Good Intentions

Recently, I was involved in a discussion about whether birth control pills cause abortion.

pill

I am NOT a fan of birth control pills and other hormonal contraception, and it’s not just because the Pope says that “the Pill is a no-no”. K used to take them and they made her weepy and tanked her libido, which was no fun for either of us.  I understand that some women do need them as medicine, however, normal fertility is not a disease. Treating it as one causes all sorts of physical, psychological, relational, and social problems.

Now, the “technical answer” about whether birth control pills act after conception is that it is theoretically possible, but unlikely and unproven. Combined Oral Contraceptive Pills work in four ways:

  1. Stop ovulation by suppressing ovarian activity.
  2. Stop fertilization by thickening cervical mucus.
  3. Reduce the likelihood of implantation by making the uterine lining inhospitible to the embryo.
  4. Making women depressed while reducing their libido and sexual responsiveness, leaving fewer opportunities for conception. (But for some reason the pharmaceutical companies don’t advertise this one.)

Standing alone, mechanism #3 would be abortifacient, however, there is some question about whether this is ever an issue. Specifically, if #1 and #2 (and #4) fail, will #3 fail with them? Even if the endometrium is impacted, there are other things that could possibly go wrong and prevent fertilization when a woman is taking a dose of artificial hormones that isn’t quite high enough to work as intended.

Whatever exactly happens when the Pill doesn’t quite work, studies show that combined oral contraceptive pills are very effective at stopping ovulation and preventing sperm from entering the uterus so that any other mechanism of action rarely, if ever, comes into play. If these two mechanisms fail, the studies show that there is a significant chance that pregnancy will result.

Language Matters

But there is a possibility that the Pill has an effect on early pregnancy, even though it appears to be a small one. There are two different ways to describe this possibility:

  1. Birth control pills may increase the risk of early miscarriage.
  2. Birth control pills can cause an early abortion.

Blogger Rae Jericho at No Wealth But Life points out that for any other medication, the first description would be used and that use of the second description is “grossly inappropriate” to describe what is happening. It is especially inappropriate to use the second description when birth control pills are used to treat medical conditions. Even the Pope is OK with that. (En Español)

So why do people opposed birth control pills insist that they cause abortions? Why choose the second possibility?

First, I think that many people aren’t completely aware of exactly how the pill works. They may read the package insert, see the third mechanism, assume that all three mechanisms are equal, and don’t bother to look any further. Any medication taken with the purpose of avoiding pregnancy that ends a pregnancy after conception is, by definition, an abortifacient. Pretty simple, right?

Simple, yes, but overly so. To not understand how a drug works is scientific sloppiness. While most people don’t even read the package insert, much less the detailed studies, those who are promoting an unconventional and counter-cultural method of family planning with a (largely undeserved) bad reputation cannot afford to be sloppy about the science.

But I see something a bit more troubling. The second wording, linking birth control pills to abortion is more emotionally charged than simply linking them to early miscarriage.

According to a recent Gallup poll, a majority of Americans consider abortion to be morally wrong, while the overwhelming majority of Americans, including 82% of self-identified Catholics, have no problem with contraception. The moral case against abortion is bumper-sticker simple: Thou Shalt Not Kill. The moral case against contraception and sterilization is a bit more complex, harder to understand, and easier to disagree with.

So instead of taking on the difficult case of explaining the problems of birth control pills to a largely unreceptive audience, (especially when there is so much marketing behind promoting the Pill as a solution to all woman’s problems) some people think it’s OK to take a short-cut by putting an undue emphasis on possible post-conception effects.

I understand that these people mean well. They want to spare couples the negative consequences of hormonal contraception and show them a better way.

But is this not the very “ends justify the means”, manipulative, and dishonest behavior that is contrary to basic Christian morality?

Moral failings have consequences, no matter the good intent. And the consequences for sloppiness, dishonesty, and manipulation is that these erode trust.

Sexuality and family planning are extremely sensitive subjects. Especially family planning methods based on self-knowledge and self-control. When people struggle in these area, they must be able to trust those who are there to help them. If trust has been eroded by dishonesty, they will feel betrayed. And VERY angry.

We’ve been there and we know that feeling.

