population Research, Princeton University. 28 October 1999. Piaggio, G., et al. “Comparison of Three Single Doses of Mifepristone as Emergency Contraception: A Randomized Trial.” The Lancet. 353.9154 (27 February 1999): 697-702. ProQuest. Online. 28 October 1999. Stubblefield, Phillip. “Editorial: Self-Administered Emergency Contraception-A Second Chance.” New England Journal of Medicine 339.1 (2 July 1998): 41-42. ProQuest. Online. 28 October 1999. West, Diane. “’Quiet’ Contraceptive Making Noise.” Pharmaceutical Executive 18.10 (October 1998): S4, S7. ProQuest. Online. 28 October 1999. Word Count: 2033
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