Council member Ardis Hoven emphasized to the press that the recommendation reaffirms AMA policy “which states that no physician or other professional personnel shall be required to perform any act violative of personally held moral beliefs.”
Popularly known as “morning-after pills,” the pill combinations, marketed in the United States under the names Preven and Plan B, can be taken up to three days after conception. The pills work to either prevent ovulation or, if ovulation has already occurred, to block implantation of a fertilized egg on the uterine wall. In other words, it can act to end a pregnancy.
“Ohhh. . .Ohhhh. . .Uh Oh!”, reads one sleek, postcard-size ad from
Planned Parenthood. Vickie was in bed with her boyfriend when his condom broke (a discovery, that is the catalyst for “instant, stomach clenching anxiety” in “millions of women each year,” according to the Washington Post).
A computer-programmer, Vickie naturally got up and logged onto Planned Parenthood's website to browse through her options. By dawn she was at her local pharmacy, purchasing a combination of oral-contraceptive pills (and Dramamine for the accompanying nausea) that, taken within 72 hours, would allow her to avoid the inconvenience of surgical abortion.
Vickie should probably thank emergency-contraception guru James Trussell of Princeton University. Dubbed “Repro Rights Man” by the Daily Princetonian, the former director of the school's Office of Population Research has been peddling “a woman's last chance to prevent pregnancy after unprotected sex” since 1992. He has promised that his panacea, emergency-contraception pills (ECPs), will eliminate half of America's annual three million pregnancies. But what he's really got in his bag is a convenient deathknell to life as we know it.
Former FDA head David Kessler coined the phrase “America's best-kept contraceptive secret” to describe emergency contraception, providing the title for reams of propaganda from Planned Parenthood and others. Somewhere between “The Pill” and RU-486, emergency contraception is nothing new. ECPs have long been available in the form of high doses of ordinary oral contraceptive pills, which taken within 72 hours of intercourse can, according to the FDA's Federal Register description, “act by delaying or inhibiting ovulation, and/or altering tubal transport of sperm and/or ova (thereby inhibiting fertilization), and/or altering the endometrium (thereby inhibiting implantation).”
But most women never really knew to ask, or to act fast enough. And without a dedicated product meant for emergency-contraceptive use, doctors and pharmacists had never been quick to dispense. So, in 1992, Trussell, already long-established as editor of the biblical Contraceptive Technology, set out to remedy the situation, planning to make emergency contraception roll off the tongues of a nation. A toll-free hotline (1-800-NOT-TOO-LATE), and website (www.ec.princeton.edu) later, he has made impressive progress — but not without an important boost from Uncle Sam.
In an unprecedented move, with a Republican-appointed, supposedly pro-life commissioner at its helm, the FDA rolled out a red carpet in 1997, issuing a call to action for pharmaceutical companies to mass market a dedicated emergency-contraceptive product, promising approval to any company that would step up to the plate. But there were no takers, not even among multi-national corporations like Wyeth-Ayerst Laboratories — which already manufactured six oral contraceptive pills which, administered correctly, could do the work of emergency contraception.
Determined to meet Trussell's challenge, the FDA called on Roderick Mackenzie, then president of a pharmaceutical company called Ortho. At the agency's behest, a company called Gynetics was born, with Mackenzie at its helm, and Preven, the first emergency-contraceptive kit in the United States soon followed. Heralding in Preven with a $3.1 million ad campaign during late 1998 and early 1999, Gynetics's goal has been to place Preven in every sexually-active American's medicine cabinet—”just like having a fire extinguisher next to your stove,” says Mackenzie. That hasn't happened quite yet, but with the AMA's help, it will.
There are some true believers, people like University of Pennsylvania bioethicist Arthur Caplan, who sincerely envision a truce in the abortion wars, courtesy of emergency contraception. There's “no reason to push the product for the condom-broke sort of thing” he says. “It ought to be in every emergency room, health clinic, and public-health facility. Every doctor and nurse and rape counselor ought to know about it. So should all religious leaders and social workers so they can counsel a desperate woman to use it if she so chooses.”
