Emergency Contraception (EC)

Part 1: Can EC and regular hormonal birth control
pills prevent implantation in the uterine wall?

In other words, is it contraceptive or abortifacient?

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Background material:

The very first processes that lead to the birth of a newborn infant are:

• Release of a very lucky spermatozoon about a month before conception from a man's testicle. It is one of hundreds of millions of sister and brother spermatozoa that will subsequently attempt to fuse with an ovum.
  
  
• Release of an ovum by a woman's ovary shortly before conception.
  
  
• Sexual intercourse.
  
  
• Conception occurs. The ovum is fertilized by one spermatozoon to produce a zygote (commonly referred to as a fertilized ovum, fertilized egg, or pre-embryo)
  
  
• The zygote travels down a fallopian tube towards the uterus. If all goes well, it develops into a blastocyst through cell multiplication during its travel. When it reaches the uterus, it starts to implant itself in the inner wall of the womb. A week or two after conception, it is fully implanted and the pregnancy can be detected by a urine or blood test.

Initially, medical researchers suspected that EC might prevent pregnancy in three ways:

1. By preventing ovulation -- the release of an ovum from an ovary. Thus, conception would be impossible.
   
   
2. If ovulation had already occurred, it would prevent conception by making the ovum more resistant to fertilization.
   
   
3. If the ovum was already fertilized, EC might prevent the implantation of the resulting blastocyst in the wall of the uterus.

Further research has shown that the third path is very unlikely or impossible. Still, as of early 2013-MAY, essentially all conservative social and religious information sources state that this third path is common: that EC can prevent implantation. Pro-lifers and medical professionals generally assert that pregnancy begins at implantation. Thus even if the pill did interfere with implantation, it would still be considered a contraceptive. However, pro-lifers and other social and religious conservatives generally teach that pregnancy begins at conception. Thus, they regularly refer to it as a possible abortifacient. Some appear to assume that it is always works by this third path and refer to it simply as an abortifacient.

Teva Pharmaceuticals are the developers of Plan B. They are required by the Food and Drug Administration (FDA) to place a warning label on their product stating that the drug:

"... may inhibit implantation by altering the endometrium"

The endometrium is the inside lining of the uterus (a.k.a. womb).

₁

Teva has repeatedly asked the FDA for permission to remove the warning because there is no scientific evidence to support it.

The 2003-MAY issue of Christianity Today -- North America's leading evangelical Christian publication -- was the first conservative Christian information source that we have seen that revealed accurate information to its readers about EC. ₂ Hopefully, conservative Christian news sources will recognize the danger to their credibility in the future if they continue to imply that EC works after conception. Perhaps they will start stating accurate information in their news releases.

Why is this question important?

It is the primary determining factor whether most religious conservatives, social conservatives, and pro-life advocates will accept or oppose women's access to emergency contraception (EC).

There is general agreement among pro-life, pro-choice groups, and medical professionals that:

• Contraceptives include actions, devices, sexual practices or medications that prevent pregnancy from starting.
  
  
• Abortifacients include actions, devices, or medications that terminate pregnancies that have already begun.

Unfortunately, there is no consensus on exactly when pregnancy begins. This makes it difficult for all three groups to agree on whether EC acts as an abortifacient or as a contraception.

Most pro-lifers and other conservatives believe that both a human person and pregnancy begin at the same time, during the process of fertilization. Some refer to the "instant of fertilization" or conception. However, the process actually takes hours.

They base this beliefs in pregnancy and personhood on the fact that a unique human DNA is created at that time.

• If EC subsequently prevents implantation of the embryo in the wall of the uterus, then pro-lifers could considered EC to be an abortifacient. That is, it would kill a human person just like they believe RU-486 or an early surgical abortion does. There would be no ethical difference between strangling a newborn infant, taking EC, taking RU-486 or having a surgical abortion. All would involve the termination of a human life and a human person.
  
  
• However if EC only interrupts processes before conception -- by stopping the ovary from releasing an ovum or by causing the ovum to resist sperm -- then it would merely prevent a pregnancy from starting; it would act as a method of birth control, and would ethically be similar to the use of condoms or "the pill." That is, it would be forbidden by the Roman Catholic Church, allowed by almost all other faith groups, and overwhelmingly accepted by the Catholic and Protestant laity.

