Thursday, February 28, 2008

The Pill as an Abortifacient.

Does the Birth Control Pill Cause Abortions?

A condensation by Randy Alcorn

"The Pill" is the popular term for more than forty different commercially available oral contraceptives. In medicine, they are commonly referred to as BCPs (birth control pills) or OCs (oral contraceptives). They are also called "Combination Pills," because they contain a combination of estrogen and progestin.

The Pill is used by about fourteen million American women each year. Across the globe it is used by about sixty million. The question of whether it causes abortions has direct bearing on untold millions of Christians, many of them prolife, who use and recommend it. For those who believe God is the Creator of each person and the giver and taker of human life, this is a question with profound moral implications.

In 1991, while researching the original edition of ProLife Answers to ProChoice Arguments, I heard someone suggest that birth control pills can cause abortions. This was brand new to me; in all my years as a pastor and a prolifer, I had never heard it before. I was immediately skeptical.

My vested interests were strong in that Nanci and I used the Pill in the early years of our marriage, as did many of our prolife friends. Why not? We believed it simply prevented conception. We never suspected it had any potential for abortion. No one told us this was even a possibility. I confess I never read the fine print of the Pill's package insert, nor am I sure I would have understood it even if I had.

In fourteen years as a pastor I did considerable premarital counseling, I always warned couples against the IUD because I'd read it could cause early abortions. I typically recommended young couples use the Pill because of its relative ease and effectiveness.

At the time I was researching ProLife Answers, I found only one person who could point me toward any documentation that connected the Pill and abortion. She told me of just one primary source that supported this belief and I found only one other. Still, these two sources were sufficient to compel me to include this warning in the book:

Some forms of contraception, specifically the intrauterine device (IUD), Norplant, and certain low-dose oral contraceptives, often do not prevent conception but prevent implantation of an already fertilized ovum. The result is an early abortion, the killing of an already conceived individual. Tragically, many women are not told this by their physicians, and therefore do not make an informed choice about which contraceptive to use." [1]

As it turns out, I made a critical error. At the time, I incorrectly believed that "low-dose" birth control pills were the exception, not the rule. I thought most people who took the Pill were in no danger of having abortions. What I've found in more recent research is that since 1988 virtually all oral contraceptives used in America are low-dose, that is, they contain much lower levels of estrogen than the earlier birth control pills.

The standard amount of estrogen in the birth control pills of the 1960s and early '70s was 150 micrograms.

The use of estrogen-containing formulations with less than 50 micrograms of estrogen steadily increased to 75 percent of all prescriptions in the United States in 1987. In the same year, only 3 percent of the prescriptions were for formulations that contained more than 50 micrograms of estrogen. Because these higher-dose estrogen formulations have a greater incidence of adverse effects without greater efficacy, they are no longer marketed in the United States. [2]

After the Pill had been on the market fifteen years, many serious negative side effects of estrogen had been clearly proven. These included blurred vision, nausea, cramping, irregular menstrual bleeding, headaches, increased incidence of breast cancer, strokes, and heart attacks, some of which led to fatalities. [3]

In response to these concerns, beginning in the mid-seventies, manufacturers of the Pill steadily decreased the content of estrogen and progestin in their products. The average dosage of estrogen in the Pill declined from 150 micrograms in 1960 to 35 micrograms in 1988. These facts are directly stated in an advertisement by the Association of Reproductive Health Professionals and Ortho Pharmaceutical Corporation in Hippocrates magazine. [4]

Pharmacists for Life confirms: "As of October 1988, the newer lower dosage birth control pills are the only type available in the U.S., by mutual agreement of the Food and Drug Administration and the three major Pill manufacturers." [5]

What is now considered a "high dose" of estrogen is 50 micrograms, which is in fact a very low dose in comparison to the 150 micrograms once standard for the Pill. The "low-dose" pills of today are mostly 20�35 micrograms. As far as I can tell, there are no birth control pills available today that have more than 50 micrograms of estrogen. An M.D. wrote to inform me that she had researched many pills by name and could confirm my findings. If such pills exist at all, they are certainly rare.

Not only was I wrong in thinking low-dose contraceptives were the exception rather than the rule, I didn't realize there was considerable documented medical information linking birth control pills and abortion. The evidence was there, I just didn't probe deeply enough to find it. Still more evidence has surfaced in subsequent years. I have presented this evidence in detail in my 88-page book Does the Birth Control Pill Cause Abortions? I will now summarize that research.

The Physician's Desk Reference (PDR)

The Physician's Desk Reference is the most frequently used reference book by physicians in America. The PDR, as it's often called, lists and explains the effects, benefits, and risks of every medical product that can be legally prescribed. The Food and Drug Administration requires that each manufacturer provide accurate information on its products, based on scientific research and laboratory tests. This information is included in the PDR.

As you read the following, keep in mind that the term "implantation," by definition, always involves an already conceived human being. Therefore, any agent which serves to prevent implantation functions as an abortifacient.

This is the PDR's product information for Ortho-Cept, as listed by Ortho, one of the largest manufacturers of the Pill:

Combination oral contraceptives act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus, which increase the difficulty of sperm entry into the uterus, and changes in the endometrium which reduce the likelihood of implantation. [6]

The FDA-required research information on the birth control pills Ortho-Cyclen and Ortho Tri-Cyclen also state that they cause "changes in...the endometrium (which reduce the likelihood of implantation)." [7]

Notice that these changes in the endometrium, and their reduction in the likelihood of implantation, are not stated by the manufacturer as speculative or theoretical effects, but as actual ones. They consider this such a well-established fact that it requires no statement of qualification.

Similarly, as I document in my book, Syntex and Wyeth, the other two major pill-manufacturers, say essentially the same thing about their oral contraceptives. (I also relate in the book the results of my phone calls to each of these manufacturers to discuss this issue.)

The inserts packaged with birth control pills are condensed versions of longer research papers detailing the Pill's effects, mechanisms, and risks. Near the end, the insert typically says something like the following, which is taken directly from the Desogen pill insert:

If you want more information about birth control pills, ask your doctor, clinic or pharmacist. They have a more technical leaflet called the Professional Labeling, which you may wish to read. The Professional Labeling is also published in a book entitled Physician's Desk Reference, available in many bookstores and public libraries.

Of the half dozen birth control pill package inserts I've read, only one included the information about the Pill's abortive mechanism. This was a package insert dated July 12, 1994, found in the oral contraceptive Demulen, manufactured by Searle. Yet this abortive mechanism was referred to in all cases in the FDA-required manufacturer's Professional Labeling, as documented in The Physician's Desk Reference.

In summary, according to multiple references throughout The Physician's Desk Reference, which articulate the research findings of all the birth control pill manufacturers, there are not one but three mechanisms of birth control pills:
1. inhibiting ovulation (the primary mechanism),
2. thickening the cervical mucus, thereby making it more difficult for sperm to travel to the egg, and
3. thinning and shriveling the lining of the uterus to the point that it is unable or less able to facilitate the implantation of the newly fertilized egg.

The first two mechanisms are contraceptive. The third is abortive.

When a woman taking the Pill discovers she is pregnant (according to The Physician's Desk Reference's efficacy rate tables, this is 3 percent of pill-takers each year), it means that all three of these mechanisms have failed. The third mechanism sometimes fails in its role as backup, just as the first and second mechanisms sometimes fail. Each and every time the third mechanism succeeds, however, it causes an abortion.

Medical Journals and Textbooks

The Pill alters epithelial and stromal integrins, which appear to be related to endometrial receptivity. These integrins are considered markers of normal fertility. Significantly, they are conspicuously absent in patients with various conditions associated with infertility and in women taking the Pill. Since normal implantation involves a precise synchronization of the zygote's development with the endometrium's window of maximum receptivity, the absence of these integrins logically indicates a higher failure rate of implantation for Pill-takers. According to Dr. Stephen G. Somkuti and his research colleagues, "These data suggest that the morphological changes observed in the endometrium of OC users have functional significance and provide evidence that reduced endometrial receptivity does indeed contribute to the contraceptive efficacy of OCs." [8]

In another research journal article, Drs. Chowdhury, Joshi and associates state, "The data suggests that though missing of the low-dose combination pills may result in 'escape' ovulation in some women, however, the pharmacological effects of pills on the endometrium and cervical mucus may continue to provide them contraceptive protection." [9]

Note in some of these citations "contraceptive" is used of an agent which in fact prevents the implantation of an already conceived child. Those who believe each human life begins at conception would see this function not as a contraceptive, but an abortifacient.

