THE PILL AND EARLY ABORTION by John F. Kippley IT IS A FACT THAT EVEN SOME PRO-LIFERS FIND DIFFICULT TO FACE: THE PILL CAUSES ALMOST AS MANY ABORTIONS AS ARE DONE SURGICALLY EACH YEAR IN THIS COUNTRY! In the last several months a new early-abortion drug called RU-486 has been making the headlines. Its development has been followed for years, and just two and a half years ago (December 1986) the news wires reported that researchers had found it to be 85 percent effective in causing abortions in the first six weeks of pregnancy. More recently it has been found to be as much as 95 percent effective in causing abortions when used in conjunction with prostaglandins (labor inducing agents). RU-486 acts both to prevent implantation of a newly conceived baby and to dislodge the baby who has already implanted in the mother's uterus. It does this by interfering with the normal action of progesterone, a hormone secreted after ovulation to maintain the lining of the uterus and to maintain pregnancy if it has occurred. There is no ambiguity about its action: RU-486 is intended to cause abortion. Whether and when RU-486 will be marketed in the United States is not known. The risk of boycott, the cost of liability insurance, and unknown market factors may keep it off the American market for some years. However, the ordinary birth control pill already causes as many early abortions each year as RU-486 would cause if allowed in the country! That is, the abortionists say that RU-486 could be used for about half the 1.6 million abortions currenty done yearly in the United States-- about 800,000. The current birth control pills already cause between 600,000 and 1,500,000 early abortions each year! HOW THE PILL KILLS--AND HOW OFTEN How can I say that? What factors yield that sort of result? You start with the reality that the typical "combined therapy" Pill works in three ways: 1) It generally suppresses ovulation, and that makes it a sterilizing agent, but sometimes "breakthrough ovulation" occurs; 2) it tends to thicken cervical mucus to make sperm migration more difficult, and that makes it a contraceptive; and 3) it affects the inner lining of the uterus--the--endometrium--to make it hostile to implantation, and that makes it an abortifacient--an early abortion agent. The question is: how often does the Pill achieve it birth control effectiveness by action as an abortifacient? (Here we're talking about the combination estrogen-progesterone Pill; the so-called mini-Pill which is progesterone-only acts primarily as an abortifacient because it does little or nothing to prevent ovulation.) The answer depends upon how often "breakthrough" ovulation occurs with the common combination Pill and then how often conception occurs. Estimates of breakthrough ovulation have ranged from 2 percent to 10 percent of cycles<1>, and that accounts for the wide range of estimated abortions given above. However, in 1984 a researcher reported that she had proof of ovulation occurring in 4.7 percent of cycles using a low dosage Pill<2>, so let's use that number in our calculations. The next factor is the conception rate: women don't get pregnant every cycle they have relations at the fertile time; pregnancy rates vary from 25 to 68 percent<3>, and to be conservative we will use the 25 percent figure. I am ignoring the possibility that the mucus may be thicker and impede sperm migration, because research has shown that this is a very small or non-existent factor among non-Pill-users; proximity to ovulation is much more important that the quality of the mucus. The last factor is the number of women on the Pill--generally estimated at 10 million in the United States. With 10 million women on the Pill, a 4.7 percent breakthrough ovulation rate would yield 470,000 fertile ovulations per month; a pregnancy rate of 25% yields 117,500 pregnancies and early abortions per month; if you mulitply by 12, that's 1,410,000 per year. Actually, it would be more accurate to multiply by 13 because the Pill schedule is set up to cause 13 "cycles" per a year, so that would yield, 1,527,500 early abortions per year. Either way, it appears that the Pill causes almost as many abortions as are done surgically each year in this country! The arithmetic can be worked out for the individual woman on the Pill, too. Using the 4.7 percent breakthrough ovulation rate, there would be a statistical certainty that she would experience a breakthrough ovulation every 22 cycles; a 25% pregnancy rate would yield another statistical certainty that she would have a Pill-induced early abortion every 88 cycles or every 6.8 years. Now that may not sound very often, but look at it this way: how many women would use the Pill if there was a 99% statistical certainty it would kill them in less than seven years? On an individual basis, the main point is this: the Pill might be acting as an early-abortion agent in any given cycle. DENIAL Abortionists have no trouble admitting the abortifacient nature of the Pill as well as the IUD (intrauterine device). In fact, for years pro-abortion organizations have been saying that a Human Life Amendment to stop abortion will outlaw both the IUD and the Pill. However, denial is a common reaction to these realities by Christians and others who say they are against abortion. Unless a woman sees a way out of her birth control dilemma she is likely to resort to rationalizations such as, "My doctor says that's not so and my minister (or priest) never said anything about it." The anti-abortion Christian physician who has lots of women on the Pill may be sickened by the realization that it's a matter of statistical certainty that for every seven women he has on the Pill, one of them will have a Pill-induced early abortion each year. For every 100 women he (or she) has on the Pill, that's more than one abortion each month, and that's very hard to take for someone who calls himself or herself "pro-life." THE WAY OUT OF THE DILEMMA Ever since late 1971 the Couple to Couple League has been helping couples of good will get out of this dilemma by teaching them natural family planning (NFP). It is simply amazing that so much ignorance about NFP still exists, but few couples know about NFP in any realistic way unless that have attended NFP classes or read good NFP materials. This is not the place to describe NFP, but one thing needs to be said: my experience indicates that former users of the Pill are among the most enthusiastic users of NFP and that they tend to praise the marriage-building aspects of NFP even more than couples who have never used unnatural methods of birth control. In the last year, we have been hearing from doctors who are abandoning their former practice of prescribing the Pill for birth control. One West Coast physician ordered 100 of the recently published CCL Home Study Course for Natural Family Planning since he didn't have a CCL teacher in the area to whom he could make referrals. I think that one reason we are hearing more from doctors is the teaching of a Protestant evangelical layman who gives many conferences in which he reaffirms authentic Christian teaching on love, marriage and sexuality. HEALING AND RECONCILIATION In addition to turning to the chaste practice of NFP after getting off the Pill, the couple who have been on the Pill need to admit their sinfulness and be reconciled with God. They need to admit to themselves and to God the possibility that their use of the Pill has caused an early abortion. Like every person who has caused an abortion, they need to apologize to that tiny, tiny baby, and they certainly need to ask God's forgiveness and healing. This is not something to be morbid about. That's one of the many beauties of our Christian faith. Jesus has taken our sins upon himself and died to save us. On the other hand, if we do not come to grips with our sins and admit our sinfulness, then in the words of St. John, "we are liars." They also need to do penance. One way to do this is to go out of their way to tell others about ;the abortifacient nature of the Pill and about the Christian alternative--Natural Family Planning. Practical help with NFP is available for anyone in the English speaking world by writing the Couple to Couple League, Box 111184, Cincinnati, OH 45211, or calling (513) 661-7396. REFERENCES <1> John Peel and Malcolm Potts, TEXTBOOK OF CONTRACEPTIVE PRACTICE (New York: Cambridge University Press, 1969), p. 99. <2> "We are close to lowest steriod dosage in the Pill," a report on the work of Dr. Nine van der Vange, NEWS AND VIEWS, excerpts of the Second Annual Meeting of the Society for the Advancement of Contraception in Jakarta, Indonesia, November 26-30, 1984. <3> J.C. Barrett and J. Marshall, "The risk of conception on different days of the menstrual cycle," Population Studies 23 (1959), pp. 455-461. __________________________________________________________________ John F. Kippley is President of the Couple to Couple League. Reprinted with permission from American Life League's "About Issues" P.O. Box 1350, Stafford, VA 22554