The Gauntlet

Battling the morning after

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Imagine you're having sex. You and your partner are having an enjoyable time, but the two of you aren't stupid: the appropriate half of your couple is wearing a condom. You don't want an std, and you don't want a pregnancy. You and your friend-you're responsible. Good for you.

But mistakes happen, no matter how responsible you are. Imagine, now, the condom breaks. Now what? Are you screwed… well, more screwed than before? Aware members of the sexually active crowd know the available options, including the Morning After Pill.

Essentially a super high dose of the hormones used in the birth control pill (estrogen and progesterone), emergency contraceptives prevent women from getting knocked up. In the opinions of some, however, if a woman has already been fertilized, emergency contraceptives offer the equivalent of an extremely early abortion.

It's this little issue, that these pills might be aborting a child, that could make this pill more difficult to access than you'd think.

Imagine your doctor is a pro-lifer. Hell, imagine it's a weekend, you're stuck going to the hospital and the on-call doctor doesn't believe in abortion. They can actually refuse you the ec. Imagine how you would feel while the doctor lectures you about baby killing, and how you deserve everything you get.

What gives them the right to not give it to you? The most likely reasons for which you'd be refused are ethical or moral ones, or in other words, religious. Talk about being in the wrong business. If you don't believe in approved medical procedures, why become a doctor? It's like an anarchist becoming a politician or a vegetarian becoming a meat cutter. They shouldn't take the job if they know they can't, or won't, do it right.

Granted, many doctors probably started practicing before emergency contraceptives even existed. However, as government-funded workers and doctors under oath, their personal beliefs come second. If they can't hack it, they should quit and join the local priesthood or nunnery.

However, I'd settle for a simple explanation. If a doctor refuses you and your partner an emergency contraceptive, he or she should have to explain why, and then direct you to a more liberal physician. I don't expect this to happen, as they're trying to discourage you in the first place. You'll have to find your own immoral physician. Odds are, the next physician you find will give you the pill.

That's because most doctors recognize their duty and do their job properly. In fact, some physicians have started giving out "just in case" prescriptions to their sexually active female patients so these situations can be avoided.

There's talk about moving emergency contraceptives out from under the counter and onto the shelves. Apparently, most legislators and doctors agree it's a service women should be allowed to access.

Imagine how easy that would be. You and your significant other have an accident. All you'd have to do is drive to your nearest drug store, worry and hassle free... unless, of course, you find an overly moral pharmacist, too.





(Doctors should give medically-necessary treatments regardless of religous convictions.)

Is emergency contraception "medically neccessary?" I would argue that it is not.

How is it not medically necessary? Using an emergency contraceptive prevents women from two possibilities: pregnancy or an abortion. Getting pregnant not only affects a woman's health for the rest of her life, but she obviously ends up with a kid to take care of. Having an abortion has both huge emotional and physical affects on women. ECs are therefore necessary to avoid these two medical scenarios.
I would love to hear the argument that they're not medically necessary, James.

I guess it all comes down to your definition of "medically necessary." I'm not against the morning after pill, but I just didn't agree with that line of argument.

If the morning after pill should be considered "medically necessary" because it can prevent a) pregnancy and b) abortions, then condoms, the birth control pill (and virtually all other forms of birth control) would be considered the same, and maybe even a vasectomy or a tubal ligation.

"Medically necessary" would normally mean a medical prodecure that is necessary for the patient to continue to live and function normally, like heart surgery for a cardiac patient, chemotheropy for a cancer patient and casting for someone with a broken arm. As with abortion, there are certain cases that, arguably, an EC would fit into this class--when a mother's health is put at serious risk if she were to get pregnant, rape and in similar cases.

While I agree women should have access to the morning after pill, women (and men) should also realize that this shouldn't be a regular form of contraception. I've known at least one person who has used it that way, repeatedly. If someone having sex (let's imagine this is a responsible, intellegent adult), then that person should have already weighed the risks of having sex and accepted them, even the risks of said contraception failing (especially if that person is using no form of birth control, as is the case a surprising number of people). And while perhaps she should still be able to take action after the fact, it is by no means medically necessary.


To start, read my lede--though I'm sure you already have at some point. I think I make it pretty clear I'm arguing this on the assumption that the EC is being used responsibly.

However, with that said, just because somebody you know might abuse this procedure, does that mean I--and every other woman--doesn't have the right to it? For example, some people might consider marijuana medically necessary in order to avoid pain. It might be the only way some people have of maintaining their pain, however, there is a chance some people might abuse it, so therefore, according to you, it is no longer medically necessary?

You said: "... then condoms, the birth control pill (and virtually all other forms of birth control) would be considered the same..."
Tell me exactly how birth control isn't a medical necessity? I think it is. Are you aware the lifestyle women lead before the invention of birth control? Because we were the ones blessed with pregnancies, we had two choices: first, have sex, get pregnant, stay at home. Second, don't have sex, get a job, have control over your money and your life. Many, many people credit birth control with changing that dichotomy. I can have sex now, and not get stuck at home. Don't tell me birth control pills aren't necessary for me to live and function normally, unless you don't think women have a right to sex as a normal function of their life.