In a study of oral contraceptives published in a major medical journal, Dr. G. Virginia Upton, Regional Director of Clinical Research for Wyeth, one of the major birth control pill manufacturers, says, "The graded increments in LNg in the triphasic OC serve to maximize contraceptive protection by increasing the viscosity of the cervical mucus (cervical barrier), by suppressing ovarian progesterone output, and by causing endometrial changes that will not support implantation." [10]

Drug Facts and Comparisons says this about birth control pills in its 1997 edition:

Combination OCs inhibit ovulation by suppressing the gonadotropins, follicle-stimulating hormone (FSH) and lutenizing hormone (LH). Additionally, alterations in the genital tract, including cervical mucus (which inhibits sperm penetration) and the endometrium (which reduces the likelihood of implantation), may contribute to contraceptive effectiveness. An independent clinical pharmaceutical reference also contains this assertion. [11]

Reproductive endocrinologists have demonstrated that Pill-induced changes cause the endometrium to appear "hostile" or "poorly receptive" to implantation. [12] Magnetic Resonance Imaging (MRI) reveals that the endometrial lining of Pill users is consistently thinner than that of nonusers [13] -up to 58 percent thinner. [14] Recent and fairly sophisticated ultrasound studies [15] have all concluded that endometrial thickness is related to the "functional receptivity" of the endometrium. Others have shown that when the lining of the uterus becomes too thin, implantation of the pre-born child (called the blastocyst or pre-embryo at this stage) does not occur. [16]

The minimal endometrial thickness required to maintain a pregnancy ranges from 5 to 13mm, [17] whereas the average endometrial thickness in women on the Pill is only 1.1 mm. [18] These data lend credence to the FDA-approved statement that "changes in the endometrium reduce the likelihood of implantation" [19]

Dr. Kristine Severyn says:

The third effect of combined oral contraceptives is to alter the endometrium in such a way that implantation of the fertilized egg (new life) is made more difficult, if not impossible. In effect, the endometrium becomes atrophic and unable to support implantation of the fertilized egg.... The alteration of the endometrium, making it hostile to implantation by the fertilized egg, provides a backup abortifacient method to prevent pregnancy. [20]

Researchers have repeatedly and consistently pointed out this abortifacient effect of the Pill. To date, no published studies have refuted these findings.

Dr. Walter Larimore is a Clinical Professor of Family Medicine who has written over 150 medical articles in a wide variety of journals. In two major medical journal articles, he has addressed the issue of the Pill's capacity to cause early abortions. [21] In 2000 Dr. Larimore and I coauthored a chapter on this subject in The Reproduction Revolution: A Christian Appraisal of Sexuality, Reproductive Technologies and the Family. [22] In the same chapter, four Christian physicians present their belief that the Pill does not result in early abortions. We respectfully suggest that their case is not based solidly on the medical evidence.

What Does This Mean?

As a woman's menstrual cycle progresses, her endometrium gradually gets richer and thicker in preparation for the arrival and implantation of any newly conceived child. In a natural cycle, unimpeded by the Pill, the endometrium experiences an increase of blood vessels, which allow a greater blood supply to bring oxygen and nutrients to the child. There is also an increase in the endometrium's stores of glycogen, a sugar that serves as a food source for the blastocyst (child) as soon as he or she implants.

The Pill keeps the woman's body from creating the most hospitable environment for a child, resulting instead in an endometrium that is deficient in both food (glycogen) and oxygen. The child may die because he lacks this nutrition and oxygen.

Typically, the new person attempts to implant at six days after conception. If implantation is unsuccessful, the child is flushed out of the womb in a miscarriage. When the miscarriage is the result of an environment created by a foreign device or chemical, it is in fact an abortion. This is true even if the mother does not intend it, and is not aware of it happening.

Despite all the research, including much more presented in my full booklet, there are those who insist that these contentions are incorrect and should not be taken at face value by those concerned about early abortions. In the case of the Pill manufacturers, those who say their FDA-approved assertions are false should, in my opinion, prevail upon the FDA to change their statements, and not simply ask people to disregard them.

Confirming Evidence

When the Pill thins the endometrium, it seems self-evident a zygote attempting to implant has a smaller likelihood of survival. A woman taking the Pill puts any conceived child at greater risk of being aborted than if the Pill were not being taken.

Some argue that this evidence is indirect and theoretical. But we must ask, if this is a theory, how strong and credible is the theory? If the evidence is only indirect, how compelling is that indirect evidence? Once it was only a theory that plant life grows better in rich, fertile soil than in thin, eroded soil. But it was certainly a theory good farmers believed and acted on.

Some physicians have theorized that when ovulation occurs in Pill-takers, the subsequent hormone production "turns on" the endometrium, causing it to become receptive to implantation. [23] However, there is no direct evidence to support this theory, and there is at least some evidence against it. First, after a woman stops taking the Pill, it usually takes several cycles for her menstrual flow to increase to the volume of women who are not on the Pill. This suggests to most objective researchers that the endometrium is slow to recover from its Pill-induced thinning. [24] Second, the one study that has looked at women who have ovulated on the Pill showed that after ovulation the endometrium is not receptive to implantation. [25]

Intrauterine/Extrauterine Pregnancy Ratio

Another line of evidence of the Pill's abortifacient effect is this: if the Pill has no post-fertilization effect, then reductions in the rate of intrauterine pregnancies in Pill-takers should be identical to the reduction in the rate of extrauterine (ectopic/tubal) pregnancies in Pill-takers. Therefore, an increased extrauterine/intrauterine pregnancy ratio would constitute evidence for an abortifacient effect.

Two medical studies allow review of this association. [26] Conducted at seven maternity hospitals in Paris, France, [27] and three in Sweden, [28] the studies evaluated 484 women with ectopic pregnancies and control groups of 389 women with normal pregnancies who were admitted to the hospital for delivery during the same time period. These studies were designed, in typical fashion for "case control" studies, to determine the risk factors for a particular condition (here, ectopic pregnancy) by comparing one group of individuals known to have the condition with another group of individuals not having the condition. Both of these studies showed an increase in the extrauterine/intrauterine pregnancy ratio for women taking the Pill. Researchers who have reviewed these studies have therefore suggested that "some protection against intrauterine pregnancy is provided via the Pill's post-fertilization abortifacient effect." [29]

What accounts for the Pill inhibiting intrauterine pregnancies at a disproportionately greater ratio than it inhibits extrauterine pregnancies? The most likely explanation is that while the Pill does nothing to prevent a newly conceived child from implanting in the wrong place (i.e., anywhere besides the endometrium), it may sometimes do something to prevent him from implanting in the right place (i.e., the endometrium).

Arguments Against the Pill Causing Abortion

I have received a number of letters from readers, one of them a physician, who say something like this: "My sister got pregnant while taking the Pill. This is proof that you are wrong in saying that the Pill causes abortions-obviously it couldn't have, since she had her baby!"

Without a doubt, the Pill's effects on the endometrium do not always make implantation impossible. I have never heard anyone claim that they do. To be an abortifacient does not require that something always cause an abortion, only that it sometimes does.

Whether it's RU-486, Norplant, Depo-Provera, the morning after pill, the Mini-pill, or the Pill, there is no chemical that always causes an abortion. There are only those that do so never, sometimes, often, and usually.

Children who play on the freeway, climb on the roof, or are left alone by swimming pools don't always die, but this does not prove these practices are safe and never result in fatalities. We would immediately see this inconsistency of anyone who argued in favor of leaving children alone by swimming pools because they know of cases where this has been done without harm to the children. The point that the Pill doesn't always prevent implantation is certainly true, but has no bearing on the question of whether it sometimes prevents implantation, which the data clearly suggests.

People also often argue, "The blastocyst is perfectly capable of implanting in various 'hostile' sites, e.g., the fallopian tube, the ovary, the peritoneum."

Their point is that the child sometimes implants in the wrong place. This is undeniably true. But again, the only relevant question is whether the Pill sometimes hinders the child's ability to implant in the right place.

Imagine a farmer who has two places where he might plant seed. One is rich, brown soil that has been tilled, fertilized, and watered. The other is on hard, thin, dry, and rocky soil. If the farmer wants as much seed as possible to take hold and grow, where will he plant the seed? The answer is obvious��on the fertile ground.

Now, you could say to the farmer that his preference for the rich, tilled, moist soil is based on theoretical assumptions because he has probably never seen a scientific study that proves this soil is more hospitable to seed than the thin, hard, dry soil. Likely, such a study has never been done. In other words, there is no absolute proof.

