Does the Oral Contraceptive Pill Cause Abortions?
One area of controversy among pro-life Christians concerns the oral contraceptive pill (OCP).
Actually, there is more than just one moral debate regarding this pill. However, the most important issue has to do with its potential function as an abortifacient, i.e., something that causes abortions. This will be the main focus in what follows.
THE TYPE OF PILL IN VIEW IN THIS ARTICLE
Before getting into the discussion itself, we need to be clear about the type of pill we are thinking about in this article. This is important, because not every sort of birth control pill has the same ingredients.
One kind of pill contains the hormone progesterone but does not contain the hormone estrogen. This is sometimes known as the "mini pill." It is not the pill that most women take. Pro-life Christians seem to agree quite broadly that this type of pill sometimes acts as an abortifacient and that it should be avoided.
More commonly, women use an oral contraceptive pill that contains both progesterone and estrogen. This is the standard type of pill that women take daily, and it is what "OCP" refers to in this article.
Differing views regarding the OCP
Pro-life Christians differ on whether or not it is acceptable to use the OCP.
On the one hand, there are Christians who say that concerns over the abortifacient nature of the OCP mean that it shouldn't be used. Some of these believe that the scientific evidence is clear that the OCP is an abortifacient. Others think that the evidence is not so clear, but argue that because it may be an abortifacient, women shouldn't risk using it.
On the other hand, there are Christians who say that it is morally acceptable to use the OCP. Some of these deny that the OCP acts as an abortifacient. Others think it may or does occasionally act in this way, but argue that because the main aim of taking it is not to cause an abortion, it is fine to use it.
In what follows, we will be asking which of these viewpoints is correct. To keep things concise, I will refer to pro-life Christians who say that the OCP should not be used as "anti-OCP Christians." And I will refer to pro-life Christians who say that the OCP may be used as "pro-OCP Christians."
DOES THE OCP ACT AS AN ABORTIFACIENT?
The most important question we need to ask is whether the OCP acts as an abortifacient.
I am not a doctor or biologist myself, so I am not able to speak with authority on the scientific aspects of this issue. Nevertheless, I have spent some time reading what the experts have to say, and I do think it is possible for a lay person to reach some cautious conclusions on this point.
What the pharmaceutical companies claim
Firstly and importantly, we need to take account of what the pharmaceutical companies which make the OCP say in their literature.
As far as I am aware, all these companies claim that the OCP works in two basic ways. First, it prevents the sperm fertilizing the egg, i.e., conception. And second, it prevents implantation of the fertilized egg in the lining of the womb.
If there are any companies that make a different claim, I have not come across any. And I am confident that at least the vast majority of companies claim that the OCP works in these two ways.
If the OCP does indeed work in the second of these ways, then it would certainly be an abortifacient. As pro-life Christians, we are clear that a human being exists from the moment of conception. So, if the OCP acts to prevent the implantation of the fertilized egg in the womb, it is acting to prevent the human being from continuing to live. And therefore it is an abortifacient.
It is true that fertilized eggs very often naturally fail to implant in the womb anyway. But that is beside the point. If a substance is taken that increases the likelihood of failure to implant, then that substance is certainly an abortifacient.
Pro-OCP Christians who comment on the claims of pharmaceutical companies on this point often argue as follows:
There is no scientific evidence that the OCP prevents implantation of the fertilized egg in the womb. This is misinformation by pharmaceutical companies. These companies are guarding themselves against potential lawsuits by claiming that the OCP prevents implantation, just in case it is found that it does act in this way.
This seems to be a very weak argument. Ever since the OCP was developed in the 1950s, manufacturers have claimed that one of the ways it works is by preventing implantation in the lining of the womb. And there seems to be no good reason for thinking that this is all misinformation.
Thinning of the lining of the womb
Secondly, there is the thinning of the lining of the woman's womb to consider.
Everyone agrees that the OCP usually causes women who are taking it to have a much thinner lining of the womb than women who are not on the OCP. And everyone agrees too that it is usually much more difficult for a fertilized egg to implant in a thin lining than in a lining of normal thickness. Unsurprisingly, anti-OCP Christians see this as a strong piece of evidence that the OCP is an abortifacient.
Some pro-OCP Christians try to counter by arguing in this way:
It is true that women on the OCP who are not ovulating have a thin lining of the womb. However, when the OCP fails to prevent ovulation in a woman who is taking it and she has a "breakthrough ovulation," her body will act to reverse the effect of the OCP on the lining of the womb. The chemicals that are released will thicken the lining and make it receptive to implantation. Therefore, the OCP does not act as an abortifacient.
