Talk:Abortifacient

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[edit] Plan B

I removed Plan B again: it is not among "the most prominent" medical abortifacients, indeed most pharmacologists wouldn't even classify it as one: normally it just prevents the egg from being fertilized, and even in the cases where it prevents the fertilized egg from attaching (if that even occurs, which is not clear), it doesn't end a "pregnancy" if the usual medical definition of pregnancy is used: beginning with the fertilized egg's attachment.

I will gladly revert myself if a pharmacologist reference can be found that classifies Plan B as an abortifacient. AxelBoldt 01:14, 2 December 2005 (UTC)

According to http://www.go2planb.com/section/about/index.html, Plan B does sometimes prevent the fertilized egg from attaching. Anyone who believes that human life begins at conception would therefore consider Plan B an abortifacient, or at least a potential abortifacient depending on whether it prevented conception or implantation. From that link: "Plan B is believed to act as an emergency contraceptive principally by preventing ovulation or fertilization (by altering tubal transport of sperm and/or ova). In addition, it may inhibit implantation by altering the endometrium." Wesley 16:56, 6 June 2006 (UTC)

I've added it to the list of disputed abortifacients in the "pre-implantation labeling controversy" section MamaGeek  TALK  CONTRIB  16:05, 7 June 2006 (UTC)

[edit] Fertilization vs. implantation debate

I removed the following section, as the debate about when pregnancy starts is relevant to various discussions, including abortion, and people would not search for it under "abortifacient". This article should be about substances that induce abortion as medically defined and should direct the reader to the discussion about alternative definitions of abortion and pregnancy". So the material below needs to find a new home. AxelBoldt 21:45, 4 June 2006 (UTC)

Any suggestions for the new home? It's been coming up on the oral contraceptive and emergency contraception pages with some regularity, then reverted as being off-topic. And the section was not new on this page (I just expanded, did not add it), so it's obviously come up here before, too. I had put the information here because at least this page is related to abortion (unlike the OCP and EC pages). Someone had suggested the pregnancy page, but I'm not sure that's the place for a 'debate' section. Lyrl 00:46, 5 June 2006 (UTC)
I disagree with its removal from the article. Listed in the section are all the birth control methods that many consider abortifacient based on their definition of life as beginning at conception. The title of the section and the opening paragraph are sufficient to point out the controversial nature of the information, but it definitely belongs in this article. MamaGeek  TALK  CONTRIB  12:46, 5 June 2006 (UTC)
I'm putting back the bulk of the section. MamaGeek  TALK  CONTRIB  18:29, 5 June 2006 (UTC)
I think the issue is not when pregnancy starts, but rather when human life starts. This seems like an appropriate place for this material. Wesley 16:56, 6 June 2006 (UTC)
Well if that is the case, the material doesn't belong here. An abortifacient is a substance that ends a pregnancy (causes an abortion). An abortifacient is not a substance that simply ends human life. If a women isn't pregnant, then she cannot have an abortion (even if we grant that every single fertilized egg constitutes a "human life"). I stand by my propsal to create an article specifically on the beginning of pregnancy controversy, and then briefly mention the debate in appropriate articles.--Andrew c 17:07, 6 June 2006 (UTC)
The Wiki abortion article defines abortion such that any substance which causes the expulsion of a human embryo is causing an abortion. It doesn't matter when you believe that life begins. This is why I changed the opening paragraph of the section below in the actual Abortifacient article. MamaGeek  TALK  CONTRIB  17:13, 6 June 2006 (UTC)

Medterm.com defines pregnancy as "The state of carrying a developing embryo or fetus within the female body. This condition can be indicated by positive results on an over-the-counter urine test, and confirmed through a blood test, ultrasound, detection of fetal heartbeat, or an X-ray. Pregnancy lasts for about nine months, measured from the date of the woman's last menstrual period (LMP). It is conventionally divided into three trimesters, each roughly three months long." By this definition there is a pregancy once there is a developing embryo. If measured from the LMP, the time of pregancy would include the time before implantation. Biology online defines an abortifacient as "a drug or compound that induces the expulsion of an embryo or foetus" without reference to pregnancy or implantation.[1] The definitions given by the Protection of Conscience Project [2] also include drugs that prevent implantation among abortifacients. The first two references (medterm.com and biology-online.org) are I think fairly neutral, or at least not overtly partisan. The last organization may be more partisan, but its board is chiefly comprised of doctors and lawyers from what I could tell at a glance. The key point is that the definitions of the words used in this debate are themselves debated; it appears to me that neither side is entirely unreasonable. Wesley 16:28, 7 June 2006 (UTC)

