Emergency contraception (EC) aka the morning after pill does not cause abortion. It cannot. The reason for this is quite simple really. Emergency contraception does not work once fertilisation has taken place. It takes about five days for the fertilised egg to travel down to the uterus and implant there. There is not enough time for EC to make the lining of the uterus so thin as to prevent implantation. In other words, the timing is too short to affect the endometrium, which is why it cannot cause abortion. EC works by delaying ovulation and preventing fertilisation.
If there had been any evidence whatsoever that EC did cause abortion it would never have been legalised in Malta. So, on what basis exactly do some pharmacists refuse to dispense it, let alone stock it? Do they not read the Summary of Product Characteristics (SPC)? For the lay reader this is the "bible" of a medicine’s characteristics... what it is, how it works, how safe it is, and so on. By EU law there's one for every medicine on the market. Surely if a pharmacist believes the SPC for antibiotics or anti hypertensives, then why not take that for the morning after pill?
For the general reader of this article, allow me to briefly explain the complex process that any medicinal product must go through to reach the EU market. By EU law, and for its full life cycle, the medicine must reach an approved level of quality, safety and efficacy. Stringent EU-wide regulations supported by a sophisticated legislative infrastructure cover the research and development, manufacture, distribution and pharmacovigilance of said product. Competent authorities in member states work collaboratively to achieve harmonised standards, so it is possible to state with absolute certainty how any particular medicinal product works. In issuing the marketing authorisation for EC, the Medicines Authority in Malta (aka the competent authority) drew upon the analysis of research data of thousands of experts throughout the EU.
Are local pharmacists who conscientiously object to dispensing EC suggesting that there is a conspiracy somewhere deep in the bowels of EU regulatory affairs such that the mechanism of action of EC is being misrepresented? How can such educated persons in certain positions actually voice such idiocy? Simple. When people don't have a point they resort to lies, even ones that have been long debunked. I think it is utterly presumptuous for anyone, let alone a qualified pharmacist to believe their word carries more weight against that of the experts cited above. Freedom of speech is not freedom to mis-represent the facts.
The crux of the matter is that when deciding to deny patients access to medicines they have a right to, pharmacists should elucidate the scientific rationale on which they are basing this decision. In such a matter, conscientious objection must be supported by rational argument. Otherwise they render their profession a quackery, which society could well do without.
By Prof Isabel Stabile, FRCOG