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Investigating the Birth Control Pill

I was married in the summer of 2015, and a few months prior to this my fiancé and I began researching Christian methods of birth control. The minister officiating our wedding gave us two articles to read.1,7 This was the first time I had really read anything about oral contraceptives, aka the Pill. When I was in high school, I knew girls who were taking the Pill to help ease menstrual difficulties, so I was aware that it existed. But I had no idea how it worked, or whether there were problems with using it as a contraceptive.

The two articles the minister gave us noted the Pill was not only a contraceptive, but could have an abortive function, acting after a new baby was already conceived. In conversations with other women my age, it became clear that doctors weren’t talking about the Pill’s role as an abortifacient (something that causes abortions). They had never been informed.

3 ways the pill works

So how does the pill work?

It has three different mechanisms, and the first two do indeed act to prevent pregnancy.

The most well known mechanism of the pill is prevention of ovulation. And if there is no egg for the sperm to fertilize then there is no possibility of pregnancy.

The pill also causes cervical mucus to thicken, making it more difficult for sperm to reach the egg if the woman still ovulates. These first two mechanisms are indeed contraceptive, in that when they work, they serve to prevent the joining of the egg and sperm.

But there is also a third action, and this one is not contraceptive, but abortive. The hormones in the Pill cause the lining of your endometrium (on the wall of the womb, where the egg needs to attach) to be very thin so the baby cannot implant. And because it can’t implant it has no chance to grow and develop – it is chemically aborted.2

When contraception doesn’t “contra” conception

This third action isn’t well known, perhaps because it is still called “contraceptive” even though it acts after conception. You see, if you look up the definition of “contraception” it isn’t what you might expect. In the Merriam-Webster Dictionary it says “contraception: deliberate prevention of conception or impregnation.” In other words, when we read on a box that something is a contraceptive, that doesn’t mean that it just prevents conception – the word also includes the abortive function of preventing a newly conceived little human being from implanting in its mother’s womb.

That may be why most people don’t know about the Pill’s abortive function. Physicians use this word contraception, but mean something very different by it than we might be assuming. But information about this can be easily found on the Internet. For example, an article on Webmd.com describes this third function this way:

Hormonal contraceptives can also prevent pregnancy by changing the lining of the womb so it’s unlikely the fertilized egg will be implanted.2

As pro-lifers, we understand that “the fertilized egg” they are talking about here is actually and already a human being made in God’s image.

Another sort of pill?

I now thought I knew how oral contraceptives worked, so my fiancé and I would not be considering this “option” of birth control. This does not mean that we were not scared that our other options would not be as effective. We also knew they would require more “work” than taking a pill (condoms, tracking basal body temperatures and cervical mucus, etc.).

Then I started hearing from various women that “my pill is different, my doctor says it’s not the type that can cause abortions.” I was quite interested, thinking that since I had only read two very religious articles, perhaps there were other, different pills the article authors didn’t know about – ones that do not have the third abortive mechanism of action. Wouldn’t that be great?

But it didn’t take long, searching with Google, to dig up clear information on the many different brands of oral contraceptives. There are over 80 different names but they all contain either progestin or estrogen or a combination of both (most common), and therefore they all have the same three potential actions. I began reading more research articles, both Christian-based and non-Christian, and they amusingly enough agreed that it happens but then draw different conclusions as to what we should then do.

CHRISTIAN SOURCES: We do not and cannot know how often the third mechanism has to kick in because the first two fail, but we know it can and does happen, therefore we should not be willing to risk killing our baby.1,4,6,7

NON-CHRISTIAN SOURCES: There is no precise medical testing that exists which can prove how often a fertilized egg is not implanting and so Christians should not worry or care about a non-statistic.5,9

Not care about a “non-statistic”? Just because we cannot get a precise number, does that mean we should just ignore that it is happening altogether?

Even with perfect use, babies are conceived

We might not have clear numbers, but we do know babies are being conceived in women who use the birth control pill. There is no such thing as a birth control pill that has a 0% pregnancy rate…even with perfect use.8 We should also note that on most websites it states users of the pill must take it at the same time every day and not miss a pill.2,10 This would be considered “perfect use” and even with perfection, pregnancies are still occurring.3

And the pregnancy rates go way up under “typical use” (missing a pill or taking a pill late). In an article by Dr. William F. Colliton Jr., he shared that:

“…medical literature documents an incidence of 3-5 pregnancies per 100 women per year for Pill users. Dr. Don Gambrell, Jr., a renowned gynecological endocrinologist….noted a 14% incidence of ovulation in women taking the 50 microgram [Birth Control Pill]. This rate varies from pill to pill and from patient to patient. Now, every case of fertilization that does occur in women on the pill, in which the pill has made it difficult or impossible for there to be implantation, contradicts the thesis of those stating that the [Birth Control Pill] is not abortifacient.4

