The Pill as an Abortifacient: Science Meets Morality

To many, this debate may seem trivial – a tired argument from right-wing conservatives that like to split hairs over abortion. I once shared this view, to be honest. It was a convenient stance to take, but at the end of the day it was not grounded in science or logic, but in fear and naivete.

Starting on the Pill was liberating. I was young (younger than I care to admit), in love and having sex, but the agonizing wait for my monthly reassurance was wearing on both our nerves. The Pill was a simple solution to a serious potential “problem”. Within a month’s time I was finally able to put that pesky issue of fertility behind me, and go on enjoying my sexual freedom without a care.

While I have quite a bit more to say about the Pill – the recklessness with which it is distributed, the defeminization that it imposes upon unsuspecting young women, and the cavalier disregard for its concomitant health risks perpetrated by health care professionals (check out my guest post on Laura’s blog, on my journey from the Pill to Natural Family Planning) – this post will focus on an issue even closer to my own heart than any of these. Closer to my own heart because it made a liar out of me, and I will never know the extent of my own guilt.

I will never know how many conceptions I unknowingly aborted in my seven years on the Pill. I will never know the fruit of those conceptions – never count their tiny fingers and toes, never hear their precious giggles, never feel the warmth and weight of their bodies on my chest. Granted, I was never ready to be a mother in those seven years. But had my chosen behavior resulted in a pregnancy, I certainly would have kept the baby and become a mom. More importantly, had I known that my chosen method of birth control was an abortifacient, I would have thrown it out long ago.

Not unlike many other young women in my situation, I was provided very little “education” surrounding the Pill when it was prescribed. I was told to take it at the same time every day, and to be extra cautious if I missed a pill or two in a row. That was about it. No one explained how the Pill works. I was aware of the general gist of the story – that the Pill “prevents” ovulation by regulating the level of circulating estrogen such that it

(a)    suppresses secretion of Follicle Stimulating Hormone (FSH) – which would fuel the maturation of an egg-containing ovarian follicle

and

(b)   never reaches the threshold level at which it would trigger a monthly surge in Leuteinizing Hormone (LH) – the hormonal event that triggers ovulation.

Seemed logical and effective enough to me! No ovulation, no egg, no pregnancy. Got it.

The next logical question, which apparently never occurred to me, is “How on Earth do women get pregnant on the Pill, then?” Good question.

The answer? They ovulate.

I suppose I always assumed that women who got pregnant on the Pill must have screwed up somehow. They missed a few pills, they took antibiotics that interfered with its efficacy… who knows. Certainly that is often the case. It really is tough to get pregnant on the Pill though, even under such confounding circumstances. This difficulty arises from the fact that the Pill also acts to thin the lining of the uterus so dramatically that it becomes very difficult for a fertilized egg to implant. In addition, its progesterone component thickens the cervical fluid such that it significantly reduces the survival time of sperm, and hinders the ability of sperm to enter the cervix at all, much less “swim” to the fallopian tubes where fertilization occurs.  Yet somehow, 1 woman in 1,000 who use the Pill “perfectly” still gets pregnant.

Now, let’s take that statistic a step further. Given the considerable obstacle to implantation presented by the thinned uterine lining, statistically speaking most successful fertilizations will not result in successful pregnancies. This implies, then, that there is a lot more fertilization going on in the background that simply isn’t resulting in successful implantation and pregnancy (which in turn implies a lot of ovulation).

What’s more, let’s take into account the fact that a woman is only fertile for a few days per month (assuming that she has ovulated), surrounding ovulation. That fertility window is even smaller in a woman on the Pill, because the pre-ovulatory window of fertility assumes survival of sperm for several days in fertile cervical fluid while they await the arrival of an egg. We have already established that sperm cannot survive in the thick, sticky cervical fluid produced by women on the Pill. If we allow for a generous window of survival, say 48 hours, then intercourse must occur 48 hours prior to ovulation at most, and within 24 hours after (the lifespan of the average ovulated egg). 

This gives a 3-day window that a woman who has had a so-called “breakthrough ovulation” on the Pill could physically get pregnant. What are the odds that (a) intercourse occurred during the appropriate 3-day window, (b) the sperm penetrated the thick, sticky cervical fluid barrier within the cervix to enter the uterus and “swam” to the fallopian tubes, (c) fertilization was successful, and (d) that fertilized egg managed to successfully implant in the harsh uterine environment, resulting in a pregnancy?

After considering all of these obstacles, it becomes clear that each breakthrough ovulation on the Pill practically requires an “alignment of the stars”, so to speak, to result in a pregnancy. This simple fact implies that, statistically, there must be an awful lot of breakthrough ovulation occurring in women taking the Pill, just to result in one pregnancy in 1,000.

Great, Jenna. But what does it all mean? Well, the most important point in all this (in my humble opinion) is that breakthrough ovulation on the Pill is not the extraordinary event that women are led to believe. It happens. For many women this phenomenon is of no consequence, so long as it does not result in a pregnancy. A problem arises, however, if you happen to be a woman who is firmly opposed to abortion and who fundamentally defines life as beginning at fertilization. The Pill is designed with a back-up plan – if fertilization occurs, it ensures that the uterine environment is as hostile as possible to the embryo as it attempts to implant, so that it will most likely be rejected and flushed out with menstruation. Call it splitting hairs if you want to, but the reality is that so long as a woman is taking the Pill, she is passively facilitating the possibility of aborting a conception.

No one ever told me. As a naïve young woman, I took the advice and guidance of my healthcare providers at face value, just like so many other young Christian women have done and will continue to do. None of this absolves me of responsibility – ignorance is no defense in the information age – but it speaks to a disturbing and disheartening trend in women’s healthcare. The Pill is dispensed like candy, with complete disregard for the religious and ethical ramifications of its use and with very little (if any) emphasis on patient education.

As a patient, I feel betrayed. I will never know how many breakthrough ovulations I experienced or how many unborn children my chemicalized body rejected. How many times was my integrity undermined? The truth is, I was undermining my own integrity for seven years – every night before bed when I popped that tiny little pill. Chances are, I may have had a few breakthrough ovulations in that time. Chances are none of them were fertilized successfully. But I’ll never know, and whether or not a conception ever occurred is neither here nor there. The point is that I unwittingly failed my own moral values by allowing that process to occur within my own body.

Take home message: The Pill made a liar out of me. Don’t let it make a liar out of you.


***A Note to IUD Users: Please see the Appendix on IUDs for more information on how all this applies to you. I assure you, it does, but in a slightly different way.