What are the implications of redefining Plan B as effectively abortifacient (versus contraceptive) in battles over healthcare rights of conscience under the Obamacare mandate, concerns that have been raised by employers who do not want to provide coverage for "abortion-causing drugs" in their insurance policies? In other words, does your study strengthen the hand of all the “Hobby Lobby”s?
Plan B should be redefined as emergency abortion/contraception when given prior to ovulation because abortion appears to be its dominant method of action following intercourse, at least in the late fertile period. Informed consent dictates that women be informed of this method of action. Those who value human life in the earliest stages should not be coerced into giving or paying for this method of hormonal abortion.
Some who assert that Plan B works only as a contraceptive claim that it has little effect on the endometrium (the lining of the uterus) and, therefore, they conclude it could not cause an abortion. Is this true?
No. Proponents of Plan B often note that Plan B has not been shown to have an effect on the endometrium on a histological level. However, as we noted in our “Linacre” paper, when Plan B is taken prior to ovulation, it causes endometrial bleeding (menstruation) within 7 days about 30% of the time. This is gross anatomical evidence of an unstable endometrium. In addition, we noted that there is theoretical evidence that Plan B — like other progestins — may cause slowing of tubal transport of the embryo, which increases the risk of ectopic pregnancy (generally fatal for the embryo with or without emergency surgery) and can delay the timing and efficacy of implantation. While there are different ways in which Plan B may cause a living week-old embryo to be aborted, at this time, due to current technological constraints, it is difficult to determine the exact mechanism of action. However, as we noted in our “Linacre” article, in the future one will probably be able to quantify how frequently Plan B causes abortion by employing the use of sophisticated hormonal assays (for example, Early Pregnancy Factor) which can often detect the presence of pregnancy within 48 hours of fertilization.
Chris Kahlenborn, MD is a board-certified physician and the founder and director of The Polycarp Research Institute.