If 3-5 pregnancies are occurring despite all 3 actions of the pill, how many more ovulations are occurring that we don’t see because the conceived baby is then terminated because it can’t implant in the thin endometrium? What about a 14% breakthrough ovulation rate? We don’t know how many children are killed by the Pill’s third mechanism, but the numbers could be very high. As Randy Alcorn writes:

The Pill is used by about fourteen million American women each year and sixty million women internationally. Thus, even an infinitesimally low portion (say one-hundredth of one percent) of 780 million Pill cycles per year globally could represent tens of thousands of unborn children lost to this form of chemical abortion annually. How many young lives have to be jeopardized for prolife believers to question the ethics of using the Pill? This is an issue with profound moral implications for those believing we are called to protect the lives of children.

We could guess the numbers for Canada might be around a tenth of the American figures, potentially amounting to thousands of children lost. Regardless of what the numbers are, as Christians can’t we agree that if our birth control choices risk killing even just one baby, then we need to use some other method?

Conclusion

While I was quite uninformed on this topic, it didn’t take much time to work through the readily available information and realize that the Pill is not for us. So with all this in mind I would like to encourage anyone who reads this with the following:

  • If you are a parent of a teenage girl, (and, even teenage boys should be informed too!) please talk with them about the birth control pill. Don’t let them find out for themselves or assume that they know already. I didn’t know, and many others did not and do not. This is important stuff because it truly is a matter of life and death!
  • If you are an engaged couple considering different birth control options please do more research than just asking your doctor for a non-abortive pill. The chances are high that your doctor does not have the same beliefs as you and does not consider hormonal oral contraceptives to be abortifacient (because he may regard implantation, rather than conception, as when new life begins). Don’t be tempted to take the easy way out and not ask questions. This topic is important enough to spend a few hours of your time researching it before putting hormones into your body uninformed. The information is all out there; you just have to look for it!
  • If you are married and currently taking one of the many brands of birth control pills, please don’t let guilt get in the way of change. What you’ve done in ignorance, you can turn from now that you know better. And because our God is merciful we can depend on His forgiveness, and live lives of thankfulness.

I believe that this conversation is extremely necessary, and as important, if not more so, than walking in a March for Life or standing in a Life Chain or any other pro-life work. We cannot tell others that it is wrong for them to kill their baby before it is born if we are ignoring the safety of our own unborn children. If we are pro-life, then let us truly be pro-life!

Endnotes

1 Randy Alcorn’s Does the birth control pill cause abortions? A short condensation.
2 Todd Nivin’s (MD) “Birth Control Pills” Retrieved August 16, 2016
3 Contraception: Success and failure rates of contraceptives. Retrieved January, 2017
4 W.F Colliton’s “The birth control pill: Abortifacient and Contraceptive” in Life and Learning X,
5 J.L. DeCook & D. Harrison & C. Hirsch & S. Crocket’s “Hormone contraceptives controversies and clarifications” in Prolife Obstetrician (1999)
6 M.A. Grisanti’s “Birth control and the Christian: Recent discussion and basic suggestions” in The Master’s Seminary Journal 23(1)
7 N.D. Kloosterman’s “The pilgrim’s pathway” in the Oct, 1994 issue of Christian Renewal
8 I. Milsom & T. Korver’s “Ovulation incidence with oral contraceptives: A literature review” in J Family Planning Reproductive Health Care 34(4)
9 C. Page’s “Much ado about nothing: Prolife misconceptions about contraception” posted Aug 22, 2008
10 U.S. Food and Drug Administration’s “Birth control: medicines to help you

This article first appeared in the March/April 2017 issue.

