Should the FDA Approve a Many Mornings After Pill?

A new pill could increase the window for emergency birth control

Forget the morning-after pill. French company HRA Pharma wants to provide American women with a pill (already available in France) that prevents pregnancy up to five days after unprotected sex. Call it the work-week-after pill or, more accurately, the I-just-haven't-had-time-to-go-to-the-drugstore-yet-and-take-care-of-this-potentially-life-altering-slip-up pill. But before you take your sweet time in deciding whether last night's mistake warrants a trip to the pharmacy, keep in mind that the drug must first win approval by the FDA before it's sold here. And there's no guarantee that will happen. The drug, ella (ulipristal acetate), is similar in chemical makeup to the so-called "abortion pill" RU-486 (Mifeprex), which terminates a pregnancy up to nine weeks in. Despite opposition from anti-abortion groups, Mifeprex was approved in 2000, but it was made available only through a physician.

Although ella is meant to function like other morning-after pills, critics worry that if used improperly, it may also induce abortions.

Currently in the U.S., people over the age of 16 can get over-the-counter emergency contraceptives, such as Plan B, that are effective up to 72 hours after sex. Ella would extend that time period to 120 hours. But even better than the extra wiggle room: According to The Washington Post, ella appears to be twice as effective as Plan B at preventing pregnancies.

Whereas Plan B delivers a high dose of a drug that mimics the hormone progesterone, both ella and RU-486 block the effects of progesterone. Despite the different mechanisms, all three drugs prevent the ovaries from releasing an egg. However, RU-486 can also stop a fertilized egg from attaching to the uterus. If you believe life begins the moment an egg is fertilized, RU-486 doesn't prevent pregnancy as much as it terminates one. Because ella works in a similar fashion, critics believe it, too, will be able to terminate pregnancies if taken at high doses. No one knows this for sure, though, because it's never been tested in this way.

Ella is currently approved as an emergency contraceptive in at least 22 other countries, including those in Europe. Next week, an FDA panel will get together to decide whether to approve it here too. In documents released yesterday, federal health officials reported that the drug appeared both safe and effective. Still, if next week is anything like the vetting process for Plan B, we can expect a fierce debate about when life begins, and whether ella is in fact a contraceptive or a method for terminating pregnancies--regardless of the outcome of the hearings.

Do you think ella should be approved as an over-the-counter emergency contraceptive? Chime in below.

Like this? Read these:
- The Pill Turns 50
- Am I Pregnant
- Walgreens Postpones Plans to Sell Do-It-Yourself Genetic Test
- Pregnancy: How Do Pregnancy Tests Work?
- Testosterone Injections Offer Hope for Male Contraceptive

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