Posted on 12/10/2001 8:17:12 PM PST by Brian Kopp DPM
| AMA Votes Against Letting Women Know "The Pill" Is Abortifacient |
| WASHINGTON, DC, Dec 10, 01 (LSN.ca/CWNews.com) - The American Medical Association last week voted overwhelmingly against a proposal to inform women about the potential for birth control pills to cause the abortion of an embryo by preventing implantation in the uterus.
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| Cybercast News Service reports that Dr. John C. Nelson, a member of the AMA's executive committee and a self-described conservative, said the Alabama doctor who put forward the proposal before the AMA "believes that in the spirit of enhancing the patient/physician relationship, that information ought to be disclosed to patients to help them make choices." Nelson said, "I couldn't agree more. That's exactly what the AMA is about. It's a cornerstone of American medicine." However, according to Nelson, the proposal was voted down because "many people from the American Society of Reproductive Medicine... decided that they would testify, and their testimony was that there is not sufficient scientific evidence to suggest" that birth control substances can induce abortions. Walter Weber, senior litigation counsel for the American Center for Law and Justice, a Virginia-based public interest law firm, reacted to the vote saying, "If [pro-life women] are using a method that can operate after fertilization as well as before fertilization, and they don't know it, they are basically being deceived by lack of information into violating their own consciences." The Family Research Council (FRC) condemned the attempt to conceal the truth from women. FRC Advisory Board Member John Diggs, MD, said Friday, "The AMA is doing a great disservice to women by refusing to fully inform them of their birth control options. Since informed consent is a basic medical ethic, it should be standard operating procedure to tell women that the birth control pill can cause an abortion. Each woman has the right to know what's good for her health and acceptable to her conscience. If the AMA has suppressed its conscience, it shouldn't draw American women into its own ethical lapses." FRC noted that the prescribing information for Ortho Tri-Cyclen, a popular oral contraceptive, enumerates three pathways by which the pill works: suppressing ovulation, preventing fertilization, and precluding the implantation of an already fertilized egg. The third one constitutes an abortion. The third function is conspicuously excluded from information made available to patients. "If manufacturers are telling doctors that oral contraceptives can keep a new member of the human family from being nourished, why isn't that information being passed on to patients?", asked Diggs. Nelson noted that lobbying by the American Society of Reproductive Medicine largely contributed to the AMA's decision. ==================================================== Catholic World News is available via email for personal use only. To subscribe or for further information, contact subs@cwnews.com or visit our Web page at http://www.cwnews.com. Catholic World News (c) Copyright Domus Enterprises 2001. |
ABSTRACT:
The primary mechanism of oral contraceptives is to inhibit ovulation, but this mechanism is not always operative. When breakthrough ovulation occurs, then secondary mechanisms operate to prevent clinically recognized pregnancy. These secondary mechanisms may occur either before or after fertilization. Postfertilization effects would be problematic for some patients, who may desire information about this possibility. This article evaluates the available evidence for the postfertilization effects of oral contraceptives and concludes that good evidence exists to support the hypothesis that the effectiveness of oral contraceptives depends to some degree on postfertilization effects. However, there are insufficient data to quantitate the relative contribution of postfertilization effects. Despite the lack of quantitative data, the principles of informed consent suggest that patients who may object to any postfertilization loss should be made aware of this information so that they can give fully informed consent for the use of oral contraceptives.
*****
Always a Bitter Pill, Now the Risk of Breast Cancer Makes Oral Contraceptives Even Harder to Swallow
by Dr. Brian J. Kopp
Lay Witness Magazine, January 2002 edition
"It may not have rocked the ground like the 1945 detonation of the first atomic bomb. . . , but Enovid did more than just provide a technological tour de force. It transformed the very fabric of modern society. . ."
So reported "The Pill At 40", an article in the July-August 2000 "FDA Consumer" magazine, singing the praises of the Pill and celebrating the 40th anniversary of its approval by the Food and Drug Administration. On June 23, 1960, Enovid became the first oral contraceptive approved for sale in the USA, following several years of development and trials on third world women.
The article failed to mention the bitter legacy of the Pill over that same 40 years. Minor side effects abound, such as nausea, irregular bleeding, depression, weight gain, breast tenderness, and diminished libido. Some, however, are life threatening. Blood clots, pulmonary embolism, heart attack, and stroke have claimed the lives of many women taking the Pill since its introduction in 1960. Decreasing the dosages of the hormones in the Pill have lessened but not eliminated these deadly risks.
"Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent" was the first medical journal article to explain the mechanism by which the Pill prevents implantation of a fertilized egg in the womb, its lining (or endometrium) improperly formed under the influence of the Pill's hormones. Published in the February 2000 Archives of Family Medicine, a journal of the American Medical Association, it proved for both the secular world and a divided pro-life movement that the Pill is not only a contraceptive but also a chemical abortifacient. The report concludes:
"The available evidence supports the hypothesis that when ovulation and fertilization occur in women taking OCs, postfertilization effects are operative on occasion to prevent clinically recognized pregnancy. Physicians should understand and respect the beliefs of patients who consider human life to be present and valuable from the moment of fertilization."
While litigation in the USA relative to the Pill has been limited to suits aimed at forcing insurance plans to cover the Pill, in Britain a class action lawsuit has begun addressing another aspect of informed consent. In January 2002, 122 women and/or their families will take three pharmaceutical companies before England's High Court, charging that the Pill has caused blood clots resulting in lifelong illnesses and even death, and that they were never informed of the severe risks. Ten percent of the 122 claims involve a fatality. Unfortunately, these side effects have been known for four decades, and the prospects of success for these victims are uncertain.
However, compelling data has emerged linking the Pill with the rapid increase of breast cancer in the US, with a potential of class action lawsuits that could eclipse those even of the tobacco industry. Evidence has been available for several decades linking oral contraceptives with breast cancer in certain lab animals. According to Chris Kahlenborn, MD, one of the nation's leading researchers on the breast cancer/ Pill connection, the evidence of a link in humans is incontrovertible. His book summarizing his research and findings, BREAST CANCER: Its Link to Abortion and the Birth Control Pill, was published recently by One More Soul (www.OMS.com.)
In the book he makes a compelling case for such a link. He began researching the issue after hearing a presentation in 1993 that described an increase in breast cancer risk due to abortion, apparently caused by hormonal changes in the woman's body, and began an exhaustive review of the research to ascertain whether contraceptive hormones in the Pill might have the same effect.
The bottom line, after 8 years of exhaustive research and study? Dr. Kahlenborn replied, "There is a 45% increased risk of developing breast cancer if a woman takes an oral contraceptive for four years before her first full term pregnancy. This number is statistically significant to the 99th percentile."
"Informed consent is MIA. Catholic OB/GYN's are doing a grave disservice in handing this out. Today's cigarette story [the tobacco class action lawsuits] could be tomorrow's Pill story. There is no informed consent. The breast cancer and the social effects cause such devastation to families!"
He compares the current state of denial among the American medical establishment to a similar episode that occurred several decades ago. "History is repeating itself. DES was taken in the 40's and 50's to prevent miscarriage. A 35% increased risk of breast cancer was found." At the time DES (diethylstilbestrol) was used, some were concerned of a potential risk of breast cancer, while the American medical establishment denied the possibility. Only after 25 years was it discovered that DES use carried a 35% increased breast cancer risk.
Currently, more than 175,000 U.S. women develop breast cancer and more than 43,000 die from it each year. One in eight women in the US will be diagnosed with breast cancer in their lifetime. Yet 50 years ago, breast cancer was relatively rare. When asked what other factors might account for such a rapid increase in the rates of breast cancer, Dr. Kahlenborn was blunt. "I don't know. Two other factors come into play: decreased family size and decreased breast feeding. Both come into play." Pregnancy and breast feeding have been known to protect against breast cancer for many years. Obviously, these factors cannot account for the fact that breast cancer is increasing more rapidly in western countries, countries with early Pill use before first full term pregnancy.
Medical research findings have been contradictory. In 1972 a series of animal research studies showed that an oral contraceptive appeared to cause metastatic breast cancer in rhesus monkeys, which rarely develop breast cancer. In 1989 Anderson et al published a paper that found that women who had never had children who took the Pill had a significantly higher rate of breast cell division than childless mothers who had never taken the Pill. In general, cells that divide more rapidly are more vulnerable to carcinogens and more likely to become cancerous. A study in 1981 found that women who took the Pill for 4 years prior to their first full-term pregnancy (FFTP) had a 125% increased risk of breast cancer before age 32. In 1993, the CASH study showed a 40% increased risk in women taking the Pill before FFTP. Later in England another large study revealed a 44% increased risk. The last large study in 1995 showed a 42% increased risk. A meta-analysis (a statistical analysis of many other research studies) in 1990 found that, overall, the studies up to that time confirmed an increased risk of breast cancer of 72% for women under age 45 who took oral contraceptive pills for 4 or more years before having a full-term pregnancy. Use of these contraceptives for longer periods appears to carry an even higher risk.