But the farmer would likely reply, based on years of observation, "I know good soil when I see it. Sure, I've seen some plants grow in the hard, thin soil too, but the chances of survival are much less there than in the good soil. Call it theoretical if you want to, but we all know it's true!"

Some newly conceived children manage to survive temporarily in hostile places. But this in no way changes the obvious fact that many more children will survive in a richer, thicker, more hospitable endometrium than in a thinner, more inhospitable one.

(In other publications and in a much more detailed fashion, we have discussed these and other lines of evidence, with hundreds of citations of many scientific studies, as well as researchers and experts in numerous fields. We encourage interested readers to look more deeply into these studies and arguments. [30] )

Despite this evidence, some prolife physicians state that the likelihood of the Pill having an abortifacient effect is "infinitesimally low, or nonexistent." [31] Though I would very much like to believe this, the scientific evidence does not permit me to do so.

Dr. Walt Larimore has told me that whenever he has presented this evidence to audiences of secular physicians, there has been little or no resistance to it. But when he has presented it to Christian physicians there has been substantial resistance. Since secular physicians do not care whether the Pill prevents implantation, they tend to be objective in interpreting the evidence. After all, they have little or nothing at stake either way. Christian physicians, however, very much do not want to believe the Pill causes early abortions. Therefore, I believe, they tend to resist the evidence. This is certainly understandable. Nonetheless, we should not permit what we want to believe to distract us from what the evidence indicates we should believe.

I have mentioned my own vested interests in the Pill that at first made me resist the evidence suggesting it could cause abortions. Dr. Larimore came to this issue with even greater vested interests in believing the best about the birth control pill, having prescribed it for years. When he researched it intensively over an eighteen-month period, in what he described to me as a "gut wrenching" process that involved sleepless nights, he came to the conclusion that in good conscience he could no longer prescribe hormonal contraceptives, including the Pill, the Minipill, Depo-Provera, and Norplant.

Statement by Twenty Prolife Physicians

Five months after the original printing of my booklet, in January 1998 a statement was issued opposing the idea that the Pill can cause abortions. According to a January 30, 1998, email sent me by one of its circulators, the statement "is a collaborative effort by several very active prolife OB-GYN specialists, and screened through about twenty additional OB-GYN specialists."

The statement is titled "Birth Control Pills: Contraceptive or Abortifacient?" Those wishing to read it in its entirety, which I recommend, can find it at our web page, at I have posted it there because while I disagree with its major premise and various statements in it, I believe it deserves a hearing.

The title is misleading, in that it implies there are only two possible ways to look at the Pill: always a contraceptive or always an abortifacient. In fact, I know of no one who believes it is always an abortifacient. There are only those who believe it is always a contraceptive and never an abortifacient, and those who believe it is usually a contraceptive and sometimes an abortifacient.

The paper opens with this statement:

Currently the claim that hormonal contraceptives [birth control pills, implants (Norplant), injectables (Depo-Provera)] include an abortifacient mechanism of action is being widely disseminated in the prolife community. This theory is emerging with the assumed status of "scientific fact," and is causing significant confusion among both lay and medical prolife people. With this confusion in the ranks comes a significant weakening of both our credibility with the general public and our effectiveness against the tide of elective abortion.

The assertion that the presentation of research and medical opinions causes "confusion" is interesting. Does it cause confusion, or does it bring to light pertinent information in an already existing state of confusion? Would we be better off to uncritically embrace what we have always believed than to face evidence that may challenge it?

Is our credibility and effectiveness weakened through presenting evidence that indicates the Pill can cause abortions? Or is it simply our duty to discover and share the truth regardless of whether it is well-received by the general public or the Christian community?

The physicians' statement's major thesis is this: The idea that the Pill causes a hostile endometrium is a myth.

Over time, the descriptive term "hostile endometrium" progressed to be an unchallenged assumption, then to be quasi-scientific fact, and now, for some in the prolife community, to be a proof text. And all with no demonstrated scientific validation.

When I showed this to one professor of family medicine he replied, "This is an amazing claim." What's so amazing is it requires that every physician who has directly observed the dramatic Pill-induced changes in the endometrium, and every textbook that refers to these changes, has been wrong all along in believing what appears to be obvious: that when the zygote attaches itself to the endometrium its chances of survival are greater if what it attaches to is thick and rich in nutrients and oxygen than if it is not.

This is akin to announcing to a group of farmers that all these years they have been wrong to believe the myth that rich fertilized soil is more likely to foster and maintain plant life than thin eroded soil.

It could be argued that if anything may cause prolifers to lose credibility, at least with those familiar with what the Pill does to the endometrium, it is to claim the Pill does nothing to make implantation less likely.

The authors defend their position this way:

[The blastocyst] has an invasive nature, with the demonstrated ability to invade, find a blood supply, and successfully implant on various kinds of tissue, whether "hostile," or even entirely "foreign" to its usual environment-decidualized (thinned) endometrium, tubal epithelium (lining), ovarian epithelium (covering), cervical epithelium (lining), even peritoneum (abdominal lining cells).... The presumption that implantation of a blastocyst is thwarted by "hostile endometrium" is contradicted by the "pill pregnancies" we as physicians see.

This argument misses the point, since the question is not whether the zygote sometimes implants in the wrong place. Of course it does. The question, rather, is whether the newly conceived child's chances of survival are greater when it implants in the right place (endometrium) that is thick and rich and full of nutrients than in one which lacks these qualities because of the Pill. To point out a blastocyst is capable of implanting in a fallopian tube or a thinned endometrium is akin to pointing to a seed that begins to grow on asphalt or springs up on the hard dry path. Yes, the seed is thereby shown to have an invasive nature. But surely no one believes its chances of survival are as great on asphalt as in cultivated fertilized soil.

According to the statement signed by the twenty physicians, "The entire 'abortifacient' presumption, therefore, depends on 'hostile endometrium.'"

In fact, one need not embrace the term "hostile endometrium" to believe the Pill can cause abortions. It does not take a hostile or even an inhospitable endometrium to account for an increase in abortions. It only takes a less hospitable endometrium. Even if they feel "hostile" is an overstatement, can anyone seriously argue that the Pill-transformed endometrium is not less hospitable to implantation than the endometrium at its rich thick nutrient-laden peak in a normal cycle uninfluenced by the Pill?

One medical school professor told me that until reading this statement he had never heard, in his decades in the field, anyone deny the radical changes in the endometrium caused by the Pill and the obvious implications this has for reducing the likelihood of implantation. According to this physician, the fact that secular sources embrace this reality and only prolife Christians are now rejecting it (in light of the recent attention on the Pill's connection to abortions) suggests they may be swayed by vested interests in the legitimacy of the Pill.

The paper states "there are no scientific studies that we are aware of which substantiate this presumption [that the diminished endometrium is less conducive to implantation]." But it doesn't cite any studies, or other evidence, that suggest otherwise.

In fact, surprisingly, though this statement is five-pages long it contains not a single reference to any source that backs up any of its claims. If observation and common sense have led people in medicine to a particular conclusion over decades, should their conclusion be rejected out of hand without citing specific research indicating it to be incorrect?

On which side does the burden of proof fall-the one that claims the radically diminished endometrium inhibits implantation or the one that claims it doesn't?

The most potentially significant point made in the paper is this:

The ectopic rate in the USA is about 1% of all pregnancies. Since an ectopic pregnancy involves a pre-implantation blastocyst, both the "on pill conception" and normal "non pill conception" ectopic rate should be the same-about l% (unaffected by whether the endometrium is "hostile" or "friendly.") Ectopic pregnancies in women on hormonal contraception (except for the minipill) are practically unreported. This would suggest conception on these agents is quite rare. If there are millions of "on-pill conceptions" yearly, producing millions of abortions, (as some "BC pill is abortifacient" groups allege), we would expect to see a huge increase in ectopics in women on hormonal birth control. We don't. Rather, as noted above, this is a rare occurrence.

The premise of this statement is right on target. It is exactly the premise proposed by Dr. Larimore, which I've already presented. While the statement's premise is correct, its account of the data, unfortunately, is not. The studies pointed to by Dr. Larimore, cited earlier, clearly demonstrate the statement is incorrect when it claims ectopic pregnancies in women on hormonal contraception are "practically unreported" and "rare."

