Selectivity from the Family Research Council

Some might wonder why I include some right-wing “family” organizations on the list of denialists. It’s simple. In their efforts to oppose all forms of contraception, they routinely lie about the science behind the efficacy of condoms for STD-prevention (just like HIV/AIDS denialists), the efficacy of contraception, as well as social effects of contraception like the falsehood that contraceptive availability leads to promiscuity and higher STD transmission.

Take for instance, the Family Research Council on emergency contraception.

(republished from – this was too good an example to pass up)
*Update* Calladus has a good overview of their “research” into the efficacy of abstinence education. What kind of family value is lying anyway?

According to a new study, emergency contraception is delivering. But unfortunately, that’s the problem. The study, by Cochrane Collaboration, found that instead of reducing pregnancies, women who received the so-called “morning-after pills” pills were just as likely to conceive. The research combines eight studies of over 6,000 women in the U.S., India, and China, where the results were all the same. It turns out that the morning-after pill is no cure for morning sickness. That’s hardly good news for the 21 states basing legislation on it. “We expected that easier access to contraception could help women use the pills more quickly when they needed them,” said Chelsea Polis, the lead researcher. But increasing its availability didn’t increase its effectiveness. Instead, the women who had Plan B didn’t use it—and if they did, they took it too late for the pills to work. We can add this to the long list of reasons why the FDA should not have approved the pills in the first place. Instead of fast-tracking the bills on Plan B, state leaders would be wise to take a long pregnant pause to consider all the facts.

The link in the post takes you to a lay article on the study which is actually a lot more informative than I expected, and just from reading the info in the link you see the selective message that the FRC denialists have adopted. I’m afraid the real article from Cochran is subscription only, so not everyone can actually read it, but I’ll give you some info from the front-matter.

For one, this is what is called a “systematic review”. It’s funny that today I was in a class for med students describing how great systematic reviews are and how they should use these whenever possible. They really are an excellent resource, and the Cochran collaboration exists to determine the consensus of health care science’s findings on various issues of clinical relevance help doctors make informed decisions about the the current state of knowledge on a clinical topic (I told you consensus science was valuable).

Let me first describe some terms. An ordinary review paper usually has one or more authors, usually a student or fellow working for an expert in a field writes them, and they represent that expert’s analysis of the state of a field. It is essentially their argued opinion of what the consensus is on a given field of scientific inquiry.

A systematic review, as opposed to an ordinary review, has well-defined inclusion and exclusion criteria for the science that they evaluate to determine what the field’s consensus is. In other words, it isn’t just what one expert thinks of the field, as they almost always have some bias or another, and may exclude papers or hypotheses that piss them off or conflicts with their line of study. That’s not to say all reviews are like this, but clinicians simply don’t have the time to parse every damn paper in a field when they’re trying to answer a specific question to make sure. So a systematic review, by using pre-defined inclusion criteria evaluates the best science in a reproducible and unbiased way to determine the current scientific consensus. As such they are quite valuable. The downside, of course, is that sometimes the experts have good reasons for their biases and don’t include crummy research in their reviews. Ideally a systematic review’s criteria will accomplish this, but probably not always.

So this systematic review sought to evaluate all the data on efficacy of emergency contraception – plan B – and determine what effects giving women ready access to the pills had on birth rates. Here’s the plain language summary:

Easier access to emergency contraception to help women prevent unwanted pregnancy

Emergency contraception is an increased dose of the hormones found in ordinary birth control pills. This medication can prevent unwanted pregnancy if taken soon after unprotected sex. Getting a prescription for emergency contraception can be difficult and time-consuming. Giving emergency contraception to women in advance could ensure that women have it on hand in case they need it. We searched for studies comparing women who got emergency contraception in advance to women who got emergency contraception in standard ways. We examined whether these groups had different rates of pregnancy or sexually transmitted infections. We also studied how often and how quickly both groups used emergency contraception. Finally, we looked at whether advance provision of emergency contraception changed sexual behavior. Studies showed that the chance of pregnancy was similar regardless of whether or not women have emergency contraception on hand before unprotected sex. Women who had emergency contraception in advance were more likely to use the medication, and to use it sooner after sex. Having emergency contraception on hand did not change use of other kinds of contraception or change sexual behavior.

(emphasis mine)

First of all notice that FRC doesn’t mention anything about how emergency contraception doesn’t increase risky sexual behavior, STD transmission or change people’s sexual practices, which are their standard arguments for why plan B shouldn’t be legalized. Now the way FRC presented this they made it sound like plan B just doesn’t work, but actually it works quite well to prevent conception.

Let me quote the relevant passage from the abstract, “Advance provision of emergency contraception did not reduce pregnancy rates when compared to conventional provision.” (Emphasis mine).

Plan B works! The control group is conventional provision, not people who have unprotected sex and do nothing! Nothing in this article challenges the well-established fact that Plan B can prevent an unwanted pregnancy. Here’s the results and conclusions of the linked Cochran review that refutes the FRC’s lie.

Main results
Forty-eight trials with 33110 women were included. Most trials were conducted in China (37/48). Levonorgestrel is more effective than the Yuzpe regimen in preventing pregnancy (2 trials, RR: 0.51; 95% CI: 0.31 to 0.83). Single dose (1.5 mg) administration seems to have similar effectiveness as the standard 12 hours apart split-dose (0.75 mg twice) of levonorgestrel (2 trials, RR: 0.77, 95% CI: 0.45 to 1.30). Levonorgestrel has similar effectiveness to mid-dose (8 trials, RR: 1.64; 95% CI: 0.82 to 3.25) or low-dose (7 trials, RR: 1.38; 95% CI: 0.93 to 2.05) mifepristone.


Authors’ conclusions
Levonorgestrel 1.5 mg (two split doses or a single dose) and low and mid-doses (25-50 mg) of mifepristone offer high efficacy with an acceptable side-effect profile.

It’s certainly not the best form of contraception, hell, its name is “plan B”, but it does work. It also should be easily accessible without a prescription, not just because women deserve reproductive choice, but because of all the obvious problems obtaining this drug in situations like rape and incest. It hasn’t been shown that easier access will decrease pregnancy rates, fine, so what? Why make it more difficult for women to get contraception that’s been proven safe and effective? Oh yeah, I forgot, if women get the idea they control their own uterus it will bring down Western civilization.

FRC is using denialist tactics, plain and simple. This is classic selectivity.