The Pill, The Morning After Pill / Plan B, and RU-486
Women's health care has been in the news a lot lately, and the amount of misinformation being spread around is dangerous. A lot of people are still unsure as to which of the three pill listed above - actually does what. Many believe that all of these pills do the same, or similar things, or that all three have some reference to abortion, which is not true of all three.
Coming from a school district that taught me about all these types of pills, as well as the various forms of abortion services, I find that this information is not being given out to many people today.
All the information presented here is presented as the medical side behind these particular items, this is not a political piece nor religious piece, this is a facts piece. Or, as a factual as I can be without a medical degree.
1. The birth control pill or "The Pill," is an oral contraceptive that was developed by combining progesterone (progestin) and estrogen. Designed specifically for women, the pill was first approved in the US in 1960, and only for use by married couples. The Pill has been the latest in a long time of oral contraceptives that have been used by women over time, many being herbal-based with varying levels of effectiveness. It is estimated that over 11 million women in the US use the Pill for their main method of contraception.
The general concept of the Pill functions in such a way that one takes an active tablet every day of the month except for a seven day time span in which placebo pills are taken, to allow for a woman to have a monthly menstrual cycle. The Pill is composed of the two hormones mentioned earlier, although some more modern versions contain only Progestin. There are also new versions of the Pill that limit menstrual cycles to 4 a year, since there is no scientific data that demands that women need to have a monthly cycle. Many women have irregular cycles already, and some simply find the cost and time devoted to tending to the cycle to be too much of an inconvenience.
Before we begin talking about the effect of the Pill on the prevention of pregnancy, it needs to be noted that a good deal of women have another reason for taking the Pill, that of controlling body hormones in a way that helps to regulate acne, for example. Taking the Pill can also lessen those with heavy menstrual flows during their periods, and some women experience levels of cramping that are severe enough to cause them to miss work or school simply because they cannot move. Women with severe cramps or irregular periods have even been known to become anemic or to pass out, and the Pill can help treat this so that the women lead more normal lives. That being said, we also need to note that the Pill does not work for all women, and a small percentage need hormone levels altered, or cannot take the Pill at all. This number, compared to the general population using the Pill though, is small and consistent with variations when it comes to manipulating hormone levels. In time, these women may be helped by further medical research.
So, how does the Pill prevent pregnancy? Well, essentially, there are three components that can take place (one or all) that make the Pill up to 99% effective when used properly.
A. The Pill effectively tricks the body into believing that it is already pregnant, in a sense, and thickens the lining of the uterus, known as the endometrium. The endometrium thickens in preparation for the implantation of a fertilized egg, about every 28 days. Usually, this thickening of blood is washed out of the body during a period, but when implantation occurs, it will continue to thicken with blood and nutrients to support the development of that egg, the placenta, as it were. So, while the body does this normally, the hormones in the Pill lead the ovaries to believe that they have already released the egg for the month, so the endometrium is already thickening and hardening to a level that makes it hard or impossible for a fertilized egg to implant into. Even in women not taking the pill, but who are having sex regularly without sperm inhibitors, it is a likely bet that every month there is not a full conception, the egg is being flushed from the body in the period anyway. Meaning that the Pill is simply ensuring an already relatively routine biological occurance.
B. The Pill also sends an inhibiting hormone to the ovaries, so that while the uterus is thickening, the actual egg is never released, or at least, the release is delayed to a point that would render it impossible for the egg to implant. This is known as a general suppression of ovulation.
C. The cervical mucus becomes thickened. This is done to inhibit sperm from moving effectively or being able to come into contact with the egg itself, should one have been released. This is also something that occurs naturally in the body.
In essence then, the pill's success comes from effectively suppressing the release of the egg and preventing fertilization (where sperm meets egg) and if that fails, preventing implantation. (where fertilized egg burrows into uterine lining) Women's fertility is a complex issue that varies, but it is generally true that most women can actually only conceive a few days out of the month, based on the findings of fertility doctors. What this means is that in most cases, fertilized eggs leave the body of a woman monthly after failing to implant on their own due to any number of reasons, and the pill acts as sort of insurance to make sure that this normal biological functions follows the set natural path of what is already happening in the body.