Protestant pro-lifers and conservatives generally have no objection to birth control but are unalterably opposed to abortion; they regard it as taking a human life. The Roman Catholic Church is unalterably opposed to both birth control and to abortion. However most Catholic laity has ignored the church's contraceptive teachings and has no objection to "the pill" and other methods of birth control. Further, the abortion rate by Catholic women is equal or perhaps slightly higher than the national average.

Most pro-choicers follow the medical understanding that pregnancy begins when the blastocyst becomes fully implanted in the wall of the uterus. Thus, even if EC could prevented implantation, they would not consider it to be an abortifacient since a pregnancy would not have started. In addition, most pro-choicers believe that human life, in the form of an ovum and spermatozoon becomes a human person only later in pregnancy:

• Perhaps when the fetus first becomes sentient -- i.e. it attains consciousness, becomes at least partly aware of its surroundings, may be able to feel pain, etc., or
  
  
• Perhaps when the newborn has emerged from its mother during childbirth, or
  
  
• Perhaps at some other time during pregnancy.

Thus, most pro-choicers have no objection to the use of EC, even if they are not aware of the recent medical evidence that there is reasonable certainty that EC does not interfere with the implantation of a blastocyst.

Can EC prevent implantation of a blastocyst?

The answer is a definite yes and no, depending upon whose expertise one draws.

• YES: William Cardinal Levanda, Prefect of the Congregation for the Doctrine of the Faith, issued "Instruction Dignitas Personae on certain bioethical questions" on 2008-DEC-08.
  
  Section 23 of the document covers "New forms of interception and contragestation." The document identifies in its footnote 43 that "... the IUD (intrauterine device) and the so-called 'morning-after pills' are the best known interceptive methods." Levanda states as a fact that one of the ways in which emergency contraceptive "certainly" works is as an interception agent that prevents implantation. Since the Church teaches that pregnancy and a human person both begin at the time of conception, preventing implantation kills a human being. The document condemned EC as a type of abortion and thus "gravely immoral."
  
  The document states:
  
  

  "Alongside methods of preventing pregnancy which are, properly speaking, contraceptive, that is, which prevent conception following from a sexual act, there are other technical means which act after fertilization, when the embryo is already constituted, either before or after implantation in the uterine wall. Such methods are interceptive if they interfere with the embryo before implantation and contragestative if they cause the elimination of the embryo once implanted."

  "In order to promote wider use of interceptive methods, it is sometimes stated that the way in which they function is not sufficiently understood. It is true that there is not always complete knowledge of the way that different pharmaceuticals operate, but scientific studies indicate that the effect of inhibiting implantation is certainly present, even if this does not mean that such interceptives cause an abortion every time they are used, also because conception does not occur after every act of sexual intercourse. It must be noted, however, that anyone who seeks to prevent the implantation of an embryo which may possibly have been conceived and who therefore either requests or prescribes such a pharmaceutical, generally intends abortion. ..."

  "As is known, abortion is 'the deliberate and direct killing, by whatever means it is carried out, of a human being in the initial phase of his or her existence, extending from conception to birth.' Therefore, the use of means of interception and contragestation fall within the sin of abortion and are gravely immoral. Furthermore, when there is certainty that an abortion has resulted, there are serious penalties in canon law." ₃

  Unfortunately, Levanda does not give any research findings that support his assertion that "the effect of inhibiting implantation is certainly present."
  
  In the vast majority of cases, it seems obvious that women who take EC are hoping and expecting that it will prevent ovulation or prevent conception. They do not expect to induce an abortion.

This topic continues in the next essay

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

1. Pam Belluck, "Abortion Qualms on Morning-After Pill May Be Unfounded," New York Times, 2012-JUN-05, at: http://www.nytimes.com/
2. Ruth Moon, "Murky Plan b: The morning after pill may not cause abortion." Christianity Today, 2013-MAY, Page 15.
3. William Cardinal Levanda, "Instruction Dignitas Personae on certain bioethical questions," Congregation for the Doctrine of the Faith, 2008-DEC-08, at: http://www.vatican.va/

Copyright © 2010 & 2013, by Ontario Consultants on Religious Tolerance
Originally published on 2010-JUN-19
Latest update: 2013-MAY-12
Author: B.A. Robinson

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