I actually have seen this confusion first hand and I was pretty shocked. I work as a Rape Advocate and Plan B is one of the standard medications given to women who come in. I've never seen anyone refuse it until a month ago when a woman was convinced that it would cause an abortion. The Safe Examiner and myself tried to explain to her the difference that that she was mistaken but she simply didn't believe us. She said her friends had taken it before and that it had caused an abortion. It was so frustrating that this kind of misinformation is out there to the point that people won't even believe medical professionals!

That is sad. Clarity is often obscured for the purposes of keeping a story short. "Eh, just call them both abortion pills, what's the difference anyway?" Or "Aren't they the same thing? They came out around the same time, right?"

I used EC in 95 before it was called Plan B. If the college nurse didn't have signs up telling people to come in or call in case of broken condoms or other sexual mishaps, I'd have had no idea. In response to those misguided 44% in the poll, No I didn't think "Oh wow, I get to have unprotected sex now." EC is really for emergencies (and if nausea is still a side effect, it's sure to stay that way).

i honestly feel that a majority of the people who are anti-birth control/ plan b, or even anti-abortion, would not be against it if they really understood the biological mechanisms. some people believe that there's a fully-formed (tiny, but fully-formed) human in the uterus, pretty much right after conception. if you don't understand any biology yourself, it's really easy to just take the word of your priest or dobson, or whomever is out there spreading misinformation. with the state of science education in the country, though, i'm not going to expect it to improve any time soon.

76% think EC will reduce the number of unplanned pregnancies

this is good news. and the more we talk about it, the more it might start to sink in that there's something to do in the case of rape/miscommunication/condom breakage besides helplessly wait for an abortion.

awesome timeline in mojo the other day, ann. amazingly comprehensive. i wonder how many extra abortions the republicans have caused in that time by politicizing women's health.

Understanding the biology of conception and pregnancy might not clear the confusion between Plan B and RU-486. Many people believe that pregnancy begins at conception, not at implantation. If this is your belief, then Plan B acts as an abortificant because it might not allow the fertilized egg to implant into the uterus. It is this type of non-rational belief that hinders discussion about birth control and abortion. And it is incredibly frustrating.

Ann wrote:

"Plan B can be taken up to 72 hours after sex, and works by preventing pregnancy. If a woman who takes Plan B is already pregnant, it does not cause an abortion."

Plan B is capable of terminating an existing pregnancy which has not yet reached the stage of implantation.

Conception, contrary to the claims of the abortion rights advocates and the ACOG, begins at fertilization and not implantation.

Mosby's Medical Dictionary, 7th Edition, defines conception as fertilization, and not implantation. Most, thought not all, medical dictionaries use this same singular definition.

Pregnancy begins at conception (fertilization), and preventing implantation is a method of terminating it -- which is also known as an abortion. All this can be verified by using a medical dictionary.

Please read this article on this subject...

Medical Dictionaries Prove Plan B Advocates Wrong

Excerpte

I wonder what proportion of Senators and Congresspeople could accurately distinguish the difference between the two?

Not many, I bet.

But see, there's part of the confusion. It doesn't stop implantation. What it does is prevent the woman from ovulating in the next day or two. PZ Meyers has an excellent post regarding how it works here:
http://scienceblogs.com/pharyngula/2006/04/why_the_wingnuts_hate_plan_b.php

NRFC:

Ah, you again. As I wrote in response to you once before, that definition of conception creates rather ludicrous medical results -- such as a natural abortion rate of over 50%. If you believe that people are fully formed at fertilization, God is the most prolific abortionist in history! It is for this reason that doctors define pregnancy at implantation now, not at fertilization, and try to avoid using the ambiguous word "conception", which people use to mean either fertilization or implantation depending on context.

Second, none of that is relevant because there is no clinical evidence that Plan B prevents implantation! None! Zero! It doesn't even line up theoretically! If Plan B affects implantation at all it ought to make it more likely.

NRFC - pregnancy begins at conception (fertilization), and preventing implantation is a method of terminating it -- which is also known as an abortion. All this can be verified by using a medical dictionary.

Just because it is written down doesn't mean it is so.

Also while I can see some logic in life beginning at conception I see no logic for pregnancy beginning at conception. If conception is achieved outside of the body or a fertilised egg not implanted who is pregnant for example??

