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.
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.