Abortifacient Effect of the Birth Control Pill

Reading List and Internet URLs (last accessed 11-20-01: Alcorn/EPM info updated 6/21/05)

Walter L. Larimore, MD
8605 Explorer Drive
Colorado Springs, CO 80920
Phone 719-548-5957 - Fax 719-548-4525

This resource is available from the Center for Bioethics and Human Dignity:

The Pill: Addressing the Scientific and Ethical Questions of the Abortifacient Issue

Edited by Linda K .Bevington, M.A. & Russell DiSilvestro, M.A. Ph.D. (cand.)

This resource consists of a collection of articles addressing the complex question of whether the birth control pill sometimes act to cause the death of an early embryo. This question has caused some couples, physicians, and pastors to cease use, prescription, and/or advocacy of the pill, while others remain unconvinced of its alleged abortifacient effect.

Authored by physicians and other professionals, the packet’s numerous articles outline the scientific evidence (or lack thereof) being pointed to in support of each position. The myriad of ethical questions raised by this issue are also reflected upon by those on both sides of this debate.

The packet’s introduction goes beyond the abortifacient question, encouraging the reader to engage in thoughtful reflection on such matters as the use of contraception in general, God’s design for marriage and the family, the purposes of sexuality, and the impact of the decision concerning pill use on the woman’s lifestyle and health.

Also featured are FAQ’s, position statements of major Christian organizations, and an annotated bibliography.

Cost = $15.20 for CBHD members and $19 for non-members.

Can be ordered from their website: http://www.cbhd.org/

 

Below is the list of references I’ve found helpful (and some I have written) on this complex issue. I’ve tried to discern the theological background and scientific conclusions of the authors and where possible indicate that using the following code:

Ω Reference appears to be primarily by Roman Catholic authors or from a Roman Catholic perspective

Y Reference appears to be primarily by Protestant authors or from a Protestant perspective

T Reference appears to be non-denominational or from a non-denominational perspective

Ø Reference appears to favor the abortifacient or post-fertilization effect possibility

K Reference appears to be neutral to the abortifacient or post-fertilization effect possibility

∆ Reference appears to oppose the abortifacient or post-fertilization effect possibility

1) ΩØ - A declaration of life by prolife physicians. American Life League. Stafford, VA. 1999.

This declaration has been signed by 217 prolife physicians (you can find out who signed at the website). It asserts that “...the pill and similar birth control products act, part of the time, by design, to prevent implantation of an already created human being” and that “...these products clearly cause an early abortion and are – despite the semantic gymnastics of their ardent apologists –abortifacient.”

http://www.all.org/article.php?id=10678

2) YØ - Alcorn R. A dialogue about birth control. Eternal Perspective Ministries. 1999

This is a stimulating, fictional conversation between two Christians who have different viewpoints on the issue of birth control. You will likely agree and disagree with both of them at different times. Hopefully this will help you develop and clarify your own position, which may combine elements of both or be very different from either.

A Dialogue about Birth Control

3) YØ - Alcorn R. Does the birth control pill cause abortions? Eternal Perspective Ministries. 2004.

This updated and revised booklet discusses the author’s research into the possible abortifacient effects of the Pill. To start the discussion, Alcorn says, “I came to this issue as a skeptic. Though I heard people here and there make an occasional claim that the Pill caused abortions, I learned long ago not to trust everything said by sincere Christians, who are sometimes long on zeal but short on careful research.” This URL site lets you choose between “shorter” and “longer” condensations of the booklet, HTML or Adobe Acrobat versions of the booklet, and responses from readers — both positive and negative.

/store/product/birth-control-pill-book/

4) TK - Birth control pills and other hormonal contraception. Focus on the Family Position Statement. Colorado Springs, CO. 1999.

This two-page summary was researched by Focus on the Family’s Physicians Resource Council (24 members) and reflects Dr. Dobson’s opinion regarding hormonal birth control. It says, in part, “The majority of the experts to which Dr. Dobson has spoken feel that the pill does not have an abortifacient effect. A minority of the experts feel that when conception occurs on the pill, that there is enough of a possibility for an abortifacient effect...to warrant informing women about it.”

Available by calling 1-800-A-FAMILY – ask for MS190.

5) ΩØ - Birth control pills: contraceptive or abortifacient? American Life League. Stafford, VA. 1999.

