Susan E. Wills
ell it's spring and if we are to believe Tennyson time for a young man's fancy to lightly turn to thoughts of love. On a somewhat less romantic note, the American Society for Emergency Contraception (ASEC) chose the first day of spring to kick off a campaign to promote emergency contraception.
Finding a positive and appealing image for the campaign posed a real challenge. The rumpled bed clothes and discarded, torn condoms used in past marketing efforts are too closely linked to the idea of failure. Contraceptive failure. Failure to engage in what's called "responsible" sex. A failure of judgment perhaps one in three young women seeking emergency contraception in a U.K. study admitted to having unprotected sex when they were drunk, and nearly half blamed alcohol for one-night stands they would not otherwise have had.
And so ASEC turned to the can-do, American-as-apple-pie image of Rosie the Riveter. In 1941 Rosie started life as a patriotic poster girl, recruiting American women to support the war effort by working on defense manufacturing assembly lines. Remember the confident Rosie, pushing up her shirtsleeve to reveal a (petite) flexed biceps and proclaiming to the world "We Can Do It!"?
The ASEC-updated version of Rosie has a none-too-subtle sash labeled EMERGENCY CONTRACEPTION ringing her waist. And, get this: Her biceps muscle is emblazoned with "EC" in a tattooed heart pierced by Cupid's arrow. You can almost hear her saying "We Can Undo It!"
Easy as it is to poke fun at the screwball advertising concept, the underlying campaign called "Back up your Birth Control with EC" is no laughing matter. It exacerbates what pro-choice feminist Germaine Greer calls "the cynical deception of women by selling abortifacients as if they were contraceptives," a deception she finds "incompatible with the respect due to women as human beings" (The Whole Woman, 1999, p. 93).
What kind of deceptive claims are we hearing?
CLAIM: "EC does not interrupt a pregnancy. In fact, it will not work if a woman is pregnant" ("Fact Sheet," backupyourbirthcontrol.org).
FACT: Only if you redefine pregnancy as beginning when the six- to seven-day-old human embryo begins implanting in the uterine lining. But medical textbooks uniformly agree that pregnancy is "the gestational process, comprising the growth and development within a woman of a new individual from conception ... to birth" (Mosby's Medical, Nursing & Allied Health Dictionary, 2002). In fact, a hormone called early pregnancy factor, which is produced by the developing embryo, can be measured in the mother's blood at three days before implantation. Pretending pregnancy begins at implantation is simply a ploy to avoid admitting the abortifacient properties of hormonal "contraception."
How does EC work? If taken pre-ovulation, EC may delay or inhibit ovulation, thereby preventing conception; but often it does not. If taken after the LH surge which triggers ovulation, EC will not disrupt ovulation in that cycle, but can inhibit implantation of the developing embryo (causing his death) due to changes in the uterine lining. (See, e.g., C. Kahlenborn, MD et al., "Postfertilization Effect of Hormonal Emergency Contraception," The Annals of Pharmacology, March 2002.)
CLAIM: "EC should not be confused with Mifeprex, also referred to as RU-486. EC and Mifeprex are completely different drugs. EC helps to prevent pregnancy, while Mifeprex terminates an early pregnancy" (backupyourbirthcontrol.org).
FACT: Promoters of EC take pains to distinguish it from RU-486/mifepristone/Mifeprex (the "abortion pill"), no doubt to distance EC in the public's mind from abortion. Yet mifepristone is also used as EC (See, e.g., A. Glasier et al., N Engl J Med 1992; 327:1041-4) and has been tested as an oral contraceptive alternative to combined oral contraceptives which contain estrogen (the basis for one type of EC) and progestin-only contraceptives (the basis for the second major type of EC).
Why are researchers looking for alternatives to currently available EC? Because the use of estrogen-containing pills "has been tied to adverse events such as venous thromboembolism [and progestin-only] pills have a relatively high failure rate and can produce functional cysts" (Reuters, Feb. 12, 2002, reporting on mifepristone study in The Journal of Clinical Endocrinology and Metabolism, Jan. 2002).
CLAIM: Easy access to EC will reduce the number of abortions.
FACT: EC has been readily accessible to women in Scotland for years, but abortions in Scotland increased among every age group between 1990 and 1999. Teen pregnancy and abortion rates have not gone down. For example, despite a sharp increase (almost 300%) in the number of EC prescriptions in Glasgow between 1992-1999, the abortion rate did not decline. (Scottish Council on Human Bio-ethics' "Briefing Paper on the Morning-After-Pill," Jan. 2002).
CLAIM: EC is "safer than aspirin" (Reproductive Health Technologies Project press release, Feb. 14, 2001).
FACT: Progestin-only EC (e.g., Plan-B) requires taking up to 50 times the usual daily dose of this hormone within a 12-hour period. Preven, and combined oral contraceptives (COC) when used as EC, requires taking four to eight times the usual daily COC dose within a 12-hour period. Common side effects of EC are nausea, abdominal pain, fatigue, headache, dizziness, breast tenderness, vomiting, diarrhea, and bleeding.
The Preven "Prescribing Information" warns: "Blood clots that form in the leg can cause blockage of blood flow in the leg veins [and] can travel to the lung, causing serious disability or death" ( www.preven.com). These risks are greatly increased for women who smoke.
Schering Health Care
which manufactures COC for use as EC in England warns pharmacists: Users
"of combined oral contraceptives ... experience, more often than
non-users, venous thromboembolism, arterial thrombosis, including cerebral
and myocardial infarction, and subarachnoid hemorrhage. Full recovery
from such disorders does not always occur, and it should be realized that
in a few cases, they are fatal."
FACT: The Scottish report mentioned earlier suggests two causes behind high levels both of EC use and abortion: "more unpremeditated sexual activity" and "more failures in contraception with increased use of condoms" (instead of more effective hormonal "contraceptives"). The same two factors also appear to be causing an "alarming rise" in the incidence of sexually transmitted diseases (STDs). Condoms afford inadequate, low or no protection against the most common STDs, several of which are incurable; others can cause sterility or cervical cancer.
An STD epidemic is also occurring in England, where EC is readily available. The Times (London) reports that "diagnoses of almost every STD have risen dramatically during the past five years, especially among young people" (C. Midgley, "The Price of Casual Sex," Jan. 29, 2002).
The U.S., even without easy access to EC, is already experiencing an STD epidemic: over 15.3 million new cases of STDs are contracted each year in the U.S. and a total of over 50 million Americans now carry an STD. Greater access to EC by making them available over-the-counter in drug stores and school clinics will prevent doctors from assessing risks based on family medical history, and from screening and treating young girls vulnerable to STDs. Easy access also impairs parents' ability to protect their daughters from risk to their health and emotional well-being.
The Mail (London) reported in January 2002 that more than 11 percent of prescriptions for EC at family-planning clinics in the U.K. were for girls under 16, the legal age of consent for sex. Rep. Melissa Hart has found that at least 180 school clinics in the U.S. now dispense EC without parent's permission, and she plans to introduce a bill cutting off federal funds to schools which do so.
For 60 years Rosie the Riveter has been a "proud" and "true" image of can-do American womanhood (as her WWII-vintage song attests). It's a sad day when her image is sullied by association with a sales campaign of disinformation.