Also if you have a problem with your reproductive system which means implantation cannot occur are you commiting abortion everytime you try for a baby that is not implanted knowing that it is unlikely/not possible to happen?

Carlie wrote:

"But see, there's part of the confusion. It doesn't stop implantation. What it does is prevent the woman from ovulating in the next day or two. PZ Meyers has an excellent post regarding how it works here:

Despite what PZ Meyers explains, the manufacturers of Plan B acknowledge that it may prohibit implantation:

"It is important for patients to understand that Plan B® is similar to a birth control pill and is believed to act as an EC by...Altering the endometrium, which may inhibit implantation "

This information can be found at www.go2planb.com

How Plan B Works (For Pharmicists)

Chem_Fem wrote:

"Just because it is written down doesn't mean it is so."

True, which is why I used mulitiple medical dictionaries -- most of which defined conception as fertilization. Relying on one dictionary isn't sufficient...

Chem_Fem wrote:

"for pregnancy beginning at conception. If conception is achieved outside of the body or a fertilised egg not implanted who is pregnant for example??"

"Who" is the key word. The patient is pregnant. Petri dishes are not patients, but humans *are*.

Chem_Fem wrote:

Also if you have a problem with your reproductive system which means implantation cannot occur are you commiting abortion everytime you try for a baby that is not implanted knowing that it is unlikely/not possible to happen?

Read this definition from Stedman's Medical Dictionary, and you'll have your answer:

Abortion: 1. The expulsion of an embryo or fetus before it is viable. 2. A miscarriage. 3. An aborted organism. 4. Cessation of normal growth, especially of an organ or other body part, before full development or maturation. 5. The arrest of an action or process before its completion.

They may say that to cover all bases, however, there have been several studies that show that large doses of the hormone does not affect implantation rates at all:

"Alternatively, when it was given after mating—at a time when fertilization was believed to have occurred (on the basis of previous monitoring)— the pregnancy rates observed were identical in cycles treated with levonorgestrel or with a placebo. This indicates that levonorgestrel did not interfere with any postfertilization process required for embryo implantation." - from a study in monkeys, and

“There is no doubt that fertilization would not have taken place in those women should they have had intercourse prior to treatment,� says Croxatto. “We conclude that the effects exerted by Plan B, when it is taken before the onset of the LH surge, may fully explain the pregnancies averted by emergency contraception. Failure to affect the LH surge, because treatment was begun too late in the fertile preovulatory period, explains the 20 percent failure rate of this method.� - from a study in people.

BC does affect the endometrial lining, and since the early days it wasn't certain whether that would prevent implantation (hence the ambiguous "may" in all those statements). However, the more recent studies do seem to indicate that it doesn't affect the lining enough to prevent implantation. Again, EC has a 20% failure rate when used properly - if it was actually working by prohibiting implantation, it shouldn't have any failure rate. Back of the envelope calculations would even predict approximately that failure rate if it only prevented ovulation - take about a 50% chance that ovulation will happen in the few days before or after intercourse (actually it's much less, but I'll be overly generous), then cut that in half for chances of ovulation before v. after the intercourse, and you're left with about a 25% chance of ovulation and fertilization. If the EC doesn't interfere when that process has happened, you would expect about that many women to be pregnant even if they took it, which is about what the failure rate actually is.

http://www.popcouncil.org/publications/popbriefs/pb11(2)_3.html

I just wanted to point out that the "article" this info is coming from is actually a press release, and the "survey" was conducted by a marketing research firm. I didn't see a disclosue about who funded this marketing research, though maybe it is there and I missed it.

Never lose sight of the multiple agendas in play on an issue like this. We (feminist women) want EC available because we want EC available. Others want EC on the market because selling it will enrich them, and for this reason, I'd tread carefully with PR stuff like this.

ZED Wrote:

"such as a natural abortion rate of over 50%. If you believe that people are fully formed at fertilization, God is the most prolific abortionist in history!

The difference between an abortion and a miscarriage is one is intentional while the other isn't. The 50% unintentional rate is irrelavent to this debate. The scope is intentional abortion...

Zed Wrote:

"It is for this reason that doctors define pregnancy at implantation now,"

SOME doctors may definine it this way, but many don't. People are subject to their own bias and ideology -- which is why dictionaries are more credible than doctors who play with the definition of conception.