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Marriage, Sexuality

A careful look at the issue of birth control

Children: a calling and a blessing **** God calls the Reformed husband and wife to bear children. Just as marriage is a creation ordinance, so God’s calling to bear children is a creation ordinance. Strikingly, the first thing God says after He creates the woman for the man is that together in their marriage they must bear children: “Be fruitful, and multiply”(Gen 1:28). This command necessitates a link between marital intimacy and the begetting of children (if God in His Providence grants that possibility).  For the Reformed couple, this calling intensifies as they see from Scripture that God is pleased to carry on His covenant of structured fellowship also with the children of believers (Gen 7:7, Acts 2:39). Due to this promise, the Scriptures lay further weight upon God’s people to bear children (see Malachi 2:15 “And did not he make one?...And wherefore one? That he might seek a godly seed” and also 1 Timothy 5:14). Not only is bearing children a calling, but the Reformed couple also gleans from Scripture that children (many!) are a blessing from God (Psalm 127:3-5; Psalm 128:3-4). When the Lord grants little ones to His Church, their presence stands as a reminder of His love and favor and covenant promises. This does not mean the bearing of children is easy. God’s curse for sin affects all things, and this aspect of life in particular (Gen 3:16-19). While God has not made bearing and raising children itself a curse, His curse affects the bearing and raising of children. God has, due to sin, greatly increased a woman’s sorrow in bearing children, and at the same time increased her ability to bear them. The curse has also affected the husband’s calling to support those children. The creation from which he must derive their support works against him instead of with him. REGARDING THE USE OF BIRTH CONTROL GENERALLY The first two truths (that bearing children is both a calling and a blessing) almost put the issue of birth control to rest for God’s people. Indeed, some couples will conclude it is best to never prevent or plan the conception of children. If these couples faithfully raise all the children they bear unto the Lord, then the whole Church is thankful for their godly example and prays for more of their kind. However, as much as we want to caution against its use, we would argue that the reality of the curse of God for sin may allow for the careful use of (some forms of) birth control in some cases.  But because selfishness can quickly exploit even that statement, we begin discussing this matter by addressing the heart. Why would we prevent the birth of children? Birth control broadly defined is anything that can prevent the birth of children.  There are ethically legitimate and ethically illegitimate methods of birth control. However, even if one allows for the use of ethically legitimate methods of birth control in some cases, he must recognize they can be and often are used wickedly. The issue begins in the motives of the heart. The great question everyone has to ask (including newly married couples who are expected by so many to wait at least a year or two to have children) is: “Why? Why would I prevent the birth of children into my covenant home?” And the Reformed couple must answer this question honestly, for we easily deceive ourselves (Jer. 17:9). As the Reformed couple engages in this heart-probing, consider that the very origin of chemical birth control was the constant push for sex without responsibility in society. It’s not just necessity, but the desire for pleasure, that is the mother of invention. Google a chart of birth rates in United States history, and you will see that the line plummets after 1960 when chemical birth control went on the market, and that the line continues to steadily drop until it arrives at its lowest point in 2016.  The ever-increasing desire for pleasure combined with the ever-decreasing desire for responsibility in the world can affect us as Reformed Christians too. So as you answer “why would we prevent the birth of children?” consider the following kinds of questions: Do we seek a standard of living that far exceeds even that of our parents and grandparents in their child-bearing years (not to mention that of the vast majority of the rest of the world)? Have materialism, worldly comforts, and extravagant vacations clouded our thinking? God doesn’t desire that His children be at ease, but that they joyfully and self-sacrificially serve Him by raising children, all the while detaching from the things of this world. Are we selfishly guarding a worldly notion of marriage? Are we stingy with respect to our time? Children require a tremendous sacrifice of time and energy – often around the clock. This sacrifice means less time fishing, hanging out with the guys, or sitting in front of the television or computer. Wives, is your view of physical beauty defined by the world? For a woman having children involves a sacrifice not only of her time and personal desires, but also her very body. After several children, she may look in the mirror and feel embarrassed about the dramatic changes she sees. Husbands, do you assure your wife that she has not been “ruined” as the world would say, but that she is beautiful with a beauty that the world cannot see? We can’t say for another couple That said, there is no biblical rule as to when each couple’s quiver is full, and due to the reality of the curse upon life in this world, there are factors that a couple may legitimately consider in thinking about family planning. A mother may face health issues, even ones that can endanger her life and lives of future children (just a few examples include multiple c-sections, extreme diabetes, and cancer). The mental and emotional health of especially the mother may have to be considered (taking care not to cover up selfishness). Postpartum depression is a real issue. In addition, some women are simply physically and emotionally frailer than others. Maybe there is a child (or children) with special needs requiring a great deal of time and energy. Maybe the house is full and teetering on the edge of Mom and Dad’s ability to faithfully rear the children. In these cases (and perhaps others), we believe God’s people have to make judgments with much prayer and soul-searching. This matter is intensely difficult, especially because the old man inside us can be so deceptive. Even sincere Reformed believers may disagree. We must all use sanctified wisdom and live coram Deo (before the face of God). The rule we believe is biblical is that we ought to have as many children as we are able to have, understanding “able” to mean not merely as many as we can have without cramping our lifestyle, nor meaning necessarily as many as we are able to physically produce. Rather, “able” means, able to faithfully raise in the fear of the Lord.  