Posted on 11/18/2006 3:00:48 PM PST by wagglebee
The manufacturer of Plan B, the morning after pill, claims that the drug effectively prevents pregnancy in 89 percent of cases when it is taken within 72 hours after intercourse. The Food and Drug Administration (FDA) used this high efficiency rate as grounds for making Plan B available over the counter.
A meta-analysis1 of the methods used to test the drug's efficiency, however, offers evidence that an 89 percent efficiency rate is optimistic.
Dr. Joseph B. Stanford, associate professor of Family and Preventive Medicine at the University of Utah, conducted the meta-analysis with Rafael T. Mikolajczyk, professor of Public Health Medicine at the University of Beilefeld, Germany. Dr. Stanford was one of four members of the FDA's Advisory Committee who voted against making the drug available over the counter, viewing studies of the drug's effectiveness as necessarily imprecise.
"The 'gold standard' for effectiveness of any method of contraception is considered to be a randomized trial," reads the introduction to the meta-analysis. "This standard is difficult to attain for many methods of contraception, but especially so for emergency contraception, where ethical considerations preclude a placebo controlled trial."
Few women would be cavalier enough to willingly engage in a study requiring sexual intercourse during ovulation in order to test whether a drug would leave them pregnant. Thus, studies of the effectiveness of emergency contraception have not used a placebo, an innocuous substance used in controlled experiments to compare and test the efficacy of a drug.
The lack of a placebo is one of many factors adding to the imprecision of emergency contraception studies. Another source of ambiguity is that such studies rarely take into account the women's specific days of ovulation. Instead, a proxy marker is used for ovulation and the period of time in a woman's cycle when she is fertile.
Dr. W. David Hager, a gynecologist with a subspecialty interest in infectious diseases who practices at the Women's Care Center in Lexington, Kentucky, also served on the FDA Advisory Committee that assessed whether Plan B should be sold over the counter. He agrees that studies determining the effectiveness of the drug should take the day of the woman's cycle into account if the results are to be accurate.
"When you base effectiveness on use throughout the month, without considering the day of the cycle, the results are misleading," said Dr. Hager. "You can see the significant differences in effectiveness based on the method. For example, when looking at Table 5 of [the meta-analysis] the effectiveness varies from 62-88% using Trussell's approach vs. 51-84% using the adjusted approach."
The Trussell approach, in which information about the variable timing of ovulation is disregarded, results in a higher estimate of the drug's efficiency. This approach, most widely used, assumes more days when women are fertile. In reality, the window of fertility is smaller. "Since many young women are using emergency contraception as their method of birth control, rather than using a prescribed birth control method, they will be using it unnecessarily many times," said Dr. Hager.
The adjusted approach, however, includes information about unpredictable ovulation cycles. This added factor serves to make the measurement of emergency contraception's efficiency more precise, reducing conflated estimates.
Dr. Stanford goes beyond the analysis of emergency contraception studies to refute claims that such drugs are vital to reducing the number of abortions and unwanted pregnancies. Studies in countries that have made the morning-after pill accessible to the public without a prescription demonstrate otherwise.
One major study conducted in the United Kingdom found no drop in abortion rates with over-the-counter access to emergency contraception. Another study measuring the impact of ready access to emergency contraception on unintended pregnancies in the U.S. showed no lowering of pregnancy rates.
The American Association of Pro Life Obstetricians and Gynecologists (AAPLOG) released a statement in the wake of these two studies criticizing those who claimed over-the-counter access to emergency contraception would reduce abortion and unintended pregnancy rates by one-half.
"American College of Obstetricians and Gynecologists (ACOG) president Vivian Dickerson has stated that 'FDA leaders bear significant responsibility for a public health failure to reduce these [unintended pregnancy and abortion] rates if they fail to consider sound scientific evidence.'
"Given the accumulating sound scientific evidence that over-the-counter access to emergency contraception doesn't impact unintended pregnancy or abortion rates, this accusation is simply reckless rhetoric and political grandstanding. Further, to continue to claim that over-the-counter access will cut unintended pregnancy rates and abortions in half, when sound scientific evidence exists to the contrary, is to betray public trust. (ACOG press release Statement of Vivian M. Dickerson, MD, President, The American College of Obstetricians and Gynecologists on JAMA Emergency Contraception Study, January 5, 2005)."
Other studies show that emergency contraception actually increases rates of abortion and unintended pregnancy. Teenage pregnancy in Scottish schools among 13- to 15-year-olds rose 10 percent in one year with increased access to the morning-after pill.2 In 2006, the country reported the highest number of abortions since abortion was legalized in 1967.3 In the United Kingdom, abortion rates increased by 6,000 in one year, with the largest leap among girls younger than 16 years old.4
Countries where the morning-after pill is easily accessible have also experienced an increase in sexually transmitted diseases (STDs).5 In the United Kingdom, specific STDs such as gonorrhea increased by 50 percent in only three years after the morning-after pill was distributed without a prescription.6 In a four-year period, the number of cases of chlamydia went up 76 percent, gonorrhea went up 55 percent, syphilis went up 54 percent and genital warts went up 20 percent.7
For more information about false claims surrounding Plan B, click here.
