Pro-Life Options for Family Planning

| Pro-Life Family Planning guide |

In the introduction to our Pro-Life Guide for Family Planning, I mentioned that certain options for family planning, operate after conception. In other words, the effectiveness of these methods depends on ending a life after conception.

As we’ve discussed elsewhere, we can be certain that a new person’s life begins at the moment of conception (take a look at our scientific overview and biblical overview of these discussions). Our focus here will be on applying this truth to decisions we all make in family planning.

It’s time to get practical. Certain options in family planning rely on taking life after conception for their effectiveness. So, which methods put our kids lives at risk? Which options are safe? I’ll do my best to be comprehensive here by providing an outline of our options and which carry these risks. Because some of these options (like the pill) warrant further discussion with more detail, I have more in-depth pages for some of these options that also present the medical research describing the risks. I’ll reference those more detailed pages below so you can check them out as well.

Here’s the options we’ll talk through:

Abortion (Surgical and Medical)

One aspect to planning when we’ll have kids is that things don’t always go according to plan. It certainly wasn’t our plan to have Abigail just 10 months after getting married. So, what do we do when we see the positive pregnancy test before we’re ready? What does that test even mean?

Briefly: The pregnancy test is looking for a hormone called hCG. This hormone is released by a woman’s body once the baby embryo nestles into mom’s womb for their 9-month journey to delivery day. Conception occurred just 8-9 days before implantation. In just those few days, she (or he: the baby’s gender is established at conception) has worked hard to develop dramatically. They have doubled their size and, even more amazingly, have grown from just one cell (zygote) to more than one hundred (blastocyst).

So, does a positive pregnancy test mean that a baby’s life has begun? Yes, in fact the baby’s life began several days before at fertilization (conception). (This is a good question and if you’d like to see more on the answer, our overviews are here: Is an Embryo a Baby Scientifically and Is an Embryo a Baby Biblically.)

Before I talk about what actually happens if we terminate a pregnancy, I want to say something. I know that many have found themselves ending a pregnancy in the past. I don’t want you to feel I’m trying to condemn you. My heart couldn’t possibly be any further from this. I know how life is full of challenging situations and difficult choices. The enemy is all too eager to take advantage of us in our vulnerability. To share my heart better, please take a look at the post we did for Mother’s Day a while ago where we share more of our story as well as our heart for those who’ve had an abortion.

So, what actually happens if we terminate a pregnancy? What about the abortion pill? A surgical abortion (like a D&C) aims to pull the baby from where they have implanted in the mother’s womb. A medical abortion (like the abortion pill, RU-486) operates similarly by effectively “pushing” the baby embryo from where they have implanted in the mother’s womb (first thinning the lining in the womb and then shedding that lining with the baby).

If you’ve ended a pregnancy in your past and find yourself revisiting it, Focus on the Family has abortion-recovery resources to help you talk about and overcome what happened.

If you have an unplanned pregnancy and are considering an abortion or just want to talk about your options, Option Line is a free, confidential, 24/7 helpline and chat that can talk with you and connect you with resources and assistance to help you.

If you’ve taken the first abortion pill and wish you could reverse the effects, it may not be too late. There is an effective process called abortion pill reversal. They have a free, confidential, 24/7 helpline and chat that can provide you with information and quickly connect you to the local assistance you need.

Hormonal Birth Control (The Pill/Plan B/Implant/IUD)

By far the most common method for family planning is hormonal birth control. This category includes the birth control pill, emergency contraception (Plan B pill), implants/patches/etc., and IUDs (intra-uterine devices). How do these work? What makes them effective? Most importantly, do they rely on taking life after conception to achieve their effectiveness?

First, a little background: To achieve their effectiveness, all medications rely on certain “mechanisms of action”. These mechanisms describe the way the medication impacts the body that make it work, make it effective. The Physician Desk Reference® provides healthcare professionals with this information for the medications they prescribe. Now in an online format, the PDR is “the most recognized drug information reference available in the U.S.” The mechanisms of action identified in the PDR are authoritative, having been compiled from the FDA approved documentation for the medication.

