Monday, January 21, 2013

Abortifacient Shmortifacient

I wrote this post a few weeks ago and have been reflecting on how to make it better, more informative and inclusive. Well since I'm the one writing it we're already suffering on all those fronts anyways. So after lots of edits (mostly to the spelling of 'shmortifacient')  I decided to just write a new post about the scientific proof that this actually occurs. If it takes anywhere near as long as this post you'll see it next year. ;-)

 So here is Part 1 with a little added background about my history of teaching safe sex:


Wordle: Birth ControlI have learned a lot about hormonal contraceptives in my 24 years. It all started back in high school when my first job was as a peer educator. I (ignorantly) taught my fellow high schoolers about the ins and outs of contraception and unplanned pregnancy. We also educated about other things, eating disorders, domestic violence, harms of tobacco and alcohol, how to say no, etc. In my 3 years at that job, I put a lot of rubbers on a lot of bananas. I showed a lot of teens what a diaphragm, female condom, sponge, IUD, and pack of birth control pills looked like. I'm not proud of this past and my only sorrowful excuse is that I was then ignorant, of both the harmful effects of what I was promoting and of the Church's teaching.
Since then I've becoming painstakingly aware of how damning these devices are. I've had to learn mechanisms of action for most every kind of birth control out there in order to pass my pharmacology tests, my first board licensing exam, and my family medicine shelf. I feel I'm fairly well versed in how these things work.

They work in three ways:
1) Inhibiting ovulation
2) Cervical mucus alteration
3) Endometrial alteration

Despite my years of education (devoted to medicine, mind you) I have come across many people who say some variation of this:

"I have heard that. It didn't hurt my second child as I was on birth control before and for weeks until I found out I was pregnant. So I'm not so sure I believe that."*

That's fine, I generally doubt people that spew "scientific facts" on the internet backing them up with the catch all phrase to end all catch all phrases: "studies show [insert claim here.]" What's not fine is that hoards of pro-life women are taking a medicine that could potentially be aborting their children without their doctors informing them. Fortunately though pharmaceutical companies are obligated to put how their drugs work on a little piece of paper that comes with the medicine. We are then able to read this insert and know exactly what this drug is capable of doing to our bodies, albeit it takes some searching. When it comes to the abortifacient properties of birth control let me settle the argument with this (emphasis mine):

Monophasic pills: "alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation)."
Biphasic pills: "alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation)."
Triphasic pills: alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation)."
Transdermal Patch: "alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation)."
Depo Provera shot: "inhibits the secretion of gonadotropins which, in turn, prevents follicular
maturation and ovulation and results in endometrial thinning"
Hormonal IUD: "How does Mirena work? It is not known exactly how Mirena works. Mirena may
work in several ways. It may thicken your cervical mucus, thin the lining of your uterus, inhibit sperm movement and reduce sperm survival. Mirena may stop release of your egg from your ovary, but this is not the way it works in most cases."
Copper IUD: "The contraceptive effectiveness of ParaGard® is enhanced by copper continuously released into the uterine cavity. Possible mechanism(s) by which copper enhances contraceptive efficacy include interference with sperm transport or fertilization, and prevention of implantation."
Subdermal Insert (Implanon): "The contraceptive effect of  IMPLANON™ is achieved by several mechanisms that include suppression of ovulation, increased viscosity of the cervical mucus, and alterations in the endometrium."
Emergency Contraception (Plan B): "it is possible that Plan B® may also work by preventing fertilization of an egg (the uniting of sperm with the egg) or by preventing attachment (implantation) to the uterus (womb)"

So what does this mean? It means that if you believe life begins at conception (and it does) then by using one of the aforementioned methods of contraception you are potentially aborting your newly conceived child. Scores of women who have been informed of this have been appalled their physician had chosen not to inform them of this little fact. So here it is, spread this information far and wide so no more women continue to unknowingly lose their child to a flawed womb they themselves medically induced or betray their conscience under the guise of "My physician never told me." Help put an end to internet ignorance and blatant disregard of facts. The manufacturers say it themselves, begrudgingly so, and we should all be made aware. We deserve to know what we're doing to our bodies, not just what Planned Parenthood or Big Pharma wants us to know.


*Comments taken directly from a post Abby Johnson put on Facebook about NFP.

P.S.
If anybody know hows to properly spell Shmortifacient, let me know.

17 comments:

  1. This is an AWESOME post, one that every woman needs to read. I'm so glad you shared the information from the pharmaceutical companies because it gives proof of what these things are really doing.

    ReplyDelete
  2. Ok...

    While all hormonal contraception does interfere with the endometrium, it is questionable how often, if ever, this mechanism actually prevents pregnancy. The most reliable mechanism hormonal contraception appears to be interference with cervical mucus, which prevents conception. If this mechanism fails, and the woman ovulates, odds are the endometrium is not very thin either.

    I certainly believe in informed consent, and informed consent is disturbingly lacking when it comes to women's health in general, especially contraception. But I've also seen the "birth control pills = abortion" overemphasized to the point where it does far more harm than good.