You argue that to be "Medically necessary would normally mean a medical prodecure that is necessary for the patient to continue to live and function normally." Find me any woman who lives and functions the same pregnant or with a child as she did before. While pregnant, woman are not only growing a child, but their entire body's change. I'm talking hemroids, migraines, and back problems that last a lifetime, not to mention that whole weight-gain thing. I'm not sure you fully realize what it is to be pregnant, james.

And yes James, it would be lovely if everyone who had sex was in a supportive, loving relationship. And it would be great if everyone who had sex did it safely, and it would be great if mistakes never happened. But, sorry, we don't live in a perfect world, and thank god, we still treat imperfect people. People who are obese still get their heat surgery, tho I'm sure overly fat people are fully aware of the consequences of their lifestyle. People who smoke--tho it is their choice to do so, as responsible, intelligent adults--still get their chemotherapy. People who skydive, snowboard, get into cars, ect, may take their actions responsibly or not, but they aren't lectured, and the aren't told they won't get treatment when they show up in an emergency room.

I think the majority of women are smart enough to realize that overdosing on birth control pills isn't the easiest way to prevent pregnancies. Considering many women get very sick during the procedure, that it takes several doses of pills, and requires going to a doctor each and every time, any woman who uses it repeatedly is, quite frankly, really inefficient and stupid. There are better forms of contraceptives, and the fact that she's [that one person you know] not using them properly is either a sign she's dumb, she's been poorly educated on sex/contraceptives, her family doctor is a moron, or her boyfriend just isn't a fan of condoms. Probably a combination of those. However, not allowing her access to them will either drive her to produce many unwanted children, or to have several abortions. Even in this case, the EC is the best solution.

And no, there is no "*perhaps* she should still be able to take action after the fact." Women have the right to control what happens to their bodies. I'm truly sorry you don't agree. So much for women's rights.

I tried to make sure I repeatedly qualified my response by saying that I am not coming out against the morning after pill, or any other form of birth control for that matter. I've done a lot of reading about and am well aware of the change in relationship between a women and their sexuality with, specifically the introduction of the birth control pill (arguably the first form of contraception that didn't require male intervention), and the control that gave them over their bodies that was not there before. It had a lot of further reaching effects beyond the sexual paradigm. This was and is a tremendous thing and I wasn't suggesting for a second that this should in any way be changed or ciriticized, nor was I arguing that a woman should be denied access to birth control--namely EC.

However, I still am not convinced that it a medical necessity. The reason this seemingly insignificant debate about semantics is so important is because it's a highly contested issue--and, like it or not, you're going to be hard pressed to convince those on the other side (read: the doctors you mention) that it is abosultely necessary. This is the same issue over the debate about medically necessary abortions. Are all abortions medically necessary? Not to say that these are the same thing--although there are important similarities that even the most educated feminist can't deny--but most would argue that, while access shouldn't be limited, it is not abosolutely necessary the same way a kidney transplant would be.

The birth control issue, and subsequent debates thereof, is a social one, not a medical one. From your abosultely correct point about the social implications of readily available birth control to recent attention to the morning after pill, we are dealing with social issues, linked to beliefs and values. Yes, a woman's body can be and typically is severely affected by a pregnancy, but even most of the issues you've raised are societal.

Given all of this, I agree that in almost all cases EC is being used, it is the best solution (let's assume, which you have as well, that most people who would take an EC would also consider abortion as a viable option, or just plain not want the child once it's born). And yes, there are cases of abuse (although I wouldn't, even for a second, put EC on the same level as someone using medicinal marijuana for ease the chronic pain of deseases like multiple sclerosis), but like you said, these represent problems on a much different level--education being, in my opinion, a major one.


Both of you, please look up the standard of care criteria that necessitate the use of emergency contraceptives. You may be (un)pleasantly surprised.

Or, you could just explain it to us and save us the trouble. We'd obviously just rather rant at each other rather than do any serious research.

In other words, enlighten us, won't you?

I don't think this definition is relevant for our discussion. We're not debating matters of exhisting policy or legal issues. We're instead battling with our own beliefs as to whether or not EC and other contreceptives should be considered "medically neccissary." As it stands, I don't think, while there are policies related to EC, that this fits in to our debate. It's a matter of opinion. Why don't you share yours?

I don't think this definition is relevant for our discussion. We're not debating matters of exhisting policy or legal issues. We're instead battling with our own beliefs as to whether or not EC and other contreceptives should be considered "medically neccissary."

Uhm... James, why is the standard of care which describes when and for what cases doctors should use emergency contraceptives not relevant to a discussion about the use of emergency contraceptives?