Zed wrote:

"try to avoid using the ambiguous word "conception", which people use to mean either fertilization or implantation depending on context."

According to a majority of multiple dictionaries, it means fertilization. This has been the long standing medically recognized definition. Only a segment of the medical community has attempted to redefine conception to mean implantation, but that redefinition failed to implant in the entire medical community (pun intended).

So let's clear the ambiguity here: The medically accepted definintion of conception, as supported by a majority of medical dictionaries, is fertilzation.

(If one is confused, then one simply needs to refer to these dictionaries.)

Finally, if you are stiil confused about this word, then maybe you should learn what the purpose of a dictionary is...

Zed Wrote:

"Second, none of that is relevant because there is no clinical evidence that Plan B prevents implantation! None! Zero!"

And there isn't evidence that it doesn't prevent it in humans either. The theory is that it does, and the manufacturer acknowledges this. Until this is resolved, we must treat it as if it does.

Carlie wrote:

"there have been several studies that show that large doses of the hormone does not affect implantation rates at all:"

I'm aware of those studies, however using animals can only provide a possible hint of what will happen in a human. It does not mean that the same result happens to a human being.

Until it's proven that it doesn't happen in humans, it must be treated as such.

Progesterone (Plan B) does affect the endometrial lining -- by increasing blood flow and making it more hospitable for implantation! More! Not less!

That "may" prevent implantation is entirely a political nod to people like NRFC with a specific agenda of forcing it into press releases so they can point at it and say "it doesn't matter what the science says, LOOK, A PRESS RELEASE AGREES WITH ME!"

It is just as accurate, and more likely to be true, to say that eating cheese may prevent implantation. Nobody's ever found a link, but hey, nobody's ever disproved it.

A good rule for understanding the universe: when the scientists say one thing, and the corporations and politicians say another, go with the scientists.

It is a press release, but it's based on three studies in peer-reviewed journals. I've seen the Ortiz et al. paper cited in several different places. I'm sure the press release has some bias, and I agree that the human survey stuff is more rife with potential for error, but there is some beef behind it. If it doesn't completely smother the "prevents implantation" argument, it does at least throw a large wet blanket on it.

NRFC:

The difference between an abortion and a miscarriage is one is intentional while the other isn't. The 50% unintentional rate is irrelavent to this debate. The scope is intentional abortion...

According to a majority of multiple dictionaries, it means fertilization.

And on top of that, the article claims something it doesn't demonstrate -- that those same medical dictionaries that define conception in terms of fertilization define pregnancy in terms of conception. I checked half a dozen dictionaries online just as a crosscheck, and every single one either failed to specify or specified a uterine pregnancy (i.e. post-implantation).

As far as I can tell, it is the common prevailing medical opinion that pregnancy is defined in terms of implantation, dictionaries included.

Editing error above:

"and excludes Dorland's, are excluded." should read "and excludes Dorland's, one of the more famous ones.".

I had a cut-and-paste error, apologies.

NRFC - "Who" is the key word. The patient is pregnant. Petri dishes are not patients, but humans *are*.

OK, so if I have some eggs taken out and fertilised in a petri dish then am I pregnant? If my fertilised eggs are put into another woman am I then still pregnant or is the woman carrying my fertilised egg pregnant? If she is pregnant and not me then pregnancy begins at implantation. Or am I still pregnant while she carries my fertilised egg, if so what is she??

NRFC (in reply to me) - Abortion: 1. The expulsion of an embryo or fetus before it is viable. 2. A miscarriage. 3. An aborted organism. 4. Cessation of normal growth, especially of an organ or other body part, before full development or maturation. 5. The arrest of an action or process before its completion.

NRFC (in reply to Zed) - The difference between an abortion and a miscarriage is one is intentional while the other isn't.

so are they different or the same? you seem to have contradicted yourself...

i just want to point out that plan b can actually be taken up to 120 hours after unprotected sex, not 72 (it used to be, but that's changed). however, it is very important to note that the failure rate rises significantly after 72 hours... the sooner the better...

look NRFC, i used to be an anti many moons ago and i totally get the whole "it's a human life" thing going on in your head. but maybe you need to get a dose of REALITY about this. and instead of focusing so much time and energy on arguing about embryos that are nothing but a big jumble of cells at the stage you are speaking of, start focusing on all of those KIDS who are BORN and unwanted...

how much activism/volunteer hours/etc. do you put in for the ones who are here??? shouldn't they be our primary concern???

