For the Millionth Damn Time: The Morning After Pill Is Not the Abortion Pill

Yesterday, the Associated Press reported that a proposed law in Alabama would require women who take the morning after pill to do so in the presence of a physician. This story was repeated across multiple sources, including here. But the bill itself actually isn't about the morning after pill at all — it's about RU-486, which is something totally different. How did so many people get it wrong?

The AP story led with "Women seeking to take emergency contraception like the so-called "morning after" pill would have to do so in the presence of a doctor under a bill before the Alabama Legislature." Straightforward enough, right? Except that's not how the bill's written. According to the text of the legislation,

As tested and approved by the FDA, and as outlined in the drug label, an abortion by mifepristone consists of three 200 mg tablets of mifepristone taken orally followed by two 200 mcg tablets of misopristol taken orally, through 49 days LMP, a gestational measurement using the first day of the woman's last menstrual period as a marker. The patient is to return for a follow-up visit in order to confirm that a complete termination of pregnancy has occurred... The aforementioned treatment requires three in-person office visits by the patient, and the dosages may only be administered in a clinic, medical office, or hospital and under supervision of a physician.

Horrors of the bill's absurd hoop-jumping requirement aside, the Mifepristone-misopristol combination is a pill that actually causes abortion. It's taken several weeks after pregnancy has already occurred. Taking it the morning after unprotected sex would be bizarre and inconsistant with medical advice.

Emergency contraception, or "the morning after pill" is levonorgestrel (Plan B) or ullipristal acetate (Ella). Both pills are taken after a sex accident (not, like, you broke his penis, but like the condom broke or you skipped a birth control pill that day or something). Plan B can be taken up to 72 hours after sex, and Ella works for 120 hours after sex. Both work by preventing ovulation, so your egg never has to do a fateful high five with one of his sperm, or preventing implantation, which can interfere with an already-fertilized egg's attempted implantation into the cozy mucus lining of your fecund womb. If you're already pregnant by the time you take the morning after pill, you're SOL.

The abortion pill causes abortions. The morning after pill prevents pregnancy. See? Different things.

Except that's not how Gerald Allen, the sponsor of the bill, told it. Even though the text of the bill reads that it's specifically written to require women to take the pregnancy-ending mifepristone-misopristol course (aka RU-486, aka The Abortion Pill) in the presence of a doctor, during the committee meeting addressing the bill, Allen used RU-486 and "the morning after pill" interchangeably. Leola Reis, Planned Parenthood's Vice President of External Affairs, explained that a doctor was called on to explain to Senators the difference between the abortion pill and the morning after pill, but by then, the story had already been written.

This is what happens, though, when legislators try to dabble in medicine. "(Allen) is not a doctor," sighed Reis. "There a lot of people in that chamber without a medical background. It shows how inappropriate it is for them to be mixing into medical practice."

Simply put, legislators like Gerald Allen who conflate RU-486 and Emergency Contraception are either ignorant or deliberately misleading. It's possible that they're ignorant; maybe they attended abstinence-only sex ed classes held at their local Church and make their wives hide their tampons because vagina = shame and they honestly believe that there is only one type of pill that women can take after having unprotected sex. It's certainly not unbelievable to think that maybe a person like that could get themselves elected to a state office and use their highfalutin position to hook their thumbs in their suspenders and do some lady regulatin'; this could be the same sort of person who thinks that there's only one kind of birth control and that it costs $9 at Wal-Mart and every woman can take it safely with the same results. But if, Allen and his conflating ilk know the difference between the morning after pill and the abortion pill and deliberately interchange the two in order to confuse the public, that's irresponsible and dishonest, but understandable as a weasley political move. Personhood advocates — those people who believe that life begins when the sperm says it does — think that the morning after pill causes abortions as it can interfere with the implantation of a fertilized egg. It's much easier to convince a public to get on board with regulating something that's abortion than it is to convince them that it's A-OK to regulate something that's contraception.

The anti-birth control set's adamance that emergency contraception=abortion is not a lie we can continue to let slide. Otherwise, what's next? Marital proof required prior to condom purchase?

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