NEWS: How Does This Plan Work?

POLITICS: How Does This Plan Work?

Anybody who follows reproductive rights news (and if you ever have sex, or plan to, you should) knows that Plan B, the much-discussed morning after pill, is the first non-barrier method of birth control that you can get over the counter. 'Course, you still need an ID to prove you're over 18—or you can get a legal adult friend to come with you—and the price varies ridiculously, from $10 at, say the Hennepin County Medical Center in Minneapolis to $54 at my local CVS. It doesn't prevent STDs, it's slightly less reliable than the regular pill, it's not a substitute for other forms of birth control, yadda yadda. But. It's a good thing regardless, now that we know we can get it.

What most people do not know, however, is how it actually works. The great Christian War on Sex (I'm copyrighting that, by the way) propagandists have successfully convinced most people that Plan B is an abortifacient, because the manufacturer's drug information says that it "may" prevent a fertilized ovum from attaching to the uterine wall.

So let me explain a few things. First, how the drug actually works. Plan B consists of two pills that contain a synthetic form of progesterone, one of the two main female hormones (the other is estrogen) that occur naturally and are used in birth control pills. Men, by the way, have progesterone too, though in lower doses. When you take Plan B—two pills twelve hours apart—you get a very large dose of progesterone that lasts for a day or two.

When a woman is pregnant, her body produces a lot of progesterone, which keeps her from ovulating—thereby preventing her from getting pregnant a second time and trying to carry them both, which would be a disaster. So progesterone prevents ovulation. Which, if you're a woman who doesn't want to get pregnant, is a pretty useful thing for it to do.

So let's say for some reason a woman who isn't on birth control finds herself with sperm floating around inside her: a condom broke, she was raped, she and her partner were sloppy and overly enthusiastic, whatever. If she's already ovulated within the last 24 hours, all she can do is cross her fingers: you can't stop something that's already happened. But if she hasn't, and is unlucky enough that she's just about to, she can take a big dose of progesterone that will stop her from popping an egg long enough for the sperm to die, and no pregnancy. Hurrah!

But, you ask, what if she's already ovulated, and the sperm luck out, and there's a zygote floating around but it hasn't yet stuck itself to the wall of the uterus? Would Plan B work then? And if it does, isn't that technically a kind of abortion?

Nope, and nope. If you've ovulated, the zygote either is or isn't going to be lucky enough to find a resting place. A lot of them don't, which is why pregnancy starts once the zygote takes root in the uterine lining. If you're not pregnant, you can't abort.

Okay, but. What if there's a zygote, and you personally see fertilization as the beginning point of life, even if it happens before pregnancy actually starts? If Plan B prevents implantation—and their own literature says they "may" do that—then that feels iffy to me.

This is the second thing that needs explaining. There is no evidence that Plan B prevents implantation. That's not a known effect of progesterone. But because science can't prove a negative—you can't prove that something doesn't happen, because if it doesn't happen, there is, by definition, no evidence—the drug company puts that little "may" in there. All "may" means is "even though we've never seen it happen, we can't prove that it doesn't." It's kind of like saying, "well, it might cause your skin to turn blue," or "it might cause you to grow a third arm," although they don't bother to say *that*, because it's not a possibility that would occur to anyone. But there is no evidence—none, zilch, nada—that Plan B prevents implantation. All it does is help you control the timing of ovulation; sort of the women's equivalent of guys thinking about baseball or their mother in order to keep from coming. For a guy, orgasm and ejaculation are the same event: for a woman, orgasm and ovulation aren't. If you're a guy, you can usually prevent the latter by controlling the former; if you're a woman, all you have to do is take a pill.


I got a lot of the details about this stuff from PZ Myers at Pharyngula: see Why the Wingnuts Hate Plan B and Plan B, Again.


Bitch_PhD writes the Bitch, Ph.D blog, may or may not still be a professor, and paid $45 for Plan B last month, but is happy to say she finally renewed her regular birth control prescription yesterday.

Alright.. I cant believe i am admitting it.. But I got pregnant after I took the PLAN B.
I took Plan B 10 hrs after the "Incident" and still got preggers.

So This is NOT a birth control method obviously... But I totally agree with it.

In canada We can get Plan B without a precription and as far as I know Without ID...

When I took it It wasnt availabel in this fashion and I had to wait for a while in a walk-in clinic. Who knows? Maybe if I could have gotten it sooner (10hrs?!?!?) I could have prevented the circumstances that followed.

And For the record : I terminated my pregnancy. My CHOICE... My RIGHT... ( I am not trying to be a shit disturber)..

i had the same problem obviously i was not preggers, but i got someone preggers and plan b didnt work. she took it 2 or 3 hours later and still had to get an abortion, which was totally her decsion i just supported whatever she wanted. i also believe its a womans right to chose.

It is birth control, it's just not 100% effective. If you've already ovulated, you're fucked. So to speak.

I'm curious how much each of you paid for it? The price seems to vary incredibly widely.

Bitch_PhD

I get Plan B for free with my regular birth control.

