Nick Cannon Condoms and Mifepristone

Coming Soon to a Pharmacy Near You

Happy New Year!  My apologies for starting this year one Wednesday late but the holidays were a blur of gift giving (and getting), elaborate home-cooked meals (not made by me, mind you—my husband is the cook, but I did a lot of dishes), houseguests, cocktails (also not made by me—the  16 year old is the bartender), and late-night movies. It was lovely but I started last week buried under a pile of laundry, wrapping paper, and ornaments still wondering what day of the week it was.

Today is definitely Wednesday, and we’re kicking off the year with a couple pieces of good news out of the FDA.

First, though, we have to redo the math on our Nick Cannon word problem because the singer/host/most fertile celebrity announced the birth of his 12th child right before the new year. Halo Marie Cannon was born in December, a month after her sister Beautiful Zeppelin, a few months after brothers Rice Messiah and Onyx Ice Cole (who are not twins), and six months after brother Legendary Love. For those keeping a tally, Cannon had five children with five women (Alyssa Scott, Brittany Bell, Abby De La Rosa, Brie Tiese, and LaNisha Cole) in 2022 alone.

This adds to an already large family that includes twins Monroe and Morrocan (11) with Mariah Carey; Golden Sagon (5) and Powerful Queen (2) with Bell; twins Zion and Zillion Heir (18 months) with De La Rosa; and a son named Zen with Scott who sadly died in 2021 at just five months old.

At this point, I have few doubts that Nick will have more children. The 13th may very well be in the works. I do have questions that range from basic (do you really remember all of their names? on the first try?) to the logistical (how much time have you spent with each infant?) to the psychological (is this drive to breed a long-term publicity stunt, a fetish, a symptom of deep-seated narcissism, or just an overwhelming love of children?). 

After his ninth child was born in July, I chastised Nick for an interview in which he suggested he didn’t need protection against STDs and kept having babies because he only had sex with women with whom he had a deep spiritual connection. Nope, not how it f**king works—emotional attachment does not prevent chlamydia any more than it improves sperm motility.

This time, however, I have to give Nick a few style points. He recently released a condom commercial that shows he’s a little bit in on all of our jokes about his super sperm. The New Year’s themed spot for French brand LeCondom features Nick being generally uncomfortable around condoms—he can’t open the package, ends up with one in his mouth, and flicks another one off his hands after realizing it’s sticky with lube. Sounds about right for someone who clearly never uses one.

Well played, Nick, and I hope you were paid well because by my potty-training calculations you’ve got eight butts to diaper right now.

FDA Changes Rules Around Medication Abortion

The Food and Drug Administration started this year by announcing new rules that will allow brick and mortar pharmacies to dispense mifepristone, the first of two drugs needed for a medication abortion. In response, pharmacy giants Walgreens and CVS have announced intentions to sell it. Like everything abortion, however, challenges and obstacles remain.

When we think of an abortion, many of us still default to the surgical procedure that takes place in a doctor’s office, clinic, or hospital and involves dilating the cervix and physically removing the contents of the uterus. Today, however, roughly half of abortion in this country are done with medication instead.

The standard medication abortion protocol in the U.S. starts with mifepristone which stops an established pregnancy from progressing by blocking the hormone progesterone. That is followed up 24–48 hours later with misoprostol which causes uterine contractions, cramping, and bleeding like what would happen in a miscarriage. Though only approved through 10 weeks of pregnancy here, the combination has been proven to be safe and effective up to 12 weeks (and the World Health Organization has authorized its use up to that point).

Research shows that medication abortion successfully terminates pregnancy 99.6% of the time, and carries very little risk of major complications (less than .5%). The mortality rate associated with medication abortion is .64 per 100,000 uses. This makes it far safer than pregnancy/birth which has a mortality rate of 18 deaths per 100,000 live births and is even higher for Black women at 40 deaths per 100,000 live births. It’s also safer than many medications on the market including penicillin (2 deaths per 100,000 users), Viagra and its generics (4 deaths per 100,000 users) and Tylenol/acetaminophen which accounts for over 600 deaths each year. 

Yet, mifepristone—which we used to call RU486—has always been significantly restricted. When it was approved in 2000, the FDA only allowed it to be dispensed directly from the medical provider who wrote the prescription. In many cases this meant it was only available at abortion clinics. (Misoprostol is used for other conditions such as Lupus and as such has always been available in pharmacies.)  

This restriction stayed in place until the pandemic made in-person medical appointments of any kind complicated. Emergency rules implemented by the Biden Administration allowed certain mail order clinics to send the medication to patients which paved the way for telehealth abortion appointments (though some states went out of their way to prevent these). While those rules became permanent in 2021, the even newer rules expand access to your corner pharmacy—depending, of course on where that corner is located. 

