Women are not being told the truth by the Department of Health and Human Services (HHS). Two HHS informational documents on emergency contraception fail to address ella or its abortion-inducing effects. These omissions deny women information necessary for freely-chosen and informed medical decisions. The absence of adequate information about ella is particularly problematic for women with conscience concerns about life-ending contraceptives, because ella’s mode of action goes beyond that of any other FDA-approved emergency contraceptive that has abortifacient effects. (In an article by Jonathan Imbody, he pointed to similar defects in these documents concerning “Plan B,” another “emergency contraceptive.”)
The chemical composition of ella is similar to the abortion drug, RU-486. Like RU-486, ella is a selective progesterone receptor modulator. Both ella and RU-486 act by blocking progesterone, a hormone needed to build and maintain the uterine wall during pregnancy. Medical studies show that not only can both drugs prevent a developing human embryo from implanting in the uterus, but also they can kill an implanted embryo by starving it to death.
The FDA’s own label for ella acknowledges that it may “affect implantation”: “[A]lterations to the endometrium that may affect implantation may also contribute to efficacy.” At the FDA advisory panel meeting for ella, Dr. Scott Emerson, a professor of biostatistics and panelist, noted that the low pregnancy rate for women taking ella four or five days after intercourse suggests the drug must have an “abortifacient” quality.
The FDA’s controversial decision to approve ella in August, 2010, drew a well-publicized reaction. Nevertheless, the most recent version of HHS’s fact sheet on emergency contraception issued by the HHS Office of Women’s Health, with “content last updated November 21, 2011,” completely leaves out any mention of ella.
Another HHS information document, prepared by HHS’s Office of Population Affairs, lists ella as an emergency contraceptive and states that a prescription is necessary to purchase it. No further information is provided.
Studies confirm that women care about how their “contraceptive” works. Moreover, for women concerned about post-fertilization effects of a birth control method, at least one study has found that whether that was the primary mechanism of action was less important than the fact that it can have such a life-ending effect, “[f]or those women who would not use or would stop using a method acting after fertilization, it did not matter whether such effects were common or rare.”
Clearly these two HHS documents are grossly inadequate to inform women on what ella is and how it works. Without accurate information, women are denied the opportunity to make their own decisions based upon facts.
 “The mechanism of action of ulipristal in human ovarian and endometrial tissue is identical to that of its parent compound mifepristone.” D. Harrison & J. Mitroka, Defining Reality: The Potential Role of Pharmacists in Assessing the Impact of Progesterone Receptor Modulators and Misoprostol in Reproductive Health, 45 Annals Pharmacotherapy 115 (Jan. 2011). “Ulipristal has similar biological effects to mifepristone, the antiprogestin used in medical abortion.” G. Bernagiano & H. von Hertzen, “Towards more effective emergency contraception?”, 375 The Lancet 527-28 (Feb. 13, 2010), at 527.
2 ella Labeling Information (Aug. 13, 2010), available at https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022474s000lbl.pdf (last visited Mar. 16, 2012)
3 Transcript, FDA Center for Drug Evaluation and Research, Advisory Committee for Reproductive Health Drugs, June 17, 2010, available at https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/ReproductiveHealthDrugsAdvisoryCommittee/UCM218560.pdf (last visited Mar. 20, 12).
6 See Dye et al., Women and postfertilization effects of birth control: consistency of beliefs, intentions and reported use, 5(11) BMC Women’s Health (2005). See also de Irala J, Lopez del Burgo C, Lopez de Fez CM, Arredondo J, Mikolajczyk RT, Stanford JB, Women’s attitudes towards mechanisms of action of family planning methods: survey in primary health centers in Pamplona, Spain, BMC Women’s Health 7 (2007) available at https://www.biomedcentral.com/1472-6874/7/10 (last visited Mar. 8, 2012).
LifeNews.com Note: Evangeline Jones is the Americans United for Life National Coordinator of Lawyers for Life. William Saunders, Senior Vice President of Americans United for Life, is a LifeNews blogger.