It has always been evident that the mechanism of action (MoA) of Emergency Contraception Pills (ECPs) prevalently takes post-fertilization pathways, rather than anti-ovulatory ones. This means that most of the time the effectiveness of these pills is through severing lives of human embryos and not preventing fertilization by impeding ovulation. Recently, more facts showing this have been disclosed.
In 2016, others and I had written and spoken about this matter in numerous fora. A circular interchange had also occurred, where in the first instance the Medicines Authority (MA) was deciding whether to authorize the introduction of ECPs in Malta or not. However, when the heat of public debate gained momentum, a parliamentary sub-Committee was set up (consisting of representatives from both major political parties), whose final decision was that it was not their responsibility to decide, but the MA’s. Many were befuddled. Indeed, I did not come across one single person (even those who lobbied in favour of ECPs) who actually understood why the Committee was set up in the first place. This said, the MA’s final decision was to authorize ECPs, as expected.
After the brief recapitulation of the 2016 marathon, we can now focus on the evidence which emerged recently, showing the effectiveness of ECPs in creating an inhospitable uterine environment for the embryo – the anti-implantation effect.
In a scientific paper entitled “UPA [Ulipristal] and LNG [Levonorgestrel] in emergency contraception: The information by EMA and scientific evidences indicate a prevalent anti-implantation effect” (The European Journal of Contraception and Reproductive Health Care, January 2019) the authors, Prof. Giovanni Nardelli and Associate Professor Bruno Mozzanega, wrote: “Our opinion, based on primary scientific sources is that ECPs consistently prevent ovulation only when taken at the beginning of the fertile period. Subsequently, in the days closest to ovulation in which most fertilizations occur neither LNG nor UPA has any residual anti-ovulatory effect, but transform the endometrium into a non-receptive environment.
“Emergency contraceptives work prevalently by preventing embryo-implantation. Woman, the doctors and health-operators must receive whole, accurate and correct information.
“Correct information on ECPs MoA is essential for women to express a free and informed consensus.”
Prof. Nardelli holds a Professorship in Gynaecology and Obstetrics, and is the Director of the Clinic of Gynaecology and Obstetrics (University of Padua). He is also the president of the academic courses in Obstetrics and Nursing, apart from other prestigious positions in various Italian localities. Associate Professor Mozzanega’s field is Gynaecology and Obstetrics too. He is also the president of SIPREe (Societa’ Italiana Procreazione Responsabile – Italian Society for Responsible Procreation).
Drug Bank, a Canadian pharmaceutical information provider, also refers to this publication in its description of Ulipristal, which says: “… The exact mechanism of action for Ulipristal is currently debated, though there is evidence that it functions by inhibiting ovulation… Nevertheless, current and ongoing research into the agent’s mechanism of action as an emergency contraceptive continue to provide potentially plausible evidence that Ulipristal may, in fact, elicit activity on the endometrium that prevents embryo implantation.
“Regardless, however, considering current and ongoing research into Ulipristal’s ability to prevent embryo implantation, the notion that the medication can elicit post-fertilization effects potentially raises alerts and/or ethical debates over the use of Ulipristal owing to potential abortifacient activity, which is considered at par or equipotent to that of mifepristone.”
Mifepristone is a pharmaceutical used to terminate pregnancies, meaning medical abortion.
Given this ongoing and mounting scientific evidence showing the abortifacient effect of ECPs, is the distribution and administration of ECPs in breach of articles 241 and 243 of the Criminal Code of Malta (quoted below)?
241. (1) Whosoever, by any food, drink, medicine, or by violence, or by any other means whatsoever, shall cause the miscarriage of any woman with child, whether the woman be consenting or not, shall, on conviction, be liable to imprisonment for a term from eighteen months to three years.
(2) The same punishment shall be awarded against any woman who shall procure her own miscarriage, or who shall have consented to the use of the means by which the miscarriage is procured.
243. Any physician, surgeon, obstetrician, or apothecary, who shall have knowingly prescribed or administered the means whereby the miscarriage is procured, shall, on conviction, be liable to imprisonment for a term from eighteen months to four years, and to perpetual interdiction from the exercise of his profession.
Given the ongoing and mounting scientific evidence showing the abortifacient effect of ECPs, are women, medical doctors, pharmacists and other healthcare providers, willing to participate in destruction of human life in its most vulnerable stage?
One might think that this article, or anything which opposes the pro-emergency contraception views, is just a futile rigor mortis, it is too late, it is a lost war. I categorically disagree. If one human life is saved, it is a victory of immeasurable value. I have no doubt that a zillion plus one people out there agree.
Jean Pierre Fava Dip., B.Sc. (Hons.), M.Sc. Health Science