Furthermore, such emotionally charged language polarizes the discussion. It makes others closed to your ideas, even when beneficial to them and presented by others.

But another consequence of dishonesty is how it impacts the person who engages in the dishonesty. Sin not only harms others, it degrades ourselves. Or as Rae writes:

This abuse of language is dishonest, and it hurts not only those with whom we seek to communicate, but our very selves. When we misuse language and select terms based on what we wish to prove rather than appropriateness for describing a particular situation, we end up shaping our own thinking. Eventually we lose the ability to logically consider facts because we have skewed our minds with twisted words.

Dishonesty erodes our ability to think and our ability to love. Without our minds and our hearts, we lose others . . . and ourselves.

9 thoughts on “Good Intentions

  1. Hi, An interesting piece but I have to say I’m confused about your links to two of my posts at re: Cycling, the blog of the Society for Menstrual Cycle Research. Do you think I’m polarizing the discussion? If so, I’d be interested to hear your thoughts on this. I ask because, above all, I’m trying to depolarize the discussion about contraception within the pro-choice community, to achieve some kind of agreement on the dichotomy we must acknowledge: that some women do not want to use drug- and devised-based birth control, not primarily for religious reasons but for health reasons, and that as a community we need to support and serve these women. This is currently not happening effectively or comprehensively.

    I especially appreciated the link to the story about the woman who struggled with NFP. Her story is illuminating both from personal and sociological perspectives. It speaks to the differences between choosing to use secular FAM with the option of using barriers during the fertile period, or ditching it for other methods, and being an observant Catholic who feels compelled to follow the strictures of usage for religiously-contextualized NFP. All choices are relative, it seems.

    • I absolutely do not think that you are polarizing the discussion at all. I very much support what you are doing.

      The links to your posts are to show how this discussion has been polarized in the pro-choice community. Not you, but in some of the responses to your efforts and in responses to pro-choice women who are interested in FAM. I have edited the post to clarify. NFP/FAM has an unfair reputation of being “Vatican Roulette” with the “Vatican” part being as detrimental, if not more, than the “Roulette”. People see it as a “Catholic thing” and reject it out of prejudice.

      That being said, I also think people who could benefit from FAM for health reasons get turned off by some of the Catholic NFP promotion, which has a reputation of being preachy and judgmental. Furthermore, because most Catholics did not agree with the Church on contraception, NFP came to be associated with the most conservative Catholics, who also had very conservative views on other theological and social issues–sometimes becoming “more Catholic than the Pope.”

      I also think many Catholic women specifically could benefit from FAM. Contrary to the “culture war” narrative that dominates the U.S. media, a large number of Catholic women are ambivalent toward contraception. Approaching the issue from a non-judgmental women’s health perspective would probably be appreciated.

      I’ve also seen Catholic NFP promotion be overly optimistic and fast-and-loose with the facts. For some women, fertility charting can be difficult. It takes time and effort to work this out. If you are not prepared for this, it can come as quite a shock. Furthermore, even couples committed to using NFP for religious reasons have to have a great deal of relational and spiritual maturity to be able to handle extended abstinence, should it be necessary. Most couples do not have this and they end up harming their marriage when they try to do something that they are not able to do. Then, they get frustrated and get angry because they have been mislead by these hard-sell tactics. Thus the links to the stories.

      Our own experience was that we hated NFP, but loved the FAM approach to the same material. Only then could we appreciate some of the deeper philosophy and spirituality behind it.

      We do not use barriers for personal and philosophical reasons, but I can certainly understand why others would find this option beneficial. I think some of the anti-condom rhetoric borders on the absurd.

      • Thanks for the clarification. Glad to hear it! I agree with you that people on both sides do more harm than good with the rhetoric they bring to the discussion about natural birth control methods. Women can be discouraged in both realms. And some of the most vociferous anti-FAM people I’ve met are non-observant Catholics whose image of natural birth control seems to have been forever tainted by the preachy, judgmental approach you refer to. The other thing that drives me crazy on the pro-choice sexual health side is the lack of understanding about the differences between religious and secular methods. It’s a pleasure to read something that acknowledges and understands the differences.