    There are three reasons why I bring this up.

    One is for the small number of women who really do need the Pill to treat a medical condition. (From a Catholic perspective, two Popes have said it was OK for married women to use the pill for medical reasons and continue to have sex with her husband.) These women may hear "birth control pills = abortion", then end up choose a method of treating their condition that is even MORE likely to cause a miscarriage.

    The second reason is because it isn't clear just how often this mechanism comes into play. We heard the "birth control pill = abortion" line when we first heard about NFP. When we did the research and found out that it wasn't so clear cut, that immediately made us suspicious of all the other things our NFP practitioner was telling us.

    We felt like we were being mislead and emotionally manipulated. And we did NOT appreciate it.

    We were already nervous about NFP being "Vatican roulette" and this "overselling" of the abortifacient potential didn't increase our faith in the method. When we struggled with the method, instead of sticking it out or looking for something new, it only made us believe that it was junk science.

    Finally, there are plenty of other good reasons why the taking the "crazy pills" are a really bad idea. Even women who use them to treat a medical condition must still deal with all the unpleasant side effects. Getting into this debate distracts from a lot of the problems with hormonal contraception.

    ReplyDelete
    Replies
    1. Can we have a citation on any popes ok-ing the pill and having sex? and medical conditions that the pill actually TREATS - not masks the symptoms of, but treats?? I wasn't aware there were any and I have a condition that most people want to 'treat' with the pill (PCOS).

      And why is the fact that this mechanism might not happen every time even relevant? Even the CHANCE of an abortion is enough to make me say heck no - that's the kind of roulette I'm afraid of!

      Delete
    2. Pope Pius XII on using the pill for medical reasons:

      http://www.pamphlets.org.au/australia/acts1454.html

      (The full text is available on the Vatican website, but not in English.)

      Pope Paul VI (Humanae Vitae 15)

      http://www.vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html

      PCOS should not be treated with birth control pills. That only makes it worse. But sometimes masking the symptoms is the best that you can do. It is often used to manage Endometriosis to reduce pain keep the disease from spreading.

      Even the Billings Ovulation Method, a Catholic NFP organization, recognizes that hormonal therapy (i.e. the Pill) may be necessary to manage the disease.

      http://www.thebillingsovulationmethod.org/infertility/causes-of-infertility.html

      As for the chance, when you are looking at treating medical problems, many medications have a chance of miscarriage. Ibuprofen is much more likely to cause a miscarriage than the Pill, but nobody says "Advil causes abortions". A woman with these medical problems should weigh the risks and benefits of ALL her options, including the Pill.

      Delete
    3. Just wanted to step in here... I suffered from endometriosis and the pill is the worst thing for it. It comes back with a vengeance when the client stops taking it. It's not treating the condition. The condition needs to be surgically removed and healed. When more physicians acknowledge this, more women will receive proper treatment, and more health insurance providers will cover care. Leaving the abnormal growth (while taking the pill to reduce symptoms) only increased my chances for cancer at a later date. Women deserve better, the pill is not healthcare.

      Delete
    4. The body of a woman with endometriosis will respond differently to "the pill" depending upon her body and which "pill" she is given.

      Unfortunately that is about all that can be said for surgical treatments as well.

      Delete
    5. Pope Pius XII and Pope Paul VI were speaking to the moral doctrine of double effect, applying it to the situation where a woman has a medical condition that needs to be treated with the Pill.

      There is no medical condition that the Pill cures. There is no NEED for the Pill. The Pill is sometimes convenient. But I agree with the gal above - women deserve better healthcare. The reason docs proscribe the Pill is b/c they've never been pushed to develop better, more comprehensive healthcare for women; they can mask symptoms with the pill, so who cares about causes?

      Something that causes a bad effect (sterilizing the marital act) done for a good effect (health condition) can be done only if four conditions are met: "1) act itself must be good; 2) only thing intended is the good act, not the foreseen but bad act; 3) good effect cannot arise out of the bad; 4) the unintended but foreseen bad act cannot be disproportionate to the good being performed." (see Nat'l Catholic Center for BioEthics in Philly, quoted by George Weigel: http://www.archden.org/index.cfm/ID/5552)

      Using this framework, it is clear that the Pill always fails number four. The chance of a miscarriage, the loss of a human life, cannot be outweighed by anything else - unless the mother has a condition that MUST be treated with the Pill, or she will die.

      As for your reference to ibuprofen, I completely agree. More women should be made aware of this danger so they aren't causing their children harm!

      Delete
    6. No, it's NOT clear that the Pill always fails number four.

      Women with reproductive health problems have reproductive health problems.

      So a woman in this situation needs to also consider how likely are they to miscarry under alternative treatments or under no treatment. Such as taking the Pill to treat pelvic pain vs. taking Ibuprofen. When taken as medicine, the Pill should be treated as any other medicine.

      In fact a woman might be LESS likely to miscarry on the Pill than any other treatment or not treatment because she isn't ovulating. Early natural pregnancy loss is relatively common.

