Because most philosophies that frown on reproduction don't survive.

Tuesday, January 06, 2009

Contraceptive or Abortive?

Clearly as Catholics, we're not supposed to be doing either one, nor do I have any desire to, but in regards to questions of conscience and regulation the facts of the matter are clearly important. It's been discussed often in pro-life circles over the years that oral contraception is designed such that it sometimes allows fertilization but prevents implanation -- thus in effect causing a spontaneous abortion several hours after conception. This is generally applied even more so to "morning after" pills, which is a reason why some pharmicists have conscience objections to dispensing such medications. Given that that Protestant half of the pro-life movement is often fairly comfortable with birth control in concept, this "the pill causes abortion a certain percentage of the time" argument has often been used to help unify the pro-life movement against birth control.

Regardless of whether it's true, I think that clearly the contraceptive mentality and the approach to sex it entails is certainly a major cause of support for abortion.

All that said, I'd very curious as to the reaction of Catholics more educated in the precise medical details of human reproduction than I am to this Slate post, which argues that the evidence for abortificant properties to The Pill and Plan B is slim to none.

I've no particular interest in endorsing Saletan's opinions generally, he's the one who made the to my mind rather nutty argument a while back that Planned Parenthood was overall an anti-abortion organization because contraception prevents unwanted pregnancies. But if it's correct as a matter of medical science that it's very, very rare for oral contraceptive and even "morning after" pills to cause spontaneous abortions, we'll do nothing but make ourselves look unconcerned with the truth (and the scientific truth of embryology is very much on our side when it comes to what the pro-life movement says about abortion as opposed to what the "just a clump of cells" people say) if we keep pushing it.

Feedback from those with medical or scientific knowledge of the issue would be appreciated.


Love2Learn Mom said...

Thanks for posting this. I've recently had some discussions with relatives that brought up this data, and I'd be really interested in hearing more info. My initial thought is that whether or not it's abortifacient isn't our (as Catholics) primary objection to contraceptives. Nevertheless, the question is certainly relevant.

Anonymous said...

I'm a biologist, but this is not my particular field. I did look into the issue a while back, however, after having an emotional conversation about the issue with an important person in my life.

It is incredibly difficult (and unethical, in my opinion) to ever do the experiments that could "prove" that the pill can decrease the chance of implantation. Even if it were possible to observe a chance "breakthrough ovulation" in a woman on the pill, there's now way I know of to prove the existence of an unimplanted embryo. (And to allow the event in order to prove the point would be to allow an abortion.) The study would have to be done statistically (meaning allowing a lot more abortions).

However, I've read some literature that has demonstrated that the pill does reduce the thickness of the endometrium, which can decrease the success of implantation. And "breakthrough ovulation" does seem to occur. In fact, according to what I've read, this has become more common over time, as estrogen doses have dropped over time to counteract the negative effects of high doses.

The fact that it's possible is good enough for me to consider the pill to be abortive.

However, I'd love to hear a more definitive take from someone in the know.

Anonymous said...

The piece is likely a response to the Bush administration's try last summer to define abortion as "any of the various procedures -- including the prescription and administration of any drug or the performance of any procedure or any other action -- that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation."

Nonetheless, early birth control pills, formulated simply to regulate ovulation, casued blood clots and strokes. Pfizer and Merck both admit that modern birth control pills modified the formula to do three things 1) to reduce the strength of the hormones which regulated ovulation, thus reducing clots and strokes, but allowing occasional "breakthrough ovulations" 2)to reduce the production of cervical mucus, thus inhibiting the ability of the sperm to get to the ovum, and 3) to reduce the endometrium which lines the the uterus and normally thickens upon fertilization and upon which the conceptus attaches some 3-4 days after conception.

It is hard to argue they did all these things and yet the Pill does not chemically abort a human being after conception.

Even the advocates for Plan B argued that a woman could do the same thing by taking a double or triple dose of the Pill after an "unsafe" intercourse.

CMinor said...

It took me a bit of hunting, as the commercial drug info sites all seem determined to skirt the issue, but I found the following here

Mechanism of Action
Pregnancy may be prevented through several mechanisms: Thickening of cervical mucus, which inhibits sperm passage through the uterus and sperm survival; inhibition of ovulation, from a negative feedback mechanism on the hypothalamus, leading to reduced secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH); inhibition of implantation. Levonorgestrel is not effective once the implantation process has begun.

"Inhibition of implantation" sounds like an abortion, if micro, to me.

Did you query Mary Meets Dolly at her site? She's been posting a bit infrequently lately, and may not notice right off that you linked to her.

CMinor said...