In fact, "a huge increase in ectopics" is exactly what we do see-an increase that five major studies put between 70% and 1390%. Ironically, when we remove the statement's incorrect data about the ectopic pregnancy rate and plug in the correct data, the statement supports the very thing it attempts to refute. It suggests the Pill may indeed cause early abortions, possibly a very large number of them.

Questions about This Problem

People raise many objections to the issues presented in this appendix, very few of which involve issues of evidential data or scientific fact. However, these objections deserve answers. These are some of the concerns I address in my booklet Does the Birth Control Pill Cause Abortions? [32]

  • "If this is true, why haven't we been told before?"

  • "I don't trust this evidence."

  • "If we don't know how often abortions happen, why shouldn't we take the Pill?"

  • "Spontaneous miscarriages are common; early abortions aren't that big a deal."

  • "Taking the Pill means fewer children die in spontaneous abortions."

  • "Without the Pill there would be more elective abortions."

  • "Pill-takers don't intend to have abortions."

  • "Why not just use high estrogen pills?"
  • You can't avoid every risk."
  • "How can we practice birth control without the Pill?"
  • "I never knew this—should I feel guilty?"
  • "We shouldn't lay guilt on people by talking about this."
  • "We shouldn't tell people the Pill may cause abotions because they'll be held accountable."
  • "We've prayed about it and we feel right about using the Pill."
  • "Prolifers will lose credibility if we oppose the Pill."
  • "This puts Christian physicians in a very difficult position."

  • "Are there any good alternatives to the Pill?"


The Pill is used by about fourteen million American women each year and sixty million women internationally. Thus, even an infinitesimally low portion (say one-hundredth of one percent) of 780 million Pill cycles per year globally could represent tens of thousands of unborn children lost to this form of chemical abortion annually. How many young lives have to be jeopardized for prolife believers to question the ethics of using the Pill? This is an issue with profound moral implications for those believing we are called to protect the lives of children.

[1] Randy Alcorn, Prolife Answers to ProChoice Arguments (Multnomah Publishers: Sisters, OR: 1992, 1994) 118.

[2] Danforth's Obstetrics and Gynecology (Philadelphia, PA: J. B. Lippincott Co., 1994, 7th edition), 626

[3] Nine Van der Vange, "Ovarian Activity During Low Dose Oral Contraceptives," published in Contemporary Obstetrics and Gynecology, edited by G. Chamberlain (London: Butterworths, 1988), 315-16.

[4] Hippocrates, May/June 1988, 35.

[5] Oral Contraceptives and IUDs: Birth Control or Abortifacients?, Pharmacists for Life, November 1989, 1.

[6] Physicians' Desk Reference (Montvale, NJ: Medical Economics, 1998).

[7] The PDR, 1995, page 1782.

[8] Stephen G. Somkuti, et al., "The Effect of Oral Contraceptive Pills on Markers of Endometrial Receptivity," Fertility and Sterility, Volume 65, #3, March 1996, 488.

[9] "Escape Ovulation In Women Due To The Missing Of Low Dose Combination Oral Contraceptive Pills," Contraception, September 1980; 241.

[10] G. Virginia Upton, "The Phasic Approach to Oral Contraception," The International Journal of Fertility, volume 28, 1988, 129.

[11] Kastrup, EK, ed. Drug Facts and Comparisons, Annual Edition (St. Louis: Facts and Comparisons, 1997).

[12] . Abdalla HI, Brooks AA, Johnson MR, Kirkland A, Thomas A, Studd JW. "Endometrial Thickness: A Predictor Of Implantation In Ovum Recipients?" Human Reprod 1994;9:363-365.

[13] Bartoli JM, Moulin G, Delannoy L, Chagnaud C, Kasbarian M. "The Normal Uterus On Magnetic Resonance Imaging And Variations Associated With The Hormonal State." Surg Radiol Anat 1991;13:213-20; Demas BE, Hricak H, Jaffe RB. "Uterine MR Imaging: Effects Of Hormonal Stimulation." Radiology 1986;159:123-6; McCarthy S, Tauber C, Gore J. "Female Pelvic Anatomy: MR Assessment Of Variations During The Menstrual Cycle And With Use Of Oral Contraceptives." Radiology 1986; 160: 119-23.

[14] Brown HK, Stoll BS, Nicosia SV, Fiorica JV, Hambley PS, Clarke LP, Silbiger ML. "Uterine Junctional Zone: Correlation Between Histologic Findings And MR Imaging." Radiology 1991;179:409-413.

[15] Abdalla, et al., "Endometrial thickness"; Dickey RP, Olar TT, Taylor SN, Curole DN, Matulich EM. "Relationship Of Endometrial Thickness And Pattern To Fecundity In Ovulation Induction Cycles: Effect Of Clomiphene Citrate Alone And With Human Menopausal Gonadotropin." Fertil Steril 1993;59:756-60; Gonen Y, Casper RF, Jacobson W, Blankier J. "Endometrial Thickness And Growth During Ovarian Stimulation: A Possible Predictor Of Implantation In In-Vitro Fertilization." Fertil Steril 1989;52:446-50; Schwartz LB, Chiu AS, Courtney M, Krey L, Schmidt-Sarosi C. "The Embryo Versus Endometrium Controversy Revisited As It Relates To Predicting Pregnancy Outcome In In-Vitro Fertilization-Embryo Transfer Cycles." Hum Reprod 1997;12:45-50; Shoham Z, et al. "Is It Possible To Run A Successful Ovulation Induction Program Based Solely On Ultrasound Monitoring: The Importance Of Endometrial Measurements." Fertil Steril 1991;56:836-841; Noyes N, Liu HC, Sultan K, Schattman G, Rosenwaks Z. "Endometrial Thickness Appears To Be A Significant Factor In Embryo Implantation In In-Vitro Fertilization." Hum Reprod 1995;10:919-22; Vera JA, Arguello B, Crisosto CA. "Predictive Value Of Endometrial Pattern And Thickness In The Result Of In Vitro Fertilization And Embryo Transfer." Rev Chil Obstet Gynecol 1995;60:195-8; Check JH, Nowroozi K, Choe J, Lurie D, Dietterich C. "The Effect Of Endometrial Thickness And Echo Pattern On In Vitro Fertilization Outcome In Donor Oocyte-Embryo Transfer Cycle." Fertil Steril 1993;59:72-5; Oliveira JB, Baruffi RL, Mauri AL, Petersen CG, Borges MC, Franco JG Jr. "Endometrial Ultrasonography As A Predictor Of Pregnancy In An In-Vitro Fertilization Programme After Ovarian Stimulation And Gonadotrophin-Releasing Hormone And Gonadotrophins." Hum Reprod 1997;12:2515-8; Bergh C, Hillensjo T, Nilsson L. "Sonographic Evaluation Of The Endometrium In In-Vitro Fertilization IVF Cycles. A Way To Predict Pregnancy?" Acta Obstet Gynecol Scand 1992;71:624-8.

[16] Abdalla HI, et al., "Endometrial thickness"; Dickey, et al., "Relationship Of Endometrial Thickness"; Gonen, et al., "Endometrial Thickness And Growth"; Oliveira, et al., "Endometrial Ultrasonography As A Predictor"; Bergh, et al., "Sonographic Evaluation Of The Endometrium".

[17] The 5mm figure is from Glissant, A, de Mouzon, J, Frydman R. "Ultrasound Study Of The Endometrium During In Vitro Fertilization Cycles." Fertil Steril 1985;44:786-90. The 13mm figure is from Rabinowitz R, Laufer N, Lewin A, Navot D, Bar I, Margalioth EJ, Schenker JJ. "The value of ultrasonographic endometrial measurement in the prediction of pregnancy following in vitro fertilization." Fertil Steril 1986;45:824-8

[18] McCarthy, et al., "Female Pelvic Anatomy".

[19] Physicians' Desk Reference; Kastrup, Drug Facts.

[20] Kristine Severyn, "Abortifacient Drugs and Devices: Medical and Moral Dilemmas" Linacre Quarterly, August 1990, 55.

[21] Walter L. Larimore and Joseph Stanford, "Postfertilization Effects of Oral Contraceptives and their Relation to Informed Consent." Archives of Family Medicine 9 (February, 2000); Walter L. Larimore, "The Abortifacient Effect of the Birth Control Pill and the Principle of Double Effect," Ethics and Medicine, January 2000.

[22] Walter L. Larimore and Randy Alcorn, "Using the Birth Control Pill is Ethically Unacceptable," in John F. Kilner, Paige C. Cunningham and W. David Hager (eds), The Reproduction Revolution (Grand Rapids, MI: W.B. Eerdmans, 2000), 179-191.

