Catholic journal says Plan B does not cause abortions

New finding could mean no moral dilemma in giving drug to rape victims

Mar. 31, 2010
Plan B, the nation’s most widely used emergency contraceptive, works only as a contraceptive and does not cause abortions, according to an article in the official journal of the Catholic Health Association. (La Opinion/J. Emilip Flores)

WASHINGTON -- If it holds, a finding in a Catholic health journal could be the key to ending a major dilemma for Catholic health facilities across the nation and around the world.

Plan B, the nation’s most widely used emergency contraceptive, works only as a contraceptive and does not cause abortions, according to an article in the January-February issue of Health Progress, the official journal of the Catholic Health Association.

Theologian Lisa Sowle Cahill of Boston College said if Plan B never causes abortions, then Catholic hospitals should have no moral problem providing it as an emergency contraceptive to a rape victim.

Under the U.S. bishops’ “Ethical and Religious Directives for Catholic Health Care Services,” Catholic facilities may administer emergency contraception to a rape victim, but only to prevent ovulation or fertilization. Ethical and Religious Directive 36 says if the procedure causes an already fertilized egg to be destroyed or prevents its implantation in the womb, in Catholic teaching that is no longer contraception but abortion.

The difference between the Catholic definition of abortion (any destruction of a fertilized human egg) and the American Medical Association’s definition (any destruction of an embryo following its implantation -- typically about seven days after fertilization) is a major subtext in the debate over whether Plan B is only contraceptive or also possibly abortifacient in some cases.

Barr Pharmaceuticals, manufacturer of Plan B, follows the medical association’s definition in describing the drug as strictly contraceptive and suggests that one effect could be to prevent implantation of a fertilized egg, a conclusion challenged by several scientific studies.

Dr. Sandra E. Reznik, who teaches reproductive endocrinology and reproductive pharmacology at St. John’s University in New York, wrote in Health Progress that Plan B is widely regarded in the scientific community as “the most effective emergency contraceptive agent available.” Plan B is Barr’s brand name in the United States and several other countries for the contraceptive drug levonorgestrel.

Commenting on the thesis of the article, Capuchin Franciscan Fr. Thomas Weinandy, executive director of the U.S. bishops’ Secretariat for Doctrine and Pastoral Practices, said, “If it can be proved, that would make a difference” as to how Catholic hospitals, doctors and pharmacists treat Plan B.

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The distinction between preventing fertilization and preventing implantation is a crucial moral point in Catholic teaching on the difference between contraception and abortion, but in the American Medical Association’s definition of contraception, both are treated equally. In a phone interview, Cahill said Reznik’s conclusions matched those she has seen in other literature on the topic, including an article in the Oct. 11, 2006, issue of The Journal of the American Medical Association, which she had just recently read in preparing to teach a bioethics course.

She said she knew of at least two states -- Massachusetts since 2005 and Connecticut since 2007 -- that have laws requiring hospitals to provide Plan B emergency contraception to rape victims. A number of other states -- California, Illinois, New Jersey, New Mexico, New York and Washington among them -- require hospitals to offer rape victims emergency contraception or at least inform them where to obtain it.

The question of whether Plan B can also prevent implantation of a fertilized egg as well as prevent ovulation and inhibit sperm from reaching the egg led the Catholic bishops and four Catholic hospitals of Connecticut to oppose that state’s 2007 legislation on emergency contraception unless it allowed hospitals to test for pregnancy and ovulation before administering the drug. In its final form, the law permitted hospitals to do a pregnancy test before administering Plan B, but not an ovulation test.

The question of what tests could be performed before emergency contraceptive treatment is important because of the time-sensitive nature of Plan B. As Reznik put it, “The effectiveness of Plan B decreases with every passing hour, because the chance of missing [the pill’s prevention of] ovulation increases as time passes -- and science has demonstrated Plan B doesn’t work after ovulation occurs.”

