Physicians have been prescribing emergency contraception for decades. According to the United States Food and Drug Administration, the drugs - commonly referred to as the morning-after pill - are approved \for use in preventing pregnancy after intercourse when standard contraceptives have failed, or when no contraceptives were used at all."" Clinical trials have found emergency contraception is safe and effective. But scientists, policy makers and the public disagree on the issue of improving access to this drug.
The Wisconsin State Assembly passed a bill to ban University of Wisconsin campuses from prescribing or dispensing emergency contraception such as the commercial product Plan B. According to the Associated Press, Governor Jim Doyle said he will veto the bill if it reaches his desk.
Last August, the commissioner of the FDA indefinitely postponed a decision on making Plan B available without a prescription. However, national medical experts have issued public statements in support of making Plan B more accessible.
Following the FDA's announcement, the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics both issued statements of support for nonprescription access to emergency contraception.
ACOG ""reiterates its support for making emergency contraception available without a physician's prescription to all women of reproductive age,"" according to an August 29, 2005 statement.
In response to the FDA's indecision, the director of FDA's Office of Women's Health, Susan Wood, resigned from the agency.
""I can no longer serve as staff when scientific and clinical evidence, fully evaluated and recommended for approval by the professional staff here, has been overruled,"" Wood wrote in a published email.
Research and clinical studies show that emergency contraception may act in a variety of ways.
According to UW-Madison pharmacist and clinical associate professor Connie Kraus, ""the primary mechanism is likely delaying or inhibiting ovulation, but other mechanisms also probably exist."" During ovulation, an egg bursts out of an ovary and enters a fallopian tube where it can be fertilized if sperm are present.
Emergency contraception can delay or prevent a woman's ovaries from releasing an egg and secreting the hormones that prepare the uterus for a pregnancy, according to Laura Sabo, a UW-Madison obstetrician. Sabo said if ovulation and fertilization already occurred, emergency contraception may also work by causing ""changes in the lining of the uterus, called the endometrium, and can result in failure of the embryo to implant.""
However, Sabo said emergency contraception is not an abortion pill and ""does not disrupt an established pregnancy."" Plan B is not RU-486, the controversial abortion pill that acts by blocking the pregnancy-sustaining hormone progesterone and results in the breakdown of the uterine lining and detachment of the embryo.
Although some people - traditional Catholics, among others - believe pregnancy begins at conception, the medical definition marks pregnancy as beginning with the embryo's implantation in the uterus, according to the U.S. Department of Health and Family Services. From the time of ovulation, it takes seven to eight days for an egg that has been fertilized to make its way through the fallopian tubes, enter the uterus and implant in the uterine wall.
""There is no evidence to suggest that emergency contraception will interrupt an implanted embryo,"" Kraus said.
Most studies have found the effectiveness of Plan B is highest in the first 72 hours following sex.
And, according to Kraus, ""newer data suggest that there may be some benefit up to 120 hours.""
""The fact that the efficacy trails off over the course of a few days supports the statement that emergency contraception doesn't affect an established pregnancy,"" Kraus said. ""In theory, if this medication was able to do this, time shouldn't matter.""
Although scientific evidence supports the effectiveness and safety of emergency contraception, the FDA remains hesitant to make the drug available without a prescription, citing ""unresolved regulatory and policy issues,"" according to a statement.
The FDA has also not settled whether they will limit access to the drug for women under 17 years old.
In an interview with the Village Voice following her resignation from the FDA, Wood offered her opinion on the future of emergency contraception.
""The FDA needs to make its decision based on science,"" Wood said. ""They need to stick with the evidence.""