However, the Oxford study, the largest meta-analysis to date, concluded that:
"Women who are currently using [the Pill] or have used them in the past 10 years are at a slightly increased risk of having breast cancer diagnosed, although the additional cancers tend to be localized to the breast. There is no evidence of an increase in the risk of having breast cancer diagnosed 10 or more years after cessation of use..."
Dr. Kahlenborn sees severe weaknesses in the Oxford study. He states in his book:
"The main weakness was the failure to report any evidence of what the pooled risk of oral contraceptive use before a FFTP was in women under 45 years old. . . A woman's breast is especially sensitive to carcinogenic influence. . . before [FFTP] because the breast undergoes a maturing process throughout a woman's first pregnancy. By failing to measure the effect. . . before a. . . woman's [FFTP] the Oxford study failed to give data on the one group of women who are most likely to get breast cancer from oral contraceptives."
Currently Dr. Kahlenborn is working on another meta-analysis that he hopes will be published within one year. This analysis attempts to analyze the data of all the studies available from the 1980's and 1990's, in an effort to obtain a more accurate statistical analysis specifically of women taking the Pill for several years prior to their first full-term pregnancy.
The Food and Drug Administration's FDA consumer magazine maintained that Enovid may not have rocked the ground like the 1945 detonation of the first atomic bomb. Dr. Kahlenborn would be inclined to disagree. "Hormonal chemical contraceptives are the equivalent to a nuclear bomb in their devastation to the family." Sickness, cancer and death lies in the wake of this bitter Pill. Can massive product liability suits be far behind?
Your own personal denial does not change the concrete proven reality that the pill is abortifacient.
G'nite
--Dr. Kopp
What the hell does religious belief have to do with anything? Oral contraceptives sometimes work as an abortifacient, affecting the endometrial lining of the uterus so that the one-week-old baby has a much greater risk of starving to death. This thread might help you a bit.
Each month, one of four things will happen in a woman's body: (1) an unfertilized egg may be discharged from the body; (2) a fertilized egg may be discharged from the body; (3) a fertilized egg will implant in the womb; or (4) there will be no egg.
Is the absolute likelihood of #2 happening in any given month increased or reduced by the use of oral contraceptives? My impression is that such contraceptives increase probability #4 to the point that probability #2 is well below what it would be were contraceptives not used.
To view it another way, suppose there are two groups of 1,000 sexually active women; one uses oral contraceptives but one does not. The menses from each group are examined to determine whether they contain a fertilized egg. In which group would the number of rejected fertilized eggs be higher?
MECHANISMS OF OCs
The literature discusses several mechanisms for OCs. While the primary effect of OCs is the inhibition of ovulation via suppression of pituitary gonadotropin secretion (this mechanism is operative most of the time),1, 10, 12 secondary effects are implicated at times of breakthrough ovulation to prevent clinically recognized pregnancy.17, 18 We classified these secondary effects as occurring either prefertilization or postfertilization. Secondary prefertilization effects may include alterations in cervical mucus that limit sperm penetration2, 17-20 and changes in the endometrium and fallopian tube that may impede normal sperm transport.2, 17, 18, 21
Breakthrough ovulation rates vary by the form and the dose of the OC used.2, 10, 12, 18, 22 With OCs, breakthrough ovulation is more likely with lower doses of estrogen and with imperfect rather than perfect use.10, 12, 16, 17, 23-25 Perfect use of OCs implies taking them consistently and correctly (ie, in the correct order, on time, each and every day, and without other medications that might diminish the effectiveness of OCs). Typical use is described as the full range of usage patterns for OCs that actually occur in women.1, 11, 12, 18 While some smaller studies that evaluated small numbers of women for 6 or fewer cycles have reported breakthrough ovulation rates of near 0, studies that evaluated women for at least 6 cycles demonstrated ovulation rates ranging from 1.7%25 to 28.6%23 per cycle. For POPs, reported breakthrough ovulation rates range from 33%26 to 65%.20, 27, 28
Obviously, breakthrough ovulation can result in unintended pregnancy1, 17, 18; however, the pregnancy rates with typical use vary widely and are often underestimated.29 Unadjusted analyses of unintended pregnancies while using COCs report rates of 0.1 to 1.0 per 100 woman-years of use in perfect use and 3 per 100 woman-years in the first year of typical use.1, 10, 12, 17, 18, 20 Most of these data do not account for elective abortions. One national analysis that accounted for the underreporting of elective abortions estimated that the unintended pregnancy rates during the first year of OC use were 4% for "good compliers," 8% for "poor compliers," and up to 29% for some users.29 Rates of pregnancy are higher with POPs than with COCs.1, 17, 18 Unadjusted analyses of pregnancies while taking POPs reported rates of 0.5 to 1.0 per 100 woman-years of perfect use and 3 to 7 per 100 woman-years in the first year of typical use.1, 10, 12, 17, 18, 20 However, these rates have not been adjusted for elective abortions and are almost certainly underestimated.29 Progestin-only pills are reported to have potent effects on both cervical mucus and the endometrium.19-21, 30, 31 While this has led to speculation that "the principal mode of action is . . . to make the cervical mucus hostile to the transport of the sperm,"17 animal model data32 and data on ectopic pregnancy rates (reviewed below) suggest that postfertilization effects also play a role.
