Pro-Lifers Oppose Easy Availability of Morning-After Pill

By Patrick Goodenough | July 7, 2008 | 8:13 PM EDT

Pacific Rim Bureau ( - Australia is preparing to follow Britain in allowing women to buy the controversial morning-after pill without a physician's prescription.

Australian pro-life campaigners, who oppose the pill on the grounds it can be an abortifacient, have warned that could also place women's health at risk.

The medical fraternity also has concerns about the decision.

A committee of the Therapeutic Goods Administration (TGA), a regulatory agency, has been considering a request by the drug's German manufacturer, Schering, to make the drug more easily available.

In its recommendation, the TGA said it wanted to allow for "more timely access to a safe and effective contraceptive for emergency use."

Pharmacists would be required to discuss with the customer issues relating to their sexual health, it added.

A period of public consultation will be followed by a final decision in October.

If it is approved then, the drug levonorgestrel could be available without a prescription as early as January, although the federal government has said that Australia's individual states and territories will also have to legislate the change.

Levonorgestrel, sold under the brand name Postinor-2, has been available for sale in Australia since last July, but only with a doctor's prescription.

Schering says it prevents 95 percent of pregnancies if taken within 24 hours of sex and is 85 percent effective if taken within 72 hours. Other brand names for levonorgestrel include Plan B and Levonelle.

Along with pro-abortion "family planning" organizations around the world, Schering denies outright that the morning-after pill causes an abortion.

Pro-lifers dispute this, pointing out that while one of its functions is preventing or delaying ovulation, another is stopping the successful implantation of the embryo by affecting the lining of the womb.

Supporters of the drug argue that pregnancy starts when a fertilized embryo implants in the womb, although embryologists generally agree that fertilization or conception begins with the union of male and female gametes prior to implantation.

For those who believe human life starts at this point of fertilization, the pill's action clearly constitutes an abortion.

Pro-lifers also note that, since many women do not know precisely when they ovulate, they can take the pill and remain completely unaware if their action has prevented conception or caused an abortion.

Opponents also highlight the safety aspect, particularly as its availability without prescription may prompt some women to stock up on the pill and take it regularly after sex, "just in case."

Even Schering stresses that this should be avoided.

"The morning-after pill is always an emergency measure," it warns on its website. "It is not suitable for regular use."

But critics say if the drug is made more easily available - as Schering has itself applied for in the Australian case - it will precisely make it easier for women to overuse it.

'Serious health impact'

In the U.S., levonorgestrel has been approved by the Food and Drug Administration and is available by prescription. Advocates are pressing the FDA to allow across-the-counter availability.

In Britain, women over the age of 16 have been able to buy the morning-after pill from pharmacists without a prescription since 2000.

Some British local authorities are even providing it free of charge, arguing that the cost - around $33 - may deter some women from buying it.

Earlier this year Britain's chief medical officer, Liam Davidson, warned British doctors about the possibility of a link between use of the drug and ectopic pregnancies (one occurring outside the womb).

In Australia, too, the medical fraternity is not happy with the idea of making the morning-after pill too easily available.

Australian Medical Association (AMA) president Dr. Bill Glasson said in a statement made available Monday that the TGA decision \ldblquote has the potential to seriously impact on the health and well-being of Australian women."

D octors should remain the sole prescribers, and access to the drugs should be made in the context of a medical consultation that covers a range of health issues relating to sexual intercourse.

"P harmacies are not appropriate environments for sexual health counselling," he said.

One of the arguments used by those supporting over-the-counter availability is that, with the clock ticking on the 72-hour deadline, women weren't always able to get to see a doctor in time to get a prescription before the drug would no longer be effective.

Glasson said the AMA acknowledged this could be a problem, particularly in rural and remote areas.

But where this was the case, "the public interest would be better served by seeking to improve access to doctors or sexual health services rather than access to drugs."

Some critics also fear that women may take a less responsible approach to contraception if they know they can easily pick up an after-the-fact "solution."

This, in turn, may increase the rate of sexually-transmitted diseases, according to Right to Life Australia president Margaret Tighe, who is concerned that the move will encourage young women to be more sexually active.

Another pro-life organization, the Australian Federation of Right to Life Associations, is also worried about the development.

"The drug is often described as a contraceptive, but preventing the implantation of an embryo happens after conception," said spokesman Mary Joseph. "Women can't give their informed consent to using the drug without knowing this."

She said the prescription requirement had ensured that doctors could consider a woman's medical history and examine her to ensure the drug was suitable in her particular case.

"This would include considering issues such as whether the woman is already pregnant from earlier sexual activity, or whether the woman suffers from a range of conditions such as severe hypertension, unexplained vaginal bleeding or hypersensitivity to any of the ingredients of the drug," Joseph said.

"Making the drug more easily accessible by removing the requirement for a prescription would lead to some women using the drug more regularly and putting their health and fertility at risk."

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Patrick Goodenough
Patrick Goodenough
Spencer Journalism Fellow