But among most ECP advocates, there is a calculated disingenuousness. Ad campaigns have been misleading enough to raise the EC-friendly eyebrows of the FDA — as seen in the likes of one Gynetics' Preven advertisement: “The condom broke. But my life stayed intact” — not exactly compassionate outreach to rape victims. The outreach is decidedly focused on the young, sexually-active crowd (Planned Parenthood distributes a condom in a key chain as part of their public-education campaign, the key chain complete with a sales pitch for ECPs).
The Planned Parenthood Federation of America's Teenwire, an online magazine for kids, educates the 12 to 17-year-old crowd: “Ever look down in the midst of an athletic bout of sex and discovered that the condom has decided to finish before you did? Skipped a couple of pills and then forgot that you had? Risked having Sex without using birth control, hoping that just this once it would be OK?”
While, nationwide, Preven is currently available by prescription, the future, as the AMA hopes, lies in the Washington State model, for example, where a pilot program, and the absence of minimum-age requirements for the purchase of contraception, allows statewide over-the-counter accessibility to girls of all ages.
“We wanted to make emergency contraception the same household name that McDonald's is,” James Trussell told the Philadelphia Inquirer (Gynetics even recruited the Golden arch's public-relations firm, DSS Needham for the job). But Trussell warns there are miles to go yet.
As have many others, professional left-wing ranter Molly Ivins took up the cause in a syndicated column, attacking Wal-Mart for refusing to carry Preven in their stores, blaming a pro-life conspiracy to equate emergency contraception with abortion. Wal-Mart claims it made a “strictly business decision,” independent of moral considerations — they do, after all, carry other contraceptive pills that can be used post-coitally, which was the life of emergency contraception before Preven came to be. Ivins lambastes Wal-Mart for denying women what countless pro-choice ideologues list among women's “basic healthcare needs,” particularly a travesty in rural areas, where the hegemonic superstore has often closed all the other pharmacists in town.
Pro-lifers look at 1965, the year that the FDA, National Institutes for Health, and the American College of Obstetricians and Gynecologists adopted a definitional change, equating pregnancy with the implantation of a fertilized egg in the uterus, six to 10 days later than previously. For those who haven't jumped on the farcical pregnancy-begins-at-implantation bandwagon, anything that works to prevent implantation of a fertilized egg is nothing but abortion disguised as contraception.
The murkiness of how just how ECPs work — sometimes working contraceptively to delay ovulation, sometimes working to prevent implantation — and the FDA's controversial approval of the abortion drug known as RU-486 has managed to keep ECPs out of the hot seat. But with the AMA's latest action, Monsignor William Smith, dean of St. Joseph's Seminary in Yonkers, New York, says, “Whatever respect I have had for the AMA, I have lost it.
“The AMA has downplayed the Hippocratic oath since Roe v. Wade and finally dumped it. Now they just promise not to do anything illegal,” Monsignor Smith told United Press International. He says, the AMA “has given its blessing to killing” by reducing ECPs “to the level of aspirin.”
Trussell warns, “If they want to fight over this, fine, because they're not going to win.” Pro-lifers, however, cannot afford to lose. The EC education campaign is “purely driven by ideology,” says non-Trussellite Princeton professor Robert P. George.
The spinning of emergency contraception as contraception is part of a brilliant “divide and conquer strategy” among abortion advocates. Contrary to the rhetoric, the selling of the pills as contraception is more an attempt to drive a wedge between a “politically potent coalition of Catholics and evangelicals” than a sincere desire to reduce the number of abortions in America, George observes. Trussell “is a smart guy and knows if you want to sell this you've got to change the language.”
In her recent book of second thoughts and observations, The Whole Woman, pro-choice feminist Germaine Greer scolds her fellow travelers for lying to their sisters. “Whether you feel that the creation and wastage of so many embryos is an important issue or not, you must see that the cynical deception of millions of women by selling abortifacients as if they were contraceptives is incompatible with the respect due to women as human beings. Fake contraceptive technology manipulates women in ways that we are coming to condemn when they are practiced on members of other species.”
Greer must have had emergency contraception in mind — the most convenient misnomer to hit reproductive-rights, well, since the “pro-choice” movement was implanted in the nation's consciousness.
