The US Food and Drug Administration has recently (and finally) updated the leaflet of the so-called «morning after pill», the drug – containing an active ingredient of the progestogen type – which must be taken within 72 hours of risky intercourse to avoid unwanted pregnancy. The American agency specifies, with great delay compared to the scientific evidence and also to what has been done by the corresponding European authorities, that it is not an abortion practice but emergency contraception: in the packages it will in fact be indicated that the levonorgestrel – in the USA sold under the name Plan B One-Step – does not prevent the fertilized egg from implanting itself in the uterus, which has so far been written on the package insert, since there is no scientific evidence that this occurs. The crux is political: it concerns the exploitation by anti-abortion organizations of the concept of a fertilized oocyte, assimilated tout court to that of an embryo and therefore, ultimately, of an aborted human life. The equation is that if the drug prevents this from taking hold, then it is an abortifacient drug.
In the new indications it is therefore specified that the drug «it occurs before the oocyte is released from the ovary» and therefore before it is fertilized and not after. In fact, another objective is to differentiate it even more clearly from the RU486the abortion pill based on mifepristone which is used for pharmacological abortion, interrupting a pregnancy in progress. At high concentrations, 1.5 mg of active ingredient per tablet, the levonorgestrel exactly acts preventing ovulation and fertilization when sexual intercourse occurs in the pre-ovulatory phase. The primary mechanism of action is to block or delay ovulation by suppressing the luteinizing hormone (LH) surge. Obviously, if the relationship considered at risk took place when the process leading to ovulation has already begun or if the implantation process has already begun, the levonorgestrel it cannot take effect. Elements which, once again, exclude any abortive intervention for I didn’t take it, Plan B One-Step or Escapelle (trade names of drugs in the various international markets).
In fact, the FDA specifies – also in the questions and answers on its website – that the pill “does not work if you are already pregnant and in any case does not damage a pre-existing pregnancy”. An important step, particularly in light of the US Supreme Court ruling which last June abolished the historic Roe v. Wade with which in 1973 the same Court had legalized abortion in the USA providing federal coverage to this choice, which therefore it is no longer a constitutional right. For some months now, individual states have been deciding: In 12 states it is prohibited at all times, in one (Georgia) restricted within the first six weeks of pregnancy. In others it is allowed within certain time limits, and in many – from North Dakota to Iowa – the most restrictive laws have been blocked by local court rulings. On the most restrictive list are Alabama, Texas, Oklahoma, Wisconsin or Tennessee where you cannot proceed not even in cases of rape or incest. The picture is very complex and this insight of the New York Times it can help to track the different legislative changes.
In short, the risk is that even products that are not abortifacients, such as the morning-after pill, could be affected by the wave of disinformation – which has its roots back in time, even to the electoral campaign for the 2012 US presidential elections – and exploitation carried out by the most conservative fringes of politics and health institutions. In addition, some surveys had shown that 60% of people believed that the levonorgestrel was an abortifacient and non-contraceptive active principle, which in fact it is. Considering that no scientific evidence has ever demonstrated that the drug prevents the embryo from taking root in the uterus and grow. On the contrary, according to an FDA spokesman, more recent data would suggest that it does not inhibit implantation at all. In Europe, these indications have been clear for years, since 2013.
In Italy the prescription for the drug I didn’t take it, precisely the so-called morning-after pill, is not necessary for adult women who can therefore buy it and take it independently. For minors, on the other hand, the “non-repeatable” prescription is necessary, i.e. to be renewed whenever it becomes necessary and article 2 of law 194/78 applies. This is established by a decision of AIFA, the n. 219 of February 1, 2016 published in the Official Gazette on the following March 3. You find it at this link: show it to the pharmacist if he does not want to sell you the drug. There five days after pillknown commercially as EllaOne and based on another active ingredient – theulipristal acetatewhich acts as a progesterone receptor modulator – is instead available over the counter, without a prescription, for everyone, minors and adults.
Pharmacological abortion: compulsory hospitalization cancelled, the new guidelines
USA, since abortion was banned, online orders for abortion pills have increased by 120%.
Source: Vanity Fair

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