I’m Pro-Life and I’m on the Pill

Being the first of most of my friends, either from church or college, to get married has made it necessary to do my own research on birth control options, without having many married female friends to pass information onto me about their decisions and research (this is, of course, because in conservative Christian circles, it’s usually assumed that you don’t have sex before marriage, and so education about birth control is either passed on by hearsay, your mom’s [usually bad] experience with it, or WORLD magazine articles about the pro-life movement). Any information I received was either 20 years outdated, sketchy on the science, or based on Catholic “rhythm method” information about how the female fertility cycle works.

My mom’s a nurse, so I like to take medical science seriously and believe in the worth of precautionary measures and immunizations and all that stuff that’s often dismissed in super-conservative circles as bad science and propaganda from pharmaceutical companies. While I am suspicious of the FDA and pharmaceutical groups and their back room brokerage, I do believe that most of the fine print information for medications is as accurate as possible, and I have the curiosity and patience to sort through it.

So when Kevin and I got engaged, we talked a lot about our expectations for family planning and what we felt convicted about and called to (to use the common phrases). Since I came from a big family where I had been heavily involved in helping with my younger siblings, I really didn’t feel comfortable trying to have kids right away. I [rightly, so far] felt like God had a lot of things to teach me before I became a mom, and we both wanted some time to be a married couple together before starting a family. (This is a bigger issue for some people–“Is God okay with me trying to control when I become a parent? Is this an issue where I lack faith?”–than it was for us. These questions are worth prayerfully considering on your own and together as a couple. For us, we felt like we would honor God better by waiting a bit so we could be a more mature couple and give our kids stable home, financially and emotionally and spiritually.)

We didn’t want to try to use the fertility charting method, since it would be hard for me, for various reasons, to get an accurate prediction. Once we were agreed that we both liked babies, wanted some eventually but not right away, and that we are pro-life, Kevin told me that what we decided to use was up to me, saying “it’s your body, you decide. Just talk me to me about it and explain why.” Then I got real cozy with researching hormonal birth control methods and why the pro-life movement is so strongly opposed to most of them.

What I found surprised me. Most of the information I had heard growing up was based on half-science, old science, or Catholic theology (which is a different thing entirely, and I’ll get into that a bit more later). And just for the record, my mom wasn’t the source of this misinformation–she understood the science, but she and dad felt a particular call (not just the Quiverfull-that’s-what-every-godly-couple-does! groupthink) to have a large family right away. But what I found is that, if you’re protestant, there’s no reason why you can’t be staunchly pro-life and ethically use most hormonal forms of contraception. (I’m going to leave out, for the sake of time and space, discussion of why a Christian would want to control fertility and only have planned babies. The protestant position on this is usually pretty laissez-faire as long as the right-to-life of a fetus is upheld. The Catholic perspective is much more complex. For my part, I want children and am very “pro-life”–on this issue, the death penalty, and war.)

The biggest problem that I see is simply a lack of education on the subject. A lot of abstinence-only sex-ed leaves out information on what contraceptives are and how they work, because it’s assumed that if you educate kids on that, they’ll feel more comfortable having sex. This is a weak argument–if kids are horny and don’t have the self-control or moral impetus to abstain, they’ll just have sex anyway. Abstinence-affirming sex ed with information on contraceptives could potentially prevent a lot more abortions than continuing to promote abstinence-only.

In homeschool circles, sex-ed is usually absent altogether, which is an even worse issue. This causes fear and body image problems and a ton of guilt issues that just shouldn’t exist for Christians. But I digress.

So, common things I heard about birth control that aren’t true (I’m not going to cite a lot of sources, because I want to encourage you to do your own Google search and read the fine print yourself. Also because I’m lazy, and I’d prefer to keep this post to layman’s terms.):

  1. All hormonal birth control is abortifacient.
  2. If you use the pill for a certain amount of time, it’ll be harder to have a baby later or might even make you infertile.
  3. Hormonal birth control might be abortifacient, but we don’t know. However, all morning-after pills cause abortions.
  4. Birth control should only be discussed once a couple is engaged, otherwise it’ll encourage premarital sex.

[if you think of other common assertions that should be discussed, comment and let me know!]

Here’s what I learned, in response to each of those statements!

One. Most birth control isn’t hormonally strong enough to cause an abortion if taken during pregnancy, and it’s designed to work in such a way that conception can’t occur if taken properly. The pill comes in two forms: one type uses a combination of the hormones progesterone and estrogen, and this fools the body into thinking that the woman is pregnant. Although ovulation and a period still happen, the uterine lining is thickened so an egg can’t implant , and the cervix forms a mucus plug during ovulation to prevent sperm from passing through. Essentially this allows for a normal cycle (using placebo pills to initiate a period), but creates an environment where it’s essentially impossible for fertilization to occur.

The second type iprogesterone only, and this inhibits ovulation altogether and stops the usual cycle from occurring. This is the method, I believe, which caused some infertility scares in the past, but I understand that this issue has been eliminated and doctors generally agree that there are no real detriments from preventing ovulation and a period from occurring–the earlier issues was caused by the hormone dosage.