So, does the Pill have anything to do with abortion? Absolutely not. The Pill does not cause abortion or miscarriage, there is no scientific data to support that claim. So why do some people still think it does? It's a matter of definition. For those who claim life begins at conception/fertilization, they might believe that if the Pill failed at task 1 of preventing the original fertilization, that the simultaneous other act of preventing implantation is essentially an "abortion." This is by definition then, hard to really define, since both are happening at the same time, one does not impact the other, and the majority of fertilized eggs never implant on their own anyway, as is the dictate of nature. There is also no way to separate the two functions, so if the qualifier is that sperm never joined with egg, it is impossible to really know if that that never happened originally. I have seen people saying that they can tell, but many are organizations with political agendas, and i could not find legitimate medical data to back up those claims.
Thus some people are actually seeking to ban the Pill although because of this, but medically speaking, the prevention of fertilization or implantation is not abortion by the standards of the US medical health boards or many other world health organizations. When you consider that up to 50% of pregnancies end in miscarriage (technically termed: Spontaneous Abortion) in the first trimester and without often, full knowledge of the woman, the body by that definition, aborts a good deal of it's own naturally conceived pregnancies for one reason or another.
Before we end with the Pill, it is best to talk to your doctor about the pill for further information about if it is right for you and your hormones. The Pill does not prevent STDs, and in some women can cause blood clots. It is very unlikely that the Pill will affect your future fertility. You may gain some weight, you may lose acne, and some women can find the symptoms of PMS or PMDD lessened. It is not "one" thing for all women, and advice from a board certified medical professional is the best.
Remember, your health is nothing to play with.
2. The Morning After Pill / Plan B
Another pill that has gotten some attention recently for being legalized to some extent is the Morning After / Plan B pill.
Many people openly confuse this with the Abortion pill, but this is simply not the case. It should be noted that there is a definite campaign of misinformation regarding this Pill that does say that this pill is the "abortion pill" in an effort to ban it. These campaigns seem to be religiously or gender motivated, meaning that their assertions cannot be scientifically verified or trusted by those looking for impartial information.
First, Plan B is the brand name attached to a type of Pill that is referred to as "The Morning After Pill." It is referred to as the "Morning-After" because that is when it is meant to be taken, or in a period of 3-5 days after the sexual intercourse.
I'm going to call it Plan B (it's quicker to type) from now on, but just know that these aren't two separate pills, which is a mistake I've seen some make recently.
Plan B was designed to help those women who find themselves in an adverse situation due to a sexual encounter. For instance, for women who cannot take the Pill, Plan B can function as a contraception in the event of a broken condom or failed other contraceptive (It uses an alternate hormone in some varieties). It should be noted that development of this pill was very much intended for the victim of rape. Instead of a rape victim being forced to navigate the state by state rules on abortion, she could essentially prevent the pregnancy from occurring in the first place, thus lessening her trauma and leaving her time to heal, physically and mentally, from the assault without further strain or stress on her body. Not to mention her legal right to choose if she wants to exercise it.
How does Plan B work? Well, let's look at the mechanics of fertilization.
When sperm enters the body, it has to travel past the cervix, up through the uterus, and into the Fallopian tubes. Fertilization occurs in the tubes. Now, women are not releasing eggs constantly, only one per month and it is unlikely to know exactly when that egg is released unless the woman is undergoing continuous medical testing. It can take a sperm and an egg up to six days to actually meet, it should be noted that the time frame from ejaculate to full implantation in the uterus and continued growth (ie. pregnancy) can be up to two weeks. In that time, we have the potential for fertilization and the egg coming down the tubes into the uterus. Being that a woman only releases one egg a month (generally) the male ejaculate must be in the body during a few critical days to result in a successful fertilization, and even then, half will not implant naturally on their own. Most women, not currently attempting to be pregnant or simply having very common irregular cycles, cannot accurately track this without charts or even software, so, we don't really know for sure when that occurs in the average woman, we only know the date of sexual intercourse. Being that she is probably not tracking it - she doesn't want to be pregnant.