Again, this seems to be a weak argument. It looks unjustified to claim that when a woman on the OCP ovulates, there will be an immediate thickening and alteration of the womb's lining to the extent that all effects of being on the OCP are immediately reversed.
The amount of blood produced by women during their periods depends on the thickness of the lining of the womb. Women on the OCP usually have lighter periods than those not on the OCP. But importantly, when a woman stops using the OCP and starts ovulating again, it usually takes a few months before her blood flow is back to what it was before she started taking the OCP. This is a significant piece of evidence that when a woman's lining is thin as a result of taking the OCP, it normally takes months after she begins ovulating before her lining gets back to normal thickness.
Therefore, it makes sense to think that even if a woman on the OCP experiences breakthrough ovulation, she will very probably still have a thinner lining of the womb than she had before she started taking the OCP. And if this is right, because a thinner lining makes it more difficult for the fertilized egg to implant, the OCP would be acting to hinder implantation. In other words, it would be functioning as an abortifacient.
Drawing a conclusion
It seems, then, that there are two good reasons for thinking that the OCP does sometimes act as an abortifacient. Pharmaceutical companies widely claim that it works in this way. And the fact that it usually takes time for the blood flow of women who stop taking the OCP to return to normal is also a strong piece of evidence.
I think a balanced conclusion is that it is highly likely that the OCP does at times cause abortions.
TREATING THE OCP AS A MEDICINE
Some pro-OCP Christians agree that the OCP does at times act as an abortifacient. And other pro-OCP Christians, similarly, agree that it may sometimes act as an abortifacient.
Those in each of these groups often argue as follows:
The main purpose of the OCP is to prevent conception. It does this far more often than it acts as an abortifacient. Therefore any abortifacient function is just an unwanted side-effect. Medicines are prescribed all the time that have unwanted side-effects and even a low risk of causing death. The OCP is just one of these. Besides, there is no other medicine that achieves the same results as well as the OCP.
This is a very weak argument that includes some mistaken thinking.
A faulty understanding of the purpose of the OCP
Firstly, it is surely not the case that the main purpose of the OCP is specifically to prevent conception. Most women who take it do so for the purpose of avoiding a clinically recognized pregnancy. And relatively few of them will know how the OCP works in any detail.
Similarly, doctors who prescribe the OCP typically have the same purpose in view: preventing a clinically recognized pregnancy.
It is therefore surely wrong to see the potential abortifacient function of the OCP as a side-effect. If the OCP acts as an abortifacient, as seems highly likely, then, far from being a side-effect, this is one of the basic ways in which it works.
It is true that the OCP does apparently prevent conception far more often than it causes abortions. Nevertheless, it still seems highly probable that it causes some abortions. And many experts believe that the occasions on which it does this are far from rare.
Taking the OCP to prevent pregnancy is not medicinal
Secondly, when the OCP is prescribed for the purpose of preventing pregnancy, it is stretching things to see it as a medicine. A medicine is a substance taken to heal some ailment. However, if a woman has sex and becomes pregnant, it is hardly the case that anything is wrong with her.
Natural methods of contraception
Thirdly, there are other effective ways of preventing pregnancy that don't involve tampering with the woman's body. Nowadays natural family planning is very sophisticated and scientific, with results that are on a par with the effectiveness of the OCP.
The Creighton method of natural family planning is one that anti-OCP Christians often speak highly of. Another is the Billings method.
Drawing a conclusion
The argument by pro-OCP Christians that appeals to viewing the OCP as an important medicine with side-effects therefore seems to be a very weak one.
AVOIDING THE OCP
I have argued that it is highly likely that the OCP functions as an abortifacient. And I have just argued too that to accept its abortifacient function as an acceptable side-effect is unjustified.
If the points I have made are valid, as I think they are, it seems wrong to use this product. There is simply too much doubt about its moral acceptability. Let us be clear that we are talking here about matters of life and death. And because other, natural methods of family planning exist, there seems to be no justifiable reason for women to use the OCP for the purpose of avoiding pregnancy.
If a pregnant woman's life is in danger because of some illness, and a side-effect of her medication involves a risk of causing abortion, it seems to me that there would be a place for a legitimate ethical debate about whether she should take this medicine.