(which to me includes educating them!!!)

also, if you are so against abortion, don't you see how ec can prevent so many? it could cut the number in half... i understand that you think ec CAN MAYBE cause an abortion too but why don't we start by trying to reduce the number of ACTUAL abortions??

it just makes sense...

NRFC (in reply to Zed) - The difference between an abortion and a miscarriage is one is intentional while the other isn't.

so are they different or the same?

People technically view them differently because they define abortion as an intentionally forced miscarriage.

skyanide, I was pointing out NRFC's contradiction. The question was retorical rather that curiosity but probably still valid.

Zed,

First of all, just because doctor’s don’t use some of the resources I cite (such as the family health guides), doesn’t mean these definitions are divorced from medical reality.

Second, I assure you my X’s are in the right category. Don’t make the mistake of thinking I misrepresented my sources until you actually read the very sources themselves – not online versions which are not from the same edition, source, etc.

You are not looking at the BOOKS I cite. I purposely refrained from using online dictionaries which support my case because many do not cite sources or contain reworded source materials, or varied from their published texts books. I did list online dictionaries which argued against my own case (NCI and NIH definitions), but I would not cite them to support my own case. You overlook this fact…

Now, the books I cite can’t be verified online – even Stedmans’s doesn’t have it’s 28th Edition online for public use. Whatever is available for free use on Stedmans.com is not the edition or source I cite. You’ll have to drop by a bookstore if you want to disprove my sources.

(As for why Stedman’s Online versions differ form their books – I can’t answer for Stedman’s. I can only tell you to look at the source I cited. Interestingly enough, other online versions of Stedman’s list fertilization and not implantation.. Even a *majority* --but not all -- of Stedman’s dictionaries list fertilization and not implantation! )

In the article I allude to the fact that sources are a *representative summary* and not an exhaustive analysis – that will come later.

Very few medical dictionaries in print list implantation as the sole definition of conception. Some do indicate a primary meaning of fertilization but allusion to a lesser used secondary meaning (implantation). But the overall majority lists fertilization, followed by primarily fertilization and an allusion a lesser meaning of implantation, and even fewer listing implantation alone.

Finally, I list my sources -- please list yours!

Here are some definitions from some of the of books I used:

Mosby’s Medical dictionary, 7th Edition, 2006:

Conception (l, concipere, to take together), 1. The beginning of pregnancy, usually taken to be the instant that a spermatozoon enters an ovum and forms a viable zygote. 2. the act or process of fertilization (MY NOTE: The term “usually� mean usually, that is, commonly encountered or observed, or regularly and customarily used. )

Pregnancy: The gestational process, comprising the growth and development within a woman of a new individual from conception through the embryonic and fetal periods to birth.

Stedman’s Medical Dictionary, 28th Edition, 2006:
Conception. 3. Fertilziation of oocyte by a sperm (latin conception; see concept)

Pregnancy: The state of the female after conception and until the termination of the gestation.

Websters New World Medical Dictionary, Second Edition, 2003

Conception: The union of a sperm and an egg to create the first cell of a new organism. The term Conception has also been used to imply implantation of the blastocyst, the formation of a viable zygote, and the onset of pregnancy.

Pregnancy: The state of carrying a developing embryo or fetus within the female body.

Embryo: An organism in the early stages of growth and differentiation from fertilization to the beginning of the third month in humans.

chem_fem said:

OK, so if I have some eggs taken out and fertilised in a petri dish then am I pregnant?

