To Be or Not To Be: That is the Question on Ella
The latest “morning-after” pill controversy is swirling around Ella, which is on the verge of approval by the FDA. It’s an enhanced version of Plan B, extending the period of effectiveness from 3 to 5 days.
Both Ella and Plan B are “emergency contraception.” But isn’t contraception supposed to work before sex? Yes, except when it works after sex. How can that be? Because there’s a window of preventive opportunity between the act of passion and the act of “creation.”
Get ready to split some medical hairs. Just what is happening inside that window? Is the drug delaying ovulation, or stopping a fertilized egg from implanting itself in the uterus?
To some pro-lifers, it doesn’t mater. Anything that interferes with nature is wrong. Others draw a distinction: blocking ovulation is regarded technically as contraception; interdicting a fertilized egg is equivalent to abortion.
Plan B prevents ovulation. It’s not exactly clear how Ella works, and there’s where the debate begins. Those opposed to Ella regard it as an “abortifacient"---an intervention after an egg has formed. The manufacturer, on the other hand, insists that the drug inhibits ovulation and no egg is fertilized. Some doctors think it does both.
At least we’re having the debate. There was a time, not very long ago, when chemical contraception was virtually taboo. In 1961, the director of Connecticut Planned Parenthood was arrested for providing information to a married couple about a new birth control method.
That revolutionary pill began as an answer to a national epidemic of menstrual cramps. Enovid was FDA approved in 1957 to treat the condition. The small print carried a warning that it will prevent ovulation. Menstrual disorders were suddenly being diagnosed in unprecedented numbers. Half a million American women had a bottle in their medicine cabinet.
When Enovid was submitted for FDA approval as a contraceptive, the clinical trials were held quietly under the radar in Puerto Rico. A hundred years earlier, Congress had declared contraceptive information "obscene, lewd and lascivious," prohibiting its dissemination by mail or other means. At the introduction of the birth control pill in 1961, the federal law was off the books, but thirty states continued to restrict information.
By the time the Supreme Court struck down the last such state statute in 1972, the number of users in the U.S had skyrocketed to 6.5 million, up from 1.2 million ten years earlier.
Ella is currently sold in 22 European countries and will soon be in America to stay. Apparently, so will the controversy.
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