        One more thing. Women who truly want to practice NFP but have menstrual cycle problems that make it difficult might want to know about Justisse Healthworks for Women found at http://www.justisse.ca. Justisse trains Holistic Reproductive Health Practitioners who teach the Justisse Fertility Awareness Method (similar to Creighton) and provide holistic health-care support to women experiencing all manner of menstrual problems. Most menstrual issues that make it challenging to practice NFP or FAM can be sorted out. A list of practitioners, who can work with women long distance via Skype, can be found on the Justisse Site.

      • Is Justisse available in the USA? I found the website, but hadn’t heard of anything in the states.

        K struggled with Creighton, but had a lot of success with Billings. We were able to take long distance classes via Skype. Billings is a Catholic organization, but operates in a non-sectarian way and puts a heavy emphasis on the women’s health aspect, which we really liked.

        I think that some of the angry non-observant Catholics either had or knew people who had bad experiences with older methods or “rhythm”. Good science makes a big difference.

        I noticed you have a Canadian email address. You are fortunate not to have to deal with our crazy US politics and crazier health care system. 🙂

  2. Excellent article. I do not know why so many Catholics accept the ‘pill as abortion’ rhetoric so readily. I know women who still feel guilty for possibly aborting their children by being on the pill in their younger years. Why do we encourage this guilt when we aren’t sure that it is the truth?

    • I think that some in the pro-life movement have gotten so caught up in the idea that “life begins at conception” that they think ovulation + unprotected sex = conception = baby. However, conception isn’t always so easy and natural early pregnancy loss (< 3wks post-conception/5wks LMP) is very common. Plus, the Pill known to degrade cervical mucus and NFP/FAM is based on the fact that good cervical mucus is key to conception.

      Then there is the logical fallacy where if someone believes the something is generally bad, then they believe that everything bad about that something is true. I see this on BOTH sides: Catholics thinking that because they believe Pill is bad that it causes abortions and Pro-choice people thinking that because they believe Catholic Church is bad that NFP/FAM doesn't work and can’t be a good option for family planning for many couples.

      Unfortunately, many women end up as "collateral damage" in the culture wars.

      • Plus, when you look at all the different things we come in contact with that could cause an early miscarriage like many painkillers, caffeine, soft cheeses, deli meats, and a whole lot of other things can possibly increase chance of miscarriage. Sometimes with the way intense Catholics talk birth control causing miscarriages (even when taken for a medical reason), I wonder if they would expect married women to avoid all these things too.

        And you are right about people believing the worst since they already don’t like a part of it. I would love to hear some arguments against the pill that are more about birth control, and the health complications it can cause, while mentioning it may possibly cause miscarriages too, rather than throwing around that it causes abortion.

      • Yes, I agree completely.

        I would like to see an argument against hormonal/bioactive birth control along the lines of the argument against using artificial hormones (i.e. steroids) to improve athletic performance. Steroids improve performance, but that comes at a price. There are significant health risks. Society recognizes that the risks of health problems outweigh the benefits of improved performance.

        Applied to hormonal/bioactive BC, the argument is simple: Don’t put your health at risk for sex when there are other safe and effective ways of preventing pregnancy.

        Furthermore, there is the moral aspect of whether it is OK to take steroids in an athletic competition. Even if all competitors are allowed to use steroids so that it’s “fair”, people still find doping disturbing. We have this ideal that athletics are supposed to be about training our bodies so that we can be best that we can be, not finding the best pharmaceutical team so that we can be better. This difference changes the nature of the athletic event.

        It may be a stretch to say that hormonal/bioactive BC changes sex in the way that steroids change sports, but there are definitely some parallels.

        Of course, steroids are an important medication that has helped millions. Nobody questions the morality of appropriate medical use of steroids nor does anyone have any trouble with distinguishing the two uses of the same drug.

  3. Justisse has practitioners in Canada, the U.S. and some other countries. Here’s the link to the practitioner directory: http://www.justisse.ca/PractitionerDirectory.htm

    Yes, I do appreciate Canada’s saner approach to sexuality and sexual health education, as well as our public health care system that provides frontline sexual and reproductive health care. But I spend a lot of time reading about and following the goings on in the U.S. It’s so much more interesting!

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