Dr Colin Ong, Deputy Master of the Catholic Medical Guild, says that the new "morning after" pill is not just a contraceptive, but has abortifacient effects to the embryo too.

A new “morning after” pill has hit our shores. Named “Ella”, it is touted as being better than the current “morning after” or “mini” pill, as it supposedly prevents pregnancy for up to five days after unprotected sex, compared to only three days with the current pill.

Ella’s arrival provides us with a good opportunity to re-look at the ethical considerations of the so-called “morning after” pill.


What’s wrong with Contraception?
It is well-known that the Catholic Church firmly opposes contraception. It would be easier to understand the Church’s stand by first comprehending its view on marriage. The Church sees marriage as a sacrament, as a sign of God’s divine love. If marriage is supposed to bear witness to God’s love, then the reason why contraception is wrong becomes clearer. God’s love, epitomised by Christ’s death on the cross for the redemption of mankind and the Church, speaks of a love that is willing to sacrifice everything for the beloved and that says, “I love you so completely and totally that I freely give my life for you”.

Blessed John Paul II wrote in Familiaris Consortio that when couples separate the unitive and the procreative meaning in their relationship, they “degrade human sexuality – and with it themselves and their married partner – by altering its value of ‘total’ self-giving”. The innate language that expresses the total reciprocal self-giving love of the spouses is contradicted by contraception, because the couple is no longer giving themselves totally to the other. “This leads not only to a positive refusal to be open to life,” the late Pontiff added, “but also to a falsification of the inner truth of conjugal love, which is called upon to give itself in personal totality”. Contraception in marriage is nothing other than the spouses saying that “I give myself to you, but not totally – not my fertility nor all the responsibilities and sacrifices that come with it”. As such, any contracepted marital act does not reflect the divine love of the Creator and fails to live up to its original lofty calling.

More than a Contraceptive
Both Ella and the current “morning after” pills (marketed in Singapore as Postinor-2, Estinor or Norlevo), act by preventing ovulation. If there is no ovulation, which is the releasing of the egg, then no fertilisation or subsequent pregnancy can take place. As such, if a woman has unprotected sex at a point in which she has yet to ovulate, Ella and the other pills act as a contraceptive since no egg is available for fertilisation and no human embryo is formed (see figure 1).

However, both Ella and the other pills also act on the uterine wall to make it less conducive for implantation of the human embryo. Thus, if a woman taking the pill has already ovulated and fertilisation does take place, then the embryo that cannot implant properly will die. In this way, these “morning after” pills not only act as contraceptives; but in cases in which the woman taking the pill has already ovulated, they act as abortifacients as well, killing the human embryo in the process (see figure 2).

Lack of Clear Information
What is particularly worrying about Ella is that it is being marketed as a new and improved version of the “mini” pill without stating all its ill effects. The European Medicines Agency, Europe’s equivalent of the US Food and Drug Association (FDA), states vaguely that “Ella is thought to work by stopping your ovaries from releasing an egg” and does not mention anything about Ella’s effect on the uterine endometrial wall, thus completely leaving out any hint that it can cause an abortion. Across the Altantic, American Cardinal Daniel DiNardo has also criticised what he called a “misleading campaign to present Ulipristal (Ella) simply as a ‘contraceptive’”. He says that it would “ill-serve” millions of American women who would be “willing to use a contraceptive to prevent fertilisation” but who would “never choose to have an abortion”, since they would not have taken the drug if they knew about its abortifacient effects.

Also downplayed by the manufacturers are the potentially harmful risks to the baby if Ella is taken and if the pregnancy manages to carry through. Studies on lab animals revealed that Ella is lethal to rat, rabbit and monkey embryos, killing most of them. This is not surprising given that the molecular structure of Ella is very similar to that of RU-486, the only licensed drug in the world that is given specifically to cause an abortion. To be fair, manufacturers do say that Ella is contraindicated in pregnant women (a contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment). However, they claim that they do not have much information about the effects on the foetus if the pregnancy carries through. This lack of data on Ella’s effect on live births is again not surprising given that most of the pregnancies that have been exposed to Ella have resulted in the death of the foetus either through abortion or miscarriage. Still, we do know that one out of two live births in one study did have developmental and visual problems after birth.

So why did the manufacturers not study the effects that Ella has on live babies/foetus more carefully? Indeed, the manufacturers’ lack of concern for the health of the babies/foetus exposed to Ella does suggest an invisible link between contraception and abortion: there is no real need to study more thoroughly the effects on live births if it is assumed that if contraception fails, the next step would be to abort the child.

Moreover, even if the manufacturers do warn that pregnant women should not take Ella, this simply doesn’t make any sense. Cardinal DiNardo brings out the inanity of the situation well when he points out, “This drug is contraindicated for women who are or may be pregnant. Yet its proposed use here is targeted precisely at women who may already have conceived”.

Finally, there are also other effects of Ella that are not sufficiently explained. For example, women are advised not to take Ella more than once in each menstrual cycle because of possible toxicity to the liver. Yet, there is little data on what these harmful effects are. At particular risk are adolescent women and minors who may be harmed either by sheer ignorance or by their vulnerability to sexual abuse and forced repeated ingestion.

So the next time someone you know is tempted to try Ella, remember: it is not just a pretty name! It acts not only as a contraceptive but has abortifacient effects on the embryo as well. In addition, it is also potentially harmful to women (and their babies) who use it.


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