Letter to the Editor: Another view

BY Daran Parham, M.D., Tulsa
Sunday, December 02, 2012
12/02/12 at 3:38 AM


Hobby Lobby has chosen to appeal a judge's ruling regarding the mandate requiring companies to provide insurance coverage for contraception (including emergency contraception and intrauterine devices). Hobby Lobby believes that these products prevent a fertilized egg from implanting and therefore are abortifacients.

Many forms of birth control work by more than one mechanism. Birth control pills primarily work by inhibiting ovulation. They also cause the cervical mucus to thicken, which decreases the ability of sperm to reach the Fallopian tubes. What this means is that if a woman happens to ovulate while on BCPs, she is still not likely to become pregnant.

Emergency contraception is just a short course of BCPs packaged in a specific way. It is generally believed that EC works by delaying ovulation, not preventing implantation.

IUDs cause a sterile inflammatory reaction within the endometrium. This inflammation effectively prevents sperm from reaching the egg.

Hypothetically, any of these methods of contraception could prevent implantation of a fertilized egg. This is not the primary mechanism of action, and it is unknown how often this occurs.

Another recent article reported that the abortion rate has dropped by about 5 percent in the U.S. Clearly, access to and utilization of effective forms of birth control are key factors in this decrease. The mandate in the Affordable Care Act requiring coverage of all forms of contraception is a big step towards reducing the number of unintended pregnancies and abortions in our country.

Editor's note: Parham is a Tulsa OB/GYN.




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