E-Mail This Article to a Friend Not so EC after all (continued)
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Which is, of course, exactly what the pending EC bill aims to do. For starters, the legislation would require hospitals to offer information about EC to the more than 7000 women in Massachusetts who suffer rape every year; if it’s requested, hospitals would have to make the pill available. Toni Troop, of the Boston-based victims-advocacy group Jane Doe Inc., which endorses the EC bill, considers mandatory dispensing of EC to assault survivors an act of compassion, one that gives them "a level of control and security after having control over their bodies violently taken away." Because rape victims almost never get to pick the hospital to which they’re escorted, Troop says, EC should become the standard of care for all patients. "Someone’s access to this health-care option should not be limited by luck of the draw."

The measure would also improve access to EC by enabling women to get the pill from pharmacists without a doctor’s prescription. Instead, the bill would authorize a special program allowing pharmacists to work with physicians to legally dispense EC. Under the legislation, the Massachusetts Department of Public Health (DPH) would set up protocols for such collaborations, and train pharmacists in how to dispense EC — which would include, for instance, how to ask questions to determine whether EC is appropriate. This way, women could get EC without having to worry about reaching a physician in time to get a prescription. After all, landing an appointment within the 72-hour time limit can be tough if you don’t have a primary doctor. Or if you have unprotected sex over the weekend. Or if you live in a rural area that doesn’t have a health clinic. On the other hand, pharmacists "are very accessible," observes Dan Robinson, dean of the Northeastern University School of Pharmacy, which backs the bill. "They’re open 24 hours a day, seven days a week. They’re everywhere."

Robinson echoes nearly every proponent of the EC bill when he describes "the most important reason" for passing this legislation as "the need to prevent unintended pregnancies." Improved access to EC will result in fewer unwanted pregnancies, which, in turn, will result in fewer abortions. In the United States, according to the American Medical Women’s Association, there are as many as 1.7 million unintended pregnancies yearly. Approximately half of those — or 800,000 — end in abortions. In Massachusetts, the numbers are large; in 2001 (the latest figures available), the DPH reported 70,250 unintended pregnancies and 26,852 abortions.

It’s reasonable to think these figures would drop if EC were more readily available here. Strong evidence also supports that conclusion: researchers at the Alan Guttmacher Institute, in Washington, DC, estimate that as many as 51,000 abortions were averted by the use of EC pills across the country in 2000 alone. And that the pill is most effective when taken shortly after having unprotected sex or experiencing contraceptive failure. Of those women who use EC in the first 24 hours, according to the World Health Organization, fewer than one in 100 will get pregnant. This, compared to the 2.7 who will get pregnant when the pill is used within 72 hours. Simply put, the sooner a woman can get her hands on EC, the better — not just for her, but for everyone.

State Representative Martin Walsh, of Dorchester, who personally opposes abortion yet supports the EC bill, sums up supporters’ sentiment best. "People need to look at the fact that this prevents pregnancy," he says. "If you prevent pregnancy, you prevent abortion. If you’re on the side of life, you want to prevent fetuses from being destroyed."

DAN AVILA, the associate director for policy and research at the Massachusetts Catholic Conference (MCC), the lobbying arm of the Catholic Church, says that Church leaders do not object to improving access to EC in principle — at least not for rape victims. But the MCC does reject the language of the pending EC bill because, he says, it would force Catholic hospitals to violate the Church’s own teachings on abortion.

Officially, the Church forbids all forms of artificial contraception, EC included. But because its doctrine defines rape as "an act of aggression," Avila explains, the Church allows women who have been sexually assaulted "to prevent all the consequences of that act, including interrupting her cycle." That means Catholic hospitals can, in theory, give EC to rape victims. Indeed, according to the latest Mass NARAL survey, 36 percent of the state’s Catholic hospitals offer the pill to victims who ask for it — but only in some cases. Many Catholic hospitals, Avila says, do not provide EC to assault survivors when it’s believed that the pill would prevent implantation, which the Church links to abortion. By forcing Catholic hospitals to provide EC all the time, the argument goes, the state would force it to violate its doctrine — which would violate religious freedom.

Avila notes that such objections to EC "go beyond the confines of the Catholic community" to include pro-life activists. He adds, "When a contraceptive method is used, albeit for a good purpose, in a way that would imperil human life, that causes problems."

Marge Sturgis, of Massachusetts Citizens for Life (MCLF), agrees. She and her colleagues, she says, "are concerned about the possibility that human life has been conceived" in the hours before a rape victim can take EC. In these instances, she argues, the pill would simply act as a chemical abortion. "It’s called contraception," she says, "but there is an abortion part to it. And that shifts the whole picture for us."

As far as the medical community is concerned, though, EC does not equal abortion. Medical experts define pregnancy as the moment of implantation, whereas the Catholic Church and other religious conservatives in the pro-life movement define it as that of conception. If EC works to stop implantation, it follows that a woman cannot be pregnant when taking the pill and that no abortion can occur. But if you believe that life begins once the sperm fertilizes the egg, well, then, you see things differently.

BU’s Stubblefield notes that reproductive scientists link pregnancy to implantation for one clear reason: "You can have conception in a test tube," he explains, "but a woman isn’t pregnant until you put the fertilized egg inside her. So how can there be a pregnancy without implantation?"

It’s a point well taken, but don’t expect pro-life activists to be swayed by such opinions. Avila, of the MCC, acknowledges that the complaints about EC acting as an abortifacient aren’t considered legitimate because of "a definition of pregnancy that differs from the Church’s understanding." Still, he says, bill proponents expect that "there should be no moral problem here for those concerned about abortion. And we disagree."

Both the Catholic Church and pro-life activists are actively lobbying the House — in particular, the leadership — against what the MCLF’s Sturgis calls an attempt "to railroad this measure through the House in the 12th hour." But despite these fierce objections, proponents of the EC bill are convinced that it will pass — if, of course, it makes it to the floor for debate. As it stands, the bill enjoys broad bipartisan support. About a half dozen legislators who personally oppose abortion, like Representative Walsh, are standing behind it because they see it as smart family planning. And while 59 legislators signed the June 29 letter delivered to Finneran, bill sponsors such as Petersen and Ellen Story, an Amherst representative, are continuing to circulate the letter among colleagues in hopes of further pressing a House vote.

All of which works in the EC bill’s favor. But if history is any guide, we shouldn’t get too excited. After all, time has almost run out on the legislative calendar, which is expected to end on July 23. And Catholic-conservative politicians such as Finneran will surely see this measure as controversial. Rather than approve a sensible bill on women’s reproductive health — one that makes available a proven contraceptive method — chances are that the leadership will let personal morality stand in the way.

Amherst representative Story sums up the sentiment among reproductive-rights supporters best: "The reality is there are some powerful people who think of this as a moral issue. If your objective is to stop women from having babies when they don’t want babies, this makes sense. But people can get so confused by the morality."

Kristen Lombardi can be reached at klombardi[a]phx.com