[23] Susan Crockett, Joseph L. DeCook, Donna Harrison, and Camilla Hersh, "Using Hormone Contraceptives Is a Decision Involving Science, Scripture, and Conscience," in John F. Kilner, Paige C. Cunningham and W. David Hager (eds), The Reproduction Revolution (Grand Rapids, MI: W.B. Eerdmans, 2000), 192-201.

[24] Stanford JB, Daly KD. "Menstrual And Mucus Cycle Characteristics In Women Discontinuing Oral Contraceptives (Abstract)." Paediatr Perinat Epidemiol 1995;9(4): A9.

[25] Chowdhury V, Joshi UM, Gopalkrishna K, Betrabet S, Mehta S, Saxena BN. "'Escape' Ovulation In Women Due To The Missing Of Low Dose Combination Oral Contraceptive Pills." Contraception 1980;22(3):241-7.

[26] Thorburn J, Berntsson C, Philipson M, Lindbolm B. "Background Factors Of Ectopic Pregnancy. I. Frequency Distribution In A Case-Control Study." Eur J Obstet Gynecol Reprod Biol 1986;23:321-331 (the original data was reevaluated by: Mol, et al., "Contraception and the Risk"); Coste J, Job-Spira N, Fernandez H, Papiernik E, Spira A. "Risk Factors For Ectopic Pregnancy: A Case-Control Study In France, With Special Focus On Infectious Factors." Am J Epidemiol 1991;133:839-49.

[27] Coste, et al., "Risk Factors For Ectopic Pregnancy".

[28] Thorburn, et al., "Background Factors Of Ectopic Pregnancy".

[29] Larimore and Stanford JB. "Postfertilization Effects"; Thorburn et al., "Background Factors"; (the original data was reevaluated by: Mol BWJ, Ankum WM, Bossuyt PMM, Van der Veen F. "Contraception And The Risk Of Ectopic Pregnancy: A Meta Analysis." Contraception 1995;52:337-341); Mol, et al., "Contraception and the Risk".

[30] . Alcorn, "Does The Birth Control Pill Cause Abortions?"; Larimore WL, Stanford JB. "Postfertilization Effects Of Oral Contraceptives And Their Relation To Informed Consent." Larimore WL. "The Growing Debate about the Abortifacient Effect of the Birth Control Pill and the Principle of the Double Effect." Ethics and Medicine: in review.

[31] DeCook JL, McIlhaney J, et al. Hormonal Contraceptives: Are they Abortifacients? (Sparta, MI: Frontlines Publishing, 1998).

[32] Randy Alcorn, Does the Birth Control Pill Cause Abortions? Fifth edition (Gresham, OR: Eternal Perspective Ministries), 50-73.

Randy Alcorn, Eternal Perspective Ministries, 39085 Pioneer Blvd., Suite 206, Sandy, OR 97055, 503-668-5200,

Monday, February 25, 2008

More on the Life Front

Death of unborn child as a result of Mother's drug us a Homicide
By Thaddeus M. Baklinski

These fetal homocide cases have some pro-abortion advocates concerned. If killing a child through the intentional drug use of the mother is homicide, then how is chemical abortion not homicide?

EDWARDSVILLE, IL (LifeSiteNews) - A coroner's jury has determined that the death of an Illinois woman's unborn child was a homicide because of the woman's use of illegal drugs, reports the Belleville News-Democrat.

An autopsy on 26-year-old Alicia Tucker's stillborn baby revealed cocaine and amphetamines in the child's system. Tucker was eight months pregnant at the time. The doctor who treated Tucker told the inquest that the "fetus died due to a placental abruption (premature separation of the placenta from the wall of the uterus), which can be caused by cocaine use."

The inquest was told that Tucker had bought a "bag of pills for $11 from a man outside a currency exchange in Granite City shortly before the stillbirth," which she said she thought were painkillers for which she had a prescription. She said she doesn't know why she bought the pills. "I don't know. I honestly don't know," she said. "Sometimes people make stupid mistakes." A detective also testified that Tucker told him she inhaled methamphetamine that she had purchased for someone else, a week before the stillbirth. The result of the police investigation will be forwarded to the county prosecutor for consideration as to whether criminal charges should be filed against the mother.

Robert Weisberg, a law professor and director of the Stanford University Criminal Justice Center, commented on the incongruity of legal abortion and criminal fetal homicide. "Pro-choice groups find this issue difficult," he said. "They know that so long as Roe v. Wade is good law, fetal homicide statutes passed by states can't threaten the right to an abortion. But I think they're concerned that if it becomes well-known that fetal homicide outside abortion can be considered a crime, then the notion of a fetus as a human being might become more widespread in public opinion."

Although Illinois has a fetal homicide law under which only another person can be convicted of killing a child in utero, and not the mother herself, other US states have legislation that allow a mother to be convicted of involuntary manslaughter or reckless homicide if her drug use leads to the death of her fetus.

Good News on the Life Front

French Court: Parents Can Register Names for Fetuses
By John Jalsevac

According to the AFP report, the ruling is triggering a storm over the issue of abortion in France.

PARIS, France (LifeSiteNews) - France's supreme court has ruled that parents of miscarried or stillborn children can register a name for the child, no matter what stage of development the child was at at the time of miscarriage or birth, reports the AFP. Previous to this most recent ruling, parents in France were allowed to register a name for miscarried or stillborn children, but only after 22 weeks gestation, or if the child weighed over 1.1 pounds. This new ruling gives parents the right to claim the body of their child, which, until this point, was incinerated by the hospital along with other waste tissues. It also allows the mothers of miscarried or stillborn children to claim maternity leave.

According to the AFP report, the ruling is triggering a storm over the issue of abortion in France, with pro-abortion activists arguing that the ruling gives pro-life activists a strongly emotional argument for the humanity of the child, by indicating that a fetus at any stage has a right to a name. "A fetus is only viable after 26 weeks," said Chantal Birman, deputy president of a pro-abortion group called ANCIC. "You have to take the timetable of pregnancy into account." She said that the court decision, "will help a rollback [on abortion availability] that has been taking place in Europe for the last few months."

However, there is an increasing recognition in medical circles that miscarriage or stillbirth can be an extremely traumatic experience for mothers and fathers alike, who may have developed a profound emotional connection with their unborn child. "The mourning process can be long and lonely," says the Helping After Neonatal Death (HAND) website. "After the death of a baby, it generally takes twelve to twenty-four months simply to find your new base." Many parents have found that the process of grieving is helped significantly by the giving of a name to their child. "Giving the baby a name and having the baby baptized or blessed, if such rituals are important to us, are ways for us to acknowledge the reality of the life that has come and gone so quickly," says HAND.

New York Times IVF Article and Dr. Solenni's Responce

Lowering Odds of Multiple Births

In the complex, expensive and emotionally charged world of fertility treatment, doctors are sounding a call to arms to reverse the soaring rate of multiple births. The doctors are responding to an unintended consequence of the success of in vitro fertilization — that it is often too successful. Since 1980, when the technique became available in the United States, the rate of twins in all births has climbed 70 percent, to 3.2 percent of births in 2004. Much of the increase, experts say, is a result of in vitro treatment. The rate of triplets and higher-order multiples increased even more from 1980 to 1998. It is not that twins or triplets are undesirable, doctors say. But multiple pregnancies often lead to risky preterm births and other complications. With that in mind, fertility centers are trying to lower the odds of such pregnancies, even at a cost of slightly lower success rates.

Fertility Center in Boston. “Is it a pregnancy without regard to the number of gestations or a pregnancy with a singleton live birth?” “Now is the time for all of us to rethink what is the paradigm of a successful I.V.F. pregnancy,” said Dr. Aaron K. Styer, a reproductive endocrinologist at the Massachusetts General Hospital. In I.V.F., a woman is given ovulation-induction hormones to produce multiple eggs, which are retrieved, fertilized with her partner’s sperm and transferred back to her uterus. The more embryos transferred, the higher the likelihood of multiples.

To achieve the goal of a single healthy baby, clinics are focusing on transferring fewer embryos and on developing more sophisticated ways to identify the healthiest embryos with the greatest chance of success. “We have been getting better at I.V.F. over the years, and as success rates go up, the number we transfer has to go down accordingly,” said Dr. Judy E. Stern, director of the human embryology and andrology lab at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H. “Where three embryos used to work and give you mostly singletons, now we transfer two, because we’re making better embryos.”

