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it's spring and — if we are to believe Tennyson — time
for a young man's fancy to lightly turn to thoughts of love. On
a somewhat less romantic note, the American Society for Emergency
Contraception (ASEC) chose the first day of spring to kick off a
campaign to promote emergency contraception.
Finding a positive
and appealing image for the campaign posed a real challenge. The
rumpled bed clothes and discarded, torn condoms used in past marketing
efforts are too closely linked to the idea of failure. Contraceptive
failure. Failure to engage in what's called "responsible"
sex. A failure of judgment perhaps — one in three young women
seeking emergency contraception in a U.K. study admitted to having
unprotected sex when they were drunk, and nearly half blamed alcohol
for one-night stands they would not otherwise have had.
And so ASEC
turned to the can-do, American-as-apple-pie image of Rosie the Riveter.
In 1941 Rosie started life as a patriotic poster girl, recruiting
American women to support the war effort by working on defense manufacturing
assembly lines. Remember the confident Rosie, pushing up her shirtsleeve
to reveal a (petite) flexed biceps and proclaiming to the world
"We Can Do It!"?
The ASEC-updated
version of Rosie has a none-too-subtle sash labeled EMERGENCY CONTRACEPTION
ringing her waist. And, get this: Her biceps muscle is emblazoned
with "EC" in a tattooed heart pierced by Cupid's arrow.
You can almost hear her saying "We Can Undo It!"
Easy as it
is to poke fun at the screwball advertising concept, the underlying
campaign called "Back up your Birth Control with EC" is
no laughing matter. It exacerbates what pro-choice feminist Germaine
Greer calls "the cynical deception of women by selling abortifacients
as if they were contraceptives," a deception she finds "incompatible
with the respect due to women as human beings" (The Whole
Woman, 1999, p. 93).
What kind of
deceptive claims are we hearing?
CLAIM:
"EC does not interrupt a pregnancy. In fact, it will not work
if a woman is pregnant" ("Fact Sheet," backupyourbirthcontrol.org).
FACT:
Only if you redefine pregnancy as beginning when the six- to seven-day-old
human embryo begins implanting in the uterine lining. But medical
textbooks uniformly agree that pregnancy is "the gestational
process, comprising the growth and development within a woman of
a new individual from conception ... to birth" (Mosby's
Medical, Nursing & Allied Health Dictionary, 2002). In fact,
a hormone called early pregnancy factor, which is produced
by the developing embryo, can be measured in the mother's blood
at three days before implantation. Pretending pregnancy begins
at implantation is simply a ploy to avoid admitting the abortifacient
properties of hormonal "contraception."
How does EC
work? If taken pre-ovulation, EC may delay or inhibit ovulation,
thereby preventing conception; but often it does not. If taken after
the LH surge which triggers ovulation, EC will not disrupt ovulation
in that cycle, but can inhibit implantation of the developing embryo
(causing his death) due to changes in the uterine lining. (See,
e.g., C. Kahlenborn, MD et al., "Postfertilization Effect of
Hormonal Emergency Contraception," The Annals of Pharmacology,
March 2002.)
CLAIM:
"EC should not be confused with Mifeprex, also referred to
as RU-486. EC and Mifeprex are completely different drugs. EC helps
to prevent pregnancy, while Mifeprex terminates an early pregnancy"
(backupyourbirthcontrol.org).
FACT:
Promoters of EC take pains to distinguish it from RU-486/mifepristone/Mifeprex
(the "abortion pill"), no doubt to distance EC in the
public's mind from abortion. Yet mifepristone is also used as EC
(See, e.g., A. Glasier et al., N Engl J Med
1992; 327:1041-4) and has been tested as an oral contraceptive alternative
to combined oral contraceptives which contain estrogen (the basis
for one type of EC) and progestin-only contraceptives (the basis
for the second major type of EC).
