Ella: the Anti-Plan B [Serge]

Elizabeth and Scott have awakened me from my slumber (thanks guys). There is a lot of confusion regarding the new "emergency contraceptive" Ella (ulipristal), and hopefully I'll be able to provide some clarification in the next few posts.

Let me contrast Plan B and Ella. Plan B is basically synthetic progesterone, and is merely a larger dose of a form of oral contraceptive that has been used for years. Ella is a progesterone antagonist, which means that it works by blocking the effect of progesterone. The only other progesterone antagonist on the market at this time is mifepristone, otherwise known as RU-486, the abortion pill.

Its seems a bit strange that the proposed mechanism for both of these drugs is to suppress ovulation, and the evidence is clear that both of them do that. The concern is with any other effects the medications may have on a developing embryo and its ability to attach to the uterine lining.

Since human beings are intrinsically valuable from the moment they become human beings, any medication that serves to end the life of a human being after fertilization is morally wrong. This is true whether or not the medication has a direct effect on an implanted embryo or if it adversely effects that uterine lining to make implantation more difficult. I would oppose any medication that has been shown to have either effect.

In the case of Plan B - there is no direct evidence that it decreases the receptivity of the uterine lining to an embryo that is attempting to implant. There is some indirect evidence that has concerned many in our movement, but there is also evidence from both animal studies and human studies that indicate no post-fertilization effects from Plan B. In the absence of clear evidence, I urge caution, but cannot state that using Plan B is wrong because of its post-fertilization effects. Lots of my older posts on this topic can be found here.

This may seem like a win for the pro-EC crowd, but in truth it is an epic fail. If EC only works before fertilization, than its effectiveness will be far less than the stated 90%. In fact, the evidence now supports this. There have been over 14 studies that have tried to show that taking EC will decrease pregnancies within a certain group. The number of the studies that showed a decrease in pregnancies for those taking Plan B have been a whopping zero.

What about Ella? I will show in following posts that just about everything that I stated about Plan B is completely different than Ella. Ella has been shown conclusively to have an adverse effect on the uterine lining. Investigators admit that if taken in higher doses, Ella will cause an abortion just like her sister RU-486. This is not an emergency contraceptive drug - it is a low dose abortifacient.