The number of I.V.F. cycles in which four or more embryos were transferred has dropped sharply, to 21 percent in 2004 from 62 percent in 1996. Although the efforts have substantially lowered the rates of triplets born through in vitro fertilization, they have not made a dent in the twin rate. That is because many doctors and patients are reluctant to take the final step to ensure a single birth, a process called S.E.T., for single embryo transfer. From 1996 to 2004, the rate of such procedures rose modestly, to 8 percent from 6 percent.

The American Society of Reproductive Medicine now recommends that women younger than 35 with a good prognosis have just one embryo transferred. Women under 35 make up 44 percent of I.V.F. cycles. In women older than 37, who have a higher incidence of embryos with chromosomal defects, three to five embryos are still recommended, depending on the woman’s age.

The main obstacle to single embryo transfer is its lower success rate. Some experts ask women to agree to two cycles, first transferring one fresh embryo while freezing the others. If the first transfer fails, doctors transfer a single frozen embryo, a much less costly and onerous procedure. That approach yields similar success rates to transferring two at once while drastically reducing twin rates. With momentum building to transfer just one or two embryos, clinics focus on choosing the embryo most likely to succeed. Selecting embryos has traditionally been based on a visual examination of their morphology — shape, number of divisions and other physical factors. But morphology does not tell all, and many embryos that look great under the microscope have undetected chromosomal abnormalities like missing or extra chromosomes, called aneuploidy. One method used to weed out unhealthy embryos is to leave the embryos in a Petri dish for five days, two more than usual, to allow more time for hidden chromosomal abnormalities to show up.

Other researchers are looking at the traits of women at high risk of having multiples. In research presented at the reproductive society’s annual meeting last October, Dr. Stern linked a higher number of oocytes, or eggs retrieved from ovaries, with higher rates of single and multiple pregnancies. “This will change our practice,” she said. “If more oocytes are retrieved, we’ll want to transfer fewer embryos.”

Other experts are turning to genetic screening before transfers to cull embryos without aneuploidy. The screening is used to select healthy embryos in families with histories of genetic diseases. Because one or two cells have to be removed for analysis, there is some concern that the process can damage embryos, lowering pregnancy rates. Another screening, comparative genomic hybridization, can assess all 23 pairs of chromosomes, providing an 80 percent chance of a healthy embryo and a 60 percent chance of a live birth, says Dr. Geoffrey Sher, executive medical director of the Sher Institutes of Reproductive Medicine, a nationwide group of fertility centers.

But Dr. Sher, whose lab performs this procedure, has encountered the same obstacles as others. He has a very high twin rate, hovering around 60 percent, because although the technique yields a higher success rate, women are refusing to have just one embryo transferred. Many women in fertility treatment say that they simply do not view having twins as a risky situation and that they are willing, if not eager, to have them to speed the completion of their family, to avoid the high costs of future I.V.F. cycles or to ensure that their child has a sibling, among other reasons.

For a couple in Brooklyn who asked that just the woman’s first name be used to protect their privacy, six years of infertility and several failed procedures was enough. When the woman, Marie, was 28, they requested that three embryos be transferred, even though their doctor advised transferring two. “I wanted a set of twins,” Marie said. “It is such a complicated and sometimes painful thing to go through I.V.F., and to have to go through it all again for a second child was just a waste for me.” In the third in vitro cycle, last June, Marie became pregnant, with triplets. At four weeks, she lost a fetus. At four and a half months, she lost the entire pregnancy. She was devastated, she said, but she added, “I don’t regret my decision.”

Though it is widely accepted that carrying three or more fetuses can have serious complications, some fertility specialists do not view a pregnancy with twins as risky, as long as the patient is carefully monitored. “Yes, twin delivery has more risk than singleton delivery, but with good obstetrical care and educated patients, the risk of twin delivery is minimally higher,” said Dr. Norbert Gleicher, medical director of the Center for Human Reproduction in New York.

Carrying twins or higher-order multiples raises the risk of preterm births; low-birth-weight babies, with the possibility of death in very premature infants; long-term health problems; and pregnancy complications, including pre-eclampsia, gestational diabetes and Caesarean section. Studies show that 56 percent of I.V.F. twins born in 2004 weighed less than 5.5 pounds, and 65 percent were born prematurely, before 37 weeks of gestation. Still, many patients take comfort in the improvements in neonatal care. The survival rate for newborns over 2 pounds 3 ounces is 85 percent. And many people just see the adorable twins cooing in the double strollers crisscrossing Central Park — not the ones that do not make it out of neonatal intensive care — or the fetus that was eliminated in a medical procedure called a reduction to improve the chance of survival for the remaining fetus or fetuses.

Along with changes to in vitro fertilization, experts say, physicians need to improve monitoring drugs used to enhance ovulation. “The biggest problem with high multiples is coming from ovulation induction,” said Dr. Richard P. Dickey, chief of reproductive endocrinology and infertility at Louisiana State University Medical School in New Orleans. If ovaries are too aggressively stimulated with hormones, a woman can produce a nest full of eggs and increase her risk of having triplets, quadruplets and even sextuplets. All ovulation-induction cycles should be closely monitored, and the cycles that produce too many oocytes should be canceled, Dr. Dickey said.

The biggest obstacles to reducing twins in infertility treatment are not medical, experts said, but the lack of insurance coverage, as well as pressure from patients to be aggressive. “People have to recognize that there’s a connection between cost and how the treatment is going to play out,” said Barbara Collura, executive director of Resolve, a patient advocacy organization for people with infertility. “If you have $10,000 that you’ve begged, borrowed and stolen for this one I.V.F. cycle, you’re not going to say, ‘Please just transfer one.’" Even doctors in the vanguard of the trend face resistance from patients like Marie. Despite her pregnancy loss, she said, “With all the hard work I put into getting pregnant, I’d just rather have a set of twins than a singleton.”

Gimme, Gimme
Dr Pia de Solenni

When we go about having children the way we order a customized car, design a kitchen, or buy a wardrobe, maybe it's a sign that we should get a pet or stick to inanimate things like cars, clothing, and cuisinarts rather than babies.....

The New York Times has this piece on reducing the chances of multiple births for women who use IVF to become pregnant. Granted, infertility is a very difficult thing to deal with, but it doesn't follow that we can therefore use any means to achieve what we want - a child, our own child. This article raises some interesting points that deserve consideration. Here are a few:

"Women under 35 make up 44 percent of I.V.F. cycles."

- That's a lot of relatively young women. What IVF clinics won't tell women is that there are natural methods to overcoming many cases of infertility. Dr. Hilger's Pope Paul VI Institute is a very good place to start. Imagine treating women holistically and integrally - there's a revolutionary concept.

"But Dr. Sher, whose lab performs this procedure, has encountered the same obstacles as others. He has a very high twin rate, hovering around 60 percent, because although the technique yields a higher success rate, women are refusing to have just one embryo implanted." [emphasis mine]

- It's all about the baby, right? Yet people are willing to allow numerous embyros to die in the process of getting a "baby." Remember, that embryo is its own unique entity with it own DNA. It's not a clump of cells that will grow into a bit of hair or bone or any other isolated matter. Unimpeded, it will become the "baby" desperately desired by some. It will continue to become the screaming toddler, the morose teenager, the college graduate, the young spouse, and so on.

"Many women in fertility treatment say that they simply do not view having twins as a risky situation and that they are willing, if not eager, to have them to speed the completion of their family, to avoid the high costs of future I.V.F. cycles or to ensure that their child has a sibling, among other reasons."

- ["And I'll have one of those, and one of those, and that one, and that one, and one of those in every color, and...."] Sorry, not to trivialize infertility, but this sounds ridiculous. Only in a culture that has lost the sense of what gifts are (think of those endless registries for every occasion besides getting married; think of how acceptable it has become to buy gifts for ourselves or to select the gifts that other people will "give" us) would be so blind as to realize that we lose what it means for a child to be a gift. This is about having a baby my way, when and how I want it, without thought even for the well being of the baby that I want. Because, after all, I want it.

"And many people just see the adorable twins cooing in the double strollers crisscrossing Central Park — not the ones that do not make it out of neonatal intensive care — or the vanishing twin, a fetus that was eliminated in a medical procedure called a reduction to improve the chance of survival for the remaining fetus or fetuses."

- Need I say more? It's about getting what we want, no matter the cost to others.

"Despite her pregnancy loss, she said, 'With all the hard work I put into getting pregnant, I’d just rather have a set of twins than a singleton.'"

- Well, that's one way of looking at it.

