These abortion-causing drugs go against our faith… We simply cannot abandon our religious beliefs to comply with this mandate.

And thus David Green, founder and chief executive officer of privately-held Hobby Lobby, explained this week why his privately-held company is suing the federal government over mandated contraceptive coverage in health insurance. Green, with a net worth estimated at $2.6 billion in 2010, is an evangelical philanthropist. Like Chick-fil-A, the Hobby Lobby stores are closed on Sunday.

The problem is … his objection isn’t grounded in science or an understanding of how the morning-after pill works. Well, that’s not the only problem with his position, but it is a substantive one.

***

Plan B, photo by Lillian FurlongIn 1965, the Supreme Court (7-2) ruled as unconstitutional an 1897 Connecticut law that banned the use of “any drug, medicinal article or instrument for the purpose of preventing conception.” The birth control pill was five years old.

The lawsuit, Griswold v Connecticut, was brought by (wait for it) the Planned Parenthood League of Connecticut.

It’s almost 50 years later, and we are still engaged in a struggle over women’s use of and access to contraception. And we’ve been engaged in this struggle for 150 years. The Connecticut law was first cousins with the Comstock Act, a federal law passed in 1873 that prohibited mailing information about abortion or contraception. Anthony Comstock was a religious zealot. His efforts amended an 1865 act dealing with obscenity.

I think this is the right time to remind everyone of Susan B. Anthony, champion of women’s right to vote and opponent of slavery, who said:

The religious persecution of the ages has been done under what was claimed to be the command of God. I distrust those people who know so well what God wants them to do to their fellows, because it always coincides with their own desires.

***

Earlier this year, Republican presidential nominee Mitt Romney referenced the morning-after pill as “abortive pills.” In this example of rhetorical excess, Romney is being consistent in his willful ignorance. From a 2005 column in the Boston Globe, written to explain why as Governor he had vetoed a bill providing morning-after contraception for rape victims:

Though described by its sponsors as a measure relating to contraception, there is more to it than that. The bill does not involve only the prevention of conception: The drug it authorizes would also terminate life after conception.

Despite Romney and Green’s assertions, this is not how the morning after pill works.

It may be how you think it works. Heck, it’s how I thought it worked until this latest brouhaha.

But this explanation is wrong. It conflates the morning-after pill with RU-486.

From the New York Times, June 2012:

Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say. Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized; and some pills also thicken cervical mucus so sperm have trouble swimming.

It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work. Because they block creation of fertilized eggs, they would not meet abortion opponents’ definition of abortion-inducing drugs. In contrast, RU-486, a medication prescribed for terminating pregnancies, destroys implanted embryos.

[…]

Scientists say the pills work up to five days after sex, primarily stalling an egg’s release until sperm can no longer fertilize it. Although many people think sperm and egg unite immediately after sex, sperm need time to position themselves.

Emergency contraception was approved in Great Britain in 1984, 15 years before approval here.

The New York Times article details the history of the drug approval and labeling process. In a nutshell, the Food and Drug Administration decided that the label for “Plan B” (approved in 1999) should say that the drug might work by preventing a fertilized egg from implanting in the uterine lining.

That was the Clinton FDA. And the FDA took this action even though the pharmaceutical company protested.

By 2002, research showed “that Plan B did not interrupt implantation.”

In 2006, the FDA made Plan B available over-the-counter for women age 18 and older.

The pharmaceutical company again asked that the label be changed to accurately reflect the science. The FDA refused.

That was the Bush FDA.

Addressing the issue in a 2005 memorandum, Dr. Steven Galson, director of the F.D.A.’s Center for Drug Evaluation and Research, wrote that studies “conclusively demonstrate” that Plan B’s ability to block ovulation, is “responsible for most, if not all, instances in which emergency contraception prevents pregnancy.” But he also said that studies at that time could not exclude the possibility the pills impeded implantation “in a small percentage of women.” He declined a request to be interviewed.

And then in 2010, Teva Pharmaceuticals once more asked that implantation be removed from the label. The FDA again declined.

This time, it was the Obama FDA.

