Part II: Contraceptives

This post is the second of a series of three posts I'm writing about sex in marriage. If you haven't read the first post, Part I: NFP event at UNC and The Church's Teaching on Sex in Marriage, I would encourage you to do so before reading today's post. In Part I I stated that this post would be about contraceptives and Natural Family Planning, but I've decide to focus it just on contraceptive methods, how they work, and the bioethical concerns surrounding some.

Contraceptives

In addition to the Church's theological reasons for not practicing contraception in marriage there are also some other ethical concerns with many forms of contraception that, sadly, through no fault of their own, many people are not aware of.

Here is a list of birth control methods, all of which the Church considers immoral (this is not intended to be an exhaustive list, I may have forgotten some methods) and how they function :

• spermicides--contraceptive


• male condom--contraceptive


• female condom--contraceptive


• diaphragm--contraceptive


• cervical cap--contraceptive


• Various hormonal contraceptive methods including: the pill, the shot, the patch, the vaginal ring, etc.--contraceptive and an abortifacient


• the Intrauterine Device (IUD) (hormonal and non-hormonal)--mainly an abortifacient


• withdrawal--contraceptive


• direct sterilization (meaning not a side effect of another surgery or a therapeutic necessity)--contraceptive

Hormonal Contraceptives And Bioethical Concerns

Hormonal birth Control (HBC) works in three ways:

1. It prevents ovulation by suppressing the part of the brain that signals ovulation to begin


2. It changes cervical mucus to make it more difficult for sperm to pass through and fertilize an egg


3. It thins the lining of the uterus so that if breakthrough ovulation occurs and an egg is fertilized, that embryo (new life) can't implant itself in the uterus

The first two methods are contraceptive in nature. The third method is an abortifacient. This means the third method causes an early abortion to the small embryo. This is a serious ethical concern for anyone taking or considering taking HBC.

It is very important to note that, unfortunately, the working definition of pregnancy has changed over the years from "beginning at fertilization a.k.a. conception - when the sperm meets the egg" to "beginning at implantation." Remember, implantation of the embryo (fertilized egg) in the womb occurs 6-10 days after conception. When the sperm and the egg meet at conception a new, genetically unique human life is created. It is not a tadpole or some weird primordial being. From the moment of conception YOU were YOU. The only thing that has changed in you since then is your particular stage of development. They are all just labels: fertilized egg, embryo, fetus, infant, child, teenager, adult, etc. So, even during this pre-implantation stage, this fertilized egg is a new human life that deserves protection. This abortifacient aspect of HBC is not protecting human life at its earliest stages of development --it's attacking it.

I have talked with my doctor about the ethical concerns of all of this and I know that he, unfortunately, uses this "new" definition of pregnancy. It's sad that we can't even get accurate, truthful information from many doctors anymore. Everything seems to be meant to mislead us.


A Plethora Of False Information

There is so much information on this subject that is flat out false or misleading. During my last doctors appointment, I began looking at his brochures about contraception in the exam room while waiting for him to see me. The first brochure I looked at was put out by Ortho-McNeil-Janssen Pharmaceuticals. The brochure discusses all of the different methods of female birth control and how they work. In this brochure the IUD is listed as working by: "...providing a barrier against sperm by interfering with sperm movement, or by creating an 'unfriendly' environment for sperm..." This is not how an IUD works most of the time. The IUD does little to nothing to prevent the sperm from fertilizing the egg. It works primarily by preventing a fertilized egg from attaching in the uterus, making it an abortifacient. Read more about IUDs here. I pointed this error out to my doctor and told him that I think women should be given the truth about how it works. He then stared at the floor in silence for about 30 seconds, looked at me and replied, "Well, if I was going to implant an IUD in someone I would make sure she had accurate information--not just what's on that brochure." I replied, "So it's acceptable to you that you have a brochure in your office, published by a major drug company, that has false information on it?" He never responded back to this question.

Another brochure I brought to my doctors attention was written by The American College of Obstetricians and Gynecologists. It is entitled, "Birth Control". It contained misleading, vague information on the abortifacient aspect of HBC. It states,

"Birth control methods work in a number of ways. They may:

• Block the sperm from reaching the egg
• Kill sperm
• Keep eggs from being released each month
• Change the endometrium (lining of the uterus)
• Thicken the mucus in the cervix so sperm can not easily pass through
  it."