Again, I don't intend to belittle infertility in any way. My only point is that maybe there are some good reasons for rethinking IVF. A friend of mine, faced with infertility, was ready to adopt. Her husband was completely opposed. But my friend reasoned, "Whether I have the baby or someone else does, there's no guarantee that he will be good, honest, intelligent, good looking, whatever." Even with all the choices that IVF offers, there are no guarantees of this kind. In the meantime, there are children who already exist and need homes. What about helping out one of them? Granted, it won't happen on our terms, but do we really think that having a baby on our terms with IVF will mean that everything will continue to be on our terms after that? That wouldn't really be life, would it?


I love these YouTube videos and what these guys did to the Mac v. PC commercials. I especially appreciate the last logo and quick tip they show at the end of each episode. There are 6 videos total, just search for "NFP vs. Contraception." Enjoy!

Thursday, February 21, 2008

The Truth About Birth Control 1 & 2

A Challenging Truth, Part One: How Birth Control Works

Patti Maguire Armstrong
Catholic Exchange
February 9, 2008

How can something be both immense and minute at the same time, something upon which all of human history depends, yet fragile and almost non-existent to the eye? It is the union of an egg and sperm — an embryo. Such is God's way. He takes something smaller than a mustard seed and brings forth all of civilization. After creating everything in the universe single-handedly, He created us in his own image and bestowed upon us the power to become co-creators with Him. Working in union with us, when the sperm unites with the egg, not only has a new human life been set in motion, but so too has a spiritual life. God places an everlasting soul into the being of every son and daughter.

Most of us rarely think that deeply about it all. In our worldly way, we forget eternity and begin to affix costs — physical, emotional and monetary. The costs can seem exorbitant when we focus only through the eyes of the world. And looking through those same worldly eyes, the way to prevent the miracle we clearly do not recognize as such is so easy, inexpensive, and ironically, also so small — the birth control pill. But the pill does not just prevent the miracle, it also destroys it, a fact that is often surprising to committed pro-lifers. This fact is true for all contraception that works through manipulation of hormone levels.


The pill has become a symbol of freedom to those who have been told they can "have it all". And it has become a symbol of destruction to those who support a "Theology of the Body," philosophy, the essence of Catholic teaching that artificial means must not disrupt God's natural order of things.

The first birth control pill received approval from the Food and Drug Administration in 1960. Using a synthetic estrogen hormone, the pill tricked a women's body into thinking it was pregnant. No egg would be released thereby preventing the opportunity for conception.

Although the pill was initially introduced with the idea of affording women a reliable way of limiting their family size, it soon became the ticket to the Sexual Revolution that began in the Sixties and never really ended. The pill promised something it's never been able to deliver: sex with "no strings attached". There are always emotional and moral consequences to thwarting God's purpose, but women discovered physical problems too. Blood clots, heart attacks and strokes were some of the side effects caused by the Pill's high estrogen levels. Drug manufacturers lowered these levels in order to reduce the side effects but that also increased the incidence of breakthrough ovulation. With the lower levels of estrogen, eggs would sometimes still get released and pregnancies resulted.

The drug companies tackled this situation by adding the synthetic hormone progesterone, which makes the uterine wall (the endometrium) inhospitable to implantation by an embryo. So if an egg was released and became fertilized by a sperm, thus creating life, the pill would have actually failed to prevent a conception, meaning it failed as a contraceptive. But, through preventing implantation of the embryo, the pill acts as an abortifacient and stops life from continuing to the next stage. (A clear and simple demonstration of this can be seen here.)

Since some women actually do become pregnant while on the pill, there are some embryos that manage to implant into the uterus. Whether it's RU-486, Norplant, Depo-Provera, the morning after pill, the Mini-pill, or the Pill, there is no chemical "contraceptive" that always causes an abortion. There is also none that never causes an abortion.


There is no way of knowing what percentage of pregnancies result in abortion through the pill. The woman using the pill with this scenario never even knows that she conceived a child. Her cycle will continue on schedule with no realization that an embryo is being flushed from her body. The Catholic Church has never wavered on the teaching that life begins at conception. Although Catholics are contracepting at rates parallel to non-Catholics, using artificial means to change our body's natural functions in order to block the potential for life has been recognized as rebellion against God's plan for humanity. However, using natural means to understand the rhythms of life and then to work in union with God is encouraged through Natural Family Planning.

The issue of birth control is a big one where misunderstanding and ignorance often misguide people. But when it comes to the pill, the ignorance that many women fall prey to is lack of understanding of its abortifacient properties. Most women don't consider that while taking their birth control, they may also be aborting a life within them. As Pope Paul VI predicted when he issued his encyclical Humanae Vitae (Of Human Life) in 1968, the use of artificial contraception would lead to abortions.

Although it seemed to many to be an overdramatic prediction, it proved to be prophetic. In hindsight, its logic in saying that widespread use of contraception would lead to "conjugal infidelity and the general lowering of morality" was prophetic. Since the Pill began to be sold in 1960, divorces have tripled, out-of-wedlock births jumped from 224,000 to 1.2 million, abortions doubled, and cohabitation soared 10-fold from 430,000 to 4.2 million.

Sex both inside and outside marriage ceased to be about a bond of marital love in which a couple became one in union with God. It became merely an activity for personal satisfaction devoid of anything more. The Pope predicted man would lose respect for woman, considering her "as a mere instrument of selfish enjoyment, and no longer as his respected and beloved companion."

Society as a whole moved from recognizing sex as something reserved for married couples to something for everyone, since the possibility for pregnancy was greatly reduced (although never completely removed). Thus, people completely opposed to having children could have sex with others whom they had chosen as bed partners but would never chose to co-parent their children. The most intimate experience intended to be shared in love and self-giving with the potential for creating life became merely a form of recreation. And if life sprang forth, such a life was easily regarded as nothing more than an unintended problem that could legally be disposed of through abortion.

But women choosing abortion and the men who either make that choice with them or plead for them to do otherwise, are very aware of the decision that is being made, whereas women who choose to take birth control pills are not so aware of the potential ramifications of their choice. There is not a baby with a heartbeat who must forcefully be removed, but unbeknownst to many, there is a baby. Since life begins at conception, a life, even though undetectable to us, is still a life. It is the way God chooses to begin things, small and yet mighty in its eternal existence.

In addition to the pill, IUDs, Depo-Provera and Norplant also cause early, undetectable abortions. Doctor usually fail to warn women of the abortifacient properties of the pill. I've heard some doctors admit they were not actually even aware of these properties. Women often choose contraception as a means to avoid pregnancy without realizing they are not actually stopping pregnancy, but quickly ending it.


In his booklet, titled Does the Birth Control Pill Cause Abortions?, Randy Alcorn states: "The question of whether it causes abortions has direct bearing on untold millions of Christians, many of them pro-life, who use and recommend it. For those who believe God is the Creator of each person and the giver and taker of human life, this is a question with profound moral implications."

Alcorn was a Protestant pastor who not only used the pill in his married life, but also counseled other married couples to do so. He had a vested interest in not recognizing the pill as an abortifactient. But when confronted with the facts through his own research, it demanded changes in his own behavior and philosophy. His booklet was written in 1998 to inform others of the truth.

Alcorn's booklet has met some opposition. According to him: "Despite evidence, some pro-life physicians state that the likelihood of the Pill having an abortifacient effect is infinitesimally low, or nonexistent. Though I would very much like to believe this, the scientific evidence does not permit me to do so."

Alcorn, surprisingly, found that the greatest resistance to recognizing the abortifacient quality of the pill comes from the Christian community. "Dr. Walt Larimore has told me that whenever he has presented this evidence to audiences of secular physicians, there has been little or no resistance to it. But when he has presented it to Christian physicians there has been substantial resistance. Since secular physicians do not care whether the Pill prevents implantation, they tend to be objective in interpreting the evidence. After all, they have little or nothing at stake either way. Christian physicians, however, very much do not want to believe the Pill causes early abortions. Therefore, I believe, they tend to resist the evidence. This is certainly understandable. Nonetheless, we should not permit what we want to believe to distract us from what the evidence indicates we should believe."

It's easier to be pro-life when we limit the discussion to the abortion industry. The inclusion of artificial birth control complicates and confuses people. With so many opinions even among Catholics, how is a person to know what to believe? I understand the confusion. While living in Montana, I had a doctor who was also a priest, who told me it was not realistic to expect a couple to follow the Catholic teaching on birth control. He prescribed birth control pills to many of his female patients. So, is it any surprise there are many Catholics, ones like me, ignorant of the true teaching?

