Pharyngula

Why the wingnuts hate Plan B

There has been an oddly evasive struggle going on in Washington DC for the last several years. We have a safe, easy method of emergency contraception that has been turned into a political football, with Republicans playing their usual role of criminally stupid thugs, trying to crush a simple idea: Plan B contraception. It illustrates exactly how the Religious Right is trying to intrude on your private life, and in particular, how they want to control women.

I’ll explain how Plan B works, but to do so I’m going to have to explain some basics of the hormonal control of the menstrual cycle.

This is a fairly complicated but typical diagram illustrating the various organs, hormones, and changes that go on in the menstrual cycle. At the top is the master gland, the pituitary, that secretes regulatory hormones; below that is a diagram of the changes in the ovary; below that is a diagram of changes in the lining of the uterus; and finally, at the very bottom, is a graph of the concentration of various hormones in the blood during the phases of the cycle.

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Intimidating, I know. My students are going to get grilled on this in the next month, and will have to memorize it all and much more, but here I will give you the greatly simplified version.

Forget the uterus for the moment. It’s the most familiar part of the story to most women; as you can see in the diagram, there is a thickening of the lining over the course of a month, and then that lining is abruptly sloughed off in the actual process of menstruation. It’s overt, but it’s actually a symptom, not a cause, of the more interesting things going on in the ovary.

The ovary contains a supply of eggs. One egg each month begins to ripen and mature into a large structure called a follicle, regulated by a hormone from the pituitary called Follicle Stimulating Hormone, FSH. The follicle is going to produce estrogen, which is what causes the growth of the uterine lining. FSH is particularly important early in the cycle.

A second pituitary hormone, Luteinizing Hormone, assists in stimulating the mature follicle, and in particular, a rapid surge in LH is what triggers the follicle to pop, releasing the egg, in a process called ovulation. This is a key step, so remember this: a spike in LH levels triggers ovulation.

After ovulation, the egg goes on its way, and might be fertilized, leading to pregnancy. The follicle left behind isn’t done yet, though; it becomes a structure called the corpus luteum, which continues to produce estrogen (necessary to maintain the uterine lining), and also gradually produces more and more progesterone. Progesterone helps maintain the uterine lining, but also suppresses LH production by the pituitary. It’s a kind of timer. The corpus luteum is maintained by the levels of LH, but the corpus luteum also produces rising levels of progesterone, which shut off LH…and when too little LH is produced, the corpus luteum shuts down, no estrogen and progesterone are produced, the uterine lining is no longer maintained, and a woman finds a bloody mess in her panties.

The key thing to remember about this part, though, is that progesterone suppresses LH.

Put two pieces of the story together: a spike in LH levels triggers ovulation and progesterone suppresses LH. Hmmm. This suggests an idea. If you wanted to prevent ovulation, how would you do it?

(Consider this a test. Imagine that Jeopardy jingle playing right now.)

Time’s up—I bet everyone came up with the right answer, though. Giving someone a large dose of progesterone would shut down LH production, so there would be no ovulation, so no egg would be released, and any sperm happening to be in the woman’s reproductive tract would find nothing to fertilize.

You have just figured out what is called Plan B contraception. It is a form of birth control that tells the woman’s ovaries to hold off on releasing any eggs for a short while. It’s called emergency contraception, because it is used by a woman who has, for whatever reason (rape, a broken condom, misplaced enthusiasm, second thoughts, anything) had unwanted sperm in her reproductive tract, and she wants to make sure that this isn’t the moment her ovaries happen to pop a follicle.

Plan B is not an abortion.

Plan B doesn’t help if one is already pregnant, and it doesn’t affect any implanted zygotes. Pregnant women produce progesterone naturally.

Plan B gives women the ability to control, to a limited extent, when they will expel a gamete. In purely reproductive terms, it’s a bit like a male’s ability to control when he will ejaculate, or expel his gametes. That’s it. No fertilized zygotes are involved, so that level of the birth control debate isn’t even relevant. It’s simple, responsible, and safe. You’d have to be insane to object to Plan B.

So why are Republicans holding it up?

