Nearly 15 years after the Federal Drug Administration approved emergency contraception to be sold without a prescription, a bill in the Arizona Legislature seeks to equate the use of emergency contraception with abortion, perpetuating a myth that birth control can somehow harm and end an established pregnancy. As an obstetrician/gynecologist in training in Arizona, I specialize in women’s health, including fertility, pregnancy, childbirth, and birth control. SB1362 is another example of health care policy that ignores medicine and science.
Under brand names such as “Plan B” or “Next Choice” and commonly called “the morning-after pill,” this emergency contraception is essentially a higher dose of a birth control pill. And it works just like traditional birth control pills – by preventing the release of an egg from the ovary. If no egg is released, then there is nothing for a sperm to fertilize, and a pregnancy cannot occur. In addition to the well-known pill, insertion of intrauterine devices can also be used to prevent pregnancy after unprotected intercourse. After the initial placement, intrauterine devices have the added benefit of being used as long-acting contraception – continuously protecting against pregnancy several years after placement.
An abortifacient, or a medication that causes an abortion, by definition, is an agent (such as a drug) that induces an abortion. In order to induce an abortion, there must be a pregnancy – which does not occur until a fertilized egg successfully implants into the uterus. Because emergency contraception is being utilized to prevent pregnancy, not end one, it is simply not an abortifacient.
Conflating emergency contraception and abortion is a common misconception that can have a significant impact on health outcomes for women. This fallacy is often perpetuated by interest groups in order to restrict access to birth control, which ironically can increase the rate of unintended pregnancies and increase the rate of abortion. By defining emergency contraception as an abortifacient, the undue hurdles and restrictions women are subjected to in order to obtain an abortion would likely be applied to obtaining Plan B or an IUD. However, studies have repeatedly shown that reducing access to birth control – not increased abortion restrictions – reduces unplanned pregnancies and abortions.
In the United States, approximately 49% of pregnancies are unintended. The emotional and financial cost of this is high. While consistent and affordable access to contraception is the best way to reduce abortion rates, it also reduces health care costs. For each dollar spent on publicly funded contraceptive services, the U.S. health care system saves $6. Furthermore, contraception has numerous benefits that improve the health and well-being of women, including reducing maternal mortality, decreasing the risk of gynecological cancers, and increasing female economic self-sufficiency. Reduced access to contraception disproportionately affects low-income and minority women. Unequal access to contraception leads to higher rates of unintended pregnancies and consequently higher rates of unintended births and abortions. Higher rates of unintended births are linked with increased risk of infant and maternal mortality, further compounding health disparities that plague our country.
Proponents of SB1362 will say that the bill helps to make sure that people who object to abortion and emergency contraception won’t have to participate in either. The reality is that conscience clauses in Arizona already exist to allow anyone to opt-out of providing support to any medical procedure they object to. SB 362 is unnecessary at best, and harmful at worst.
If interest groups and lawmakers want to reduce abortions, it behooves them to follow science and increase access to contraception, not restrict it. Words have meaning. Facts are important. Scientific evidence should shape health care policy, not political rhetoric. SB1362 should receive a resounding “nay” from the responsible legislators in Arizona.
Gabriella Smith is an OB/GYN resident in Phoenix and a member of the American College of Obstetricians & Gynecologists.