Does contraception prevent abortion?

by William E. May, Ph. D., Senior Fellow

In Culture of Life Foundation

Andrew Koppelman and others say “It certainly does!”

Andrew Koppelman, John Paul Stevens Professor of Law at Northwestern University, and others claim that contraception definitely prevents abortion. This April (2010) Koppelman posted a commentary, “How the Religious Right Promotes Abortion,” [1] that was immediately attacked byspokespersons of the “Religious Right” (e.g., Michael New of the Witherspoon Institute). Koppelman judges it to be “astoundingly stupid and tragic” to argue over this. Continuing, he said, “One of the rare areas of common ground between opponents and supporters of abortion rights is that neither side thinks that unintended pregnancy is a good thing. We should be able to come together on measures that would actually reduce the rate of unwanted pregnancy, and thus, inevitably, reduce the abortion rate. That might even help the anti-abortion cause in the long run, because it would reduce the number of American women who have had abortions…. Yet instead, we are having this silly argument. It is dispiriting.”

Factual errors in Koppelman’s allies June Carbone and Naomi Cahn

Koppelman calls on June Carbone and Naomi Cahn, well-known for their advocacy of contraception as the best way to prevent abortion, to support his view and show how foolish a critic like New is. After repeating Koppelman’s mantra that contraception is the best way to reduce abortion and that pro-lifers should welcome its use, they declare: “Every time legislators advocate recognition of women’s needs, conservatives work to derail them. When President Obama proposed strengthening family planning efforts in the stimulus package, Republicans blocked the measure.” They apparently equate “Republican” with “pro-lifer” as if opponents to abortion, euthanasia, assisted suicide and other hallmarks of the “culture of death” were all Republicans, conveniently forgetting pro-life Democrats like the late Governor Casey of Pennsylvania.

Carbone and Cahn misrepresent New’s critique of Koppelman. New had written: “…existing research indicates that there is relatively little the government can do to increase contraceptive use among sexually active women. Nine years ago, the Alan Guttmacher Institute, which was Planned Parenthood’s research arm and which strongly supports more funding for contraception, surveyed 10,000 women who had abortions. Among those who were not using contraception at the time they conceived, a very small percent cited cost or lack of availability as their reason for not using contraception. Specifically, only 12 percent said that they lacked access to contraceptives due to financial or other reasons. Given all the existing programs, it is by no means clear that more federal spending on contraceptives could increase contraceptive use among this subset of women.”[2] Carbone and Cahn say this means that “the only way to prevent abortions is to prevent sex.” This is not what New said nor does there seem to be any relationship at all between New’s conclusion, which is based on existing research, and Carbone and Cahn’s misleading restatement of it.

Contraception: the Gateway to Abortion

I think we can show that contraception is itself the gateway to abortion. Before doing so, I want to note that May 2010 marks the 50th anniversary of the famous birth-control Pill, as Melinda Beck reminds us in her essay “The Birth Control Riddle” in the April 20 issue of the Wall Street Journal.[3] At the end of her piece Beck describes the latest developments in contraceptive technology, summarized in the following footnote.[4] In her essay, a paean to the Pill and all kinds of “contraceptives,” Beck has to admit that although there are today more options than ever before, “some three million U.S. women have an unplanned pregnancy every year.” In fact, she has to say: “Almost half of all pregnancies in the U.S.--some 3.1million a year--are unintended, according to the most recent government survey, from 2001. One out of every two American women aged 15 to 44 has at least one unplanned pregnancy in her lifetime. Among unmarried women in their 20s, seven out of 10 pregnancies are unplanned. An updated version of those numbers from the 2006 National Survey of Family Growth is expected to be released next month. But population experts don't anticipate much change; the rate of unplanned pregnancy was the same in 1994, and smaller studies have found that even newer birth-control methods haven't made much of a dent.”

This makes it evident that contraceptives are not a panacea for preventing abortion—Koppelman’s central message. Since 70 percent of the pregnancies experienced by women in their 20s are “unplanned,” this renders implausible the claim that contraception is the best way to prevent conception.

Are some “contraceptives” actually “abortifacient”?

This is highly controversial. Many persons, particularly those seeking to develop a “culture of life” as opposed to the “culture of death,” sincerely believe that some contraceptives do in fact “work” by not only causing anovulation or by rendering the mucus hostile to sperm but also by rendering the endometrium of the womb hostile to the implantation of a child already conceived. In short, they have a “postfertilization” mechanism. This belief refers precisely to the abortifacient potential of Pills using a combination of estrogen and progesterone, of IUDs, various kinds of implants (Norplant and now Implanon), the “morning after” pill and others. This belief, moreover, seems substantiated by the advice given in the prescriptions of some contraceptives, notably those combining estrogen with progesterone and by on-line advice given by Columbia University of New York’s Health Q&A Internet Service “Go ask Alice” (http://www.goaskalice.columbia.edu/).