By this year [2012], the International Federation of Gynecology and Obstetrics considered the research so strong that it issued a statement saying that pills with Plan B’s active ingredient “do not inhibit implantation.”

The American Medical Association explained the social benefits of easy access to contraception and the reason that government action is needed to exert countervailing power in a oligopolistic system:

The goal behind the ACA provision on preventive health care services is to eliminate financial disincentives to using effective preventive care, thereby improving health. Numerous studies have found that even modest cost-sharing requirements can dramatically reduce use of preventive health services, particularly among lower-income Americans [4].

[…]

The HHS decision builds on major changes in private-sector contraceptive coverage over the past two decades. Since the late 1990s, 28 states have required plans to cover contraception when other prescription drugs are covered [7]. And in December 2000, the U.S. Equal Employment Opportunity Commission first made it clear that an employer’s failure to cover contraception when it covers other prescription drugs and preventive care violates protections against sex discrimination under Title VII of the Civil Rights Act [8]. By 2002, the vast majority of private insurance plans were covering a comprehensive array of contraceptive services and supplies, a substantial shift from coverage practices in 1993, when the issue was first studied [9].

[…]

Despite the well-documented benefits of contraception, many women face problems using contraceptives consistently over several decades. The result is that nearly half of U.S. pregnancies—more than 3 million annually—are unintended, and unintended pregnancy rates increased by 50 percent among poor women between 1994 and 2006 [20, 21]. Although there are myriad reasons behind these statistics, cost is one important access barrier, particularly with respect to long-acting, reversible methods (such as the IUD and the implant) that are extremely effective and cost-effective in the long run, but have high up-front costs.

A vocal minority — only about 20 percent of Americans, based on polling data — insist that their worldview on abortion and personhood be the law of the land. Why are the 80 percent acquiescing?

The issue is bigger than contraception or abortion. This issue goes beyond the heart of Susan B. Anthony’s arguments for the franchise to human agency, which I define as an individual’s ability to act on goals that matter to her, to freely make a meaningful choice.

But that minority – the 1-in-5 – is hellbent on reducing or removing choices for the 4-in-5.

When you vote in November, keep this in mind.

Photo: Lillian Furlong in Klipsun Magazine, an independent student publication at Western Washington University, Bellingham.

KATHY GILL, Technology Policy Analyst
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Copyright 2012 The Moderate Voice
  • ShannonLeee

    As with most Americans problems… ignorance and religion are the root causes.
    Most frightening is the FDA’s role in all of this. I know many people outside of the US are sick of the FDA being the gold standard for medicinal approval and are trying to find way to replace the FDA’s influence with something more international.

  • zephyr

    Superstitious, controlling, backward, anti-science, anti-women, anti-reason dimwits. Today’s GOP is channeling sensibilities from the 15th century – and they seem proud of it! I’d say more but the words that come to my fingertips would get me in trouble with the TMV powers.

  • rdstack

    If the pill functions as stated in the article then the only religious issue would be for those who don’t believe in any form of contraception. That leaves it as a great option for a lot of people. Unfortunately that information has been poorly relayed to the American public. The fault for that lack of information lies mainly with the manufacturer. If they want to sell a product they need to properly inform the public as to way it’s a viable option for them. How is the general public supposed to know that THIS “morning after pill” is different from that OTHER “morning after pill” even though they were never informed otherwise. Secondly… consensual sex is an choice as is the birth control required to prevent unwanted consequences. I don’t see why a private company who is free to believe in any way they like should be forced to pay for someone’s recreational drug. Why is there NO individual responsibility left in this country? Everyone wants to do whatever they feel like when they feel like and they want someone else to pay the bill. Personally I’m fine with the drug but I’m not fine with being forced to pay for other people’s recreational activities. People need to take responsibility for what they do and pay for what they want.

  • ShannonLeee

    contraception labeled a recreational drug
    wow!

  • zephyr

    I’d say that righteous indignation meme – being-forced-to-pay-for-others-reproductive-choices is pretty much out of control at this point.

  • rdstack

    All I’m saying is it’s a choice… not that it’s wrong by any stretch!

