Emergency Contraception

Emergency Contraception

Emergency Contraception (EC) is a safe and effective means of preventing pregnancy after unprotected intercourse. EC — also known as "Plan B" or "the morning after pill" — contains a higher dosage of the same hormones found in regular birth control. Emergency contraception is NOT the same medication as RU-486 ("the abortion pill").

Emergency contraception can be 95% effective in preventing pregnancy from rape if taken within 24 hours. A delay of even 12 hours can increase the odds of pregnancy by almost 50%.^[1] Emergency contraception was approved by the FDA for over-the-counter sales in August 2006. It is available at most pharmacies to women over the age of 18 with a valid photo ID when a pharmacist is on duty.

Emergency contraception works in two ways:

• Prevents or interferes with ovulation (i.e. such that an egg is never released or the released egg is resistant to fertilization)
• Prevents fertilization - it thickens the cervical mucous and alkalinizes the uterine cavity, creating an inhospitable environment for sperm, and thereby impairing a sperm’s ability to make it to the egg.^[2]

Legislation

Currently Pennsylvania has no law on the books outlining standard emergency medical treatment for victims of sexual assault. As a result, care varies widely between hospitals; some providing comprehensive care which includes access to emergency contraception, and others refusing to provide access to the medication even if it’s requested. Click here to read about an ACLU survey of hospital emergency room provision of EC in Pennsylvania.

A bill that would make emergency contraception available in all Pennsylvania hospital rooms has been pending in the Pennsylvania legislature for several years. 2007 is the first year the bill has significantly progressed in the legislature; due in large part to intense education efforts, targeted constituent contact, and legislative leadership.

In 2007, House Bill 288 was introduced by Rep. Daylin Leach (D-Montgomery) with 28 co-sponsors. A public hearing on the legislation was held by the House Health and Human Services Committee in May, and the bill was voted out of committee without any damaging amendments by a vote of 20-8 in June. Since then, final debate and consideration has been delayed three times. A legislative working group is in the process of developing a compromise for consideration by opponents of the current bill. Opposition to the legislation is based on claims by the Pennsylvania Catholic Conference. As interpreted by Catholic doctrine, the Catholic Conference maintains that in certain cases emergency contraception may interfere with the implantation of a fertilized egg; thereby constituting an abortion.

Despite those claims, NO epidemiological and clinical evidence have shown that EC prevents pregnancy after fertilization (when sperm and egg meet); meaning that the medication does not prevent implantation of a fertilized ovum.^[3][4] Even the United States Catholic Health Association's senior director for ethics has stated "conclusive evidence supporting this position has not surfaced."^[5] On their website, the makers of Plan B list the interference with implantation as a possible effect of the medication for legal and not medical purposes. Barr Pharmaceuticals, the makers of Plan B, have no evidence to show emergency contraception interferes with implantation of a fertilized egg. The mechanism of action can simply not be disproved with absolute certainty due to ethical considerations of medical testing on humans.

Planned Parenthood Pennsylvania Advocates supports House Bill 288, with only the Ross Amendment. The Ross Amendment is an omnibus amendment with three components:

• Pregnancy Test: a pregnancy test would be administered and the standard of care requirements relating to dispensation of emergency contraception would apply only if the test showed the victim was not pregnant.
• Individual Refusal: if an individual doctor objects to providing the medication, the hospital/facility still must fulfill the requirements of dispensation of emergency contraception as outlined in the bill through another health care provider employed by the hospital, or by an independent entity.
• Institutional Refusal: this section requires a hospital/facility to contract with an independent entity in the event that the hospital/facility has a religious objection to providing emergency contraception.

Other Information

In October 2007, the Pennsylvania Independent Regulatory Review Commission (IRRC) approved regulations that standardize sexual assault victim emergency services in the state. For more information on these regulations, click here.

The regulations outline standard medical protocol, including that a victim is to be educated about and offered the full regimen of emergency contraception on site. Because regulations must adhere to current Pennsylvania law, and do not create new law, the Department of Health was limited in their regulation of religiously affiliated hospitals — of which there are currently fifteen that provide emergency services in the Commonwealth. Regulations can also be overturned by statute — or law — enacted by the state legislature.

As written and approved, the regulations allow a religiously affiliated hospital to opt out of providing emergency contraception so long as they register with the Department of Health, provide medically accurate information about emergency contraception to the victim, and provide transportation of the victim to the closest hospital that provides emergency contraception at her request. Planned Parenthood and the sexual assault community oppose transportation of a victim to receive standard medical treatment. However, the standardization of care and the assurance that emergency contraception will be provided at all non-religiously affiliated hospitals is a major improvement in the emergency care of sexual assault victims.

It's important to note that with the recent approval of the regulations, victims in non-religious hospitals are receiving standard comprehensive care, and in light of the regulations, the impact of any passing legislation is more narrow. Any compromise amendment that is passed must ensure women receive emergency contraception on site at ALL Pennsylvania hospitals from a medical professional; regardless of the religious affiliation of the institution. Any alternative means of provision of emergency contraception included in a compromise must be stated clearly in the amendment, so that the practice is fully protected by law if challenged in court.

What You Can Do

First, you can call your legislator and ask for his or her vote in favor of House Bill 288 with only the Ross Amendment.

Letters to the Editor make a major impact! If you’re interested, send an email to administration@pppamail.org and we can help you draft one, and even submit it for you!