Emergency Contraception &
Birth Control
Types of Birth Control
Breakthrough Ovulation
Debate
Other Organizations’ Stances
Rationale
Texas Right to Life’s Position
Even within the Pro-Life movement, people have different views about birth control.
- The Catholic Church teaches strongly against almost all forms of artificial contraception.
- Other Christian traditions vary in their stances.
- But many agree on this: Any method that ends a human life after fertilization is wrong.
A lot of the debate focuses on hormonal birth control and whether it could cause a very early abortion, making it an abortifacient. Unfortunately, there isn’t enough clear research on how different birth control methods actually work. One complication is that many studies define the start of pregnancy as implantation, not fertilization—so they may overlook anything that happens before a baby attaches to the womb.
That’s why there’s so much confusion about how often birth control methods fail and whether those failures could lead to the loss of a fertilized egg (a tiny human being). Below is a summary of the most common types of birth control, how they work, and how that shapes Texas Right to Life’s position.
Types of Contraception
There are several different types of contraception, each with differing methods of action, which determines their ability to abort a child.
Intrauterine contraceptive devices (IUD)
- Copper-T IUDs
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- This device is placed in the uterus where it releases copper ions and causes an inflammatory reaction in the endometrium (the innermost lining of the uterus).
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- Method of action: release copper to stop sperm from reaching and fertilizing an egg. They also change the lining of the uterus, which can stop a new baby (embryo) from attaching and growing.
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- In addition to typical contraceptive use, this device is also the most effective method of emergency contraception (EC) and is routinely encouraged for that purpose. Medical professionals recommend Copper-T IUD to be used as emergency contraception for up to five days after sex, which interferes with the implantation of newly created human life. The primary function of this type of device is to prevent or disrupt implantation, and can therefore cause the death of a newly-created embryo either before or after implantation.
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- Hormonal IUDs (LNG-IUD)
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- A device that is placed in the uterus and releases levonorgestrel (a synthetic hormone) and causes an inflammatory reaction in the lining of the uterus (the endometrium).
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- Method of action: prevents sperm from fertilizing the egg by thickening the cervical mucus, thereby making the mucus impenetrable, and thins the uterine lining.
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- Though not currently used as emergency contraception, they prevent the lining of the uterus from developing normally and prevent the newly created embryo from implanting.
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Hormonal Methods
The key question for Pro-Lifers on hormonal methods of birth control is about the level of certainty we have that each method prevents ovulation. If the method does not reliably prevent ovulation, is the method preventing the new embryonic human from implanting in the uterine wall? If yes, the method may cause an early abortion.
- Progestin-only methods (including “the Mini-Pill”, subdermal implants, and injections)
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- These methods release progestin (a synthetic version of the hormone progesterone, which plays a crucial role in the menstrual cycle and pregnancy).
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- Method of action: suppresses ovulation, thickens cervical mucus, and thins uterine lining.
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- These are overall less effective than combined methods, and they appear to unreliably prevent ovulation because the main agent is progestin. If a woman becomes pregnant while using a progestin-only method, she has a higher likelihood of an ectopic pregnancy, which suggests progestin-only methods may be more likely to upset normal implantation beyond the prevention of fertilization. The endometrial change recorded in women using progestin-only methods is more profound than in women using combined methods.
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- Combined Methods (including “the Pill”, the patch, and hormonal vaginal contraceptive rings)
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- Release progestin and estrogen.
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- Method of action: prevent ovulation, thicken cervical mucus, and thin uterine lining.
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- These primarily act through the suppression of ovulation via estrogen. If the primary mechanism of ovulation prevention fails and breakthrough ovulation occurs, to what extent the contraceptive is still working to thin the uterine lining and to prevent implantation is unknown.
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What is breakthrough ovulation and how frequently does that occur?
Breakthrough ovulation occurs when an ovum (egg) is released from the fallopian tube(s) despite taking hormonal contraception to stop ovulation. In other words, these are occasions when the hormonal contraception does not prevent LH (the hormone that controls ovulation) levels from rising to the threshold needed to release an egg. Reasons are varied, and partly can be attributed to user error or decreased effectiveness of a contraceptive method because of other medications. Breakthrough ovulation occurs 1.1% – 10% of the time when taking combined methods of birth control and 42.6% of the time when using progestin-only pills.
