Scientists Refute Claims About Emergency Contraception Made by Opponents of Contraceptive Coverage

February 22, 2013 — Scientists and public health experts are frustrated by inaccurate claims that emergency contraception can act as an abortifacient, which is a central assertion by plaintiffs in lawsuits challenging the federal contraceptive coverage rules, NPR's "Shots" reports (Rovner, "Shots," NPR, 2/21).

The rules, which are being implemented under the Affordable Care Act (PL 111-148), require most health plans to cover contraceptive services (Women's Health Policy Report, 2/21). The requirement applies to EC, including Plan B and ella, both of which FDA classifies as contraceptives. The rules do not apply to mifepristone, which is used in medication abortion, because it is not a contraceptive.

Despite this, several religious conservative groups contend that providing their employees with health coverage for EC would violate their faith because they believe the drugs cause abortions. Specifically, they believe the drugs can prevent a fertilized egg from implanting in the uterus, which they equate with abortion.

Susan Wood, a health policy professor at George Washington University and former assistant commissioner for women's health at FDA, said this belief is "not only factually incorrect, it is downright misleading." An abortion-inducing drug "is something that interrupts an established pregnancy," she said, adding that the only link between EC pills and abortion "is that they can prevent the need for one."

Recent studies have verified that Plan B works by preventing ovulation and therefore, fertilization. Researchers previously thought that the drug also might make it more difficult for a fertilized egg to implant in the uterus, which Wood noted is still not the same as an abortion. However, newer research led the International Federation of Gynecology and Obstetrics to declare that Plan B does not prevent implantation.

Much of the remaining controversy surrounds ella, about which less is known. Abortion-rights opponents have noted that the medication is a chemical cousin of mifepristone.

However, Diana Blithe -- a biochemist and contraceptive researcher at the National Institute of Child Health and Human Development -- notes that mifepristone changes the lining of the uterus to make it inhospitable to a pregnancy, while ella is "designed to have stronger effects on the ovary and less effect on the [uterine lining]." In addition, ella -- like plan B -- cannot prevent pregnancy in women who have already ovulated, Blithe said ("Shots," NPR, 2/21).