This white paper was developed by the ALL in response to reference #9 and urges the authors of references #9 and #10 “...to reconsider their paper and evaluate the uses to which pro-abortion forces will use their efforts to achieve their anti-life goals.”

http://www.all.org/article.php?id=10177

6) TK - Possible post-conceptional effects of hormonal birth control. Christian Medical and Dental Associations Position Statements. Bristol, TN. 1998.

This scientific summary was approved by the CMDA Board of Directors and concludes, “...while additional investigation is needed, current knowledge does not confirm or refute conclusions that routine use of hormonal birth control causes abortion.”

http://www.cmdahome.org/?CONTEXT=art&cat=143&art=1183&BISKIT=1343357503

7) ΩØ - Colliton WF. Birth control pill: abortifacient and contraceptive. Linacre Quarterly. November 1999:26-36.

This white paper is a direct response to reference #9. The 27 signatories of this paper are all specialists in obstetrics and gynecology, many with sub-specialty interests and faculty appointments at teaching institutions, who discuss the facts which indicate to them the abortifacient nature of hormonal contraception. They conclude, “The undersigned believe that the facts as detailed in this document indicate the abortifacient nature of hormonal contraception...We also want to make it clear that we have no desire to cause confusion and division among prolife forces. However, we do want to make it clear that we do desire that all women using the pill are truthfully and fully informed about all its modes of action.”

http://www.aaplog.org/collition.htm and http://www.aaplog.org/oral.htm

8) T∆ - Colliton WF. Response to Joel Goodnough MD’s, “Redux: Is the Oral Contraceptive Pill an Abortifacient?” Ethics and Medicine 2001;17(2):103-15.

This article is in response to reference #15, is an expansion of reference #7 and is accompanied by reference #27 in criticizing Goodnough’s review. A reprint of the article can be ordered at http://www.ethicsandmedicine.com/order.html.

9) Ω - Contraception: A Symposium. First Things. December, 1998:17-29.

On the 30th anniversary of Humanae Vitae, the editors of this journal asked Protestant, Catholic, and Jewish thinkers to respond to the questions: (1) Do you judge the argument of Humanae Vitae convincing with respect to contraception? (2) How do you think the argument could have been made more convincingly? (3) In view of developments in the last thirty years, was Paul VI right about the moral and social consequences of contraception? (4) If you agree that the message of the encyclical has not been effectively communicated, why is that the case?

http://www.leaderu.com/ftissues/ft9812/articles/contraception.html

10) Y∆ - Crockett SA, DeCook J, Harrison D, Hersh C. Hormone Contraceptives Controversies and Clarifications. ProLife Obstetrician. Fennville, MI. April1999.

This white paper is one of only three publications (the others are references #10 and 14) that oppose the abortifacient mechanism of the Pill. This particular paper has resulted in several responses, including references 1, 3, 5, 7, 12 and 15. The 22 signatories of this paper are all specialists in obstetrics and gynecology, many with sub-specialty interests and faculty appointments at teaching institutions. They discuss the facts that indicate to them that if a woman decides to use the Pill, then they (the authors) “...are confident that (she) is not using an abortifacient.”

http://www.aaplog.org/decook.htm

http://www.aaplog.org/oral.htm

11) Y∆ - Crockett SA, DeCook J, Harrison D, Hersh C. Using hormone contraceptives is a decision involving science, scripture, and conscience. In: Kilner JF, Paige PC, Hager WD (eds.), The Reproduction Revolution: A Christian Appraisal of Sexuality, Reproductive Technologies, and the Family. WB Eerdmans, Grand Rapids, MI, and Cambridge, UK. January, 2000:192-201.

This article is the second part of a two-part series on the abortifacient effect of the Pill. Its companion is reference 18. This article contains very little information that is not outlined in reference #9.

This book can be ordered from the Center for Bioethics and Human Dignity

12) ΩØ - Fact Sheet - Contraceptive pills: abortifacient. Human Life International. Front Royal, VA. 1999.

This position statement from HLI “...supports the Catholic Church in accepting NFP as the only morally acceptable means of family planning and the only one worthy of the dignity of mankind.”

http://www.hli.org

13) ΩØ - Fernández JR. The pill vs. NFP. How it works. Online Pamphlet. One More Soul.

