Saturday, November 15, 2008

Conceptually wrong

Via Stuart Sharpe, I see that Dizzy has commented upon a mildly unwise policy from Greenwich Council; his analysis is fine but then, alas, he gets his facts wrong.
The other thing that amused was a semantic point about the phrase "emergency contraception". Contraception is clearly about contra (contrary) ception (conception). In other words it is about the prevention of conception.

The morning-after pill however is not about preventing conception. It works by getting rid of a conceived egg and sperm. It's not contraception at all.

No. This is entirely wrong, I am afraid. Strange though it may seem to all of you randy people out there, it actually takes quite a bit of time for the sperm to make its way to the egg.

As I have pointed out before, the so-called morning-after pill (it's effective up to about 72 hours after sex) is not an abortifacient (unless you are some kind of medically ignorant religio-conservative nutcase)—it is a method of contraception.
Emergency contraceptive pills (sometimes referred to as emergency hormonal contraception (EHC) in the U.K.) may contain higher doses of the same hormones (estrogens, progestins, or both) found in regular combined oral contraceptive pills. Taken after unprotected sexual intercourse, such higher doses may prevent pregnancy from occurring.

There is speculation that these pills may prevent the implantation of a blastocyst into the uterine wall, but this is unproved and is certainly not the accepted route of effectiveness.
Emergency contraceptive pills (ECPs)—sometimes simply referred to as emergency contraceptives (ECs) or the "morning-after pill"—are drugs that act both to prevent ovulation or fertilization...

Legally and medically, the morning after pill is regarded as being a contraceptive and not an abortifacient. Because, you see, its mechanism is to prevent pregnancy, not to terminate it.


Anonymous said...

You are entirely correct, DK, and Dizzy is sadly wrong on quite a number of points - biological, medical, grammatical and semantic (I'm sure that, as an Eton Old Boy, you winced at his mangling of the etymology of conception).

Sadly, though, contraception is one of those zones where "right" and "wrong" are used to refer to one's moral stance rather than to one's grasp of fact. Even amongst many people who approve of the use of the Morning-After Pill, there is often a desire to put it in the same realm as abortion and therefore to allow a moralistic tut-tutting attitude to its employment and, indeed, to treat its use as a sign of fecklessness and irresponsibility when it is clearly the reverse.

Even amongst libertarians, the urge to moralise (or perhaps to the Will to Self-Righteousness, if you want to go all Nietzschean) is a strong drive and one to which far too many people give in.

MrHunnybun said...

Well said, I couldn't agree more. It's a common, er, miconception that EHC causes abortions.

When EHC first became available over-the-counter, I had quite a few run ins with local religious nuts who insisted I was an abortionist when I sold EHC.

However, It was okay for them to glueup my door locks, apparently. Plus, they threatened to cut the brakes in my car. All life is sacred- apart from mine presumably!

Anonymous said...

Ah....DK, spot on; may I offer you an occasional column on NHS BLOG DOCTOR?


Perhaps you can explain - I have never understood - why the anti-abortion loonies (not the thoughtful ones) also disapprove of contraception. Take a look at Nadine, to name but one. I half suspect that they all disapprove of sex too.

Odd, isn't it!


Stu said...

Good point, well made, DK. Although Dizzy's right that encouraging the use of morning after pills will inevitably lead (probably already is leading) to a rise in STD's.

Since the start of the pregnancy is usually deemed to be the end of the previous menstrual cycle, you could make a convoluted argument to say that contraception is really pre-abortion. Using a condom would then be an abortion at 1.5-2 weeks.

You'd have to be a complete nutter, but you could make that argument...

Pogo said...

Perhaps you can explain - I have never understood - why the anti-abortion loonies (not the thoughtful ones) also disapprove of contraception. Take a look at Nadine, to name but one. I half suspect that they all disapprove of sex too.

One gets the impression that they disapprove of recreational sex... Sex should only be utilised for "outnumbering purposes". (Python?)

Anonymous said...

Every site I have seen states that the "morning after pill" has two possible effects:
1. prevents fertilisation
2. prevents implantation of already fertilised egg.

Clearly in the first case the MAP acts as a contraceptive, in the second as an abortifacient.

Unfortunately the medical establishment has caved in to the abortionists/ultra feminists/pharmaceutical industry to whitewash the MAP as purely a contraceptive. It makes the laws simpler for the politicians - redefine something and make it go away. But I can always rely on DK to expose such lies. Actually I was just being sarcastic with my last comment there.

Anonymous said...

Reading the wiki page you link to, you seem to be glossing over some things:

Basically, it might be abortifacient but it's unlikely. If you're a life-starts-at-conception believer then you're going to view those slim odds differently to those of us that see the human person coming into being some time later. I'm not sure there is evidence for an absolute position here and I'd recommend informing people about the potential so that they can come to their own moral terms with a decision.

Of course, I'm basing my point on the authority of a wikipedia entry. Anyone got a ref to a recent peer-reviewed paper that concludes with any certainty on mechanisms?

Anonymous said...

Another biology master class Devil, perhaps you have missed you true calling ?

Perhaps it is worth adding that post-coital contraception [Levonelle] does NOT induce abortion if a women is already pregnant.

The exact mode of action of Levonelle depends on the phase of the menstrual cycle but may:
*inhibit/delay ovulation.
*inhibit tubal transport of the egg/sperm.
*alter the lining of the uterus [i.e. causes bleeding thus inhibiting implantation].

The failure rate of Levonelle may be as high as 10% - it is more effective the sooner it is used.
It is unkown if this drug is teratogenic [i.e. harmful to the foetus] should it fail to prevent conception.

As you known, alcohol and caffiene reduce sperm motility, so I suspect the ejeculate of your average libertarian probably flows backwards - now I never imagined I'd start my Sunday morning with an arcane theory about the relationship between politics and the flow of spunk, but as ever your post has opened a can of worms.

Anonymous said...

Well seen as we're throwing around the whole religious bit....

Leviticus 17:11 states quite clearly 'For the life of the flesh is in the blood', which is at about 18 days, so even if you were to abort at 17 days it wouldn't be an abortion per se because there is no blood for the life to 'be'

Hat tip to CSI :D

Trixy said...

Dr Crippen, the reason the true and righteous don't approve of contraception is because sex is for procreation purposes only. I really am surprised you.needed to ask; don't tell me you're one of those people who view it as 'fun'?

As for Mad Nad: can she really get all high and mighty given her interview in the Metro the other week? She may have got stroppy when her original 'what would you like to be doing right now' was published but she said it...

Unknown said...

Couple fo points, first I;m not anti-abortion inc ase anyone thinks I am. Second I stand corrected. I am curious though, can it be the case that if taken right at the wire as it were that conception has occurred and so MAP is not a contraceptive anymore? Honest question.

p.s. logged in a machine under my actual name rather than handle.

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