Last week a bunch of news services picked up and distributed a true story about a seminary professor in the Dallas/Fort Worth area who told students that taking birth control pills is murder. His reason: “The pill causes abortion.”
Whoa. Not so fast.
Three years ago ob-gyn, William Cutrer, M.D., and I were doing a radio show during which we discussed that topic as part of the launch of our then-new book, The Contraception Guidebook (Zondervan/Christian Medical Association). Someone during the call-in segment made the same claim, so we asked his supporting evidence. He cited a source who said women taking the pill have “breakthrough ovulation” about 50 percent of the time. And when such a breakthrough occurs, he said, the pill causes the uterine lining to be hostile to the embryo—hence causing abortion.
Afterward, I found a source on the web (and quoted on numerous pro-life sites) who cited a breakthrough ovulation rate of 30 to 40 percent. Not surprisingly, all sources were a couple of decades old, and the one appearing most often may even have been fictitious. (A so-called researcher at NIH turned out to be a podiatrist in North Carolina.)
Before I go further, let me say I’m not marketing the pill. I can’t give birth, so it’s not about me. Nor do I have any friends who work for drug companies. I’m just a pro-life journalist looking for honesty in reporting. So here goes.
Here’s what gets interesting with the pill. Although sonograms confirm that women taking the pill sometimes continue to develop such fluid-filled sacs, the egg inside doesn’t necessarily “get released” nor is there necessarily an actual human egg inside. Consider the best evidence we have:
In a normal menstrual cycle, if a woman has a vaginal ultrasound just prior to ovulation, she and the machine operator will likely see one cyst (sac). And they can assume there’s probably one egg maturing inside.
. In 1996, twenty-four healthy female volunteers ages 20–34 with normal cycles were included in a study to investigate the effect the pill had on stopping ovulation. No escape ovulation was observed.
. In 1997, one hundred eighteen women at ten centers participated in a study to measure the impact of two low-dose pills and their ability to stop ovarian activity. No patients ovulated in any treatment cycle.
. In 2002, one hundred women were randomly assigned to receive varying oral contraceptives over a single treatment cycle. Breakthrough ovulation was observed in three subjects in one group. Only one of these escape ovulations was considered the result of treatment failure. (The patients either failed to take their pills or took medications that reversed the pills’ effects).
. In a 2002 study, one hundred thirty women took oral contraceptives beginning three days later than recommended. These women had significantly more ovarian sac development than women who took the pill as prescribed. Yet the postponement did not appear to increase actual ovulation rates. (Either the eggs weren’t released or there were no eggs inside.)
Conclusion: Breakthrough ovulation is a relatively rare event—a far cry from 40-50 percent.
Still, the presence of any breakthrough ovulation raises another question, doesn’t it? If it happens, won’t the pill hormones make the uterine lining too hostile for implantation (as the “pill packaging” claims)?
Here’s the thing: For an egg to mature enough to ovulate, estrogen has to be present in the ovary to mature the egg. And the presence of that estrogen has another effect—it simultaneously grows the uterine lining. So the same estrogen that’s developing the egg for ovulation is preparing the uterine lining until the time of ovulation. Then during the days from ovulation to implantation, the sac that ruptured to release the egg produces progesterone, further preparing the lining for about another week before the embryo arrives.
That’s why we’ve heard about women on the pill who didn’t realize taking antibiotics would cancel its effectiveness. They’ve ovulated and gone on to give birth. Did you catch that? When they ovulated, the fertilized egg also implanted.
Also, the FDA-required information distributed with the pill says that a thinned uterine lining is a third “mechanism of action,” or way that the pill prevents pregnancy. Yet the drug makers submitted that information before the FDA actually required a shred of evidence to support such claims. And to date no such evidence exists. (Remember, manufacturers were trying to convince pill users they wouldn’t get pregnant so they had an incentive to make the pill sound multi-effective.)
My co-author asked Dr. Barry Schwartz, vice chairman of the Department of Obstetrics and Gynecology at the University of Texas Southwestern Medical Center and medical director of Parkland Hospital’s School of Midwifery about uterine lining issues. And Dr. Schwartz told him that if a thin uterine lining made the uterus hostile to implantation, researchers could expect to see a spectrum of disorders related to embryo implantation. Yet no such spectrum exists. Also, Dr. Steve Harris, a pro-life ob-gyn, notes that doctors in his profession should see a higher rate of miscarriage in pregnancies (due to implantation issues) that follow pill use. But again, no such connection exists.
If someone wants to avoid taking oral contraceptive pills as a matter of conscience, fine. But when we say without hesitancy that taking the pill equals murder, we are, as my dad says, more sure than right.
The Christian Medical Association’s official statement is that we don’t know for sure. There’s a mounting body of evidence to support the hypothesis that taking the pill does not prevent implantation, but we don’ t know with absolute certainty.
So let’s say a woman in your ministry is taking medication for acne that’s dangerous for a baby in utero, so her doctor also prescribes the pill. Rather than clobbering her with words like “murder,” you can simply recommend that she also use an ovulation predictor kit and switch to a back-up method of contraception if results indicate ovulation has occurred.
One more thing: People who argue against the pill for the reason given above often also say, “I’d rather err on the side of life.” And again, I respect that decision. Yet the same people get into their cars every day and risk life by driving. Now, I would respect someone who rode only a bicycle for the same reason, but I probably wouldn’t appreciate it if he or she acted more holy than me over it. Or called me a murderer when I put my kid in a car seat.
We do need to honor life. Doing so is one of our core values. But so is telling the truth.