pdf version
AAPLOG NEWS RELEASE
For Release:
August 26, 2005
STATEMENT OF THE AMERICAN ASSOCIATION OF PRO-LIFE OBSTETRICIANS AND GYNECOLOGISTS on The FDA's Decision to Delay Action on Over-the-Counter Approval Request for Emergency Contraception
Holland,
MI
– The requested Food and Drug Administration (FDA) approval of
over-the-counter (OTC) emergency contraception (EC) for women 17 years of
age and older would be bad medical practice. Further, it would be a
disaster for many women--especially for teenagers, who are more prone to
risk-taking behavior, and more susceptible to sexually transmitted
diseases (STDs). And certainly 17 year olds would procure it for 13 year
olds, so the OTC age limit, in practice, is unworkable.
Emergency contraception simply is not as effective as advertised. The
public is told that if taken right after unprotected midcycle intercourse,
EC will prevent 88% of expected pregnancies. This is, at best, a very poor
half-truth. Recent large studies in Scotland (See A Glaiser et al,
Advanced Provision of Emergency Contraception Does Not Reduce Abortion
Rates, Contraception 2004;69:361-366, at
www.contraceptionjournal.org) and San Francisco (See TR Raine et al,
Direct Access to Emergency Contraception Through Pharmacies and Effect
on Unintended Pregnancy and STIs, JAMA, 2005; 293:54-62, at
www.jama.com) demonstrate this point.
Women in these studies were given the EC to take home and put on the
nightstand for immediate availability after unprotected sex. But they had
the same abortion rates and the same unintended pregnancy rates as a
control group of women (who had to procure their prescription from a
physician after their "emergency" arose.) This medication is a dangerous
deception, since it encourages women to trust it for contraception, but
fails to reliably deliver on that promise. Or, as the Scottish research
article concluded, "advanced provision of EC probably prevents some
pregnancies for some women some of the time."
Additional serious medical down-sides to OTC availability are equally
problematic. Many women would be using EC without accompanying medical
follow-up for sexually transmitted disease testing. Chlamydia, a STD
already seen in epidemic proportions among teens and college age women,
would go undiagnosed and untreated, scarring fallopian tubes, and
resulting in future infertility for many. Human Papilloma Virus (HPV), a
widespread and very communicable STD, is associated with the development
of cervical cancer, and untreated HPV would put many women at future risk
for this deadly cancer.
The British government warned its doctors last year that pregnancies
resulting from "failed" use of EC had a tripled rate of ectopic pregnancy. With no doctor
involvement, this diagnosis would be missed, or at best, delayed.
Undiagnosed, untreated ectopic pregnancy is a life threatening condition.
Doubtless, OTC emergency contraception would become a popular "date rape"
drug. Boyfriends and predatory males would find this drug a very helpful
tool to "persuade" women comply with their demands. Women under 17 years
of age will be as "at risk" for this type of forced sex as those 17 and
over.
However you look at it, OTC "emergency contraception" is bad medicine for
women. The FDA has asked for input. We strongly urge parents and doctors
alike to express their feelings to the FDA .
The American Association of Pro-Life Obstetricians and Gynecologists represents over 1000 Obstetricians and Gynecologists as a Special Interest Group of the American College of Obstetricians and Gynecologists.
616-546-2639