This is an issue on which we can completely ignore any assertion that life begins at fertilization (which I personally find absurd), because it’s irrelevant: fertilization doesn’t take place. No zygote, no fetus, no embryo, no babies. The claim that this argument is about the life of a baby is null and void, and the opposition to Plan B makes it glaringly, brilliantly clear that this isn’t about the sanctity of life at all: it’s all about controlling a woman’s ovaries. She will not be allowed to tamper with the timing of ovulation.

The ugly intent of the right wing fundies is unmasked right here, with no phony piety to hide their goals. They want the power to regulate a woman’s physiology against her will.

What contraceptive method do you use? If it’s not abstinence, you ought to realize that these kooks will be after you, next.

Comments

  1. #1 Ichthyic
    February 9, 2007

    Barr indicates independently in the patient literature that the Contraception article is correct by contraindicating use of Plan B in the event of pregnancy (yes, you read that right — the delicious irony of it all).

    methinks you build irony where there is none.

    alcohol is contraindicated during pregnancy as well.

    does that make it ironic?

  2. #2 Greg D
    February 18, 2007

    Um, “Ichthyic”,

    Last I checked, alcohol isn’t sold as a contraceptive that prevents ovulation, but doesn’t affect anything once the ovum is released.

    The host of this blog, however, claims that Plan B does “prevent ovulation, but doesn’t affect anything once the ovum is released.”

    Something with those characteristics would not be “contraindicated during pregnancy .”

  3. #3 thelonman
    March 26, 2008

    I am completely in awe of the “far left” view of the “far right”. I am a Christian. I am conservative. I have no desire to control a woman’s sexuality. None.
    As an educated individual I find it interesting that if I have any value for human life and want to take responsibility for my actions, I am a religious zealot who is hell bent on sterilizing sex down to the missionary position only when I plan on creating life.
    Did I miss something?
    When did it become “far right” to be responsible for one’s actions? If you don’t want children, there are numerous ways to prevent pregnancy. If you want to be a “wild child” and “sew your wild oats”, fine. You can still do that and prevent unwanted pregnancy. One can have surgery, take the pill, wear condoms, etc. The problem isn’t that I or anyone else wants to control women…The problem is that no one wants to take responsibility for anything today, including their sexual pleasures! Now, you can make yourself feel better if you wish, but it doesn’t take a rocket scientist to figure out if you take one single sperm cell and combine it with a single egg cell, a magical thing happens, they multiply and become four cells, then eight and so on and so forth, exponentially increasing until they finally become a baby! Now picture two rocks lying next to each other, ten years later (if left alone)the rocks will not have increased in size or number, consume no energy and produce no waste. Now that fertilized egg…duh! Now how can you say that isn’t life? NASA is spending billions of dollars to find any signs of life. Are they looking for walking, talking aliens? NO, THEY ARE LOOKING FOR JUST A SINGLE LIVING CELL. L – I – F – E . An amoeba, bacteria, virus or any similar thing. Do you think the scientific community would not be shaken to the core if they were to find a fertilized egg on another planet? Think they might want to see what this might become? Double-duh People. If this earth last for a few hundred more years, I think people will be appalled at the murdering of unborn children just as we shudder at the annihalation of Jewish people by Adolf Hitler. Pat yourself on the back, tell yourself that everything you have said and done is justified, put me down for being an ethical and decent “right winger” and blame all your problems on someone else. Grow up people. If you don’t want children, do something really high-tech, you know, like wearing a condom or something extremely hard like that! And if you are too cheap to buy them, go to the Health Department.

  4. #4 Gesyckah
    May 10, 2008

    Hey Thelonman, did you read the original blog about how plan B works? If a woman is raped, a condom breaks, (insert a billion other situations here) immediate access to plan B is one of her best shots at being responsible and not bringing a child into this world that she can’t support. You seem to be opposing that while simultaneously advising that people grow up and take responsibility. Why is your idea of taking responsibility for your sexuality not using every possible option to prevent the birth of an un-loved, un-affordable, unplanned child?

  5. #5 Patches
    July 13, 2008

    While controlling women may play a part of this, control over people in general is probably one of the biggest drives of this sort of mindset.

