Plan B - Does it work?

Ales Rarus comments on new notes at the LTI Blog citing evidence that Plan B is not very effective.
As Serge summarizes on the LTI Blog,

"As it was, the group who had to go to the pharmacy to get EC used it 197 times, while the group who had direct access used it 309 times. The result on pregnancy: absolutely nothing! The pregnancy rate for the first group was identical despite the fact that they used EC one third more often."

(Warning! Statistics Alert! The following may contain too much information for some people. You may just want to skip to my brilliant insights at the end. But, I do love my references.)

The Journal of the Americal Medical Association article that is used to show that women with advance access to Plan B don't engage in any more risky behavior than those who have to go to the pharmacy, even when the pills are free to each group (but which didn't note that they don't become any less likely, either) notes that those who have advance access and those who don't have similar pregnancy rates at 7.7%

There were no significant differences in frequency of unprotected intercourse by study group; 37.5% of study participants reported having unprotected intercourse (Table 2). Only half (46.7%) of study participants who had unprotected sex reported using EC 1 or more times over the study period; 54.9% of women who had unprotected intercourse in the advance provision group used EC. There were no significant differences in patterns of oral contraceptive use or the proportion of women switching their regular contraceptive method by study group (Table 2). Sexual risk behaviors, including frequency of intercourse or number of partners, were also the same across study groups (Table 3). While a significantly lower proportion of participants in the advance provision group (47%) reported condom use at last intercourse than in the clinic access group (54%), this difference was not significant after adjusting for race/ethnicity and clinic site (OR , 0.79; 95% CI, 0.60-1.04, P = .09). There were no differences in frequency of condom use or proportion of women who reported consistent condom use across study groups (Table 3). . . .The pregnancy rate correlated with self-reported measures of risk; the pregnancy rate increased as the reported frequency of unprotected intercourse increased.
* * *
We did not observe a difference in pregnancy rates in women with either pharmacy access or advance provision; the adjusted risk of pregnancy for both treatment groups was not significantly less than 1. Previous studies also failed to show significant differences in pregnancy or abortion rates among women with advance provisions of EC.6-7,19 It is possible that the effect of increased access on pregnancy rates is truly negligible because EC is not as effective as found in the single-use clinical trials, or because women at highest risk do not use EC frequently enough or at all. Indeed, almost half of women in the advance provision group who reported having unprotected sex did not use EC. Thus, it is not surprising that the vast majority of pregnancies (73%) occurred in the women who reported having unprotected intercourse rather than in women experiencing method failures.

Emphases are mine. The "Duh!" statements are in bold.

Could that be why none of the pro-abortion crowd is eager to spread the word that the protocol is not abortifacient?
It's not a simple matter of using the controversy to make pro-life advocates look extreme or fight among ourselves.
Its not just that conceding that the protocol does not cause the loss of embryos, making themselves look extreme because they don't care about those losses anymore than the losses due to interventional and intentional abortions.
It's not even to strengthen the new definition of pregnancy as beginning at implantation and dependent on the effects on the mother than the baby, a definition based not on what happens in nature, but on what happens in in vitro pregnancies and embryo freezing and research.

Perhaps the main reason is that they don't care how it works or how it doesn't, because they have a back up "plan C," abortion, and the political, cultural, and financial (including fund raising) benefits are more important than the efficacy of the contraceptive, itself.

Otherwise, why isn't their more acknowledgement that Plan B can only work in the narrow period of time when a woman is fertile and that the great majority of uses through the month are unnecessary and wasted?

At the very least, good medicine and public policy would require medical care for women who have unprotected intercourse when they don't want to become pregnanct. For those who use Plan B, they should have an opportunity to receive education and skills to allow them to be more aware of their cycle and the signs and symptoms of their fertile vs. non-fertile times.