However, taking a substance to avoid getting pregnant is hardly of the same urgency as combating a life-threatening illness. Regardless of whether or not it is by design, the evidence suggests that one of the ways the OCP works is by causing abortions, and that should be enough to decide against using it.
IGNORANCE ABOUT THE OCP'S POTENTIAL TO CAUSE ABORTIONS
As far as I am aware, there are huge numbers of pro-life Christians who have never heard any suggestion that the OCP is or might be an abortifacient. Until a few years ago I myself had never heard anyone mention this.
I think one reason for this ignorance is that over the last 50 years or so there has been a change in how pregnancy is defined. It used to be the case that a woman was said to become pregnant at the moment of conception, when the sperm fertilized the egg. Increasingly, however, people now say that pregnancy begins when the fertilized egg attaches to the lining of the womb, about a week after conception.
The definition of abortion has remained the same, i.e., as a termination of pregnancy. However, because the definition of pregnancy has changed, this means that destroying a fertilized egg in the first few days of its existence is no longer usually classed as an abortion. Therefore, the OCP's potential ability to destroy in this way is not usually described using the word "abortion." And so, most people are unaware of its probable abortifacient function.
The reason for the change in the definition of pregnancy seems obvious. People have suppressed their consciences (Romans 1:18) and are trying to kid others and themselves that wrong is not wrong. If they can persuade people, including themselves, that a woman doesn't get pregnant until a few days after conception, and that any destruction of a fertilized egg in that time window is not an abortion, then it is not so hard on their consciences. They are more able to have all the sex they want without any consequences they don't want.
A HUMAN BEING FROM THE MOMENT OF CONCEPTION
We must not be fooled into thinking that the tiny physical size of a fertilized egg in the first few days after conception means that it is somehow less than human. That would make no sense.
Christian theology rightly recognizes that human beings are made up of a material part and an immaterial soul. Although the material part of the human grows in size as fertilized egg, embryo and fetus, and then after birth as a body, the soul is indivisible and cannot grow in size or exist in part. This means that whenever a human soul is present, a complete soul has to be present.
There should be no doubt that immediately before a baby is born it already has a soul, and few people calling themselves Christians would dispute this. But if it already has a soul before birth, it makes sense to think that the joining of the soul to the material part of the human occurs at some critical point. However, before birth the only really critical point that exists is conception.
If we were to say that the soul joins to the fertilized egg or embryo or fetus at some time after conception but before birth, what reason would we give for taking this view? Why would we think that the soul joins after the physical component of the human has been growing for a week? Or why would we think this happens after 10 days or after 20 or 40? Crucially, nothing critical happens at these times. But, by contrast, the time the sperm fertilizes the egg is a real critical point, and this is surely the time at which the soul joins the physical part of the human.
Thinking, then, that the tiny size of a human fertilized egg in the first few days after conception means that it is not really a human being doesn't make sense. In fact, a human being with a human soul is present. And we must therefore not underestimate the seriousness of what taking the OCP involves.
ANOTHER MORAL ISSUE CONCERNING THE OCP
The potential abortifacient function of the OCP is not the only moral issue concerning this product. The fact that it works by preventing a woman ovulating is also controversial.
This is not such an important topic as the one we have been discussing. Nevertheless, for the record, I personally think it is doubtful that deliberately preventing a woman from ovulating is in itself morally acceptable. I think this is one of the few areas where Roman Catholics are more likely to be on God's side than most evangelicals. Hindering the normal function of a woman's reproductive organs seems to me to be intruding into what should be God's domain.
Mainstream Western culture sees individual choice as something that is almost sacred. This includes a woman's choice to destroy a pre-born human that she may be carrying in her womb.
However, the Western, human-centered worldview is poles apart from the Christian, God-centered worldview. Christians need to understand clearly that many choices which Western people typically regard as legitimate are nothing other than grave sins in God's sight. We must understand too that on the Day of Judgment we will each have to give an account to Him for all that we have done.
Any believer who is not submitting to God in matters of family planning is therefore committing a serious sin. And that includes decisions about whether to use or endorse using the OCP.
In view of the points we have discussed, it makes sense to think that the dangers of using this product are too great. There are other, natural methods of family planning that don't carry the risk of causing abortions, and these should be used instead.
I would also love to see church leaders do more to teach their flocks about this and similar issues. Too often, there seem to be "no go areas" that leaders shy away from. However, a leader who is concerned about the spiritual well-being of his flock should want to warn them about anything that is outside the will of God. And that includes issues of family planning.
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