  • ShannonLeee

    The phrase “recreational drug” implies many things, “choice” being 3rd or 4th on the list. I think you knew exactly what you were trying to say with those words.

    but that is just my opinion…

  • irisgarden55

    The absolute hypocrisy of this is that for the past 20+ years, birth control has been funded by insurance companies across the country and no one said a word about it. Even Catholic universities and institutions had this in their policies. Some had them removed, but a majority of them let it stand. 98% of Catholics polled said they use birth control. It is a fact, so, to make this a big issue in the presidential election is ridiculous! Why, in the year 2012, we are STILL arguing about Roe v Wade, a woman’s right to choose, and MEDICINE for half the population. Birth control pills are not just used to prevent pregnancy. Some take it for hormone regulation, others to regulate periods, for fibroid tumors, etc. To assume that it’s only used for “recreation” just shows how little you know about female reproductive health.

  • DaGoat

    If I follow the post correctly, the FDA under Obama is also willfully ignoring science. If that’s the case, it’s probably more accurate to say there is scientific controversy whether the morning-after pill prevents implantation.

  • Dear @rdstack — you write: “The fault for that lack of information lies mainly with the manufacturer.”

    Please re-read the article. The manufacturer has TRIED to get FDA labeling corrected. When the science was unclear (Clinton Admin), the FDA was, predictably, conservative in labeling. When the science became clear (early in Bush Admin), the FDA refused to change the label. Then the issue was taken up by the extremely vocal “my way or the highway” evangelicals and the Obama FDA refused (predictably) to alter the labeling.

  • @daGoat – read the above comment. For some reason, I can’t edit my comments right now, so I can’t add you to that one.

  • DaGoat

    So the Obama administration is willfully ignoring science for political reasons? Sounds like the GOP.

  • SteveK

    Yes, DaGoat, “the Democrats are just as bad as the Republicans”… Probably even worse if you listen to Rush Limbaugh, Glen Beck, et al.

    But that’s only because “It’s just the same on both sides” and of course “They both do it”!

    Get ready for the Republicans to haul back out:

    • “Just the same” on Global Warming.
    • “Just the same” on Evolution.
    • “Just the same” on Intelligent Design.
    • “Just the same” on Women’s Right to Choose.
    • “Just the same” on Public Education.

    [shake head]

  • ProWife

    I am pro consortium. I am not Pro Life. No one is pro abortion! I am Pro Wife.
    The consortium I refer to is regards the confidential relationship a patient has a right to have with her own doctor. Keep the government out of doctor patient relations.

  • roro80

    There is no “other” morning after pill. You have to be actually, definitely pregnant for a doctor to prescribe RU-486. Meaning you can’t get it the morning after. It’s great between 5-9 weeks of pregnancy, and that’s it. Most women who have been sexually active while specifically not wanting to get pregnant know this, because it’s important to us to know this, so we’ve asked our doctors. A long time ago. The rest of the folks who feel they get a vote on this (you don’t), are strongly advised to ask your doctors about it too, so as to keep you from (a) sounding like idiots, and (b) accidentally restricting the rights of millions while sounding like idiots. Of course, let’s be honest – it’s not really “accidental” now is it?

  • rdstack

    Kathy… sorry that I missed that. Regardless of where the blame lies… it is a shame that the public is either misinformed or uninformed in such circumstances.

  • roro80

    It’s not a “shame”, it’s on purpose. The information is pretty easily accessible, given that all you have to do is ask a doctor and they will tell you.

  • DaGoat

    There are many differences between Republicans and Democrats, but stretching the truth when politically expedient is not one of them.

  • SteveK

    There are many differences between Republicans and Democrats, but stretching the truth when politically expedient is not one of them.

    That’s right DaGoat… It’s all the same, it’s all equal.

  • Rcoutme

    It is not equal, Steve, but it is similar. Meanwhile, the Clinton administration allowed the Republicans in Washington to chase out David Kessler. He was the last ‘good’ FDA head. We need Kessler (or his clone) back! Right after Kessler left, pharmaceutical companies began advertising prescription-only medicines on television and in magazines. Not by coincidence, the sales of these medications skyrocketed! Does this mean that doctors before that time were denying their patients drastically needed medication? I doubt it.