Why are researchers
looking for alternatives to currently available EC? Because the
use of estrogen-containing pills "has been tied to adverse
events such as venous thromboembolism [and progestin-only] pills
have a relatively high failure rate and can produce functional cysts"
(Reuters, Feb. 12, 2002, reporting on mifepristone study in The
Journal of Clinical Endocrinology and Metabolism, Jan. 2002).
CLAIM:
Easy access to EC will reduce the number of abortions.
FACT:
EC has been readily accessible to women in Scotland for years, but
abortions in Scotland increased among every age group between
1990 and 1999. Teen pregnancy and abortion rates have not gone down.
For example, despite a sharp increase (almost 300%) in the number
of EC prescriptions in Glasgow between 1992-1999, the abortion rate
did not decline. (Scottish Council on Human Bio-ethics' "Briefing
Paper on the Morning-After-Pill," Jan. 2002).
CLAIM:
EC is "safer than aspirin" (Reproductive Health Technologies
Project press release, Feb. 14, 2001).
FACT:
Progestin-only EC (e.g., Plan-B) requires taking up to 50
times the usual daily dose of this hormone within a 12-hour
period. Preven, and combined oral contraceptives (COC) when used
as EC, requires taking four to eight times the usual daily COC dose
within a 12-hour period. Common side effects of EC are nausea, abdominal
pain, fatigue, headache, dizziness, breast tenderness, vomiting,
diarrhea, and bleeding.
The Preven
"Prescribing Information" warns: "Blood clots that
form in the leg can cause blockage of blood flow in the leg veins
[and] can travel to the lung, causing serious disability or death"
( www.preven.com).
These risks are greatly increased for women who smoke.
Schering Health
Care which manufactures COC for use as EC in England warns pharmacists:
Users "of combined oral contraceptives ... experience, more
often than non-users, venous thromboembolism, arterial thrombosis,
including cerebral and myocardial infarction, and subarachnoid hemorrhage.
Full recovery from such disorders does not always occur, and it
should be realized that in a few cases, they are fatal."
Women also are sometimes warned not to take EC containing estrogen
if they have diabetes with blood vessel involvement, severe headaches,
current or past breast cancer, liver tumors or disease, or a known
allergy to any component.
CLAIM: Increased access to EC will not increase promiscuity.
FACT:
The Scottish report mentioned earlier suggests two causes behind
high levels both of EC use and abortion: "more unpremeditated
sexual activity" and "more failures in contraception with
increased use of condoms" (instead of more effective hormonal
"contraceptives"). The same two factors also appear to
be causing an "alarming rise" in the incidence of sexually
transmitted diseases (STDs). Condoms afford inadequate, low or no
protection against the most common STDs, several of which are incurable;
others can cause sterility or cervical cancer.
An STD epidemic
is also occurring in England, where EC is readily available. The
Times (London) reports that "diagnoses of almost every
STD have risen dramatically during the past five years, especially
among young people" (C. Midgley, "The Price of Casual
Sex," Jan. 29, 2002).
The U.S., even
without easy access to EC, is already experiencing an STD epidemic:
over 15.3 million new cases of STDs are contracted each year in
the U.S. and a total of over 50 million Americans now carry an STD.
Greater access to EC by making them available over-the-counter in
drug stores and school clinics will prevent doctors from assessing
risks based on family medical history, and from screening and treating
young girls vulnerable to STDs. Easy access also impairs parents'
ability to protect their daughters from risk to their health and
emotional well-being.
The Mail
(London) reported in January 2002 that more than 11 percent of prescriptions
for EC at family-planning clinics in the U.K. were for girls under
16, the legal age of consent for sex. Rep. Melissa Hart has found
that at least 180 school clinics in the U.S. now dispense EC without
parent's permission, and she plans to introduce a bill cutting off
federal funds to schools which do so.
For 60 years
Rosie the Riveter has been a "proud" and "true"
image of can-do American womanhood (as her WWII-vintage song attests).
It's a sad day when her image is sullied by association with a sales
campaign of disinformation.
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