On Friday, the FDA approved a new emergency contraceptive called “ella,” which can prevent pregnancy up to 5 days after sex. It passed with little fanfare or resistance, compared to the uproar surrounding the approval of Plan B, also known as the “morning after” pill (which is effective up to three days at most).
The differences between ella and Plan B are subtle, but important:
Plan B prevents a pregnancy by administering high doses of a hormone that mimics progesterone. It works primarily by inhibiting the ovaries from producing eggs. Critics argue that it can also prevent a fertilized egg from implanting in the womb, which some consider equivalent to abortion.
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Ella, known generically as ulipristal acetate, works as a contraceptive by blocking progesterone’s activity, delaying the ovaries from producing an egg. But progesterone is also needed to prepare the womb to accept a fertilized egg and to nurture a developing embryo. That’s how RU-486 prevents a fertilized egg from implanting and dislodges growing embryos. Ella’s chemical similarity to RU-486 raises the possibility that it might do the same thing, perhaps if taken at elevated doses. But no one knows for sure whether the drug would induce an abortion, because the drug has never been tested that way.
Women need a prescription for ella, but they can “keep a supply at home” — which means administration of the drug won’t necessarily be monitored to prevent someone from, say, taking an elevated dose after the recommended five days, which could result in the abortion of an implanted embryo. Reassurances along the lines that “it probably wouldn’t, if used correctly” are…not all that reassuring.
And then there is the question of who will be paying for ella:
Critics are already concerned that ella’s approval as a contraceptive will make it eligible to receive federal tax subsidies, which are banned for the abortion pill RU-486. They also are concerned that ella will be included in the services that health plans will have to pay for under the new health-care overhaul law.
“By misclassifying ella as emergency contraception, this administration has paved the way to covertly allow federal funding for abortion,” said Rep. Christopher H. Smith (R-N.J.), who called on Obama to issue an executive order prohibiting federal funds from paying for ella.
The Family Research Council has compiled an article titled “Myth and Fact: The Truth about ella and How It Works” with more information. The gray area in the “it’s contraception, not an abortifacient” argument gets grayer all the time.