Having identified a highly authoritative resource, our question for the PDR is this: What makes hormonal birth control effective, what are its mechanisms of action? The most common hormonal birth control is the combination pill which is a combination of estrogen and progesterone. Let’s take a look at the mechanisms of action for one of the more common combination pills, Yaz:

“Both estrogen and progestin ultimately inhibit maturation and release of the dominant ovule. In addition, viscosity of the cervical mucus increases with hormonal contraceptive use, which increases the difficulty of sperm entry into the uterus. Alteration in endometrial tissues also occurs, which reduces the likelihood of implantation of the fertilized ovum.”[1]

In short, these are the three mechanisms of action identified (note that every type of hormonal birth control relies on these same three mechanisms of action):

  1. Inhibit ovulation which reduces the chances of conception (fertilization),
  2. Thicken cervical mucus which also reduces the chances of conception,
  3. Change the lining of the uterus (endometrium) to reduce the chances that the embryo (fertilized ovum) can implant.

While the first two operate to simply reduce the chances of conception, they do not function perfectly. In other words, conception does still occur among women who are on the pill. When conception does occur, the pill relies on the third mechanism of action for its effectiveness. The problem is that this mechanism operates AFTER conception has occurred by preventing the baby embryo from implanting. What does all this mean? In short, the effectiveness of the pill relies in part on taking life after conception.

I realize that’s possibly a shocking and controversial statement. There are plenty of good questions. Is there actually evidence for this or is it just theoretical? Is this just for the combination pill? Is there any difference with emergency contraceptives (Plan B)? What about IUDs? How often does this happen? Like I said, these are all good questions. These are all questions that I asked too. Since this page is meant to be an overview though, I’ve reserved the more in-depth discussion for another page in this guide: Is Hormonal Birth Control Pro-Life?

While I’ve reserved the evidence for that page, let me summarize that every variety of hormonal birth control relies on these same mechanisms of action, and these mechanisms are real. Simply put, to be effective hormonal birth control relies in part on taking life after conception. But what does that leave us with? What pro-life options do we have for family planning? The good news is that there are still several effective, pro-life options. Let’s explore them together.

Condoms

Perhaps the simplest pro-life option for family planning is condoms. They are highly effective and operate only to prevent conception (by preventing sperm from entering the uterus), not posing a risk to the baby after conception. In general, the male condom is highly effective (98% with perfect use and 82% with typical use), and the female condom is similar (95% with perfect use and 79% with typical use). Note that the way most people use condoms (typical use) reduces the effectiveness, so it might be worth double checking you’re doing it right if you use this method.

I can understand (particularly as a man) that using a condom isn’t always the most desirable. Of course, that would never be the reason we’d chose an option that risks our kids’ lives, but it does leave us with a couple more questions. Are there other pro-life options for family planning? If we chose to use a condom, do we always have to use one? I’ll explore the answer to those questions in our section below on “Timing Intercourse”, but before that I want to briefly cover one more somewhat related method for family planning: spermicides.

Spermicides (Sponge/Cap/Diaphragm)

Spermicides are chemicals designed to disable the sperm before they reach the egg.  Spermicides can come in various forms including creams, gels, foams, films, and suppositories. Many times, spermicides are used as part of another method. For example, whereas condoms don’t need spermicides to be effective, some condoms are coated in spermicides. Additionally, some methods (like the Sponge, Cap, or Diaphram) rely on spermicides to be effective.

At a simple level, spermicides are designed to be toxic. So, it makes good sense that they would carry some risks. For example, if some of the sperm were damaged by the spermicide but still fertilized an egg, the damage the spermicide did might carry risks for the baby. A few studies have noted an increased risk of miscarriage or birth defects.[2] [3] [4] However, most studies have not found a statistically significant correlation. It’s important to note though that while some studies have looked at the risk of miscarriage (post-implantation loss), no studies have been done on the risk of pre-implantation loss. So, there may be risks before implantation that we simply don’t know exist. For example, the toxic effect of the spermicides might affect the baby embryo’s development and ability to implant.