In theory, postfertilization effects of OCs could involve any 1 or more of the following 3 mechanisms of action: (1) A postfertilization preimplantation effect would consist of a slower transport of the preembryo through the fallopian tube, preventing the preembryo from implanting in the uterus; this could result either in the unrecognized loss of the preembryo or in an ectopic (tubal) pregnancy if the preembryo had slower tubal transport and ended up implanting in the fallopian tube. (2) A peri-implantation effect would be the alteration of the endometrium, such that a preembryo that reached the uterus was unable to successfully implant into the endometrial lining of the uterus. (3) A postimplantation effect could result from alteration of the endometrium not sufficient to prevent implantation but unfavorable for maintenance of the pregnancy; a preembryo or embryo already implanted in the endometrial lining of the uterus would be unable to maintain itself long enough to result in a clinically recognized pregnancy.
If you are intellectually capable of comprehending it, a big "if", you will realize your error.
sorry . birth control is not abortion, but I respect catholics for their believes. However, other religious believes should be respected too. Once again birth control is not Abortion....The question here is not whether birth control is or is not abortion. That depends a great deal on the type of birth control. A condom, for example, is not. Here we are talking about just one form of birth control – the pill – not about all of them. Please understand that. We are not discussing the condom or any of the myriad other forms of birth control. Just the one form, the pill.
Second, this is not a matter of belief for a Catholic. Whether or not the pill also acts as both a contraceptive and an abortifacient is not an article of the Catholic faith. So far as I know the Vatican has never addressed the issue, nor has my bishop. What is a matter of faith to us is that we consider abortion wrong AND we consider contraception wrong. Please understand though, that we do see the difference between them. One is murder, one is merely resisting God’s will. But whether a particular method is an abortifacient or a contraceptive, this is science, it is not faith to a Catholic.
You, on the other hand, in asking us to respect your beliefs, seem to be indicating that this is a matter of faith to you. I can’t understand why, at all. Whether the pill acts as a contraceptive and an abortifacient is a scientific fact. It can be scientifically studied, and has been. Whether it is right or wrong, given the scientific facts, that is faith.
I could see you saying that contraception is morally OK, because that is a matter of faith. That is a religious belief, and I understand that a large number of modern Christians hold that view. Indeed, the pill usually acts as a contraceptive. You need to understand though, that powerful drugs often do more than one thing in the body. Once a drug is approved by the FDA for one use, it is frequently prescribed by doctors for other uses. This is even more true when the multiple effects the drug has all effect the same part of the body, here the reproductive system. That is because the drug often does more than one thing once in the body, and this is true for the pill. It acts as a contraceptive in many cases. The fact is though, that the contraceptive function of the pill has a failure rate. ANY scientist is forced to admit this, the pill does not always work. When it does not successfully contracept, sometimes the egg will fertilize. And of these cases, some will result in a chemical abortion.
If you will read nothing else in this article, read the summary:
The primary mechanism of oral contraceptives is to inhibit ovulation, but this mechanism is not always operative. When breakthrough ovulation occurs, then secondary mechanisms operate to prevent clinically recognized pregnancy. These secondary mechanisms may occur either before or after fertilization. Postfertilization effects would be problematic for some patients, who may desire information about this possibility. This article evaluates the available evidence for the postfertilization effects of oral contraceptives and concludes that good evidence exists to support the hypothesis that the effectiveness of oral contraceptives depends to some degree on postfertilization effects. However, there are insufficient data to quantitate the relative contribution of postfertilization effects. Despite the lack of quantitative data, the principles of informed consent suggest that patients who may object to any postfertilization loss should be made aware of this information so that they can give fully informed consent for the use of oral contraceptives.
patent +AMDG
Hey Robert, try not to be a jerk.
patent
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