The hope is that this will make access to medication abortions easier and faster which is important given that they’re time sensitive. (Remember many people don’t know they’re pregnant until the somewhere around week five or six and the regimen is only approved up to 10 weeks.)

Some experts say the FDA rule change didn’t go far enough since it left in place the requirement that health care providers and pharmacies be specially certified to dispense mifepristone, a regulation that advocates say is about politics and not medicine given how safe the drug is (no pharmacist needs special certification to give out Viagra). Despite these barriers, Walgreens and CVS—which blanket the country—have said they will seek certification and comply with other rules including some designed to keep the names of prescribing physicians as private as possible.

While Walgreens boasts that 78% of the population lives within five miles of one of its stores and CVS brags that 85% of the country lives within ten miles of one of its stores, mifepristone will only be available in states where abortion remains legal. For those of us in states with abortion rights (between the two chains, I can count at least nine stores that sit firmly in my blue bubble), this rule should indeed make medication abortion easier and faster to access. Unfortunately, since the Supreme Court ruling last summer, about half of the states have banned abortion and this rule is unlikely to help with that no matter how close the nearest chain pharmacy is.

Not surprisingly, mifepristone is also facing a legal challenge from a far-right group. Alliance Defending Freedom filed a lawsuit in November to overturn the FDA’s approval of the drug altogether (20+ years after the fact). The group’s claim that the drug is not safe seems bogus given the stats above, but the challenge will initially be heard by Judge Matthew Kacsmaryk, a Trump appointee in Texas who is famously anti-abortion, anti-birth control, and anti-sex.

Another FDA Change Could Clear Up Confusion Around Emergency Contraception  

In another important move, the FDA changed the label on emergency contraceptive pills (ECPs) to clear up confusion around how they work. Back in the late 90s/early 2000s when neither had been FDA approved there was a lot of confusion around the difference between “the abortion pill” (then RU-486 now mifepristone) and “the morning after pill” (then and now emergency contraception). Much of that confusion has cleared up as the two options were approved and became more widely available, but some people still don’t understand the difference and abortion foes like to blur the lines between the two.

We’ve been over this many times before because ECPs are responsible for some important that’s not how it f**king works moments (like when a Missouri hospital system stopped providing them this summer because of the state’s new abortion law). Even though they are taken after unprotected sex, ECPs work like birth control pills—they prevent ovulation.

Emergency contraception is really a timing game—you need to make sure sperm and egg are not in or near the fallopian tubes at the same time. Some people who take it may have ovulated earlier in the cycle and weren’t at risk of pregnancy anyhow (but better safe than sorry for sure). Some may unknowingly take it after they’ve already become pregnant—meaning the sperm and egg met in the fallopian tube and the fertilized egg implanted in the uterus—in which case nothing will happen because ECPs cannot interrupt an established pregnancy. The people who benefit most from ECPs are those who had unprotected sex around the time they would ovulate. Sperm can only live in the reproductive tract for between three and five days, so making sure no egg appears during that time will prevent pregnancy.   

The FDA was always clear on all of this, but the labeling suggested another possibility that was confusing, highly unlikely, and never proven by research—the idea that someone could take ECPs after ovulation/fertilization but before implantation and that the drug could prevent the fertilized egg from implanting. To hardliners this was enough to argue that ECPs qualified as an abortifacient. Abortion opponents often used the labeling itself to bolster that argument.

The new label removes this ambiguity. It says simply: “Plan B One-Step works before release of an egg from the ovary. As a result, Plan B One-Step usually stops or delays the release of an egg from the ovary. Plan B One-Step is one tablet that contains a higher dose of levonorgestrel than birth control pills and works in a similar way to prevent pregnancy.”

The FDA also updated its website’s Q&A page to make what EC does and doesn’t do even more clear:

Q. Is Plan B One-Step an abortifacient (causing abortion)?

A. No. Plan B One-Step will not work if a person is already pregnant, meaning it will not affect an existing pregnancy. Plan B One-Step prevents pregnancy by acting on ovulation, which occurs well before implantation. Evidence does not support that the drug affects implantation or maintenance of a pregnancy after implantation, therefore it does not terminate a pregnancy.  

Abortion foes are not known for relying on facts, so this probably won’t stop them from manipulating science and laws to try to prevent the distribution and use of ECPs especially in places where abortion is now illegal. Hopefully this clarification will help fight those attempts. More importantly though, it can help people who may need the drugs understand the difference between ECPs and medication abortions and find the services they need.