    The goal of pretty much every religion is to convince people that they can only be happy by submitting themselves completely to that religion. Therefore, they drill that things like sex, music, dancing, parties and whatnot are all evil and you should be ashamed for enjoying them. Religion is the only enjoyable thing on earth. Convincing people of this is what brainwashes people into needing religion, to give themselves their happiness “fix” when all others have been lost to them.

    Unwanted pregnancies and STDs are one way religions “prove” that sex is evil. However, if people can start having consequence-free sex, suddenly it opens up this new source of enjoyment that has nothing to do with religion at all, and religions see that as a great danger. Thus the ubiquitous push to ban anything and everything that could possibly make sex safe and fun.

  6. #6 R.j.
    July 14, 2008

    Thanks for posting this! I teach comprehensive sex-ed at a (very, very, very) conservative university, and its nice to have the physiology info just in case people ask. I have to explain the “Plan B vs. RU-486″ thing in EVERY lecture.

  7. #7 jb
    July 14, 2008

    I just wanted to say thank you for this, PZ. I’ve shared this with two friends, and both appreciated having a clear, comprhensible, and easily shared piece explaning how this medication works.

  8. #8 truth machine, OM
    July 14, 2008

    When did it become “far right” to be responsible for one’s actions?

    You’re right, it’s not far right to be responsible for one’s actions. Rather, it’s far right to be refuse responsibility for the consequences of your own actions but hypocritically blather about other people being responsible for their actions, to generally be an asshole about it, to be dishonest about your own motives, to be dishonest or blind about the motives of others on the far right, and to be extra triple dense about the difference between finding life and the beginning of a human life, and to talk about “murdering unborn children” and Hitler and the Jews, as if you actually gave a damn about either children or Jews, and had any concern about Hitler other than as a role model.

  9. #9 truth machine, OM
    July 14, 2008

    Hey Thelonman, did you read the original blog about how plan B works?

    Didn’t you read that he’s a Christian conservative? Comprehension is not part of their skill set.

  10. #10 Drew
    July 14, 2008

    Hey PZ I’d doubt you’re still reading the comments but just in case you are…Isn’t there also something that Plan B does that thickens the coat around already released egg cells thereby helping to prevent their fertilization? I seem to recall reading something akin to that somewhere. But I could have made that up in my mind or read some dubious materials.

    I know the whole abortion thing is garbage, I have a friend who called a place about getting plan B and the woman on the phone actually told her that if you take plan B it’s the same as having an abortion. I can’t recall the name of the place but I suspect that it was run by religious folks.

  11. #11 JoJo
    July 14, 2008

    thelonman #128

    When did it become “far right” to be responsible for one’s actions?

    It isn’t “far right” to be responsible for one’s actions. What is far right is the following:

    The problem is that no one wants to take responsibility for anything today, including their sexual pleasures!

    Many rightists keep saying that nobody accepts responsibility. What’s usually meant is that people are not being frightened or pressured into forgoing certain, usually sexual, pleasures. It’s a form of puritanism. H.L. Mencken described it well: Puritanism: The haunting fear that someone, somewhere, may be happy.

  12. #12 MAJeff, OM
    July 14, 2008

    .The problem is that no one wants to take responsibility for anything today, including their sexual pleasures!

    Plan B is taking responsibility. Abortion is taking responsibility.

  13. #13 amanda
    July 16, 2008

    Since many people are probably rereading these old entries, wanted to put here that FTR, NFP is 98-99.5% effective as a form of birth control (depending on the method you use), as shown in several peer reviewed studies. It works by observing physical signs of the hormones listed in Dr. Myers chart up there. Many women have many medical conditions that make things like the pill very dangerous to take–or just plain unpleasant, and barrier methods, even when used every time and correctly, are less effective than that. It is good for them to have this alternative.

  14. #14 niuzai033
    December 23, 2009

    Lrg prdcts whlsl sl, prvds cstmrs dmnd

  15. #15 dendad
    February 19, 2010

    What if a egg is in the tube before the drug has been taken or the drug has not had a chance to take effect. Please reply . Thank you

  16. #16 digital thermometer
    July 30, 2010
  17. #17 digital thermometer
    July 30, 2010

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