In a carefully worded statement Sept. 27, 2007, shortly after the Connecticut law was enacted, the state’s bishops and Catholic hospital leaders said they “believe that this law is seriously flawed, but not sufficiently to bar compliance with it at the present time.”

They said they would continue to work to change the law, but they had come to a judgment that “to administer Plan B pills in Catholic hospitals to victims of rape, a pregnancy test to determine that the woman has not conceived is sufficient. An ovulation test will not be required. The administration of Plan B pills in this instance cannot be judged to be the commission of an abortion because of such doubt about how Plan B pills and similar drugs work and because of the current impossibility of knowing from the ovulation test whether a new life is present. To administer the Plan B pills without an ovulation test is not an intrinsically evil act.”

“The teaching authority of the church has not definitively resolved this matter,” they added, and “if it becomes clear that Plan B pills would lead to an early chemical abortion in some instances, this matter would have to be reopened.”

The statement illustrates the delicacy and fine moral distinctions involved in trying to determine what Plan B actually does and the moral evaluations that would follow from a Catholic perspective.

Reznik wrote that since it takes about a week from an egg’s fertilization to its implantation, the scientific evidence that Plan B treatment is completely ineffective after five days is overwhelming: It works only by preventing fertilization, not by preventing implantation.

Otherwise, she said, the drug would also be found effective from five to 12 days after coitus, because that is the time frame between the last chance for a sperm to fertilize an egg and the time a fertilized egg would implant. The declining effectiveness of Plan B between 48 and 120 hours after coitus adds to the argument that preventing a fertilized egg from being implanted is not one of its effects, she said.

Cahill told NCR that if scientific data show conclusively that Plan B is only contraceptive, any pregnancy or ovulation test before its use as an emergency contraceptive after rape “seems to me an unjustified delay that increases the possibility that the raped woman will become pregnant.”

“From the evidence that you were just telling me [from the Health Progress article] and that I read in The Journal of the American Medical Association, it has a limited effectiveness -- you have to use it right away,” she said.

Plan B apparently “does not affect pregnancies that are already established, so what’s really the point in doing a pregnancy test?” she asked. “It doesn’t seem to have a scientific validity to it in the way that Plan B, by all accounts, operates.”

“If the Catholic church wants to put its abortion teaching, its pro-life teaching, in the best light possible, it really has to be accompanied by equally dedicated and aggressive attempts to help women,” she said. “Taking measures to prevent medically appropriate and legally mandated assistance to basics in the name of protecting the unborn -- in ways that are indicated scientifically not protecting the unborn anyway -- that just seems to undermine the pro-life stance of the Catholic church.

“So I think politically it’s a really bad idea even in terms of the church’s own goals,” she added. “And practically, it’s a huge injustice to the women who have been raped.”

It is certainly interesting

It is certainly interesting for me to read the post. Thanks for it. I like such themes and anything that is connected to this matter. I would like to read a bit more on that blog soon. BTW, rather good design you have at that blog, but don’t you think it should be changed from time to time?

Jane Stone
outcall escorts

COMMENTARY: Understanding

COMMENTARY: Understanding Plan B
Written by Rev. Deacon Tom Davis
Friday, 27 April 2007 03:51
Abortion advocates overwhelmed the Human Services Committee of the State Legislature on March 13 with a dizzying array of soft science and misrepresentations in their unrelenting drive to undermine religious liberty in Connecticut. They were joined by compassionate but poorly informed allies who gave apparent legitimacy to their attack on our first freedom – the right to practice one’s religious faith and apply its moral precepts.

The weapon of choice was a bill that would force Catholic hospitals to provide certain drugs to rape victims in cases where they could produce a chemical abortion by altering the endometrial lining of the womb so as to impede implantation of a fertilized ovum. That fertilized ovum is a tiny embryonic human being, one the Church will not harm and is duty bound to defend. Any direct attack upon its environment designed to prevent its survival is a very early chemical abortion.

