By Patricia Pitkus Bainbridge
Director, Respect Life Office
I attended a meeting recently where a discussion ensued about the mechanisms of the birth control pill (“The Pill”) and other hormonal “contraceptives.” Sitting around a large configuration of tables were about forty people all of whom are ardently pro-life. All but four were Catholic.
With the exception of two individuals (one Catholic and one Evangelical), everyone in the group agreed that the scientific evidence clearly demonstrates that one of the mechanisms of hormonal contraception is to render the endometrium of the uterus hostile to implantation—thus potentially acting as an early abortifacient.
The dissenters said they did not know if hormonal contraception can cause an abortion. If these two solidly pro-life individuals are unclear about the nature of hormonal contraception, it logically follows that there are many others who are also confused.
First things first
There are basically two categories of hormonal contraceptives—combined (monophasic, biphasic, or triphasic) oral contraceptives (COCs) and progestin-only methods.
Common COCs are “The Pill” (including, but not limited to: Allesse, Estrostep, Lo/Ovral, Milvane, Mircette, Mirelle, Nordette, Ortho-Novum, Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Ovral, Sequilar, Seasonale, Triphasil, Triquilar, and Yasmin); the hormone releasing vaginal ring (NuvaRing); and the patch (Ortho Evra).
Progestin-only methods include “mini-pills” including but not limited to: Micronor, Nor-QD, Ovrette; Depo-Provera also known as DMPA that is given by injection every three months; the intrauterine system (IUS) Mirena which may be left in place for up to five years and the intrauterine device (IUD) Progestasert Progesterone T which must be replaced yearly.
How do hormonal contraceptives work?
The Physicians’ Desk Reference (PDR) has been published for more than fifty years and is the most trusted source of information on both prescription and over-the-counter drugs. It is used by physicians, nurses, pharmacists, and others who need accurate information about drugs.
The pharmacology of COCs is explained in the PDR’s 2006 edition (p. 2395):
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.The pharmacology of progestin-only contraceptives is also addressed (p. 2411):
Progestin-only contraceptives prevent conception by suppressing ovulation in approximately half of users, thickening the cervical mucus to inhibit sperm penetration, lowering mid-cycle LH and FSH peaks, slowing the movement of the ovum through the fallopian tubes, and altering the endometrium.
While this same information concerning the mechanisms of combined oral contraceptives and progestin-only contraceptives is included in the package inserts for physicians and pharmacists, it typically is not found in the patient package insert.
Every hormonal “contraceptive,” without exception, lists altering of the endometrium as one of its possible actions. Most mention “thinning” or “atrophy” of the endometrium which makes it “unsuitable” or “hostile” for implantation of the “fertilized egg” (very tiny human being). Some describe the action as “keeping the uterine lining from thickening to prevent implantation of a fertilized egg.” Of course, these descriptions are just clinical ways of describing a potential, very early abortion; if a human embryo cannot implant in the endometrium, he or she will die.
Speaking before the United States Supreme Court in the 1989 case of Webster v. Reproductive Health Services, attorney Frank Sussman (representing the abortionists) commented, “The most common forms of what we most generally in common parlance call contraception today, IUD’s, low-dose birth control pills, which are the safest type of birth control pills available, act as abortifacients. They are correctly labeled as both.”
According to the Mayo clinic website (hardly a pro-life site), “hormonal contraceptives, a popular method of birth control . . . prevent pregnancy by inhibiting ovulation, by altering cervical mucus, which decreases sperm mobility, and by impairing embryo implantation in the uterus.”
Why, then, is there lack of agreement?
The 1995 edition of Stedman's Medical Dictionary defines pregnancy as “the condition of a woman or female mammal from conception until birth.” It defines “conception” as “the formation of a viable zygote by the union of a spermatozoon and an ovum; fertilization.”
The American College of Obstetricians and Gynecologists (ACOG) and other abortion advocacy groups reject the traditional definition. They want people to believe that conception and pregnancy begin at implantation. This is one reason some physicians do not acknowledge the abortifacient mechanism of hormonal contraceptives. If you reject the long standing definition of conception, you can refuse to recognize that preventing implantation is an early abortion.
No wonder there is so much confusion. It would seem that a standard medical dictionary would take precedence over a vote by members of an organization, but sadly, that is not the reality. Those who claim that hormonal contraceptives cannot cause early abortions do so on the basis of this distorted and politically convenient definition of “conception.”
It is sometimes argued that hormonal “contraceptives” cannot have an abortifacient mechanism as some women do become pregnant while taking the pill. In reality, this means all three mechanisms of the pill failed. Altering the endometrium does not imply that implantation is impossible, just that it is less likely.
One does not have to be a researcher to recognize that the manufacturers of hormonal contraception know the mechanism of action of their products. The drug companies concede, albeit sometimes reluctantly, that these “contraceptives” alter the endometrium. They know that when the endometrium is thinned or altered, the survival of tiny humans if far less likely.
It does not take a leap of logic to understand that if a woman is taking hormonal “contraceptives” and ovulation occurs, there is a greater chance that the newly formed human will be aborted. Denying this is intellectually dishonest, even if it is politically and financially beneficial.
So far, 227 physicians have publicly signed on to the following:
We, the undersigned physicians do therefore declare that the pill and similar birth control products act, part of the time, by design, to prevent implantation of an already created human being. These products clearly cause an early abortion and are — despite the semantic gymnastics of their ardent apologistsIn no way, does this mean that hormonal contraceptives always act as abortifacients. Implying that would be as intellectually dishonest as saying they never do.
Those who remain unconvinced may learn more by visiting the following web sites: