Birth Control Pills: Abortive or Contraceptive?

[Stuart]

Let's see if we can keep this from turning into a flaming session or a religious debate. My intention here is not to debate the question of abortion, simply to determine the validity of the claims you will see below.

We all know that there are options of birth control available today. Some are mechanical methods (condom, diaphragm, etc.), others are hormonal methods (birth control bills, etc.). I recently stumbled across some articles on birth control pills (BCP) that brough an issue to my attention of which I was completely unaware. I know that there are a couple of pharmacists on the site, and some others in the medical field, so let's see where this goes.

As I always understood it, BCPs were purely contraceptive in nature. To my understanding they worked to inhibit ovulation and to make it difficult for sperm to travel to an egg. Both of these actions are contraceptive in nature.

The article I came across, however, states that BCPs also actually thin and shrivel the line of the uterus to the point where it is unable to facilitate the implantation of a newly fertilised egg. Assume for a moment (let's not debate this right now) that human life begins at conception--when the egg is fertilised by the sperm. If BCPs prevent implantation of a fertilised egg, and if life begins when the egg is fertilised, this means that BCPs actually have an abortive effect too.

The Physician's Desk Reference, which is (I'm told) the most widely used reference book by American physicians, says this about one BCP:

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.

It says similar things about other BCPs. This article makes similar claims.

So, again without delving (unnecessarily) into the abortion and beginning-of-life debate, anyone have any insight into precisely how these pills work?

[Sojourn]

Combined oral contraceptive pills were developed to prevent ovulation by suppressing the release of gonadotropins. Combined hormonal contraceptives, including COCPs, inhibit follicular development and prevent ovulation as their primary mechanism of action.[1][19][60][61][62]

Progestagen negative feedback decreases the pulse frequency of gonadotropin-releasing hormone (GnRH) release by the hypothalamus, which decreases the release of follicle-stimulating hormone (FSH) and greatly decreases the release of luteinizing hormone (LH) by the anterior pituitary. Decreased levels of FSH inhibit follicular development, preventing an increase in estradiol levels. Progestagen negative feedback and the lack of estrogen positive feedback on LH release prevent a mid-cycle LH surge. Inhibition of follicular development and the absence of a LH surge prevent ovulation.[1][19][60]

Estrogen was originally included in oral contraceptives for better cycle control (to stabilize the endometrium and thereby reduce the incidence of breakthrough bleeding), but was also found to inhibit follicular development and help prevent ovulation. Estrogen negative feedback on the anterior pituitary greatly decreases the release of FSH, which inhibits follicular development and helps prevent ovulation.[1][19][60]

A secondary mechanism of action of all progestagen-containing contraceptives is inhibition of sperm penetration through the cervix into the upper genital tract (uterus and fallopian tubes) by decreasing the amount of and increasing the viscosity of the cervical mucus.[62]

Other secondary mechanisms have been hypothesized. One example is endometrial effects that prevent implantation of an embryo in the uterus. Some pro-life groups consider such a mechanism to be abortifacient, and the existence of postfertilization mechanisms is a controversial topic. Some scientists point out that the possibility of fertilization during COCP use is very small. From this, they conclude that endometrial changes are unlikely to play an important role, if any, in the observed effectiveness of COCPs.[62] Others make more complex arguments against the existence of these mechanisms ,[63] while yet other scientists argue the existing data supports such mechanisms.[64] The controversy is currently unresolved.

Shameless wiki copy/paste.

[Stuart]

I should probably add that really technical medical discussions are going to be WAY over my head. I was hoping for simplified discussion. That being said ...

Other secondary mechanisms have been hypothesized. One example is endometrial effects that prevent implantation of an embryo in the uterus. Some pro-life groups consider such a mechanism to be abortifacient, and the existence of postfertilization mechanisms is a controversial topic. Some scientists point out that the possibility of fertilization during COCP use is very small. From this, they conclude that endometrial changes are unlikely to play an important role, if any, in the observed effectiveness of COCPs.[62] Others make more complex arguments against the existence of these mechanisms ,[63] while yet other scientists argue the existing data supports such mechanisms.[64] The controversy is currently unresolved.

Fair enough, but despite the small odds it's still possible? At least that's what I can garner from the above.

[Monty]

The female body naturally aborts fertilized ovum, if the egg is not fertilized at the right time and in the right manner, the chances of it implanting are tiny. If the pill does stop inplanting, it just makes the criteria a bit harder to meet. (BCP are no means a 100% safe for preventing an implanting - there are cases of women falling pregnant while on the pill)


And I think life only truly starts when you have a functioning Central Nervous System (aka Brain and spinal chord)

[ryanrich]

The female body naturally aborts fertilized ovum, if the egg is not fertilized at the right time and in the right manner, the chances of it implanting are tiny.


And I think life only truly starts when you have a functioning Central Nervous System (aka Brain and spinal chord)

Yup. And agreed.

