April 23rd 2009 saw more than just the chinking of glasses toasting England’s national patron, it saw the first TV screening of the so-called emergency contraceptive, Levonelle one step advert.
The purple-hued animation (1) depicts a couple in bed who have just had a bit of a mishap - ‘no way to explain it’ though, according to the lyrics of the jaunty tune. So, off she goes on a traumatic bus journey, plagued by the wailing cries of a young baby, to the local pharmacist to pick up a pack containing one round white tablet.
It may all seem harmless enough, and many may claim that this information is necessary, but despite the warnings that it is not 100% effective and is more effective the sooner you take it (2), they fail to mention a few key things: the risk of catching sexually transmitted infections from unprotected sex, its possible side effects, that it isn’t suitable for all women to take and oh, one extremely important fact - that it’s an abortifacient - a fact categorically denied by the makers and promoters of Levonelle one step. Visit their website (3). They claim it acts solely as a contraceptive; that it does not end a pregnancy.
How does levonorgestrel, the hormone used in this pill, work? Very briefly, the morning after pill is thought to have three mechanisms of action: 1) it can delay ovulation 2) it can act on the sperm to prevent fertilisation of the egg 3) it can prevent the implantation of the fertilised egg, otherwise known as an embryo.
So, question – when does pregnancy start? Hmm, a ponderous scratch of the head. Surely it starts when the egg is fertilised? Well, you would think so. I had thought so too. And that’s not just schoolgirl biology talking; I quite distinctly recall my university human physiology text book (4) stating that pregnancy begins at fertilisation, otherwise known as conception.
However, it seems there is a new option for the multiple choice answers to this question; pregnancy has been redefined. It now starts at implantation (5). How medical knowledge advances! But, what is going on for the ten or so days before the embryo embeds itself in the lining of the womb? Is that not part of the pregnancy too, a rather vital part, one might add? What I find hard to get my head round is how any of us can explain how we got here in this world without passing through these early embryonic days before implantation. How can implantation possibly be the start of a pregnancy?
A new biology and smart logic, that’s how. But this is best explained by Norman Wells and Helena Haywood in Waking up to the Morning-After Pill:
“In 1983, the Attorney-General ruled that EHBC [emergency hormonal birth control] did not constitute a criminal offence under the Offences Against the Person Act 1861, which forbids any action which has the intent of procuring a miscarriage. He considered that prior to the implantation of the embryo in the lining of the womb, five or six days after conception, ‘carriage’ cannot have occurred, and that the use of a pill which operated prior to implantation could not be deemed to procure a ‘miscarriage’ under the terms of the 1861 Act.
It is on the basis of this advice that successive governments have taken the view that ‘a pregnancy begins at implantation’ (rather than at conception) and can refer to this as ‘the accepted legal and medical view’. It also cleared the way to licence the emergency pill as a ‘contraceptive’.” (6)
I could spend a long time unpicking this, but quite simply, to restrict the meaning of ‘carriage’ merely to implantation and thereafter, is a misleading use of language; isn’t the woman ‘carrying’ the embryo within her body, within the fallopian tube, within the womb from the moment of fertilisation onwards? She is, indeed. The problem here is that we tend to associate pregnancy and implantation together because a woman normally finds out she is pregnant only after this stage. And she only knows she’s lost a pregnancy, or had a miscarriage, as it’s commonly called, sometime after implantation has occurred.
To be continued....
_____________
(1) The advertisement can be viewed here on YouTube:
http://www.youtube.com/watch?v=z5522FT9GyY
(2) 95% effective within 24 hours of unprotected sex, 85% between 25 - 48 hours and 58% if taken between 49 - 72 hours
(3) http://www.levonelle.co.uk
(4) ’Human Physiology’ 6th Edition, International Edition. Vander, Sherman, Luciano. McGraw-Hill, Inc. 1994. London
(5) Implantation is when the embryo embeds itself in the lining of the womb, a process which starts around day 10 after fertilization and takes around 4 days to complete.
(6) ‘Waking Up To The Morning-After Pill’. Norman Wells and Helena Hayward, Family Education Trust, 2007, Pg 3.