It’s implicit that pregnancy occurs *within* a human body, not externally. A woman is pregnant at fertilization since the human is inside of her. She *carries* offspring (hers or another’s) in her body. Under normal circumstances, this means fertilization within her body.
Under *abnormal* circumstances when a newly created human is [unnaturally] introduced into her body -- she is pregnant when they are introduced (prior to implantation). But understand that is the exception, not the rule, of pregnancy, and doesn’t mean that fertilization is not the start of a normal pregnancy.
chem_fem wrote:

“If my fertilised eggs are put into another woman am I then still pregnant or is the woman carrying my fertilised egg pregnant? If she is pregnant and not me then pregnancy begins at implantation. Or am I still pregnant while she carries my fertilised egg, if so what is she??�

Once again, the exception does not define the rule. You speak of abnormal cirucumstances. Routine pregnancies begin at fertilization…
>>so are they different or the same? you seem to have contradicted yourself...
Abortions can be intentional (ie, surgery) or unintentional (miscarriage). No contradiction there…

so by that definition, if abortions are outlawed, does that mean that the "unintentional" ones are too?? are we going to see a surge of women with miscarriages going to jail??

i know that's a bit cheeky, but seriously...

NRFC:

I don't own the books. Since your representation of their contents conflicts with pretty much all of the sources that I can check from here, I am strongly suspicious that you are selectively quoting.

Nonetheless, I will make a point of stopping by the local Barnes and Noble to see if the texts are available for browsing to check.

However, even granting you all of those claims for the sake of argument, you still have a number of major problems to overcome with your argument:

1) Even among your own sources, a third of them note that pregnancy begins at implantation. This means that under the most generous possible terms to you, there is still substantial medical disagreement in your primary claim. Unanimity in medical dictionaries would have been a strong indicator of consensus among medical professionals. As it is, all it shows is that some of those dictionaries may be behind the times.

2) The natural implantation failure rate is over 50% (and has been seen as even higher than that in some studies). This means that if you define pregnancy as being from fertilization, natural abortions of pregnancy far exceed all other forms of abortion, and dwarfs all other forms of child death combined. If you make this trump the rights of adults, then this mandates a large number of very ugly reactions.

3) You have not demonstrated personhood of a fertilized egg, or for that matter an implanted embryo. Embryonic development is pretty well understood, and there are no synaptic connections prior to about 28 weeks of gestation, which is the absolutely minimal requirement for any kind of sentience. It's not sufficient, mind you, but minimally necessary.

4) If, for the sake of argument, you do assign personhood to fertilized eggs, then a natural result is that fertility clinics must be immediately banned, as they result in the destruction of large numbers of fertilized eggs during treatment (every successful pregnancy will generally result in at least half a dozen "abortions", and probably many time that number). Also, the numbers would dictate saving a cart with a hundred frozen fertilized eggs from a burning building is more important than saving a grown woman and her 7 year old child. I'm curious as to whether or not you support that. These are some of the more visible of the very ugly outcomes I noted in (2), but by no means the only ones.

5) Plan B doesn't prevent implantation, so as far as it affects the topic at hand, the point is moot. If you want to claim otherwise, point me at a clinical study, not a press release. The burden of proof on this rests solidly on you, because you are endorsing criminal penalties based on your claim. The burden is not on those that do not wish to be prosecuted to prove a negative (which is rhetorically impossible, anyway). By your logic, women should also be prevented from drinking, smoking, driving, eating dairy products or beef (BGH), eating preprocessed foods (additives/preservatives), or doing anything stressful, because all of those things could be reasonably theorized to reduce implantation rates. This is ludicrous.

Pregnancy begins at conception (fertilization), and preventing implantation is a method of terminating it -- which is also known as an abortion. All this can be verified by using a medical dictionary.

It's a red herring. It doesn't matter what conception is or when it takes place. When your OB is calculating a due date, she works from the first day of the last menstrual cycle. It is extremely unlikely that that is when one actually became pregnant.

Prior to implantation it cannot be determined that one is pregnant. There is a 50% chance of implantation. Call it Shroedinger's Pregnancy. If the pregnancy cannot be detected then it cannot be ended, only prevented.

EC does not reduce the liklihood of implantation, only of fertilization. And other substance or device or procedure that does prevent implantation of a fertilized ova must be considered birth control because it cannot be proven to be anything else.

I'm not surprised by this either. I've been explaining the difference between EC and RU-486 for awhile now--folks are definitely confused.

kaethe - call it Shroedinger's Pregnancy. If the pregnancy cannot be detected then it cannot be ended, only prevented.

I wish I'd said that! Well put.

NRFC - It’s implicit that pregnancy occurs *within* a human body, not externally. A woman is pregnant at fertilization since the human is inside of her.