[Stuart]

The female body naturally aborts fertilized ovum

But that is the natural process of the human body. There's a difference (in my mind) between a woman's body naturally aborting a fertilised egg and a third party checmical process doing so. I guess my question is, is it possible for BCPs to act in this abortive capacity quite apart from the natural action of the female body?

[RuadRauFlessa]

The female body naturally aborts fertilized ovum

But that is the natural process of the human body. There's a difference (in my mind) between a woman's body naturally aborting a fertilised egg and a third party checmical process doing so. I guess my question is, is it possible for BCPs to act in this abortive capacity quite apart from the natural action of the female body?

No as it uses the same hormones present in the human body to facilitate the desired results. Ex it is either a hormone booster or suppressor. It does not alter the genetic makeup of the body itself.

[Tribble]

No idea - I took the pill when I first got married. We were not ready for children and I believe it would have been detrimental to the marriage had I fallen pregnant too early. Saying that - my third child was conceived while I was on the injection. I believe that if it is meant to happen - it will no matter what preventative measures you take.

Before I had kids I believed strongly that abortion was wrong. Now I see things differently. Kids that are born to mothers who did not want them are often mistreated, abused and left to fend for themselves. That is a far worse crime in my eyes than taking a pill to prevent the birth in the first place. So whether a pill is used or a condom - a child will not have to suffer in this world.

[Sojourn]

Stu, great starting this conv... but what is your stance on this?

[Stuart]

The female body naturally aborts fertilized ovum

But that is the natural process of the human body. There's a difference (in my mind) between a woman's body naturally aborting a fertilised egg and a third party checmical process doing so. I guess my question is, is it possible for BCPs to act in this abortive capacity quite apart from the natural action of the female body?

No as it uses the same hormones present in the human body to facilitate the desired results. Ex it is either a hormone booster or suppressor. It does not alter the genetic makeup of the body itself.

Okay, fine, but that still means that it's an external factor that is creating a hostile environment in the womb for implantation.

(BCP are no means a 100% safe for preventing an implanting - there are cases of women falling pregnant while on the pill)

For what it's worth, I'm well aware of this fact. As a matter of interest, here is a table containing failure rates for various forms of contraception.

I believe that if it is meant to happen - it will no matter what preventative measures you take.

I know a couple who, after the birth of their last (planned) child, had surgical procedures done. She had her tubes tied; he had a vasectomy. When she turned 40 she fell pregnant (and carried the child to full term)!

[ryanrich]

She had her tubes tied; he had a vasectomy. When she turned 40 she fell pregnant (and carried the child to full term)!

I want the name of their doctor please. I'd like to make a note to never ever use him/her...

I'm considering getting a vasectomy, but I'll probably wait another 5 years just to make sure...

[Stuart]

She had her tubes tied; he had a vasectomy. When she turned 40 she fell pregnant (and carried the child to full term)!

I want the name of their doctor please. I'd like to make a note to never ever use him/her...

It was in the US, so I think you're safe. On the other hand ...

I'm considering getting a vasectomy, but I'll probably wait another 5 years just to make sure...

Another friend had his done at the Linksfield and, well, let's just say it wasn't pretty. Infections ... ICU ... weeks off work ... you getting the picture?

(Interestingly, his wife fell pregnant too after the ordeal was over, but she lost the baby.)

[Stuart]

Stu, great starting this conv... but what is your stance on this?

I'm just interested in the medical side of things. You see, from where I sit things are quite different. People are going to ask me what the Bible says about the issue. Obviously, the Bible doesn't address BCPs per se, but there are principles.

For example, the Bible teaches that human life begins at conception. That means when an egg is fertilised inside the female body, human life has begun. To do anything to terminate that life, or to make the womb hostile towards that life, would be equivalent to ending human life, which we have no right to do.

So, if the research that I came across is correct--if BCPs inhibit the implantation of a fertilised egg into the uterus, thereby effectively terminating a pregnancy--I would not in good conscience be able to recommend BCPs to anyone.

It's a sensitive subject, because I've always assumed that BCPs do no more than inhibit fertilisation, which is one thing. But if they actually do harm to an egg that is already fertilised, it's another matter entirely.

This is why I said I do not wish to delve into a religious debate. Obviously, your views will vary depending on your view of abortion, on your view of when life begins, etc. but you understand where I'm coming from.

[jee]

I'm considering getting a vasectomy, but I'll probably wait another 5 years just to make sure...

Doctors (proper ones ) will not do it if you are too young.

[ryanrich]

I'm considering getting a vasectomy, but I'll probably wait another 5 years just to make sure...

Doctors (proper ones ) will not do it if you are too young.

I know, many Doctor friends in our family. They take many things into consideration nowadays such as age (over 25), the consent of both partners, previous relationships and children, mental wellbeing etc...

I'm quite fine in all of the above.

I won't soon though. It can be reversed, but yikes!