Plan B, utilizing this time, introduces a hormone that immediately suppresses ovulation. Since it can take more time to build up that uterine wall against an egg, suppressing ovulation is the best method to prevent sperm and egg meeting. According to statistics, taking Plan B within 12-24 hours of intercourse has a 95% effective rate of preventing an egg from being released, therefore, not even touching the issue of fertilization. Plan B is recommended to be taken within 24-72 hours for 85% effectiveness, and recent studies have shown that for those who cannot get the pill so quickly, up to 120 (5 days) can be effective to some extent. (Remember, we don't know when ovulation would occur in these cases) This looks to be changing though, since it appears the pill will be sold more widely and openly than in the past, probably guaranteeing that most women will have it within 24 hours and therefore, fertilization will never even occur.
For those using the debate that life begins at fertilization, Plan B is actually preventing this from being a talking point.
So, what is the quickest way to determine that Plan B is not the abortion pill? When given to a pregnant woman, it will not terminate that pregnancy. When a pregnancy, meaning the implantation and growth of the fertilized egg in the uterine lining has already occurred, Plan B will not cause that to stop. Since pregnancy does not medically occur by definition for at least 7-14 days on average after sexual intercourse, this pill is not terminating an existing pregnancy and does not allow for one to even occur to be terminated. Many have stated that Plan B being offered more openly to women, will reduce the number of abortions in the US, and we should eventually get statistics on that point.
The pill itself even has fewer impacts on a woman's health. Being a one or two dose pill, it does not interfere with hormones over an extended period of time, and the FDA has even indicated that Plan B is about comparable to taking an aspirin in terms of the overall effect on the body.
3. RU-486 / The Abortion Pill (Mifeprex / Mifepristone)
This is the only pill that is meant to medically induce an abortion. First developed in France, it was brought to the US in 2000, it is legal and available in all 50 states when given and followed up with a doctor.
RU-486 is what is known as an early pregnancy termination pill, meaning that the chemicals contained in the pill will not work after a certain point in fetal development. It remains one of the safest ways to induce an early term abortion, the cutoff being 49 days after the first day of the last period. The effectiveness is reported at 92-95%, it has a very small risk of failure and this particular chemical is the most effective way to terminate an early pregnancy.
If you recall, not that long ago, the pill was featured in a youtube video wherein a woman had decided to broadcast her medical abortion to show what it actually looked like and what actually happened, in order to penetrate the sort of secrecy that surrounds the pill in the US.
You may watch the original video here:
http://www.youtube.com/watch?v=59Ud3g2ymOM
The chemical in the pill, in smaller dosages, can be used for contraceptive purposes, to induce labor in the case of fetal death, and the treat various other diseases unrelated to pregnancy. You can also find it in conjunction with other drugs in medical abortions up to 13 weeks, but it requires the additional drug to work effectively.
How RU-486 works, as is mentioned in the video if you didn't watch it, is to basically induce a miscarriage. It blocks the hormone progesterone, which is need to maintain the pregnancy (at this point, the thickened uterine walls) and causes them to begin to detach. RU-486 is actually in two parts, once the first part causes the hormone blockage, the second application will cause the uterus to contract and expel as it would happen in a natural miscarriage. Women typically report a slightly heavier, longer flow than their normal period. At this point in the pregnancy, there is very little to be removed from the body, so recovery time is often quick.
In many cases, about 2/3 of women will have reached full effectiveness of RU-486 within 4 hours and 90% by 24.
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Regardless of anyone's feelings on abortion, I feel that since I am seeing a good deal of misinformation around today, and since school sexual education seems to get less and less year by year - that it should be stated as to what each pill does and why two are contraceptives and one is an actual abortion pill.
Just in doing some additional research today, I noticed my Google search results were stacked up with biased websites clearly run by groups with definite agendas. I think it is important to present facts about the basic functions of these three items that are legal and available, and I encourage you to talk to your doctor about these items if you want to obtain them. Your relationship to medicine should not be interfered with by political agents, and only trained medical professionals can help you make an informed choice about what to do with your body.
Sadly, I feel I need to state that any abusive message sent to me won't be dignified with a response. If we can't handle a conversation about things that are present and legal within our society, even just on points of clarification... then we are a very sad society indeed.