I have heard Anon's assessment of the difference between the old and new bc pill formulations from a doc with a background in reproductive med as well, btw.

Ginkgo100 said...

It is likely, but unproven, that hormonal contraceptives occasionally allow fertilization and subsequently prevent implantation by altering the endometrium. In my opinion, the Slate author is being disingenuous by suggesting that just because it is very difficult if not impossible to prove that this occurs, there is no reason to believe that it does occur. Because it cannot (presently) be observed, it is impossible to quantify how often it happens. More information from a peer reviewed journal here:

The Opinionated Homeschooler said...

Where this matters is in the case of rape victims. Catholic teaching permits post-rape contraceptive action. It doesn't seem enough in the case of rape to say that it *might* have an abortifacient effect; if post-rape contraception is morally licit, then it joins the ranks of other morally licit actions that *might* cause fetal death. There are many drugs that can put a pregnancy at risk, but if that isn't their intended effect, they may be taken.

Anonymous said...

The slate article raises a very good question that I have not seen answered: How does breast feeding prevent pregnancy? Is fertilization inhibited, or is implantation inhibited?


Darwin said...

I have the feeling you're joking, but...

Breastfeeding often (varies greatly from one woman to another) results in an extended period during which the woman does not ovulate at all. Since there's no egg available, there's nothing to fertilize and nothing to implant.

The biological reason such a characteristic would be selected for (and most mammals have it to one extent or another) is pretty obvious: If the female has children too close together her ability to care for herself and them is reduced thus increasing the likelihood that she and/or they will not survive.

CMinor said...

I believe there are cases in which a fertile nursing mother may experience a failed implantation due to a short luteal phase. The woman versed in NFP can recognize that her cycles have not normalized enough for a pregnancy to take and wait for her luteal phases to return to normal.

It is correct that women who breastfeed ecologically (on demand with no supplements or pacifiers) will usually not ovulate or have menses before the baby begins to eat other foods. For some women this period may last for months later, even until the child has completely weaned. Nursing mothers who have not experienced menses are generally assumed not to be ovulating although after six months (or when solids are introduced) it is considered a possibility even before menses have returned.

Based on anecdotal accounts from friends, though, I think ovulation before returning to menses is infrequent; moreover,it's not unusual for nursing mothers to be prone to anovular cycles during the first few menstrual periods.

Literacy-chic said...

I believe there are cases in which a fertile nursing mother may experience a failed implantation due to a short luteal phase.

This is absolutely true--it's even in the Art of Natural Family Planning and was featured as a good aspect of breastfeeding-child-spacing by the couple who did the class. I found it a bit problematic that this should be mentioned as one of the (good) ways that breastfeeding spaces children, but of course the theological answer would be that this is a natural process, and that if the fertilized egg were meant to implant, then by the will of God, it certainly would!

I have monitored a return to fertility during breastfeeding twice, and I can tell you that I certainly had cycles in which I did ovulate but had a luteal period of fewer than 12 days. The chances of fertilization occurring are always subject to numerous factors, so it is not likely, but it is possible that the hormone-level (is it the progesterone spike?--I forget) was not sustained long enough to allow the pregnancy to progress.

Of all the things you can anticipate or predict with NFP, I am at a loss to see how this could be one.

The distinction, as I see it, is that it is working with God and with the body to allow the possibility of fertilization at a time when the body can not biologically sustain a pregnancy.

Mark Adams said...

The Opinionated Homeschooler,

Very well said. Thanks.

Rebecca Taylor said...

Thanks for the link. Thank-you also for the confidence in my knowledge on this subject, which unfortunately is no better than yours.

I believe it is true that the pill and Plan B prevent ovulation more often than they prevent implantation. But the point here is that how could we possible know for sure.

Society now errs on the side of death instead of life. It used to be that if we didn't know, we erred on the side of life. Now it seems that whenever there is a disagreement, the pro-death side looks to the pro-life side and says, "prove it."

That is so backward. I always think it is the pro-pill/plan B crowd's job to prove to me that it only prevents ovulation and not implantation. Until that can be done definitively and the Catholic Medical Association is satisfied enough to make a statement, I have to remain opposed to possible abortifacents like the pill and plan B

Anonymous said...

I've NEVER EVER have heard of the Church allowing post rape contraception!!!!!! Please quote source. I am wrong I humbly will admit it. Please show me Vatican document supporting this barbarity!

cuz I can? said...

"Church allowing post rape contraception"

Is does not for much the same logical construction as: God can do all things *possible*

Post rape contraception is not possible by definition.


Refer to either the Physicians Desk Refernce or Medline

ALL current chemical female "birth" control relies on the 'tertiary' abortifacient POTENTIAL.

See also "Why use contraception?"