Since Holly and I are engaged to be married soon (only 127 days to go!), we have had to think through and discuss the issues of contraception/family planning. One of the issues we have to consider is whether or not for Holly to use the pill. Certainly it is a convenient and commonly used option for contraception. When we first discussed the issue—within a week of engagement, I believe—I expressed my initial resistance to using the pill since I had heard that it can sometimes cause spontaneous abortions when the contraceptive mechanisms don't work. To see what the actual evidence is that this might take place, I picked up a copy of Does the Birth Control Pill Cause Abortions? by Randy Alcorn.
In this book, Alcorn shares his own journey of investigating the pill and its various mechanisms for preventing pregnancy. He frames the story by sharing his initial reluctance to question the ethical propriety of using the pill, it having been a method of contraception that he both recommended in pre-marital counseling and used in his own marriage. However, as he digs into the evidence, it quickly becomes apparent that the issue is not as clear as he would have hoped.
The birth control pill in its various forms works by manipulating a woman's hormones to prevent pregnancy. There are several mechanisms by which it accomplishes this, but the primary ones are the following (p.23):
- Preventing ovulation so no egg is released to be fertilized
- Thickening cervical mucus so sperm have less likelihood of reaching the egg if there is one
- Thinning the lining of the uterus so the fertilized egg, if there is one, has less likelihood of implanting and surviving
If human life really does begin at conception and is intrinsically valuable, then the third mechanism becomes ethically problematic. While it is not quite the same as out-and-out killing, it does create an environment which is hostile to the development of human life and in which death is much more likely. In short, it is, in fact, an abortive mechanism.
It is practically impossible to really know how frequently the first two mechanisms fail and the third one is effective, but Alcorn spends a chapter doing his best with the numbers that are available in order to take a stab at figuring out how often the birth control pill might cause abortions. His conclusion: "There is no way to be certain, but a woman taking the Pill might over time have no Pill-induced abortions, or she might have one, three or a dozen of them."
After drawing his conclusions about the birth control pill, Alcorn devotes a long appendix to interacting with the objections that he has received since originally publishing this book in 1997.
Now, I want to be careful not to lay any guilt at the door of people who have chosen to use the pill for birth control. Many people may not be aware of what the pill can do. Others may have heard something or another but don't feel that the ethical implications are sufficiently weighty to compensate for the convenience of the pill. I find Alcorn's evidence to be sufficiently compelling that I choose for us not to take that risk. At any rate, it behooves all of us to be well-informed of both the biological and ethical issues at stake as we make decisions, and Alcorn's book is very helpful in that regard.