Well this is opening up a whole can of worms. If LMP is counted, a woman is "pregnant" around 2 weeks before fertilization and intercourse. Also, if having a developing embryo in the uterus is enough to constitute pregnancy, then 100% of IVF cases result in pregnancy (even though 40-60% fail to implant or are lost by the next menstrual cycle). But you are missing the key point of your cited definition. A pregnancy will NOT show up on any known test before implantation. A woman's body does not physically/chemically change until implantation. The AMA and the ACOG and the BMA, among many, many others, all define pregnancy as starting from implantation (even if gestational age is counted by LMP). And to further complicate matters, there is no scientific evidence that there are post-fertilization effects to hormonal contraception (including EC). So not only are the terms and definitions debated (as you point out), but the actual reality of implantation prevention is unproven. Anyway, I think a reasonable solution would be to create an article about the begining of pregnancy controversy (so we don't have to hash this out in full on every semi-relevent article), and then mention that certain forms of BC are seen to be abortifacients by those who hold a specific definition of pregnancy (or err on the side of caution in regards to hypothetical modes of action of hormonal contraception).--Andrew c 20:03, 7 June 2006 (UTC)
I agree, the beginning of pregnancy/beginning of life/beginning of humanity controversy deserves its own article, if it doesn't have one already. Here, we could follow your suggestion, or we could slant it the other way and mention that certain forms of abortifacients are seen as birth control by those who hold a narrow definition of pregnancy. Better of course would be to present this in a rather more neutral fashion without tilting so far either way. Wesley 16:30, 12 June 2006 (UTC)

[edit] disputed section

The medical community defines pregnancy as beginng at implantation, because of the ramifications of in vitro fertilization: embryos conceived in a laboratory dish do not make a woman pregnant. However, in the general public there is some debate over whether a woman is considered pregnant at the time of conception, or at implantation of the fertilized egg in the uterine lining.

Fertilised embryos naturally fail to implant some 30% to 60% of the time.[1] It is argued that the high loss rate of early embryos is reason to avoid defining pregnancy at conception.

Those who consider the beginning of pregnancy to be at the point of fertilization count among abortifacients any agent which may prevent implantation of an already-fertilized egg, even if the primary function of said methods is to prevent fertilization:

Breastfeeding infertility partially works by causing luteal phase defect,[2] which makes the uterine lining hostile to implantation; as such, defining implantation as the start of pregnancy would indicate that breastfeeding can be a form of abortion.

Some anti-abortion groups acknowledge the postfertilization effect of breastfeeding, but defend it based on the bioethical principle of double effect. Use of hormonal contraceptives, including EC, is usually motivated by an intention to avoid pregnancy - when one of the proposed mechanisms operates after fertilization, they consider these methods immoral. Breastfeeding is motivated by - and has the primary effect of - nourishing a child. Because the intention is not related to avoiding pregnancy, they do not consider immoral any secondary, or double, effect of harm done to unimplanted embryos.[3]

[edit] References

  1. ^ Kennedy, T.G. Physiology of implantation. 10th World Congress on in vitro fertilization and assisted reproduction. Vancouver, Canada, 24-28 May 1997.
  2. ^ Diaz, S. et. al. Relative contributions of anovulation and luteal phase defect to the reduced pregnancy rate of breastfeeding women. Fertility and Sterility. 1992 Sep;58(3):498-503. PMID 1521642.
  3. ^ Doesn't breastfeeding do the same thing as the Pill? Eternal Perspective Ministries, 2006. Accessed May 2006.

[edit] Side effects

There should be something in the article about the dangerous side effects of certain abortifacients, especially the do-it-yourself herbal variety. It would be irresponsible to put this information out there without such a warning. Does anyone know enough about them to tackle the job, or should we just search online for the info? MamaGeek  TALK  CONTRIB  15:59, 7 June 2006 (UTC)

[edit] Witchhunt

I added a "citation needed" tag to the line about witchhunts. It certainly seems plausible, but there is no reference, and there is not even a date or date range. The sentence is also very vague (e.g. "European society"). Any help putting that sentence in order would be appreciated. MamaGeek  TALK  CONTRIB  16:10, 7 June 2006 (UTC)