There are, obviously, some risks associated (however inconclusively–increased risk of breast or cervical cancer for those with genetic predispositions to these diseases), and some side effects (water retention, moodiness, etc.), but the side effects are usually minimal or none if you’re on a dosage and hormonal proportion that works well for your body type and preexisting issues. (For example, I was on a pill for 9 months which made me prone to anxiety attacks, and once I switched to one that had a different variant of progesterone, as well as a slightly different progesterone to estrogen ratio, the mood swings and anxiety subsided and I was more my normal self. The downside was that on the previous medication, I didn’t have any cramping, but on the new one I experience some normal cramping on the first day of my cycle. )

The primary concern I’ve come across from pro-lifers who are okay (in theory) with the pill and accept that it won’t cause an abortion if taken according to the doctor’s instructions is this: if I miss a day, the packet tells me to take two pills in a row. It also says that if I miss 3 days in a row, I need to use other forms of BC and wait for my period to start before going back on the pill. Does this mean it’s trying to overcompensate and abort an accidental conception?  I don’t think so, and here’s why: one day isn’t long enough for conception to happen–it’s just trying to keep you from experiencing “breakthrough bleeding” mid-cycle (caused by missing the hormones for a day or two). With the three-day instruction, if your body goes back to its own cycle in the fastest way possible (conception after 3 days would be highly unlikely) and you do accidentally conceive in those 3 days, the direction to stop taking the pill is to prevent birth defects if you are pregnant at that point (taking the pill then wouldn’t cause an abortion, but it might hinder proper development a bit). If you haven’t conceived and have missed 3 days of the pill, the instructions still ask you to stop taking it because your body has experienced withdrawal from the hormones and needs to “reset” by going through the normal period cycle before you can restart the medication.

Two. The pill/patch/Nuva ring (I’m going to just lump these together as “the pill” or “BC” from here on out) have been constantly improved since they first came out. Various brands have had problems and lawsuits over the side effects, and each time this happens, the company producing the drug has had to go back to the drawing board and try to improve the “recipe” to eliminate these issues, just like any other big manufacturer. They want customer loyalty. In the 70s and 80s, there were definitely issues where some forms of hormonal birth control made it harder to conceive right after discontinuing use, and some even caused infertility.

These issues have largely been eliminated now, though it depends, of course, on how fertile you were before going on the BC, how much of the hormone is in your system and how long your body will take to adjust to start cycling normally again. A lot of this is more connected to your own metabolism, cycle length, and natural hormone balances. Because hormonal BC has been improved so much since the 80s, infertility issues after using BC are going to be preexisting issues with your own body and not the fault of the pill. Check with your gynecologist to make sure you get the best hormonal option for your body–because every woman is different, different hormonal cocktails will work better with your body than with mine or anyone else’s.

This is the benefit of coming to BC right now–there’s been enough time and research put into this so that there are a lot of different dosage options and just about everything is a refined and improved version of the stuff our moms had available to them.I had irregular cycles, but no major issues like endometriosis,  and I have high metabolism and a naturally low BMI, so I needed a low-dosage option. Someone else might be better off using a higher dosage or a different proportion of progesterone and estrogen in their BC than what I use.

Three. The morning-after pill isn’t actually an abortifacient, either, even though it’s designed to prevent pregnancy after unprotected sex. There are three main types of the morning-after pill and they use different hormone combinations/dosages to thicken internal mucus and delay ovulation. This creates an unwelcome environment for sperm and allows the woman’s body to hold off on releasing an egg until after the longest potential life span of sperm. The one emergency contraceptive that would be unethical for a Christian to use is the RU-486 pill, which does terminate a pregnancy in the first trimester. Personally, I think that the RU-486 is as morally wrong as abortion. But I also think that victims of incest or rape should have access to the standard morning-after pill as a matter of course.

Four. I think every adolescent should be educated about birth control. And I think that a couple should discuss their expectations and ethical beliefs long before they get engaged–these are issues where it’d be healthy for spouses to be in agreement. I appreciate Kevin’s respect in letting me decided what I’m most comfortable with, but I also really want him to be equally comfortable with the choices we make in this area.

Beyond all this, girls should be comfortable with their bodies and taught to understand how things work and why, and hormonal birth control can be a great help for a woman with endometriosis, irregular cycles, painful cramps, etc. Even if a girl isn’t sexually active and doesn’t need to get a pap smear or vaginal exam done, it’s healthy for her to go to a gynecologist to just discuss her cycle and make sure there aren’t any issues that may need investigation or treatment–things like delayed puberty or missed periods are often symptoms of an eating disorder or intense stress; severe cramps can signal endometriosis or polycystic ovarian syndrome or a hormone imbalance, etc. These things are significant, and parental insecurity about a sex talk isn’t a good reason to avoid helping your daughter know why her body works the way it does and how to know if something is amiss.

What else am I missing here? Feel free to raise questions in the comments–but be kind to me. I’m strongly pro-life (don’t bother arguing this), I’m not a chemist or a doctor, so this is just what I’ve learned through research, and I might be wrong. Check with a real doctor if you’re unsure about something, and correct me if you have medical qualification on this subject and see a mistake I’ve made out of my inexperience.

Finally, regarding the Catholic position (and I’ll just summarize generally because I’m not a Catholic–feel free to chime in if you are!): Catholics have a very detailed theology of the body that overshadows their theology of marriage and the purpose of it. Protestants don’t consider marriage to be a sacrament, and this is the fundamental difference. Because marriage is one of the seven Catholic sacraments, procreation in marriage is a sacred duty and the ability of that union to give life has a higher sacramental value than is commonly held by protestants. Therefore, any contraception is considered to be going against God’s design for marriage. This would include, I have been told, even the use of condoms. As a result, Catholics attempting to delay pregnancy will typically use a method where the couple charts the woman’s fertility via temperature readings,  learning to understand what types of mucus are discharged during peak fertility, etc. When the woman’s 3-5 day fertile window opens up, they will abstain if they want to avoid pregnancy. This is actually a pretty safe method of preventing pregnancy (and a really useful tool if you’re trying to conceive), but you have to really pay attention to your body’s rhythms and be very accurate with the temperature readings and subsequent charting (there’s actually some good technology available to make this easier, too). It’s a lot of work, but if marriage is a sacrament for procreation in your theology, it is worthwhile and ethical.