The Abortifacient Effect of the Birth Control Pill (A Reading List)
Friday, 29 May 2009
Below is the list of references I’ve found helpful (and some I have written) on the complex debate about whether the birth control pill can have an abortifacient (or post-fertilization) effect. (Last updated June 20, 2009) Please comment, below, if you have any other references to suggest.
I’ve indicated with each article whether, in my opinion, it is PRO, CON, or NEUTRAL to the idea or theory that the birth control pill is abortifacient or can have a post-fertilization effect:
1) (PRO) A declaration of life by pro-life physicians. American Life League. Stafford, VA. 1999. (last accessed February 9, 2008)
This declaration has been signed by 229 (as of February 9, 2008) pro-life 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.”
2) (PRO) Alcorn R. A dialogue about birth control. Eternal Perspective Ministries. 1999 (last accessed February 9, 2008)
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.
3) (PRO) Alcorn R Does the birth control pill cause abortions? (5th Edition) Eternal Perspective Ministries. 2000. (last accessed February 9, 2008)
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.
4) (NEUTRAL) Birth control pills and other hormonal contraception. Focus on the Family Position Statement. Colorado Springs, CO. 1999. (last accessed February 9, 2008)
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.”
5) (PRO) Birth control pills: contraceptive or abortifacient? American Life League. Stafford, VA. 1999. (last accessed February 9, 2008)
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.”
6) (NEUTRAL) Possible post-conceptional effects of hormonal birth control. Christian Medical and Dental Associations Position Statements. Bristol, TN. 1998. (last accessed February 9, 2008)
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.”
7) (CON) Christ in Your Family: Thoughts on Christian Marriage and Contraception. LCMS (Lutheran Church – Missouri Synod) Sanctity of Human Life Committee. May 2008. (last accessed June 19, 2008)
8) (PRO) Colliton WF. Birth control pill: abortifacient and contraceptive. Linacre Quarterly. November 1999:26-36. (last accessed February 9, 2008)
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 pro-life 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.”
9) (PRO) 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 and critical to Goodnough’s review. A reprint of the article can be ordered here. (accessed February 9, 2008)
10) (NEUTRAL) Contraception: A Symposium. First Things. December, 1998:17–29. (last accessed February 9, 2008)
On the 30th anniversary of Humanae Vitae, the editors of this journal asked Protestant, Catholic, and Jewish thinkers to respond to the questions:
- Do you judge the argument of Humanae Vitae convincing with respect to contraception?
- How do you think the argument could have been made more convincingly?
- In view of developments in the last thirty years, was Paul VI right about the moral and social consequences of contraception?
- If you agree that the message of the encyclical has not been effectively communicated, why is that the case?
11) (CON) Crockett SA, DeCook J, Harrison D, Hersh C. Hormone Contraceptives Controversies and Clarifications. ProLife Obstetrician. Fennville, MI. April1999. (accessed February 9, 2008)
This white paper opposes the theory of the abortifacient mechanism of the Pill. This particular paper has resulted in several responses included in this reading list. 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.” Unfortunately, they’ve never published their opinion in a peer-reviewed medical journal.
12) (CON) 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 of two chapters on the abortifacient effect of the Pill. This article contains very little information that is not outlined in reference #11. This book can be ordered from the Center for Bioethics and Human Dignity here. (last accessed February 9, 2008)
13) (PRO) Fernández JR. The pill vs. NFP. How it works. Online Pamphlet. One More Soul. (accessed February 9, 2008)
The testimony of a Catholic family physician’s conversion from the practice of contraception to the practice of natural family planning.
14) (NEUTRAL) 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 . . .”
You can search their site, from their home page, here, for several articles on Birth Control and The Birth Control Pill. You can find several examples on here, here, here, or here. (last accessed February 9, 2008)
The booklet entitled, “The Christian and Birth Control,” which is published by Christian Life Resources (an agency affiliated with the Wisconsin Evangelical Lutheran Synod), is inexpensive and can be found on their store site here. (last accessed February 9, 2008)
The booklet entitled, “Birth Control Facts You Should Know About,” which is published by Christian Life Resources (an agency affiliated with the Wisconsin Evangelical Lutheran Synod), is inexpensive and can be found on their store site here. (last accessed February 9, 2008)
15) (CON) 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. The most critical response to Goodnough is found in reference #24. A reprint of Goodnough’s article can be ordered here. (last accessed February 9, 2008)
16) (PRO) Kahlenborn C. How do the pill and other contraceptives work? Life Advocate 1997;12(7). (last accessed February 9, 2008)
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.
17) (PRO) 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) (PRO) Larimore WL. Postfertilization effects of oral contraceptives and their relationship to informed consent (Commentary). Arch Fam Med 2000;9:133. (last accessed February 9, 2008)
The testimony of a my personal conversion from the practice of contraception to the practice of natural family planning.
19) (PRO) 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 two chapters on the abortifacient effect of the Pill. Its companion is reference #12. This book can be ordered from the Center for Bioethics and Human Dignity here. (last accessed February 9, 2008)
20) (PRO) Larimore WL, Stanford JB. Postfertilization effects of oral contraceptives and their relationship to informed consent. Arch Fam Med 2000;9:126-133.(last accessed February 9, 2008)
This systematic review, that I co-authored, 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, Dr. Stanford and I 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.”
The article resulted in one letter to the editor:
a) 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.
b) 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. (last accessed February 9, 2008)
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.”
21) (PRO) 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. (accessed February 9, 2008)
22) (PRO) 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 is a critique of Goodnough (reference #16) and addresses a number of the inaccuracies in Goodnough. A reprint of the article can be ordered here. (accessed February 9, 2008)
23) (CON) Lutheran Church Missouri Synod. Resolution 6-10: Guidance on Contraceptive Methods. Sanctity of Human Life Committee under the oversight of LCMS World Relief and Human Care and the Board for Human Care Ministries of The Lutheran Church—Missouri Synod. 20009.
The LCMS Sanctity of Human Life Committee, following the mandate given to it by the Synod in convention, cannot state definitively that hormonal contraception does not at least some of the time cause a chemical abortion. The medical and scientific community acknowledges this possibility, but cannot state how frequently or if, in fact, this does occur. In light of this, some Christian couples may have concerns about hormonal contraception.
24) Mirkes, Renee. The Oral Contraceptive Pill and The Principle of Double Effect. Ethics & Medicine, Summer 2002.
The author systematically argues against virtually every contention made by Goodnough in his article supporting the use of BCPs (reference #15). In addition, she makes a very strong argument that to prescribe or use the BCP is unethical and immoral. She concludes, “. . . the prescription of the OC, even when judged primarily from a medicinal rather than from a moral perspective, is not a good human act. That is, prescribing the OC is not in the best health interests (physical and moral) of the patient, nor is it, by logical extension, in the best professional interests of the health professionals who is bound to promote the integral good of every patient.”
25) (PRO) McCrystal P. Contraceptive pills: Abortifacient. Fact Sheet. Human Life International (Ireland). (last accessed February 9, 2008)
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.”
26) (PRO) Fact Sheet – Contraceptive Pills Abortifacient. Online Pamphlet. One More Soul. (last accessed February 9, 2008)
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.”
27) (CON) Sullivan, Dennis M. The Oral Contraceptive as Abortifacient: An Analysis of the Evidence. Perspectives on Science and Christian Faith. Volume 58, Number 3, September 2006:189-195. (last accessed February 9, 2008)
This article, written by a professor of biology at Cedarville University examines the scientific evidence for an abortifacient effect of such contraceptive agents, and concludes that such an effect is yet unproven. Some of the ethical arguments are also examined, and the author suggests that further research on early pregnancy factor (EPF) may help to resolve this controversial issue.
28) (PRO) Tonti-Filippini N. The pill: abortifacient or contraceptive? A literature review. Linacre Quarterly. February, 1995:5-10. (last accessed February 9, 2008)
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.”
29) (PRO) 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.”
Go here and 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) (last accessed February 9, 2008)
30) (NEUTRAL) 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.”
Can be purchased from HLI here. (last accessed February 9, 2008)
31) (CON) 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 another criticism to Goodnough (reference #15). A reprint of the article can be ordered here. (last accessed February 9, 2008)
Okay, this in not an article, or a book, but rather a 45-minute DVD in which a Christian worker, his family, and a nurse investigate throughout North America to “uncover the truth about the birth control pill.”