The genesis of the debate is the so-called “morning after” emergency contraceptive, which is marketed under the trade name “Plan B.” It contains a single active steroid ingredient, levonorgestrel, a totally synthetic progestogen. When administered at various times in a woman’s menstrual cycle, it may prevent ovulation: that is the release of a female gamete or egg from the ovaries into the Fallopian tube. However, if ovulation occurs, Plan B may prevent a fertilized ovum from implanting in the uterine wall. This is well attested by the literature distributed by the pharmaceutical company that manufactures Plan B as well as by the United States Food and Drug Administration, and, surprisingly enough, by leading abortion advocacy groups. (See below.)

Make no mistake. There are powerful advocacy and pharmaceutical interests lobbying legislators all over this county with word games designed to hide the reality of abortion. The manufacturer of Plan B, the National Abortion Rights Action League of Connecticut, Planned Parenthood, The American Civil Liberties Union and other allied organizations and legislators are determined to mandate such chemical abortions in Connecticut’s Catholic hospitals. In order to groom public opinion to accept this violation of religious liberty, they have resorted to a clever but disingenuous approach of redefining words so as to rob them of their meaning. They assert that the definition of “abortion” is limited to disruption of a pregnancy established by implantation of an embryo in the womb. Likewise, “conception” is admitted only after implantation, but not at fertilization. Some medical associations have accepted these new definitions. Others have not. By these evasions, proponents of chemical or other means of preventing implantation of nascent human life hope to avoid the label of “abortion” and limit discussion to contraception. The strategy is to isolate the Church by playing to widespread support for contraception without confronting the deep societal rift over abortion.

But Catholic doctrine is not about word games or junk science. The Church teaches that the embryo, even before implantation, is a human being. That is why she is opposed to embryonic stem cell research, which kills a member of the human family, but supports adult stem cell and umbilical cord stem cell research, which does not. In February 2006, Pope Benedict XVI addressed the topic of “The Human Embryo in the Pre-implantation Phase” and reminded all that the Magisterium proclaims: “... the sacred and inviolable character of every human life from conception until its natural end. This moral judgment also applies to the origins of the life of an embryo even before it is implanted in the mother’s womb.”

That underlying reality is at the heart of the Church’s teaching. But that does not mean that the Church rejects Plan B entirely in the rape treatment scenario. In fact, Catholic hospitals have operated under a carefully drawn rape treatment protocol for over a year. It supports the provision of Plan B when its likely mode of operation is the suppression of ovulation, but prohibits it in the extremely rare case where it’s more likely action is to impede implantation of an embryo in the womb. By maintaining this critical distinction, confirmed by appropriate testing in the emergency room, the protocol is consistent with Catholic doctrine on abortion by refusing cooperation when it is impossible to reach a moral certainty that Plan B will not destroy embryonic life. On the other hand, when it permits Plan B at times when there is no reasonable anticipation of abortive action, and as a form of self-defense against the continuing effects of the rape, it does no harm to the values of true sexual intimacy safeguarded by the Church’s teaching on contraception. Catholic doctrine holds that spousal love is designed to be procreative and unitive and that these two aspects must not be intentionally severed. But unitive in this context does not mean the mere joining of body parts. It refers to the complete interpenetration of being marked by a nuptial embrace that leads a couple on a spiritual ascent reflecting the mutual and total outpouring of being exchanged between the persons of the Blessed Trinity.

Rape has none of those characteristics. It is an act of violence and violation that proceeds from a radical rejection of unitive love. The procreative potential of biology is not a final value for Catholic thought in those circumstances, and, in any event, it was never joined to a properly understood unitive significance. It follows that so long as there is no likelihood that innocent embryonic life will be harmed, Plan B is compassionate and morally sound intervention in rape treatment protocols.