The testimony of a Catholic family physician’s conversion from the practice of contraception to the practice of natural family planning.

http://www.omsoul.com/pamview.phtml?idnum=100&orderid=c126dad55ba62b4c38320d14e245a3ec

14) YK - Fleischmann R. The Christian and birth control: the pill. WELS Lutherans for Life. 1999.

This white paper is the result of the research into this issue by the National Director of WELS. Rev. Fleischmann concludes, “I cannot bring myself to recommend the birth control pill, but I also cannot condemn it at this point. I think people should know of the questions concerning in and make the difficult decision for themselves as they have to make difficult decisions all the time. As for me, I find it difficult to recommend the pill with its potential for being an abortifacient when I can more comfortably recommend other birth control methods that clearly do not carry such a risk, such as natural family planning...”

http://www.christianliferesources.com/?/library/view.php&articleid=688

The WELS web site also has several other articles on contraception.

15) T∆ - Goodnough JE. “Redux: Is the Oral Contraceptive Pill an Abortifacient?” Ethics and Medicine 2001;17(1):37-50.

This article reviews Randy Alcorn’s booklet, “Does the Birth Control Pill Cause Abortions?” (Reference #3) The author asserts that the available evidence does not demonstrate that the pill acts by abortifacient mechanisms and concludes with the following statement about informed consent: “Perhaps we should tell our patients about this controversy. But what exactly do we tell them? Is there a high risk or low risk of causing abortion? I tell them that there is an unknown risk but that risk can be reduced to a tolerable level through responsible pill taking.” Several later issues of Ethics and Medicine contained long responses which claimed Goodnough’s analysis was lacking – references #8, 22 and 28. A reprint of these articles can be ordered at http://www.ethicsandmedicine.com/order.html.

16) TØ - Kahlenborn C. How do the pill and other contraceptives work? Life Advocate 1997;12(7).

This article, written by a Catholic Internal Medicine specialist, for the lay public, concludes that “...(the) OCP, Norplant, Depo-Provera, the IUD, the ‘morning after pill,’ the ‘post-rape pill,’ and in-vitro fertilization all work by causing an early abortion at least part of the time.” It could be used in clinical practice as a patient education handout.

http://www.lifeadvocate.org/7_97/feature.htm

17) TØ - Kuhar BM. Infant homicides through contraceptives. Eternal Life. Bardstown, KY. 1994.

This pamphlet, written by a former president of Pharmacists for Life, is the most strident of the publications suggesting an abortifacient effect of hormonal birth control. The author predicts that 834,000 to 4,170,000 chemical abortions occur each year in the US from the Pill. He predicts that there are 10 to 14 million abortions in the US, each year, of which only 1,500,000 are surgical abortions.

The pamphlet can be ordered by calling Eternal Life at 800-842-2871

18) YØ - Larimore WL. Postfertilization effects of oral contraceptives and their relationship to informed consent (Commentary). Arch Fam Med 2000;9:133.

The testimony of a Protestant family physician’s conversion from the practice of contraception to the practice of natural family planning. This is a nice match with reference #12.

Available at the Archives of Family Medicine Website

19) YØ - Larimore WL, Alcorn R. Using the birth control pill is ethically unacceptable. In: Kilner JF, Paige PC, Hager WD (eds.), The Reproduction Revolution: A Christian Appraisal of Sexuality, Reproductive Technologies, and the Family. WB Eerdmans, Grand Rapids, MI, and Cambridge, UK. January, 2000:179-191.

This article is the first of a two-part series on the abortifacient effect of the Pill. Its companion is reference 8. This article contains very little information that is not outlined in references 2, 16 and 17.

This book can be ordered from http://www.cbhd.org/

20) TØ - Larimore WL, Stanford JB. Postfertilization effects of oral contraceptives and their relationship to informed consent. Arch Fam Med 2000;9:126-133.

This systematic review evaluated the available evidence for the postfertilization effects of the birth control pill and concluded, “...good evidence exists to support the hypothesis that the effectiveness of the pill depends to some degree on postfertilization effects.” However, the review also concluded, “...there are insufficient data to quantitate the relative contribution of postfertilization effects” Nevertheless, the authors suggest, “...the principles of informed consent suggest that patients who may object to any postfertilization loss should be made aware of this information so that they can give fully informed consent for the use of the pill.”

