BEACON HILL — Scores of onlookers packed a Statehouse hearing room on April 13 for discussion about a bill that would expand the availability of emergency contraceptives. Both health care professionals and lobbyists testified in front of the Joint Committee on Public Health.
Opponents of the bill, including members of the Massachusetts Catholic Conference (MCC) and Massachusetts Citizens for Life (MCFL), raised concerns that no long-term studies have been done on the effects of emergency contraceptives, the drug sometimes works as an abortifacient and the bill does not include a conscience clause that would allow health care professionals who are morally opposed to the drug to opt out.
Those who opposed the bill faced jeers and laughter while comments from proponents were often met with cheers and applause. Several young girls wore pink Planned Parenthood shirts with the slogan “Stand Up for Choice.”
Emergency contraceptives are a high dosage of hormones — progesterone and sometimes estrogen — found in other contraceptives. They can delay ovulation so that a woman does not release an egg and cannot become pregnant. They also thin the lining of the uterus and can prevent implantation if ovulation has already occurred, thus causing the abortion of a young human embryo.
Emergency contraceptives are less effective than oral contraceptives at preventing pregnancy and become increasingly less effective when taken over 72 hours since the sexual encounter. So far six states — Alaska, California, Hawaii, Maine, New Mexico and Washington — have approved similar bills to make emergency contraceptives more readily available.
Supporters of the bill testified that emergency contraceptives are a safe and effective way to prevent unplanned pregnancies. Some argued that faster and wider availability of the drug is necessary for women’s health, especially in the case of rape. They said women should be able to obtain the drug from their pharmacist or hospital without seeing their primary care physician.
"This is just a plain common sense measure for women, and a very, very important one," said State Rep. Alice K. Wolf, D-Cambridge.
Women need universal access to emergency contraceptives in order to make abortions “less necessary,” she added.
Daniel Avila — associate director for policy and research at the MCC, the public-policy arm of the Catholic Church in Massachusetts — refuted claims that contraceptives lower the occurrence of abortions. Increased availability increases the likelihood of failed contraceptives and more unwanted pregnancies. It also increases risky behavior, which leads to unwanted pregnancies and more abortions, he said.
His comments were met with laughter, and caused State Rep. Peter J. Koutoujian, D-Waltham to say he was “perplexed” by Avila’s comments, while another legislator said Avila is living in the “twilight zone.”
While the Catholic Church does not support the use of birth control, the Church does not oppose the use of emergency contraception for rape victims in order to prevent ovulation. If ovulation has already occurred, the Church would not support taking the drug, which is considered a chemical abortion, Avila said.
While Avila explained the Church’s teaching on the issue, he stressed that his views are also based on science and ethics. Science shows that emergency contraception can “interrupt life” by preventing implantation, and ethically this should not be done, he said.
"My issue with you, sir, is that you presented your positions with regard to the Catholic Church, and your reading of science is reading it through the eyes of the Catholic Church, and I think that you're taking the position that it is superior to the legitimate rights of a patient," State Sen. Susan C. Fargo, D-Lincoln, responded.
Avila also mentioned that he feared doctors who would not provide the drug, based on their conscience, would be liable for malpractice through this bill.
Helen T. Jackson, a Catholic doctor and president of the Guild of St. Luke, said the bill does not uphold the principle of separation of church and state since it violates her faith.
"Emergency contraception is bad medicine. As a physician, I am called to do no harm. What the bill suggests is to mandate hormones in large doses for a non-diseased state," she said.
The result of these hormones is acute nausea, which can last for days, in the short term and unknown risks for long-term use.
Jackson, who has treated rape victims, stressed that rape is emotional, physiological and physical and survivors need to speak with their physician and receive follow-up care.
"Treating rape victims is not a 10 minute visit. The victim expresses herself at her pace. Then she is examined, especially for trauma and sexually transmitted diseases," she said.
Jackson has treated only two women who became pregnant as a result of rape, both made the decision to give their babies up for adoption. Those women had support from their families and made the decision not to destroy innocent life, she said.
Sen. Pamela P. Resor, D-Acton, a sponsor of the bill, said it is about choice. Women who are raped and want to choose the “risks” of pregnancy can, but most will not want to and should be provided with that option.
"Emergency contraception is an important method to prevent unwanted pregnancies, and about roughly half of unwanted pregnancies end in abortion, so obviously the decision there is not to carry the child."
Gertrude Murphy, a retired pediatrician and member of the board of directors for MCFL, said the risks of emergency contraceptives are the same as any contraceptive — blood clots, stroke, heart attack and liver damage. Murphy expressed concern for teenage girls who, through the bill, would be able to receive emergency contraceptives without seeing their doctor. Any sexually active person needs to see a doctor regularly and tested for STDs, especially teenagers who are more susceptible to these diseases, she said.
Marie Sturgis, executive director of MCFL, refuted the idea that emergency contraceptives are necessary.
"The only emergency in this case is the woman's fear of being pregnant," she said. "I think quite honestly women are being hormoned to death these days. No wonder we have infertility, no wonder we have breast cancer, no wonder we have cervical cancer."