Thursday, April 23, 2009

The Morning-After Pill: Not All It's Cracked Up to Be

When I first heard about the federal court decision last month ordering the FDA to make the morning-after pill available to 17-year olds — a decision gushingly lauded by ACOG, natch — I couldn't help but call to mind this post on the Life Training Institute blog last year.

Therein, Rich Poupard (aka Serge) writes about a web seminar (at one time accessible here) in which Dr. James Trussell made some astonishingly candid admissions about the failure of emergency contraception to reduce the rate of unintended pregnancy.

Trussell's page on Princeton's website notes that he is "a senior fellow at the Guttmacher Institute and a member of the board of directors of the NARAL Pro-Choice America Foundation, The Guttmacher Institute, the Society of Family Planning, and a member of the National Medical Committee of Planned Parenthood Federation of America". It further notes that Trussell "has actively promoted making emergency contraception more widely available as an important step in helping women reduce their risk of unintended pregnancy..."

Poupard notes that Trussell acknowledged, among other things, the following:

1. Trussell previously hoped (published in 1992) that EC would reduce unintended pregnancies and abortion by half.

2. 15 years later 11 studies have consistently showed no decrease of pregnancy rates from use of ECs.

3. Trussell also stated that a future decrease in pregnancy rates from EC use is highly unlikely - an astounding admission. ...

4. Due to difficulties in estimating the expected pregnancy rates, the published efficacy in the package insert of EC is almost certainly too high.

He then trenchantly notes:

This is amazing stuff. Since there was extensive news coverage of the effort to get Plan B to OTC status, why the silence in the wake of information that Plan B will not effect pregnancy or abortion rates? Imagine the outcry if a heart medication was thought to reduce heart attacks by 95% - and was made over-the-counter in order to increase its availability to reduce heart disease. A year later evidence comes out that no study had ever found that it had any effect on heart attack rates, and that the only thing that could be said about it is that it is "probably better than nothing". There would be a great outcry, congressional hearings, and accusations that the evil pharmaceutical companies were gouging unsuspecting patients. However, so far there has not been a peep among those concerned about "women's health" that they could be promoting an expensive medication that may not be effective.

Instead, we get this:

On Wednesday, Nancy Northrup, president of the Center for Reproductive Rights, praised the agency's apparent change of heart.

"We commend the FDA for taking swift action to ensure that its decisions on Plan B are based solely on the drug's safety and efficacy," said Northup, whose group had brought the lawsuit against the FDA. "It is a key step for the agency as it seeks to restore confidence in its ability to safeguard public health and leave politics at the lab door."

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