My dad had the snip about 7 years ago, and I still remember the look on his face when he got home...

[Stuart]

I know, many Doctor friends in our family. They take many things into consideration nowadays such as age (over 25), the consent of both partners, previous relationships and children, mental wellbeing etc...

I'm quite fine in all of the above.

Are you sure about that?



Edit: TOTP ... of course!

[lancelot]

Not all BCP pills work the same way, it would be reasonably easy to find out the mechanisms of the different types of BCP. However you are now venturing into the realms and beliefs of the Vatican, this has been their argument for years now.

My view:
If life begins at conception then by the same token if conception is prevented by what ever means, conception has not taken place. Therefore life has not begun. The same argument must apply to condoms et al, you are trying to formulate a teaching as to whether BCP or any other preventative method is acceptable. It is debatable, in the OT that is, whether sex should be had for pleasure or procreation.

[Stuart]

Not all BCP pills work the same way, it would be reasonably easy to find out the mechanisms of the different types of BCP.

Interestingly, at the original source where I read this, the author said that he researched every BCP he could find and all of them did this. He admitted that there may be some out there that don't, but if so they're rare. (I didn't quote the original site where I found this because it is a Christian site and didn't want the whole guilty-by-association thing to enter.)

Edit: The original source also said that the leaflets left in the box often didn't contain information about the "abortive" effect of BCPs, and he actually had to look at fuller research papers on the drugs in question to find this information.

However you are now venturing into the realms and beliefs of the Vatican, this has been their argument for years now.

Really? I always knew that the RCC was completely against contraception. I didn't know that this was part of the reason. But then I didn't even know that this was a reality.

My view:
If life begins at conception then by the same token if conception is prevented by what ever means, conception has not taken place. Therefore life has not begun. The same argument must apply to condoms et al, you are trying to formulate a teaching as to whether BCP or any other preventative method is acceptable.

I would agree largely with you. I don't have a problem with contraception that prevents fertilisation. I don't even think that that's a questionable issue ... regardless of what the Vatican thinks. I think it becomes questionable when a (third party) chemical procedure enters the picture to prevent implantation of an already fertilised egg.

It is debatable, in the OT that is, whether sex should be had for pleasure or procreation.

I'm not convinced that's true. Ever read Song of Solomon?

[jee]

I'm not convinced that's true. Ever read Song of Solomon?

he did not have to worry about contraceptives

[Stuart]

I'm not convinced that's true. Ever read Song of Solomon?

he did not have to worry about contraceptives

Fun Fact: Solomon had 700 wives and 300 concubines, and only (to my recollection) one recorded child.

Edit: Make that three recorded children. One son. Forgot about his daughters.

[lancelot]

Sure I have, it is eroticism at its best, excellent reading, puts the good Book right up there But then Onan? cant remember the gents name right now, was told in no uncertain terms not to spill his seed. But I digress.
Th BCP has been with us now for decades, it has always been controversial, I agree with you not quoting the site, some of these writers tend to get very carried away and allow their own ideas to take sway to the detriment of Christianity. I too have not studied the pill lately, have no need so the methodology used could have changed dramatically. When it comes to the morning after scenario it is clear cut, ie abortion but I still have my doubts that this applies to the standard BCP.
I must read up on this scenario some more. When I first read your post I was of the opinion that the referral was to the "morning after" pill which duplicates what you have been discussing, ie the fertilized egg is aborted.

[Stuart]

Sure I have, it is eroticism at its best, excellent reading, puts the good Book right up there But then Onan? cant remember the gents name right now, was told in no uncertain terms not to spill his seed. But I digress.

Onan's problem (Genesis 38:6-10) was bigger than simply spilling his seed. He had a legal obligation to father children on behalf of his dead brother (Deuteronomy 25:5-10). This was a common part of ancient legal codes, even before it was set in place by Moses. The problem wasn't with birth control per se, but with the fact that he refused to fulfil his obligation to father children on his brother's behalf.

When I first read your post I was of the opinion that the referral was to the "morning after" pill which duplicates what you have been discussing, ie the fertilized egg is aborted.

Again, I agree. I've never been in favour of the so-called morning after pill. But what the research I am now reading is saying is that even regular BCPs (as opposed to the morning after pill) produce (or are designed in such a way that they can produce) early abortions.

[lancelot]

A quick scan of the BCP and aborting the fertilised egg has brought up tons of pro lifer and so called scaremongering Christian groups. I am always wary of 'over the top' so called research. I am a raw fundamentalist Pentecostal and so hold very firm views on certain doctrine, however this is not one of them, at the moment anyway.

[Anakha56]

My views on this...

Thank the magic pill it exists!!! I would be in so much trouble without it

But I agree with:

And I think life only truly starts when you have a functioning Central Nervous System (aka Brain and spinal chord)

But then again I am just happy I have not procreated yet .

[Stuart]

But then again I am just happy I have not procreated yet .

So are we.