3.03.2008

Postfertilization Effects of "The Pill"

After several recent discussions (in person and online) with others about the abortifacient potential of hormonal contraception, I am convinced that misinformation unfortunately still abounds on this issue. Many people are of the mistaken opinion that the technology of hormonal birth control has been perfected to the degree that NO abortifacient potential exists when certain modern hormonal preparations are taken faithfully.

This belief is simply FALSE. It is not consistent with the research, leading to the
unrecognized loss (death!) of babies. These hormones do not always prevent ovulation, but do always thin the endometrium of the uterus to some degree, making implantation of the fertilized egg more difficult, and therefore causing an unknown percentage of spontaneous abortions before the mother even knows she is pregnant.

I refer you to one of the most comprehensive and well documented studies I am aware of:
Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent. And here is a personal note by the author of that study:

I have prescribed “the Pill” since 1978. My wife and I used the Pill for years, having no moral concerns about it. Then, in 1995 my friend and practice partner John Hartman, MD, showed me a patient information brochure — given to him by a friend — that claimed the Pill had a postfertilization effect causing “ . . . the unrecognized loss of preborn children.” John asked me if I had ever heard of such a thing. I had not. I did read the brochure and its claims seemed to be outlandish, excessive, and inaccurate. So, I decided to begin a literature search to disprove these claims to my partner, myself, and any patients who might ask about it. The more research I did, the more concerned I became about my findings. I called researchers around the country and interviewed them. During this process I met Joe Stanford, MD. Joe volunteered to assist in the research that ultimately became this systematic review. We were concerned enough about our findings and about the fact that so many of our colleagues and patients seemed to share our ignorance about this potential effect that we presented the preliminary results of our research at a number of research forums, just to see if we were off base. Most of the reviewers suggested that, although this evidence was new to them (as it was to us), it seemed accurate and not off target. Furthermore, several said that they thought it would change the way family physicians informed their patients about the Pill and its potential effects.

The most difficult part of this research was deciding how to apply it to my practice. I discussed it with my partners, my patients, ethicists I know and respect, and pastors in my community. I studied the ethical principle of double effect and discussed the issue with religious physicians of several faiths. Finally, after many months of debate and prayer, I decided in 1998 to no longer prescribe the Pill. As a family physician, my career has been committed to family care from conception to death. Since the evidence indicated to me that the Pill could have a postfertilization effect, I felt I could no longer, in good conscience, prescribe it — especially since viable alternatives are available. The support and encouragement that my partners, staff, and patients have given me has been unexpectedly affirming. It seems that my patients have appreciated the information I have given them. Many have been surprised or even shocked (as I was) to learn about this potential effect. Many of my patients have chosen to continue taking the Pill, and we have physicians in our practice and community who will prescribe it for them. Patients who take the Pill tell me that they are much more careful with their compliance. Others have chosen other birth control options — especially one of the modern methods of natural family planning. So, this is research that has changed my soul and my practice. It has been an extraordinarily difficult issue with which I have had to wrestle. I suspect it will be so for many who thoughtfully read and consider the evidence contained in this review.


Walter L. Larimore, MD

Kissimmee, Fla

6 comments:

D. said...

So why doesn't the LCMS come out against birth control pills? If it is an abortificent, which you are sure of, then it should be grounds for ex-communication for every member that takes them.

I found this on the LCMS website: http://www.lcms.org/graphics/assets/media/WRHC/022_Birth%20Control%20Pills_Contraceptive%20or%20Abortifacient.PDF It says they are not abortificents. What is a thinking Christian to do? Even WELS hasn't come out against bcpills.

Erich Heidenreich, DDS said...

Ruthie,

You ask: What is a thinking Christian to do?

Believe the overwhelming scientific literature rather than the weak, unsupported opinions of individuals and groups. Even the drug manufacturers themselves advertise these as "tri-phasic" birth control. What are the three phases? 1. Prevention of ovulation. 2. Mucus changes preventing fertilization. 3. Prevention of implantation.

Not one of these phases is effective 100% of the time, but combined they have greater effectiveness. If phase one fails, phase two might prevent fertilization of that egg. If phase two fails, thinning of the endometrium might prevent successful implantation.

You have pointed out what we already know - that is, that synods are in the dark on this. This simply proves my point that misinformation prevails regarding the abortifacient potential of hormonal birth control. There is an unacceptable level of ignorance out there (plus some plain denial). But, remember, none of the major Lutheran synods hold to the historic teaching of the church against contraception either! And that's something they SHOULD know better about. One can forgive theologians for being ignorant in scientific matters, but not for being ignorant regarding theology.

BTW, no one would excommunicate someone for using an abortifacient drug that she has been led to believe is not abortifacient.

Erich Heidenreich, DDS said...

Oh, and I also wanted to comment specifically on Rev. Eyer's statement which you linked to. He quotes the OPINION of "Twenty-one pro-life physicians" who hold that the pill is not abortifacient.

Sorry, Rev. Eyer, but 21 is not some kind of magic number that turns opinion into fact. There are thousands of physicians who would admit that the pill IS abortifacient. But even if I could quote them it would not make it so. Opinion is just opinion unless supported by facts.

In fact, there are "pro-life" physicians out there who erroneously tell their patients that certain IUDs are not abortifacient! Here is a recent example posted right here on this blog!

As I said, misinformation abounds. A conscientious "thinking Christian" will review the scientific research and make a decision on which opinion is right on this issue.

Even my own statement must be taken as opinion until you read the supporting scientific documentation. Don't believe it just because I say it is so. Read the research. It's not that difficult to understand, and the answer truly is a matter of life and death. I've tried to give a brief synopsis of the findings of this research. But if this is a question that has implications for you, read the research for yourself to determine if my assessment is faithful to the facts.

Erich Heidenreich, DDS said...

PSS - Contrary to Rev. Eyer's 21-gun position, Lutherans for Life states (in their position statements): “Birth control pills, promoted as contraceptives, thin the uterine lining as a back-up mechanism and, therefore, can be abortifacient in nature…”

And here is some additional discussion of the "Eyer error" right from this blog. Pay special attention also to the comments after the post, which do an excellent job of showing where Rev. Eyer goes astray.

HB said...

Erich, it appears that the link to the article is not working. This one is though: http://noabort.net/files/Postfertilization%20effects%20of%20oral%20contraceptives%20and%20their%20relationship%20to%20informed%20consent.pdf

Erich Heidenreich, DDS said...

Thanks, I'll update it.