"Emergency Contraception" versus "Chemical Abortion"

In the comments to my first post ("Rape, the 'Morning After Pill,' and Abortion") on the Connecticut bishops' decision to allow Catholic hospitals in Connecticut to administer the Plan B "morning after" pill to rape victims, as long as a pregnancy test does not indicate that the woman is pregnant, Dawn Stacey, the About.com Guide to Contraception, has offered a dissenting view. Her point centers on the way in which Plan B works and the medical definition of a pregnancy (and, hence, the medical definition of abortion).

On the question of how Plan B works, Dawn writes that "The exact mechanism of how it works is not clear." Yes and no: In order for Plan B to be approved and marketed, Barr Pharmaceuticals had to demonstrate, to the satisfaction of the FDA, the ways in which the pill achieves its effect. They demonstrated three: It can block ovulation, if it hasn't already occurred (though it is not 100-percent effective in doing so); if ovulation has already occurred, it can prevent fertilization of the egg by reducing sperm motility (again, with something less than 100-percent effectiveness); and, finally, it can prevent the implantation of a fertilized egg. And because Plan B does not stop ovulation or fertilization with 100-percent effectiveness (and neither a pregnancy test nor an ovulation test, at this early stage, offers a reliable indication of whether ovulation and fertilization may have occurred), Plan B will, in some percentage of cases, work by preventing the implantation of the fertilized egg.

In any given use of Plan B, Dawn is right: "The exact mechanism of how it works is not clear." Yet, if it does work in a given case, it works through one of those three ways, which is where the moral problem for Catholics arises. It's important to note that Barr Pharmaceuticals could not claim (as they do) that one method by which the pill achieves its effect is to prevent implantation unless they had proved to the FDA's satisfaction that this is true. Prevention of implantation is not listed as a possible side effect (in which case, it wouldn't have to be proved); it is listed as a desirable action of the pill.

So, in the end, the disagreement comes down to one of definition. As Dawn notes, "The medical definition of pregnancy is an implanted egg in the uterus; therefore, a woman is not considered to be pregnant if she has a fertilized egg that has not yet implanted." And if we take that one step further and say that abortion is the termination of a pregnancy, then prevention of implantation is not abortion.

Except that Catholics (and other pro-life Christians) do not believe that life begins at implantation; we believe that it begins at conception. This, in fact, is part of the Church's opposition to in vitro fertilization and other methods of fertility treatments that produce "excess" fertilized eggs that are later destroyed. In the Catholic understanding, there is no difference between the destruction of embryos at a fertility clinic and the third effect of Plan B, which deliberately makes the uterus hostile to the fertilized egg, preventing implantation.

Because life begins at conception, the deliberate frustration of implantation is tantamount to abortion. Yes, a pregnancy has not yet occurred; but, if a fertilized egg is present, one may have occurred if steps hadn't been taken to prevent that egg from implantating. That, for Catholics and other pro-life Christians, is the crux of the issue.