Over the past quarter century I made this claim myself. However, a thorough study of all the scientific research done on this issue by Nicanor Austriaco, O.P. Ph.D. (a Dominican priest with a doctorate in biology from Massachusetts Institute of Technology) and published in the National Catholic Bioethics Quarterly Vol. 7, No. 4 (Winter, 2007), “Is Plan B Abortificient: A Critical Look at Scientific Evidence,” 703-707, seriously questions whether this claim is true and shows that there are good reasons to think that it is not.

It is most significant, I think, that Susan A. Crockett, Donna Harrison, Joe DeCook, and Camilla Hersh in an April, 1999 study called Hormone Contraceptives and Clarifications, published by the American Association of Pro-Life Obstetricians and Gynecologists, like Austriaco, concluded that the scientific data do not show the existence of a postfertilization, i.e., abortificient, mechanism in Combined Oral Contraceptive Pills (COCPs). In their study, accessible at http://www.rcnz.org.nz/synodical/synod2008/r17.pdf, they offer this advice: “At the current time we feel that each individual physician should evaluate the available information, and then follow the leading of his/her conscience in this matter.”

“Body-Self” or “Body-Person” Dualism

It is not possible here to take this matter up fully (it has been discussed in other Culture of Life postings), but I will attempt to express it clearly. In my judgment a dualistic mindset seems to be implicit even if not recognized in those who are willing to contracept, i.e., it seems as if they are treating their bodies as part of the subpersonal world of nature over which they, as “persons,” have dominion. This view is, however, dualistic insofar as it separates the person from his or her body. Our bodies are not like clothes that we persons wear. When someone breaks his or her arm he or she is not damaging his or her property but injuring himself or herself.

Free Choice, Human Actions, Our Moral Character

In addition, we must remember that unlike other material creatures we have the power of free choice and that we determine ourselves, that is, make ourselves to be the persons we are in and through the actions we freely choose to do every day of our lives. It is and through these choices that we give to ourselves our identity as moral beings. We can rightly say that our moral character is our integral existential identity that we give to ourselves by the choices, good and bad, that we do every day. It thus follows that the actions we choose to do are not mere physical events that come and go like the falling of leaves. Although our actions indeed have effects on the outside world, their moral importance lies in the fact that in and through them, we give to ourselves our identity as the kind of person who has freely disposed himself or herself to be a liar, an adulterer, a killer of innocent human beings or to be one who speaks the truth, who is a faithful spouse and parent, one who defends and does not attack the good of human life in others, and as one who is either closed to the great gift of human life or open to it and welcoming of it when one chooses to engage in the kind of bodily act, in fact the only kind of bodily act, genital coition between a man and a woman, through which this great gift can be given. It is important to keep this in mind when one must choose either to contracept, which can be defined as an action in which we intentionally choose to impede the beginning of a new human life while choosing to engage in the kind of bodily act apt to generate that life or to welcome that life into our hearts and homes or, if there are good reasons not to cause a woman to become pregnant, to abstain from choosing to engage in actions likely to cause a pregnancy.

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Notes

[1] http://balkin.blogspoot.com/2010/04/how-religious-right-promotes-abortion/html.
[2] See New’s essay, “How Red States Reduce the Abortion Rates: A Response to Andrew Koppelman” at http://www.thepublicdiscourse.com/2010/04/1250
[3] The article is accessible at http://online.wsj.com/article/health_journal.html/
[4] Beck lists the following: 1. New IUDs—the Delkon Shield is no longer used because of its dangers; it has been supplanted by ParaGard which “protects” women from pregnancy for 12 years and Mirena, good for 5 years. 2. Implants—NorPlant is no longer used, replaced by Implanon good for 3 years. 3. Hormone Pills and other pills, Rings, Patches etc. New pills have lower hormone content but majority are combination estrogen/progesterone kinds; for women who can not take estrogen Depo-Provera is the choice; there are 40 brands of progesterone/estrogen combinations; new Pills using progesterone and estrogen are Seasonique that allows women only 4 periods a year and Lygreel that allow only one week; the NuaRing “protects” for 3 weeks and then must be replaced; Ortho-Era for only 1 week; the “morning after” pill. 4. New condoms including the woman’s condom and sponges such as the Today sponge popularized on the Simpsons. 5. Tubal ligations and vasectomies. New kind of tubal ligation is Essure.