Debate on Combined
Hormonal Methods
Those who believe the Pill sometimes acts as an abortifacient say:
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- The birth control pill can also cause early abortions in ways people don’t always realize. For example, it can change how the fallopian tubes move, sending a fertilized egg to the womb too quickly—before the womb is ready to accept it. This can prevent the baby from attaching and growing.
- Manufacturers of the Pill suggest avoiding pregnancy for the first three months after stopping the Pill, presumably because the endometrium requires months to return to normal health.
- Widely accepted and accredited sources (such as the Physician’s Desk Reference which contains FDA-required manufacturing information on every medication that is legally prescribed) readily acknowledge the fact that the Pill alters the endometrium in such a way as to reduce likelihood of implantation, and such alteration has implications for those who believe life begins at fertilization.
- Ectopic pregnancies increase between 70% and 1,390%, indicating that the newly created embryonic human is prevented from implanting in the proper place. However, those who do not believe the Pill acts as an abortifacient dismiss this claim as untrue, attributing the claims to progestin-only methods. The dissenters further claim that when numbers specific to the progestin-only methods are removed, there is no evidence linking combined methods with increased incidence of ectopic pregnancy.
Those who believe the Pill has not been proven to act as an abortifacient claim:
- The abortion-inducing effect is not yet proven because of the inability to determine in any given cycle which of the three mechanisms of action is at work.
- The third mechanism (thinning of the endometrium) is unquestionably happening, but whether this mechanism is still at work even when the contraceptive method fails, as evidenced by breakthrough ovulation, is yet unknown. No study has been conducted to assess the thickness of the uterine wall in cases of breakthrough ovulation. If ovulation occurs, a woman’s body will simultaneously produce the estrogen and progesterone she would normally produce, and this may counteract the Pill’s effects.
Where do other organizations fall on this issue?
National Catholic Bioethics Center
Is against “any action which either before, at the moment of, or after sexual intercourse is specifically intended to prevent procreation—whether as an end or as a means.”
American Association of Pro-Life Obstetricians and Gynecologists
Acknowledges the differences of belief among members on whether hormonal birth control causes early abortions and authored a Committee Opinion to summarize current medical literature and to aid informed consent.
Christian Medical and Dental Association
Is undecided on the issue. They acknowledge the concern, but also acknowledge that the current science does not establish a causal link between hormonal birth control and early abortions.
Pharmacists for Life
Takes no position but offers information on the Pill’s potential abortive effects on their website.
Pro-Life physicians in general
Have not reached a consensus regarding the abortifacient potential of hormonal methods.
Focus on the Family
Opposes any form of birth control that acts after fertilization, opposes all IUDs, and is undecided on hormonal methods, but does not recommend use of progestin-only methods.
Rationale
The position regarding emergency contraception and both types of IUDs is straightforward in that these methods make the uterus hostile to a fertilized egg, i.e., a new human. Because neither copper nor hormonal IUDs prevent ovulation, and because both types of IUDs interfere with the uterine lining to prevent implantation of a new embryonic human, these are also considered abortifacient and anti-Life.
For hormonal contraception methods in general, more research is needed to examine the question of how often they abort children by thinning the uterine lining if they fail to prevent ovulation. However, the evidence available and our understanding of the method of action for the progestin-only pills, which are gaining popularity, shows that it typically functions as an abortifacient.
Faithful Pro-Life organizations and physicians are divided on this topic, acknowledging the shortage and confusion of the available research. All Pro-Lifers should understand the seriousness of the question about what degree of uncertainty is acceptable for whether or not a method acts as an abortifacient.
Texas Right to Life’s Position
Texas Right to Life is opposed to birth control methods that are proven to act as abortifacients, including emergency contraception and IUDs. TXRTL opposes progestin-only methods of hormonal contraception, which unreliably prevent ovulation and rely on the endometrial changes making a hostile environment for the newly created child.
Because of both of the previously listed reasons, TXRTL is opposed to all methods of long-acting reversible contraception (LARCs), which include progestin-only methods and copper IUDs.
Regarding the combination method potentially acting as an abortifacient, a review of the available research indicates there are reasons for concern with this method, but the current literature ultimately leaves more questions than answers. Therefore, TXRTL is neutral and advises caution, prayer, and review of the available research for those considering this method of contraception.