The Connecticut protocol identifies the likely mode of Plan B operation by testing for the presence of leuteinizing hormone (LH), which, if positive, indicates that a woman has entered the LH surge of her cycle. Once a woman enters LH surge, ovulation is highly likely to occur, regardless of the administration of Plan B. LH surge is measured by a simple urine dip test. The onset of LH surge may be any-where from 12 to 24 hours prior to actual ovulation, and a positive LH test does not indicate how far into the LH surge a woman is. Nonetheless, what is clear is that a positive LH surge test negates the likelihood, previously existent, that Plan B will suppress ovulation, and its new principal mode of action is most likely that of impeding implantation. But even in that case, Connecticut Catholic hospitals will inform a victim about Plan B and its availability at other locations and will facilitate transfer of the patient to a secular hospital emergency room. Since there is a secular hospital emergency room within 10 minutes of every Catholic hospital in the State, it is evident that no compelling government interest supports the burden on religious freedom embedded in the pending legislation. In fact, whatever government interest may exist can be met by such transfers or by a mobile intervention team that can provide Plan B to a rape victim off-site of Catholic hospitals.

Those alternatives are critical because the Connecticut Restoration of Religious Liberties Act, Conn. Gen Stat. § 52- 571b, mandates that the State must satisfy those exacting standards before burdening the free exercise of religion, even if the Constitution would otherwise tolerate a burden imposed by neutral legislation of general applicability.

So what of the claim that Plan B does not interfere with implantation? At the hearings before the Human Services Committee, a shameless array of witnesses misrepresented the Connecticut Catholic Hospital protocol and Catholic teaching, shaded medical science and denied one of the likely chemical actions of Plan B. Witnesses asserted that Plan B is most needed when LH surge is detected because that is the time closest to ovulation. But they failed to tell the committee that once LH surge is detected, Plan B will almost certainly not inhibit ovulation and that the most likely action of Plan B at that point is the prevention of implantation – a chemical abortion in Catholic teaching.

An article published in the Journal of the American Medical Association was claimed to show that Plan B does not have an anti-implantation effect. Proponents of mandatory Plan B actually claimed that the article eliminated the reason for the Church’s objection to Plan B. Upon careful review, that balloon has crashed. The “article” was actually a “commentary,” and as the name suggests, it was an opinion piece, not a scholarly work, and it reached some unwarranted conclusions. In fact, the commentary itself actually recommends that women taking Plan B be told that it may, in fact, prevent implantation of a fertilized ovum in the womb. Shockingly, the commentary floated the “counterintuitive” notion that Plan B may actually help ensure successful implantation – the last thing rape victims want and a suggestion that no one believes.

Here are the facts: Plan B likely operates to prevent implantation, at least once LH surge is detected. That claim is not only contained in the manufacturer’s own literature, but is asserted by the Federal Drug Administration and many proabortion advocacy groups. The shocking deception perpetrated by some proponents of the mandatory Plan B is driven by ideology. In their campaign to undermine civil liberties, they pretend that the “latest” and “best” science actually demonstrates that Plan B does not have an anti-implantation effect. That claim is false and many of them know it. It is merely one more step in a long agenda aimed at the religious liberty and moral values of the Catholic Church.

Below are a few – and only a few – of the innumerable sources supporting the anti-implantation effect of Plan B. In order to avoid any suggestion that these sources are tainted by “Catholic” loyalties or are otherwise “uninformed,” they have been selected from pro-choice and pro-Plan B advocacy sources.

The author is a deacon of the Melkite Greek-Catholic Eparchy of Newton, assigned to St. Ann Church in Danbury. His background is in bioethics, law and moral theology, in which he holds a master’s degree from Holy Apostles College and Seminary. He has taught bioethics and morals at the college level and at the St. Cyril of Jerusalem Academy of the Diocese of Bridgeport. He is also a practicing attorney at law.