[edit] Breastfeeding

The topic of this article is abortifacient, which we define as substances that induce abortion. Regardless of the "when does pregnancy begin" discussion, breastfeeding would not belong in this article. Breastfeeding is not a substance (and therefore not an abortifacient) but instead is a technique. Even if one accepted the position that breastfeeding was a form of abortion, it would belong in the article on abortion and not here. Simply put - this article is narrowly focused on abortifacients, not broadly focused on all forms of abortion. - O^O

I concur. MamaGeek  TALK  CONTRIB  11:00, 8 June 2006 (UTC)

[edit] implantation prevention

I feel that we need to say "none of these listed agents can cause an abortion once a pregnancy has been established", but I am not 100% sure every single substance is covered, and I am not sure of the proper wording. What do others feel? I think its important to say that abortifacients are substances one can take after one is known to be pregnant in order to terminate that pregnancy, where this clearly doesn't apply to any of the listed hormonal contraceptives.--Andrew c 23:23, 11 June 2006 (UTC)

The copper IUD does not increase miscarriages in the 1st trimester, but if it is not (or cannot be, due to positioning of the embryo) removed, it does increase the risk of 2nd trimester miscarriage. Hormonal ones obviously don't do anything to implanted pregnancies.
The herbal ones I don't know about. I thought wild carrot, for example, was (believed by some herbalists to be) only a contraceptive, which worked primarily by disrupting implantation, but that did not affect implanted pregnancies. And yet here it is listed an abortifacient. Lyrl 23:43, 11 June 2006 (UTC)

[edit] Proposed Infobox for individual birth control method articles

Let's all work on reaching a consensus for a new infobox to be placed on each individual birth control method's article. I've created one to start with on the Wikipedia Proposed Infoboxes page, so go check it out and get involved in the process. MamaGeek (Talk/Contrib) 12:29, 14 June 2006 (UTC)

[edit] Implantation

I changed "They are not effective if taken after a woman receives a positive pregnancy test" to read "They are not effective if taken after implantation." The latter is true, the former is nonsense - taking a positive pregnancy test itself has no effect on pharmaceutical agents. Silly people.

--Almondwine 17:07, 17 June 2006 (UTC)

[edit] Labeling controversy and Law

I also removed "federal" from "British and American federal law..." Article Six of the Constitution makes "federal" level law into the law of the land. To say something is characteristic of 'federal' law suggests that there are state laws which set opposing legal precedents. If there are, then those state laws are unconstitutional and without legal legitimacy. Furthermore, to use the term "American 'federal' law" is redundant, since all American law is federal and all federal law in Washington is American. Since 'federal' in this context suggests the existence of state level law that might might legitimately contradict the current legal precedent, I have removed the adjective. --Almondwine 15:13, 19 June 2006 (UTC)

There's not necessarily a conflict in different federal and state definitions of pregnancy. When judges interpret federal laws, they use the federal definition, and when they interpret state laws, they use that state's definition. There certainly are different definitions, though. From here:
A review of state laws conduced in April 2005 by The Alan Guttmacher Institute found that 22 states have enacted one or more laws defining "pregnancy." (Some of these states have adopted an explicit definition of pregnancy, whereas others have done so implicitly, by defining either "fetus" or "unborn child.") Despite the clear and long-standing medical consensus that pregnancy is not established until implantation, 18 states have enacted provisions premised on the notion that pregnancy begins at fertilization or conception (see table). (Although many of these laws use the imprecise term "conception," all but five leave it undefined. Significantly, however, all of the five states that do define the term equate it with fertilization.) Six states have provisions defining pregnancy as beginning at implantation, although two of these states include other definitions as well.
Lyrl 21:35, 19 June 2006 (UTC)
Lyrl, I've noticed that the medical community has likewise clarified the definition of "conception" to mean implantation and not fertilization. Al 21:42, 19 June 2006 (UTC)
Lyrl, the point is that putting "federal" in there suggests a conflict and distinction that doesn't exist. If 'federal' law says pregnancy begins at implantation, then American law says pregnancy begins at implantation. If you want to say that some state laws define pregnancy as beginning at conception then you can, with the caveat that American law uses implantation. Federal goes.--Almondwine 16:01, 26 June 2006 (UTC)

The only definitions I was able to find of "American law" either are inclusive of state law ("Used in certain jurisdictions to determine criminal responsibility" [3]), or reference both federal and state levels ("The law of the United States.... the jurisdiction of federal law and the laws in the fifty U.S. states and territories." Law of the United States) I have never before seen "American law" to refer exclusively to federal law and disagree on that being the only or most common definition. Lyrl 12:33, 2 July 2006 (UTC)

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