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IIRC, the campaign against the Plan B was based on an assumption that it works.
The real reason that liberals are pushing things like "Plan B" is not that they want to avoid the problems, but rather that they want to be able to have casual sex. If pushing birth control means casual sex becomes so common that the associated problems are worse than they were before, that doesn't mean birth control was a failure, since it achieved its real objective.
Supercat has it exactly right , Plan B is just another way to encourage casual sex , Planned Parenthood gives away millions upon millions of condoms , the failure rate for properly used condoms is 25% (meaning that if a woman in her fertile years used condoms properly 100% of the time she will still become pregnant every 4th year), we all know that teens and twenties don't do anything 100% correct , their failure rate is probably at least double... Do they work? YES , Well? not really .. Does it increase the number of "oops" pregnancies and business for PP ... Absolutely.
Leftist agendas are "believed" as though they were religious dogma. Only thing is their beliefs are lies. That's why they do everything they can to suppress real debate on issues.
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Well, duh.
I'm late coming back to this but wanted you to know I appreciated your responses.
I feel differently than many people here in that I don't see a role for the government in minimizing sex - but I do want to see abortion limited to those situations where a choice between lives must be made.
The goal isn't for the government to minimize sex, but rather to try to minimize the harm that can result therefrom. Trying to hide the consequences of imprudent sexual relations will increase the harm that they do.
Personally, I believe the consequences of this change in government-ordered child support policies have been generally negative. If an adult woman wants to ensure that she'll be supported in raising a child she bears, she should marry the would-be father beforehand. If she or the would-be father isn't willing to do so, she shouldn't count on support.
On a related note, I'd suggest changing the laws to make clear that unmarried fathers have no say in what happens to their children (fair, since they wouldn't have to pay for them unless an underage-girl's father insists on marriage). This would facilitate the donation of newborns for adoption, since there would be no need for paternal consent and no worry about later paternal objection. When a mother signs over her baby, that should be it, period.
As it is, many couples in the U.S. feel a need to go overseas to get babies they can be assured of being allowed to keep. Anyone adopting a baby in the U.S. faces a very real risk that some [bleep] judge may steal their baby away from them because one of the birth parents had second thoughts.
Given that there are queues of couples waiting to adopt children, I see no reason why unmarried women who get pregnant without having a marriage-willing partner shouldn't simply be encouraged to give up the child for adoption and informed that if they don't, they alone will be responsible for its support.
Really, if a mother in that situation chooses to give up her child, in what way is that not better for the child, the mother, and the father, than having the mother pursue the father for child support and then try to raise the child by her self (but with some of the father's money)? IMHO, all child support does is provide the illusion that single motherhood is a responsible choice.
>>Personally, I believe the consequences of this change in government-ordered child support policies have been generally negative. If an adult woman wants to ensure that she'll be supported in raising a child she bears, she should marry the would-be father beforehand. If she or the would-be father isn't willing to do so, she shouldn't count on support.<<
Another good post.
I need to remember as I discuss public policy that I am not normal. I engaged in, enjoyed and would again engage in, non-marital sex. But I have never had sex unless I was prepared to marry the girl, support and raise the child for life, should a child result.
As I understand it, that is not normal, although it should be.
And if laws and practices were as I suggested they should be, in the event that one of those women had gotten pregnant, she would have had the choice of either marrying you or else freeing you of all obligation. She would not have had the choice of using you as a money tree while simultaneously shutting you out of your child's existence.
Yeah, well as for myself I was rather intimate with my fiancée before the wedding night, but with some pretty concrete limits. Had she gotten pregnant, it wouldn't have been by me.
I can't say how things would have been if we hadn't shared any pre-marital intimacy, but I think the compromise worked well. It meant that we were comfortable with each other, and yet had something special (and very nice) saved for the honeymoon.
>>And if laws and practices were as I suggested they should be, in the event that one of those women had gotten pregnant, she would have had the choice of either marrying you or else freeing you of all obligation. She would not have had the choice of using you as a money tree while simultaneously shutting you out of your child's existence.<<
I'm afraid I wouldn't make a very good male rights advocate - if the woman in question chooses not to marry me I'm not sure its right to remove my legal responsibilities to my child - in fact I'm not sure anything can remove the responsibilites toward one's child.
If the woman wants you to help care for her child, she should marry you. If the woman isn't willing to marry you, there wouldn't seem to be much of a future in the two of you raising the child together.
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