Each couple must stand before God. If a couple’s honest answer to that is three, so be it. If it is fifteen, or as many as we are physically able to bear, so be it. The key principle is that we are honest with ourselves before God and are vigilantly on the lookout for selfish motives hiding under the pretense of spiritual ones. And we ought to pray that the preaching ever warns us of that possibility. WHAT BIRTH CONTROL IS ETHICALLY PERMISSIBLE? If a couple before the face of God honestly believes they ought to use birth control at a certain time in their life, what forms are ethically acceptable? All Reformed couples ought to personally research the matter in order to make God-honoring decisions. Here is what we have discovered in our own research.  “Emergency contraception” First of all, we must begin with the conviction that life begins at conception.  So many doctors (some Christian ones too), speak of life beginning at various other points in the growth process of the fertilized egg. What one says about when life begins will determine what one says about what forms of birth control are ethically permissible.  All forms of chemical birth control that are taken after intercourse, such as the “morning-after pill,” RU-486, “emergency contraception,” etc., are abortifacients (drugs which induce abortion). Using these drugs after intercourse, and if you have conceived (which one does not know) it is no different from going into an abortion clinic to kill your child a few months later. It is murder. Other forms of chemical birth control Regarding chemical birth control one takes regularly, such as the birth control pill (whether combined or progestin only), shots, and IUDS, the Reformed couple must be aware of the facts. According to the recently published God, Marriage, and Family these common forms of chemical birth control work to prevent the birth of a child three ways: The first is by preventing an egg from being released. The second is by thickening the cervical mucus so that the sperm cannot reach the egg if an egg is released anyway (which some experts estimate happens as often as 50 percent of the time). The third is by making the lining of the uterus incapable of supporting the life of a newly conceived child given the first two methods fail. There is no ethical issue in itself with the first two actions of the pill. But the third causes an abortion. So the question becomes, do the first two methods of the pill ever fail? We quote from the book mentioned above: Statistically speaking, when taken as directed, these various types of hormone-based birth control methods are effective (in their first two lines of defense—that is preventing conception CG) 99.5 percent of the time…. From this fact, one can know for certain that while “the pill” is effective in preventing ovulation and preventing fertilization, it does not prevent all fertilization. While there is no statistical data to indicate how many births are terminated by the third mechanism, one can be assured that it does occur.  Though admittedly, the possibility of breaking the sixth commandment here is small, it is still a possibility, and therefore chemical birth control ought not be used by the child of God.  This leaves only three ethically legitimate methods: natural family planning, barrier methods, and surgical sterilization.   CONCLUSION  As with every matter in the Christian life, obedience begins in the heart. A heart that responds to the gospel of redeeming grace is filled with gratitude. Gratitude needs a riverbed to flow into. That riverbed is the law of God. We hope we have given some help in determining what God’s law is and is not in these matters, and in setting forth the principles by which we may live in godliness. May God bless us as we live before His face as husband and wife, and as we bring up the godly seed He so graciously gives us. ENDNOTES This is not the only purpose of marital intimacy as the Roman Catholic Church wrongly teaches (among other passages see 1 Corinthians 7:5 and The Song of Solomon). Otherwise, a couple who could not bear children would be required to abstain from marital intimacy. Neither does it imply that every act of marital intimacy must have the possibility of conception. However, it does mean a couple must seek to bear children in their marriage. The argument to the contrary from the case of Onan in Genesis 38 does not take into consideration the issues of levirate marriage involved in that passage. This includes everything that prevents conception, to the murder of children conceived but not yet born. 1.8 children per woman, and it’s only that high because of the Hispanic population. We understand even the question of what it means to faithfully raise children in the fear of the Lord will garner disagreement. This aspect too bears serious consideration and discussion as each couple stands before God. It would be worthwhile to read a portion of the book God Marriage and Family we refer to a few paragraphs later. Pages 123-129 are germane. Another worthwhile resource is the book, Does the Birth Control Pill Cause Abortions? by Randy Alcorn. In addition to those sources, we have conferred with believing doctors we know personally. This is another article, but the main reason for this position is conclusive. At the moment of fertilization there is a complete genome (determining gender, eye color, height, body type, etc) in the new being. Therefore, the new being is another individual life separate from that of the father and mother. If an individual being with a complete genome, separate from the life of the mother and father is not a separate life, then what is it? If you ask a doctor (even some Christian ones) if a particular form of birth control causes an abortion he may say no, but that may be because he believes life does not begin at conception. He may also further confuse the issue by stating that this particular drug cannot terminate a pregnancy. This is because he may define pregnancy as beginning later than the moment of conception. The authors cite their credible medical sources. Kostenberger, Andreas J., and David W. Jones. God, Marriage, and Family: Rebuilding the Biblical Foundation. 2nd ed. Wheaton: Crossway, 2010. 337, footnote 29. Print. There are some Christian women who take birth control pills as medicine for other physical maladies. If that is you, then you ought to also use barrier methods of birth control to prevent the possibility of breaking the sixth commandment. We are not now saying anything about whether or not these should be used in any individual case, we are merely stating that these are the only ethical forms to use. This article was originally published in the April 15, 2016 issue of The Standard Bearer and is reprinted here with permission. Rev. and Mrs. Griess live in Grand Rapids, Michigan....