Yet, we must cut through the false teachings and erroneous opinions to reach the truth. Our lives, our bodies and our souls are all we have. They are gifts that must be safeguarded. Christopher West, author and speaker, has written books and articles explaining the beauty and truth of God's plan for men and women. In his book, Good News about Sex and Marriage, he asserts that the Church's teaching on sex and marriage is good news because it's the truth about love and true love is the fulfillment of the human person. He also admits that the news is challenging. "This is so because the truth about love is always challenging."

A Challenging Truth, Part One: How Birth Control Works

Patti Maguire Armstrong
Catholic Exchange
February 12, 2008

"Everyone does it, so what's the big deal?" Taking the pill, getting "fixed", getting a shot of Depo-Provera...there's a myriad of choices for contraception. The expectation in today's modern society is that everyone uses artificial birth control at some point in their lives, be they married or not. Right?

Many years ago, I would have agreed with all of the above. I was not a rebellious Catholic, just an ignorant one. But the guilt of my ignorance rests on more shoulders than just mine. I was surrounded by contraception Catholics who discussed their birth control as easily as they spoke of which brand of toothpaste they used. And then there was the Catholic clergy. There was nary a homily I heard that even hinted of the Catholic teaching on human sexuality. Understandably, it's not an ideal topic for an audience of all ages. And, truthfully, I did not always make it to Mass, so maybe I missed the "Talk" one Sunday. Had I kept up on Catholic teaching, I would have been aware of the "Theology of the Body". This was the first major teaching Pope John Paul II gave in 129 short talks between 1979 and 1984. This project was a Biblical reflection on the meaning of human embodiment, particularly as it concerns human sexuality.

I was not aware of the "Theology of the Body" because I was not a good Catholic back in the day. Nor did I pay much heed to Natural Family Planning in which couples regulate births without recourse to unnatural methods that interfere with the way God designed our fertility. But I expected a popular priest at my parish in Montana to be up on all things Catholic. Unfortunately, he was not. As both a priest and doctor, his parishioners and patients looked up to him. He let them down by stating, "It's not realistic to expect couples to follow the Pope's teachings on birth control."

The Error of our Ways

I believed my doctor/priest and followed society. Not until I began to embrace my Catholic faith and trust its teachings to guide me did I come to trust that God's plan is always the best. When Mark and I married in 1981, I was not even aware the Catholic Church taught that contraception was against God's plan. We were both Catholic and occasionally went to Mass. It seemed like a good thing to do, but other weekend plans easily took precedence over Mass. Our Catholic faith was mostly on the back burner.

After the births of our three boys, I decided to have surgery for a tubal ligation. I loved my children very much, but three seemed like plenty. Mark said the decision was up to me. During the pre-op exam, the doctor explained the failure rate was only 1 in 500. Those odds were unsettling. "Not bad odds for a million dollar lottery," I thought. A failure could result in a tubal pregnancy, which could result in death. That thought weighed heavily on my mind. I canceled.

The next line of attack was birth control pills prescribed by my Catholic doctor/priest. (He had become a priest first then received permission to go through medical school and become a doctor.) When my cycle started up again halfway through the package of pills, it was obvious they were not working. My doctor/priest had explained they contained a low dose of estrogen to avoid common side effects. Obviously, the dose was so low that they were not preventing ovulation as intended. I tossed them out.

The following month I became pregnant. When Mark heard the news, he announced: "I've been praying for this." It turned out the big sneak had literally been praying on the sly. He liked the idea of having another baby and decided to pray rather than argue about it. I was actually happy about the news. A diehard baby lover like myself could not help but rejoice at another little one. This may seem odd from a person taking precautions against having more children, but as you can see, none of this was very well thought out.

Jacob was born on May 13, the anniversary date of Our Lady of Fatima's first appearance in Fatima, Portugal. It was also Mark's birthday and Mother's Day. Mark too had been born on Mother's Day thirty-three years earlier. Happy Birthday Mark — from God.

During this time in our lives, we began reading about various Marian apparitions and were inspired for the first time to pray the rosary. We stopped missing Sunday Mass and began learning more about our faith. Still, we were not fully converted yet — particularly when it came to family planning. There's always a learning curve and we did not go from A to Z overnight. After four children, I insisted Mark have a vasectomy. He resisted at first but finally relented.

Reality Hits

Initially, I was oblivious that we had done anything wrong. But gradually, as I grew to desire God's will in my life, started making visits to Jesus in the tabernacle and continued praying the rosary, a feeling grew in me. I realized that the Church, which Christ had founded to guide us until the end of time, had authority to teach on spiritual matters, including matters relating to sexuality. I had been given no such authority.

I shared my feelings of regret over Mark's sterilization with him. He was less than thrilled since he thought it was a bad idea to begin with. As a matter of fact, he accused me of being like Eve. "You are right," I agreed. "But remember, Adam was kicked out of the garden, too." We began praying that God's will would be done in our lives, including whether we would have more children. We determined that if it was God's will, Mark's vasectomy would fail.

But, one night, I had a dream in which I saw two babies — one blonde and one dark-haired. I felt an intense love for these babies as if they were my own. At the end of the dream, I was made to know that these were babies God had planned for us, but because we had not lived in union with His plan, they would never be born. I woke up feeling like a mother who just lost her babies. I knew the only way to get to them was to convince Mark to have a reversal of his vasectomy.

When Mark came home from work that day, I approached him with my idea for a reversal. He would have none of it. I barely got two sentences out of my mouth before he announced the subject was officially closed. Even if we could afford it, he was completely unwilling to subject himself to another surgery. Now, it was my turn to pray behind Mark's back. "Okay God," I prayed, "I want to do Your will but I am powerless to change Mark's mind. I'm putting everything in Your hands." Then, I just kept praying.

Of One Mind

Several months had passed when one morning after Sunday Mass, Mark casually wondered out loud how much a reversal operation would cost. "I know," I announced. Before Mark had shot my idea down, I had called the doctor's office to get all the information.

"I can't get off from work this month," Mark said, "but next month I could go in and get it done." I was both shocked and thrilled. We did not have the money to pay for it, but we determined we could probably make payments.

"What changed your mind?" I finally asked, wondering what had caused such a drastic change of heart. His answer took my breath away.

"I had a dream last night," Mark said. "I saw two babies that God had planned for us." I had never told a single soul about my dream.

Three months later, we were expecting a baby. I had a strong feeling that it would be our first girl and God wanted us to name her Mary after the Blessed Mother who had intervened for us. We had never considered the name with any previous pregnancy. I wrote on a slip of paper, "Yes, I think Mary would be a good name," and tucked it in my wallet. I figured that when God let Mark in on the plan, I would pull out the slip and show him.

Our blond-haired baby girl, Mary, was born on December 22, 1993. A few months before her birth, we inherited the exact amount of money we needed to pay Mark's reversal surgery in full. Dark-haired Teresa was born on my birthday, April 18, 1996. I thought we must be done now that we had the babies from our dream. Mark said he thought ten would be a good number of children. I did not actually take this seriously. I recalled that when St. Maximilian Kolbe was young, he had received a vision of Our Blessed Mother. She had shown him two wreaths of roses — one of red representing martyrdom, and one of white, representing purity. She asked him which he would like to choose. He chose both. I wondered if, like St. Maximilian, we should volunteer to take on more than God asked? We prayed for guidance.

John was born on August 31, 1999 and Isaac was born on his sister Mary's birthday, December 22, 2001. We are a family of twelve now, including two brothers who were AIDS orphans from Kenya. As of this writing, the ages range from 24 to 6. There could be no greater blessing on our family than our precious children. The kid's love for each other runs deep. I know that one of the biggest draws for my oldest sons to come home for visits is to spend time with their siblings.

The moral of this story is not that everyone must have a big family to do the will of God. No, my plan is not your plan. The moral of my story is that God has a plan for us all. To discern His plan and strive to live in union with it, we must learn and embrace the teachings He gives us through His Church. Nowadays, there is an abundance of authors, speakers and organizations that support and encourage couples in this way. I have no doubt that much of that information was available back when I first married, but I did not make it my business to learn about it. Make it your business to learn because, until your plan is God's plan, it's the wrong one.

Patti Maguire Armstrong is the mother of ten children including two Kenyan AIDS orphans. She is a speaker and the author of Catholic Truths for Our Children: A Parent's Guide (Scepter). She is also the managing editor and co-author of Ascension Press's Amazing Grace book series. Her website is