Also I would like to point out that even though Plan B is technically legal, otc, it can still be difficult to get because some pharmacists will not give it to you or make you give out very personal information and some will say that they don't even carry it!

i think it was 30 or 40 bux and ya if a 230 pound guy is askin for something he tends to get it just my experiance in life

Plan B comes in two little pills. And let me just say from experience. Blessed are those two little pills.

i feel like an idiot for saying this, but i have taken plan b and not exactly known how it works until this article.

i got it about 4 years ago, three individual packets (each with the 2 doses), one of which i lost, one of which i gave away, and one i took. i got them all for free from a free clinic near my high school.

i was under the impression that it did prevent implantation.

that said, i've been taking ortho-tri-cyclen for years and i'm pretty happy with the whole keeping me baby-free deal. i also didn't really "get" how that worked until i went to that clinic to ask about it, too (but, yanno, now i do).

So basically the study saying it may interfere with implantation says that it happens only rarely and primarily only if you wait a while before going out and getting it.

So if you have concerns about that (which seems weird to me since people who take such a view tend to be uber-christian and shouldn't be having sex unless they're married and ready for a baby anyway) then take the pill right after the sex.

Or for christ's sake, just get on one of the huge variety of regular contraceptive methods. It's a guy's job to make sure he's stocked with condoms if he's gonna get any and it's the girl's job to make sure she's on the pill. Right?

WOW, stereotypes are super fun.

Bitch_PHD, thanks for posting this, my personal feelings aside, I thought it was pretty informative

Thank you, for posting this, you beat me to the punch and did a better job than I would have.

Reporting research consists of people making careful statements about findings. This is why most popular publications muck up the discussion of research; they want to speak in generalities and generalities smooth over the nuances of research findings.

Anything (anything) that changes the character of the endometrium has a potential effect on implantation. This is why the inserts say "may," not because they can't prove the negative, but because there is an unexplained aspect of the data and results.

That being said, It comes down to this: either you don't get pregnant or you do. If you do, you carry a pregnancy to term or you interrupt it. Those are the options.

If you are going to have sex, you should familiarize yourself with the options, and be comfortable with the choices you have to make.

This is called personal responsibility and it applies to all voluntary actions a person may take.

0_o

And here I was thinking it was the 'miracle pill' that works every time.

Side note: Planned parenthood charges on a sliding scale. If you're a poor college student, you can get it for free. Huzzah!

Ten hours and you still got preggo? That seems like enough time, maybe the sperm was expecially aggressive? It does work better the sooner you take it obviously. My husband and I had a little condom accident as I was getting off my depo shot. I was pretty sure that I was going to be fine, but we got the Plan B about 14 hours after the incident. I still had depo in my system so I was probably fine anyway, but we wanted piece of mind. It was 37 bucks for us at a Rexall which is worth the piece of mind.

The list of things they have to go through with you before they give it to you is pretty hilarious. No, it doesn't 'kill' a baby inside of you, and No it doesn't cure AIDS. Jesus...the pharmacist lady and I had a good laugh.

I believe you when you say it's not an abortificant, but so what if it was?

Well, the fact that a lot of people think it is has a lot to do with why making it OTC got held up for over a year, and why you have to show i.d. to get it, and why a lot of pharmacies won't carry it and a lot of pharmacists won't give it to you if you ask.

Bitch_Ph.D.

But many of those people will still refuse to carry it, because even if it isn't an OTC-abortion they'll be saying "sex before marriage is a sin and it's my duty as a pharmacist to dispense medication but more importantly to stop people BURNING IN HELL".

When some of those people believe in creationism and use stuff like 'partial birth abortions' as propaganda I don't think they're going to be persuaded by the truth.

Obviously, having the truth is a good thing.

If it is not an abortificant, the anti-abortionists' stance against PlanB is pretty much squashed.

If it were...their stance would be supported.

Assuming you mean, that their stance was based on something other than their entirely faith-based ideas about conception, souls, the "sanctity of life" and other such completely irrational concepts.

Right?

Abstinence still remains the only 100% effective form of birth control.

Except, of course, for Mary.

But that all worked out in the end, right?

No...you would be incorrect in your assumption. It is not "completely irrational" to have faith-based ideas about conception, souls & the sanctity of life. It is perfectly possible for a sane, rational, competent person to have those beliefs.

What is irrational is to believe that your personal, individual beliefs should dictate the rights of others who may not SHARE your beliefs.

In layman's terms...you're not crazy for believing that life is sacred & abortions are wrong. However, you ARE crazy if you believe that nobody can have a different opinion...or the RIGHT to choice.

I'm confused. Why would they give you Plan B with birth control? Is your BC a barrier method?

The people who are concerned about it aren't content to dictate their own actions, they want to legislate everyone's behavior.

Abstinence still remains the only 100% effective form of birth control.

Not true. See this post and the follow-up.

Why would they give you Plan B with birth control? Is your BC a barrier method?

For the same reasons referenced in the posts I linked above; perfect compliance with most methods of birth control is fairly unusual. People sometimes forget pills.