From the manufacturer at www.go2planb.com/ForConsumers/AboutPlanB/HowItWorks.aspx
Plan B works like a regular birth control pill. It prevents pregnancy mainly by stopping the release of an egg from the ovary, and may also prevent the fertilization of an egg (the uniting of the sperm with the egg). Plan B may also work by preventing it from attaching to the uterus (womb).”

From NARAL (National Abortion Rights Action League) at www.prochoiceamerica.org/issues/birth_control/emergency-contraception/em...
Emergency Contraception (EC), also known as the “morning-after” pill, is simply a concentrated dose of ordinary birth-control pills that can substantially reduce a woman’s chance of becoming pregnant when taken within days of unprotected sex. EC does not cause abortion; rather it prevents pregnancy by inhibiting ovulation, fertilization, or implantation before a pregnancy occurs.”

From The Federal Food and Drug Administration at www.fda.gov/cder/drug/infopage/planB/planBQandA20060824.htm
Plan B works like a birth control pill to prevent pregnancy mainly by stopping the release of an egg from the ovary. It is possible that Plan B may also work by preventing fertilization of an egg (the uniting of sperm with the egg) or by preventing attachment (implantation) to the uterus (womb), which usually occurs beginning 7 days after release of an egg from the ovary. Plan B will not do anything to a fertilized egg already attached to the uterus. The pregnancy will continue.”

From the Center for Reproductive Rights at www.reproductiverights.org/pub_fac_ecicpd.html
“Because emergency contraception is used at all stages of a woman’s menstrual cycle, its mode of action varies. After intercourse, emergency contraception may prevent pregnancy by delaying or inhibiting ovulation, inhibiting fertilization, or inhibiting implantation of the fertilized egg.”

From The Kaiser Family Foundation at www.kaiseredu.org/topics_im.asp?id=400&imID=1&parentID=72#1b
“Research suggests that Plan B prevents pregnancy by delaying or inhibiting ovulation or fertilization, or inhibiting a fertilized egg from implanting in the uterus.”

From Princeton University’s Emergency Contraception Information Web site at http://ec.princeton.edu/questions/echosp.html
“If you have been raped, however, a Catholic hospital might be able to provide emergency contraceptive pills to help you prevent pregnancy. Directive 36 seems to allow providing emergency contraception to ‘a female who has been raped to defend herself against a potential conception from the sexual assault . . . if, after appropriate testing there is no indication she is pregnant.’ It does not say how to determine if conception has occurred and, since emergency contraception might sometimes prevent implantation of a fertilized egg (which happens after conception), Catholic hospitals still have to interpret the directives and decide if they can provide emergency contraceptive pills to a woman who has been raped.”

Just read: "Plan B works like

Just read: "Plan B works like other birth control pills to prevent pregnancy. Plan B acts primarily by stopping the release of an egg from the ovary (ovulation). It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation). If a fertilized egg is implanted prior to taking Plan B, Plan B will not work."

Link at: http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpa...

And this: "PLAN B FACTS:

Levonorgestrel is a female hormone that prevents ovulation (the release of an egg from an ovary).

This medication makes it very hard for the sperm and egg to meet and is recommended to be taken within a specific time after sex, usually 48 hours, to prevent the sperm and egg from meeting at all. This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus. This is very iffy for some, although MOST fertilized eggs in women not on Plan B or any type of birth control also do not reach the uterus. So the question then comes is that a miscarriage? Even though we never know it happens all the time.

Levonorgestrel emergency contraceptive is used to prevent pregnancy after unprotected sex or failure of other forms of birth control (such as condom breakage, or missing 2 or more birth control pills).

Levonorgestrel emergency contraceptive is not intended for use as a routine form of birth control and should not be used in this manner. Talk with your doctor about the many forms of birth control available. Do not use this medication if you are already pregnant.

Levonorgestrel emergency contraceptive will not terminate a pregnancy that has already begun (the fertilized egg has attached to the uterus)."

But the fertilized egg is God's creation attached to the uterus or not, sperm and egg have united and is a child of God

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