In short, spermicides do pose a rational, theoretical risk to life after conception. On balance though, that risk has not been consistently demonstrated in most studies. In the context of this ambiguity, it might be helpful to share our decision and rationale. Because of the possible risk and the fact that there are other safer and effective methods, we chose not to use spermicides in our family planning.

Timing Intercourse

Because women are not fertile every day of the month, this implies that intercourse on those non-fertile days will not result in pregnancy (even without a condom). As we explained in our guide for couples who are trying to conceive, the fertile window is generally from about 7 days before ovulation to about 1 day after. If the couple knows when she will ovulate then they can use a condom (or abstain from intercourse) during this window to effectively prevent conception.

The challenge to this is learning your (wife’s) cycle so that you know when you are fertile. The old-fashioned “rhythm” method did a poor job predicting ovulation which is why it was so ineffective. However, there are more recent methods that have credible scientific research supporting their accuracy. For example, Clearblue makes a contraception monitor (called Persona) that is 94% effective, and it makes it easy. It monitors your (wife’s) hormone levels throughout the month to learn your cycle and tells you when you’re fertile. You can buy that on Amazon (no prescription needed) and the instructions in the box explain the process.

There are several other methods as well for predicting ovulation and timing intercourse to avoid conception. We’ve gone into more detail on our page: Timing Intercourse to Avoid Conception

Surgical (Vasectomy/Tubal Ligation)

Thus far, we’ve focused on methods for family planning when you want to delay getting pregnant, but what about when you’re done? Once you’ve decided that you don’t want to have any more kids, there are surgical options that prevent future pregnancies. In particular, there are two main options: the vasectomy (for men) and tubal ligation (for women). Both of these methods are meant to be permanent and both are highly effective (well over 99% effective).

Vasectomy: After a vasectomy, sperm are unable to reach the semen which is why it is so effective. Recovery is reasonably easy (back to work in about 3 days, back to physical activity in about a week). It’s important to note however, that it does take a little time for the vasectomy to be fully effective (i.e. it can take three months for semen to be sperm free; your doctor can test you). For our discussion here, perhaps the most important point is that if conception does somehow occur after the vasectomy, there is no risk to the baby embryo as a result of the vasectomy. So, this is a safe and effective permanent method for birth control.

Tubal Ligation (TL): After a TL, eggs cannot reach the uterus. A TL is also highly effective, but recovery is a little longer (typically 1-3 weeks). However, more importantly (especially for our discussion here) is that TL does carry some additional risks if conception does occur. Should conception occur after a TL (which is very rare but possible), then the baby embryo will not likely be able to make it to the uterus to implant. Without being able to reach the uterus, the baby embryo will either die or attempt to implant in the fallopian tubes (a serious condition known as ectopic pregnancy). The baby cannot survive an ectopic pregnancy and they carry significant risk for the mother as well. Because conception is very unlikely after TL, the overall risk of this is small. However, because the vasectomy doesn’t carry this risk it is the safer choice for both baby and mom in this regard.

Got Questions?

I realize some of the information in here might come as a surprise. You also might have specific questions about family planning/birth control that I didn’t cover here.  Please feel free to email us at [email protected] with your question and we’d be happy to help.

[1] https://www.pdr.net/drug-summary/Yaz-drospirenone-ethinyl-estradiol-98.3934

[2] Gallaway, M. S. (2008). The association between maternal use of spermicides, condoms, intra-uterine devices or progesterone and major structural birth defects. Texas Medical Center Dissertations. Retrieved from http://digitalcommons.library.tmc.edu/dissertations/AAI3330698

[3] Scholl, T., Sobel, E., Tanfer, K., Soefer, E., & Saidman, B. (1983). Effects of vaginal spermicides on pregnancy outcome. Family Planning Perspectives, 249-250.

[4] Huggins, G., Vessey, M., Flavel, R., Yeates, D., & McPherson, K. (1982). Vaginal spermicides and outcome of pregnancy: findings in a large cohort study. Contraception, 219-230.