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  Fact Sheet: Postinor-2 morning-after pill
5 June 2002
Postinor-2 (Levonorgestrel) is a morning-after pill to be marketed in Australia by drug
company Schering. It is expected to be launched in Australia in July.(1)
Postinor-2 is the first commercially prepared dedicated morning-after pill to be marketed
in Australia. Until this time, morning-after pills have been prepared by family planning
associations and by individual doctors using large numbers of contraceptive pills to make
up the high progestogen dose.(2)
What's wrong with morning-after pills?
Morning-after pills like Postinor-2 can cause an early abortion by preventing the embryo
from implanting in the uterus. This means that the drug has an abortifacient effect.
The Macquarie Dictionary defines abortion as, among other things, "the arrested
development of an embryo or an organ at its (more or less) early stage".(3)
There are more than 80,000 surgical abortions performed in Australia every year. Allowing
wider access to chemical abortion will do nothing to address the real problems that women
face which may lead them to consider using a morning-after pill or surgical abortion,
including: ongoing discrimination against pregnancy in the workplace, the continuing
difficulty for young women of balancing education with motherhood and being trapped in an
abusive relationship.
Misleading language threatening informed consent
Postinor-2 is being promoted as an "emergency contraceptive" drug - implying
that it prevents conception, ie. the union of sperm and ovum, creating a new human life,
rather than induces an abortion. This is misleading to women who will be offered the drug.
They will be denied facts about the way the drug works. They will not have the opportunity
for counselling. There will be no abortion-related informed consent process.(4)
Advocates promoting the morning-after pill try to minimize the implications of the
abortifacient effect of the drug, describing the embryo as a "fertilized ovum".
Women using the morning-after pill will not know whether the pill has prevented a child
from being conceived or whether it has caused an abortion.
How it works
The morning after pill consists of hormones which must be taken in two doses. The first
dose should be taken within 72 hours of sexual intercourse and the second dose should be
taken 12 hours after the first one.(5)
Postinor-2 contains 0.75mg of levonorgestrel.(6) Levonorgestrel is a synthetic hormone
derived from progesterone which is often used in smaller doses in contraceptive pills.(7)
Morning-after pills operate in a number of ways. They can prevent or delay ovulation and
thereby conception is avoided. Conception is the union of sperm and ovum, forming a new
human being. However, if conception is not avoided, the morning-after pill can induce an
abortion by preventing the implantation of the embryo by affecting the lining of the
uterus.(8)
The manufacturer of Postinor-2, the drug company Schering, acknowledges that the
morning-after pill "… prevents the implantation of a fertilized ovum in the
lining of the uterus".(9)
Side effects
Schering says that "irregular bleeding, breast tenderness and nausea are the most
common side-effects" of the morning-after pill.(10) The Australian arm of Schering is
now reported to be claiming that Postinor-2 is 'nausea-free'.(11)
Schering also states that the morning after pill is not suitable for regular use.(12)
The World Health Organisation has warned that:
- "… repeated use of emergency contraceptive pills
in any month can expose women to higher doses of steroids than those recommended during
one cycle";
- "… there may be a higher percentage of ectopic
pregnancies among emergency contraceptive pill failure cases than among a normal pregnant
population"; and,
- morning-after pills "… are not recommended for
routine use, because of the higher possibility of failure compared to regular
contraceptives and the increased risk of side effects". (13)
Abortion-inducing
Under Australian law, any substance which prohibits the development of the conceptus is an
abortifacient.(14) It is not necessary for the embryo or conceptus to implant in the
uterus, establishing the pregnancy, before an abortion can be induced.
Those promoting the morning-after pill often argue that preventing the implantation of the
embryo is not an abortion. They state that an abortion only occurs if it disrupts an
established pregnancy and that pregnancy does not occur until the embryo implants in the
uterine wall. The objection of pro-life people to abortion is not that it ends a pregnancy
- all pregnancies end one way or another, preferably in birth. The objection is that an
abortion ends a human life - the embryo that may be aborted by the morning-after pill.
Cost
Postinor-2 is expected to be sold for between $17 and $20 per script.(15)
Requirements for sale in Australia
In August 2001 the Australian Drug Evaluation Committee recommended that the Parliamentary
Secretary to the Minister for Health and Aged Care approve Postinor-2 (Levonorgestrel) for
registration. The drug was described as a "new dose regimen indicated for use as an
emergency oral contraceptive within 72 hours of unprotected intercourse".(16)
Abortifacient drugs are restricted goods under Australian law and cannot be imported
without the written approval of the Health Minister. This approval must be tabled in the
Australian Parliament.
Under the Therapeutic Goods Act, abortion-inducing or abortifacient drugs can
only be imported into Australia with the approval of the Health Minister. That approval
must be tabled in the Australian Parliament.
Therapeutic Goods Act 1989
restricted goods means medicines (including
progesterone antagonists and vaccines against human chorionic gonadotrophin) intended for
use in women as abortifacients.
6AA Importation of restricted goods
- In spite of any other provision of this Act, a person must
not, without the written approval of the Minister, import any restricted goods into
Australia.
Penalty: 300 penalty units.
- A written approval may be given:
(a) unconditionally or subject to conditions; or
(b) in respect of particular restricted goods or
classes of restricted goods.
- It is an offence to breach a condition of an approval.
Penalty: 200 penalty units.
- A written approval shall be laid before each House of the
Parliament by the Minister within 5 sitting days of being given.
- Unless:
(a) a written approval is in effect; and
(b) the Minister has notified the Chief Executive
Officer of Customs in writing of the approval;
restricted goods are for the purposes of the Customs Act 1901 taken to be
prohibited imports.
6AB Exempt goods
Regulations exempting restricted goods from the operation of a Part of this Act must not
take effect before the expiration of the time within which a House of the Parliament may
disallow the regulations.
References
1. The Advertiser, 3 June 2002; Australian Doctor, 10 May 2002, pages 37-38.
2. The Health Report, ABC Radio, 9 April 2001.
3. The Macquarie Dictionary, second revision, 1988.
4. Kahlenborn, C et al (2002), Postfertilization effect of hormonal emergency
contraception. The Annals of Pharmacotherapy, Vol 36, pp465-470.
5. Schering Internet site - www.women-and-men.de/
6. Therapeutic Goods Administration, www.tga.health.gov.au
7. US Food and Drug Administration, Carton Text Plan B (levonorgestrel) tablets, 0.75 mg
(http://www.fda.gov/cder/foi/label/1999/21045ppilbl.pdf); World Health Organisation, press
release WHO/58, 7 August 1998.
8. Kahlenborn, C et al (2002), op cit.
9. Schering Internet site - www.women-and-men.de/
10. Schering, op cit
11. The Advertiser, 3 June 2002.
12. Schering, op cit
13. Emergency Contraception: A Guide for Service Delivery (WHO, Geneva, 1998)
14. Opinion commissioned from Brian Donovan QC, 16 April 2002.
15. Australian Doctor, 10 May 2002, pages 37-38.
16. Therapeutic Goods Administration, www.tga.health.gov.au
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