New 'Morning After' Pill: Contraception Or Abortion? - by Ofelia Mybona

"Controversy equalizes fools and wise men in the same way, and the fools know it."

- Oliver Wendell Holmes

When the control rods are pulled out a nuclear reactor core, atoms smash each other into oblivion in an uncontrolled and chaotic display of nature's most extreme fury.

Similarly, when the zealots on either side of the abortion debate clash to get it on, the result is very much the same. Such occurrences can make for an entertaining spectacle if viewed from a safe distance.

It's kind of like watching the running of the bulls in Pamplona, Spain. There are casualties on both sides but no clear winner.

So what's the attraction? Morbid curiosity I suppose. If a bunch of stupid people are going to let a half dozen 3000 pound angry bulls with really sharp horns chase them around a small section of narrow streets - yea sure, I'll watch.

Whether it will result in a spectacle that rivals nature's most extreme fury remains to be seen, but a new 'morning after' pill has yet again reignited debate over the issue of abortion, and it's headed for a showdown. The FDA is preparing for an advisory committee meeting on June 17 to consider whether the agency should approve a new drug called ulipristal.

The drug, which goes by the brand name ellaOne in the United States, will be sold as an "emergency" contraceptive if the required FDA approval is given. A close chemical relative of the shorter acting abortion pill RU-486, ulipristal prevents pregnancy for up to five days after unprotected sex.

Already being used in over 22 countries, the drug was invented by a French pharmaceutical company and has been used safely and successfully for the past several years, but it has only recently cleared the necessary hurdles for required FDA clearance that could allow it to be sold in the United States.

Perhaps the biggest controversy surrounding ulipristal is its potential to induce the abortion of an already formed embryo by making the womb unable to retain it.

It is precisely this issue that has the Pro-Life lobby poised for confrontation as they contend that in this capacity, the drug doesn't technically qualify as a form of contraception and shouldn't be approved for use as such.

Critics fear that women who do not realize they are already pregnant will use the drug and unwittingly give themselves an abortion.

"The difference between preventing life and destroying life is hugely significant to many women," said Jeanne Monahan, director of the Family Research Council's Center for Human Dignity. "Women deserve to know that difference."

Ah, yea right Jeanne, but that being said a woman who takes the drug is quite obviously less concerned about whether or not she's pregnant and more concerned about not wanting to be pregnant. Otherwise, why would she be taking the drug?

Critics also fear that some women will try to use ulipristal well after the first 5 days of becoming pregnant (as the drug is intended to be used) to abort a fetus. This, critics say, could put them at risk for potentially life-threatening complications that have been reported among a small number of women using RU-486, and possibly damage their developing child if it doesn't work.

Proponents dismiss these concerns, saying that ulipristal has been tested only within five days of unprotected sex and there is no evidence that it works as anything other than a contraceptive. Ella appears to be about twice as effective as RU486 in preventing pregnancy, and its effectiveness remains constant for at least 120 hours. RU486 begins to lose its effectiveness almost immediately and becomes ineffective after 72 hours.

Among ulipristal's supporters is Paul Fine, medical director of Planned Parenthood of Houston and Southeast Texas. Fine would like to stop seeing emergency contraceptives referred to as "morning-after pills." This is because ulipristal works for up to five days after unprotected sex.

"Emergency contraception is a woman's last chance to prevent an unintended pregnancy," says Fine. "And half of all pregnancies in the U.S. are unintended" he continued. And unlike RU486, the leading drug now used to prevent pregnancy after the fact whose effectiveness declines the longer a woman waits to take it, "ulipristal is just as effective between four and five days as it is in the first couple of days."

Controversy over whether ulipristal is intended to end pregnancy or prevent it will undoubtedly overshadow the work of a federal panel as they consider endorsing the drug. The last and only time the Food and Drug Administration considered an emergency contraceptive, RU486 (the original morning after pill), the decision to approve it incited teeth-gritting, white-knuckle debate over such fundamental questions as when life begins and the distinction between preventing and terminating a pregnancy.

Ulipristal is raising many of these same politically charged questions and because of this it will test the Obama administration's pledge to keep ideology from influencing scientific decisions in addition to bringing the abortion debate back into the spotlight of the media circus.