  • Rcoutme

    As to the comment that the results of sexual activity are a ‘responsibility’ of those engaged in the activity: more than 50% of all children in the US receive food stamps. Similar huge numbers are on medicaid. There is also the cost of schools and police (domestic violence, gangs, etc). Are you really going to suggest that birth control costs are an expense that society should not bear? If you are going to look only at the costs, births are far more expensive.

    Just sayin’

  • rdstack

    @roro80… it is a shame that the information you see on the label directly contradicts the information your doctor is telling you. Perhaps you research every item your doctor recommends and/or prescribes but not everyone takes the time or even has access to that information. The fact that it is, or is not on purpose has nothing to do with the point that the labeling is just plain wrong.

  • rdstack

    @Rcoutme… No… more than 50% of US children are NOT on food stamps. If you’re referring to the study discussed in US Today it says that half of all children will rely on food stamps at some point in time prior to the age of 20. Most of them will do so only on a very short-term basis. And yes… I believe birth control should be paid for by the people that desire it. My feelings on the costs related to children who once born place an even greater burden on society relates directly back to personal responsibility and the lack of it in this country. That however is a subject that varies too far from the point of the article.

  • roro80

    One thing I think is being missed in the article is that even if Plan B did prevent implantation, it still would NOT be an abortifacient. A fertilized egg that is implanted is the definition of pregnancy. An end to a pregnancy not resulting in birth is the definition of an abortion. You cannot abort a pregnancy that has not started yet, so preventing implantation would still be just plain ol’ pregnancy prevention.

  • roro80

    And yes… I believe birth control should be paid for by the people that desire it.

    And it’s different from every other prescription drug in that….?

  • rdstack

    @roro80… if you seriously can not see the difference between birth control and life saving drugs… isn’t the rest of this conversation pointless?

    BTW… I pay for ALL my insurance/prescriptions.

  • roro80

    If you really cannot see that you are acting like your medicine is more important than mine, you’re right, the rest of the conversation is pointless. When something like pregnancy is treated like a flitty little non-medical consequence by those who will never go through it, there’s obviously a serious amount of ignorance going on. Nope, there’s obviously no medical issues involved in pregnancy! Things growing inside people have no consequences at all! Besides which, nobody ever used OTC BC for anything besides gettin’ laid without consequences! Whoo-hoo sex for everyone! (I’ve been on BC since the age of 13 — long before having sex, in order to maintain my fertility, which would have been ruined by a medical condition that is very well-controlled by hormonal birth control. But hey, maybe I was just a pre-teen slut-in-the-making and didn’t deserve to have my medical condition controlled.)

    I’m not sure what your final sentence means, or why it matters. If an employer offers medical coverage, they have to offer BC as part of it. That’s what the law is about. Policies that cover all the drugs men need also have to cover the drugs women need. If you’ve got a problem with women having the same coverage you enjoy under the same plan, that’s pretty much the definition of sexism.

  • roro80

    Not sure why my previous comment was deleted — the misinformation about these drugs is due to the purposeful spreading of said misinformation by those who would take away women’s reproductive choices. It is therefore not a “shame”, but a purposeful action.

  • Rcoutme

    I am an anti-abortion fanatic (but a realist, so I would like to chip away at abortions first). Never the less, the Plan B medication (and other BC pills and devices) is, in fact, a medicine. I will not deny women the same access to medicines as men have. If Viagra and Cialis are to be covered by insurance plans, then so should orthotetracycline and Plan-B. The science should trump any religious or political opposition. That was what the FDA was created for…

  • DaGoat

    Rcoutme you’ve been away from the pharmacy for a while – it’s Ortho Tri-Cyclen. And as I’ve posted many times there is nothing requiring insurance plans to cover Viagra, the fact is many do not and many that do require a large co-pay. If anything the way Viagra is handled weakens the argument towards contraceptive coverage since the Viagra is often considered optional and non-essential.

  • ProWife

    It is beyond my comprehension as to why men think they should have any say in the doctor patient confidential relationship between a woman and her doctor(s). What goes on between a women and her medical professionals is no one’s business but the medical professional(s) and the women involved. To reiterate, I am ProWife!