Technically just because the fertilisation happens inside a body cavity it doesn't mean it occurs within the body. For example in biology i learnt that when you eat, all of the food that is not absorbed into the body mearly passes through and isn't said to enter the body as such. logically the same is true of fertilisation.

NRFC - You speak of abnormal cirucumstances.

Hardly, in vitro fertilisation is common enough to call the practice normal. I think you mean natural. But if pregnancy wasn't to start at fertilisation outside of the body then you can't have any qualms about terminating the fertilised egg at a later date seeing as you have already said it is not the same as 'within the body'.

Wow. Look at all the things I missed!

Thanks are in order to Zed and chem_fem for making this all so clear and for Kaethe for making me laugh.

Now I just have to remember it all for when the argument comes up again. I wish I was as smart as you guys!

Oh, and Zed, you are very patient to go look for books. I cracked up when you were told that you needed to go buy a bunch of books in order to disprove some random iNet person's theory. If only we all had so much time and money! :D

Also if you have a problem with your reproductive system which means implantation cannot occur are you commiting abortion everytime you try for a baby that is not implanted knowing that it is unlikely/not possible to happen - chem_fem

Indeed, that's the crux of it, isn't it?

I dunno about everyone's moral system, but last I checked, a key componant of morality was respect for human life. That not only means not, e.g., murdering someone, but also taking proper precautions to avoid killing someone. While of course there is a distinction between doing something intended to cause a loss of human life and accidental homocide, we still ought to try to do what we can to prevent grave accidents even if we cannot always do so ...

Indeed, legally, there is a such thing as depraved indifference homocide: if you are sufficiently indifferent to the fact that your actions have a high probability of causing a loss of human life, it is almost the same, legally and morally, as if you intentionally killed someone.

If a pre-implantation embryo is a human life, then is it not depraved indifference for a woman, whose uterus is incapable of accepting an implanted embryo, to have sex without birth control? After all, there would be a guarantee that human life is lost every time she conceived (i.e. an egg was fertilized -- I myself have never heard any other definition of conception in this context) -- isn't that depraved indifference?

Indeed, I'm no lawyer, but if you did something that (you knew) had a 50% chance of killing a person, a case could be made that you are guilty of depraved indifference, could it not?

So are all couples trying to have a baby guilty of depraved indifference?

EJ:

Heh, well, I'm actually genuinely curious about the possibility that some of the major medical dictionaries that he quoted really do define conception and pregnancy that way, because it's really not a very useful medical definition. Once upon a time I studied biomedical engineering, and although I eventually chose not to become a doctor, I retain a fair amount of interest.

I just got a chance to dig through my personal library as well, and came up with both the Oxford Concise Medical Dictionary (2003) and the Guyton and Hall Textbook of Medical Physiology, 9th Ed. (1994). The former defines conception in terms of fertilization, but then defines pregnancy both in terms of conception and in terms of uterine implantation, and separately, so I guess you could stick it either in the "Both" or possibly just the "Confused" category. The textbook avoids using the word "conception" anywhere, as far as I can tell, preferring to be specific about either fertilization or implantation, and is a little imprecise about what constitutes "pregnancy", as it refers to pregnancy and the development of a full term fetus occuring if fertilization is successful (and in the same sentence, so it obviously is referring to eventual possibilities if everything goes well, not a matter of definition), and then doesn't so much as mention the word pregnancy again until it reaches the section on implantation, when it talks about tissues of pregnancy.

But I regret somewhat having engaged the topic at all, now, because Kaethe is right -- no matter what the technical answer is, this is a red herring as far as it concerns Plan B or reproductive rights in general, and now a great deal of time has been spent discussing what amounts to a large irrelevancy.

What's the iNet for if not large irrelevancies? ;)

You really can't put too much stock in Legal/Medical definitions, anyway. Many of those were made a long time ago and people are reluctant to change them. I was reading a case yesterday that occured in Texas in 1997. A man had raped a woman and his defense was that she was a "nymphomanic" and that, medically, it is impossible to "rape" a nymphomaniac since they, basically, want sex all the time. Even when they are kicking and screaming, they secretly aren't.

The judge wouldn't allow the defense(can you blame him?) and the guy won an appeal because the legal literature supported his "defense".

Several law textbooks that they still use include 1940's definitions of rape that basically say "it's all made up".