Available at the Archives of Family Medicine Website

Sherfey MA. Informed consent for postfertilization effects of hormonal and surgical forms of birth control for women. (Letter to the Editor) Arch Fam Med. 2000 Aug;9(8):690-1.

Stanford JB, Larimore WL. Informed consent for postfertilization effects of hormonal and surgical forms of birth control for women. (Response to the Letter to the Editor) Arch Fam Med. 2000 Aug;9(8):690-1.

This letter to the editor author makes the case that other forms of hormonal birth control may have a post-fertilization effect and “...it would be just as prudent to obtain fully informed consent in the same manner for the other methods of birth control, for which there is similar evidence for these postfertilization effects.”
Available at the Archives of Family Medicine Website

21) YØ - Larimore WL. The abortifacient effect of the birth control pill and the principle of ‘double effect.’ Ethics and Medicine 2000;16(1):23-30.

This review summarizes the data from reference #20 and introduces the principle of double effect to the equation. This review has been called “...the most concise and academic review of the medical evidence and ethics of this very thorny issue.”

The most recent version is available here.

22) YØ - Larimore WL, Stanford JB. The Abortifacient Effect of the Birth Control Pill (Letter to the Editor). Ethics and Medicine, Vol. 17, No. 3, Fall 2001:133-6.

This article (like #8 and #28) is a critique of reference #15 and addresses a number of the inaccuracies of #15. A reprint of the article can be ordered at

http://www.ethicsandmedicine.com/order.html.

23) ΩØ - McCrystal P. Contraceptive pills: abortifacient. Fact Sheet.

This brief article was originally published in the Beginnings newsletter of Pharmacists for Life (Beginnings 1997;13(4):105). It concludes, “There is a high degree of certainty that tiny human embryos die during contraceptive use. What is important, however, is not the actual figures involved but the fact that it happens at all. Given the dignity and preciousness of all human life at all stages of existence, the abortive nature of contraceptive drugs poses serious ethical and moral problems for all pharmacists and doctors in their promotion.”

Available at http://www.pfli.org/

24) ΩØ - Fact Sheet - Contraceptive Pills Abortifacient. Online Pamphlet. One More Soul.

This Fact Sheet concludes, “There is a high degree of certainty that tiny human embryos die during contraceptive drug use. What is important however is not the actual figures involved but the fact that it happens at all. Given the dignity and preciousness of all human life at all stages of existence, the abortive nature of contraceptive drug poses serious ethical and moral problems for all doctors and pharmacists involved in their promotion.”

http://www.omsoul.com/pamview.phtml?idnum=105&orderid=c126dad55ba62b4c38320d14e245a3ec

25) ΩØ - Tonti-Filippini N. The pill: abortifacient or contraceptive? A literature review. Linacre Quarterly. February, 1995:5-10.

This now somewhat scientifically outdated review is still considered a classic. So many of the authors of these references list this review as being helpful to them in their academic thinking concerning these issues. The author offers timeless advice when he declares, “There is a need for clear teaching on contraceptive-abortifacients and the deceit involved, not only in order to address the matter of respect for human life, but also the matter of the rights of women to know what they are doing to their own bodies and to the lives for whom their bodies are rendered hostile.”

http://www.cin.org/life/pillabor.html

26) YØ - Trewhella M. The Protest of a Protestant Minister Against Birth Control. Missionaries to the Preborn. Milwaukee, WI.

The author is the pastor of Mercy Seat Christian Church in Milwaukee and speaks, as a Protestant, against birth control: “We have no God-given right to manipulate God’s design for marriage by using birth control.”

http://www.missionariestopreborn.com/ - click on “What About Birth Control” (left side of the page) and then on “The Protest of a Protestant Minister...” (right side of the page)

27) ΩØ - What is the historical teaching of the Christian Church on contraception? From: Clowes B. The facts of life.

This author skillfully traces the history of the acceptance of contraception by the church at large. He points out, “Until August 14, 1930, all Christian churches were unanimous in their opposition to artificial means of birth prevention.”

The Facts of Life is available for purchase from Human Life International

28) T∆ - Wilks J. Response to Joel Goodnough MD’s, “Redux: Is the Oral Contraceptive Pill an Abortifacient?” Ethics and Medicine 2001;17(2):103-15.

This well-written article is in response to reference #15 and accompanies references #8 and 22. A reprint of the article can be ordered at http://www.ethicsandmedicine.com/order.html.

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