Notice that every bullet plainly states what birth control does to prevent a new life from being created except for bullet number four! You would have to ask yourself, "Well, what does changing the lining of the uterus have to do with preventing the sperm from meeting the egg?" The answer to that is nothing. These are doctors writing this brochure and they know very well that the result of the uterine lining being changed is that a fertilized egg will have a more difficult time implanting itself in the uterus and is aborted as a result. They conveniently omit this part of the equation. The brochure explains again while specifically referring to HBC that:

"The hormones also cause changes in the cervical mucus and uterus that help prevent pregnancy." (emphasis added)

But, remember, this new definition of pregnancy considers the beginning to be at implantation not fertilization.

When I pointed all of this out to my doctor he excused it by stating, "What you really need to understand is that this is not how hormonal contraception is intended to function. There is only a small percentage of the time were this back-up method may be needed."

I found another example of completely false information about a year ago at kidshealth.org. In their explanation to "kids" on how hormonal contraception works they state, "The hormones in the Pill can also sometimes affect the lining of the uterus, making it difficult for an egg to attach to the wall of the uterus." Ummmhhh, an egg? Don't you mean a fertilized egg, kidshealth.org? I'm no scientist but I do remember from my biology classes that an egg and a fertilized egg are not the same thing! As taken from their site, this article was apparently reviewed and given a pass by THREE doctors:

Reviewed by: Larissa Hirsch, MD; Date reviewed: February 2007; Originally reviewed by: Neil Izenberg, MD, and George A. Macones, MD

I wrote kidshealth.org a letter last year pointing out this error and requesting it be changed but the information is still the same. Unfortunately they see no need to give readers this truthful information.

Further Reading And Resources

This is just the tip of the iceberg in terms of the false and misleading information that is out there. And, please, don't just take my word for it. If you don't believe me or think I have my facts wrong, do the research yourself. Here are some places to get you started:

• Birth Control Pill: Abortifacient and Contraceptive--This is a paper, carefully researched and compiled by several members of the American Association of Pro-Life Obstetricians & Gynecologists (AAPLOG). All members of AAPLOG that support this position have also signed the paper.

• To be fair, there is some controversy within AAPLOG as to whether or not hormonal contraceptives can act as abortifacients. Hormone Contraceptives Controversies and Clarifications is a paper written by four members of AAPLOG. Interestingly, though, they come to the conclusion that the only ethical hormonal contraceptives available are Combined Oral Contraceptives (COCs). The only reason they came to this conclusion is that there is no way to do a study to concretely prove or disprove the theory of the abortifacient mechanism. They warn against using progestin only pills (POPs), Depoprovera, and Norplant because of the increased risk of ectopic pregnancy and other health risks.

• Another very good paper, How The Pill And Other Contraceptives Work written by Chris Kahlenborn, MD

• Even Dr. James Dobson, an evangelical pastor and founder of Focus On The Family had a position statement on his website that POPs have an abortifacient aspect to them. He said there is not substantial evidence to say one way or the other for COCs though. I emphasize had because as of last year I was able to find his statement. This statement is no longer on his website. The only thing I was able to find was a list of resources about the controversy and I had to type in "birth control abortifacient" in his search bar to find that. He doesn't have it available in his "sanctity of life" or "marriage" section at all. This leads me to believe, unfortunately, he has compromised himself quite a bit to be in line with the popular protestant theological and philosophical belief that there is nothing wrong with contraception.

• Another great resource for information on contraceptives is the organization One More Soul. Their website has a lot of information including a list of doctors that promote NFP only and don't prescribe contraceptives.

• For information on sterilization reversals and testimonies of men and women that have had conversions of heart on this issue and had reversal surgeries, go here.
  
  

Health Risks Of Hormonal Contraceptives

There are also many health risks associated with hormonal contraceptives that are often downplayed by the mainstream media and many medical groups. Here is a link to the risks.

Good News!

The good news is that God does not look down on us being involved in our family planning. He has made us women able to know and track our own fertility through what is known as Natural Family Planning. The Catholic Church encourages the use of this method for couples that, for just reasons, wish to avoid conception (Again, please refer to Part I of this series). It can also be used to achieve pregnancy. You can read more about the methods of Natural Family Planning here, or you can wait until Part III where I will explain the details of the method and my experiences with it. I will be working on that post over the next week.