      Delete
    7. "hormonal therapy" doesn't always (or only) refer to the pill. Look at the Pope Paul VI Institute - they use all sorts of hormonal therapies to treat women's health issues, without using the pill. (I have severe PCOS, and was able to get it successfully treated, using various hormone therapies, and then, eventually, surgery, without using birth control pills.)

      Delete
    8. In response to the pill being used to "treat" reproductive health problems... it IS a form of treatment.. not a cure, but a preventative treatment. I have a severe case of PCOS (over 25 cysts on each of my ovaries). I have these cysts because my body fails to have a menstrual cycle every month. Therefore my egg sits and forms a follicle which turns into a cyst. What the pill does, is ensure that my body has a menstrual cycle every month by giving me the correct level of hormones. Without it, I could form more cysts which puts me at a VERY VERY high risk of ovarian cancer. When I choose to start having children I will, of course, go off the pill and have to start ovulation treatments in the form of self injections so my body is able to produce healthy eggs.

      Just like any medication, there are possible side effects. I discussed them with my doctor and did my own research. And although it doesn't cure me, it is preventative. So in the end, this was the best option for me.

      Delete
  3. Great post Katie! I will be sharing, thank you!

    ReplyDelete
  4. Love this post! So timely as well. About the effects on the endometrium, the problem is that a study about the frequency of mechanisms of action with the new lower dose pills has not been done (that I know of). It is true that once conception occurs and starts to implant, the trophoblast can have dramatic effects on increasing and preparing the endometrial lining, so implantation failure is probably not very frequent - in terms of percentage. However, it HAS been documented in multiple case reports where ovulation has occurred, implantation has begun and failed. Considering how many women are on the pill, even though this isn't the primary mechanism of action, it probably happens a LOT in the grand scheme of things. Some other things to consider: in the first cycle of taking the pill, it is less likely to suppress ovulation as the mechanism, theoretically increasing the chance in newly married, faithful couples that have misguidedly started the pill. Since the pill is used as a treatment for dysfunctional uterine bleeding, we know that it has long term effects on the endometrium. In fact, there is about a 3 fold increase in miscarriages in women that have been on the pill for >2 years and then (on purpose) become pregnant - probably because of these long term effects!

    Also, thank God we have such amazing people up in Omaha figuring out how to treat all these various gyn conditions so that fewer and fewer women will actually need to be on the pill at all!

    Thanks Katie!

    ReplyDelete
    Replies
    1. "However, it HAS been documented in multiple case reports where ovulation has occurred, implantation has begun and failed."

      I'm not surprised this happens, but how does this compare to natural early pregnancy loss?

      Delete
    2. Hi waywardson,

      I have asked the same question about the comparison between a miscarriage due to the pill and a natural miscarriage. I think the difference is that the first is caused by something the woman takes (ie the pill), whereas as the second the woman has no control over and cannot be held responsible for.



      Delete
  5. As someone who had never been told this was even a possibility and learned of it by reading the insert in a pack of birth control pills, I can say that I was upset no one - no doctor, no priest, no marriage preparation person - ever mentioned it as a possibility. I am also upset with myself for not reading that insert years earlier than I did. I think it is important to completely and honestly share the data and the specifics, including that it may happen rarely. I also think not owning up to the fact that this is a possiblity is eqally as wrong as exaggerating it.

    Scare tactics are wrong. Always. And had someone come at me with this information to start, I would have been very defensive and it may well have caused more harm than good. As it is, I've struggled with the fact that someday I might meet children in heaven who were conceived, but did not ever implant (yes, I realize this is unlikely given that we never had a "scare" and have since discovered our infertility - especially my blocked tubes).

    In all of this, I just think we must speak the Truth. In Love. What do we know? We know the pill thins the lining of the endometrium, it is in black and white. We know this might cause early miscarriage. Period. I personally think there are a thousand more compelling, well-documented reasons to not use the pill. Do I think this can be a reason to not use it? Yes. Should it be the whole reason? No. There is much more beauty and depth than "it might cause an abortion." (I'm leaving this exact comment on two blog posts on the same topic with different points of view. I love both of you ladies, but I think we must find some middle ground :).)

    ReplyDelete
    Replies
    1. Yes. This.

      We were one of the couples hurt by the scare tactics. We don’t know if we lost any to contraception, but we know we lost at least one, possibly two more, from TTC. Natural early pregnancy loss is real and relatively common. Ovulation + sex does not always equal baby.

      I also see some people being VERY uncharitable toward women who have very serious health problems. Some women know Church teaching, but others get very confused and doubt their faith. “Does the Church want me to be in pain?” “Are we really using each other for sex because I have to be on the Pill?” As if having a chronic illness isn’t bad enough.

      Yes, informed consent means that women should be informed of the risk and of alternative treatments. But it also means they should be informed of the size of the risk and whether hormone therapy via the Pill is a good option for their condition. And morally loaded words such as “abortifacient” shouldn’t be tossed around lightly.

      Delete

Thanks for stopping by! I love comments so if you've got something to add please don't hesitate. Also, I don't require that you agree with me but I would appreciate if you're nice. :)

Related Posts Plugin for WordPress, Blogger...