Politics & Policy

Contraception That Kills

An IUD contraceptive (Dreamstime)
The scientific evidence shows that some FDA-approved contraceptives can end the life of a human being.

Can some FDA-approved “contraceptives” end the life of a human embryo? This question is at the heart of the Hobby Lobby decision. It is a scientific question for which there is a clear scientific answer.

There are only two ways in which a contraceptive drug or device can prevent an embryo from forming:

1. Prevent an egg from being released.

2. Prevent sperm from reaching the egg

Once sperm and egg meet, fertilization takes place in a moment, and the result is a one-celled embryo, which is the beginning of mammalian life.

A drug or device can be FDA-approved as a “contraceptive,” however, if it prevents a positive pregnancy test at the end of a woman’s cycle — an event that occurs two weeks after fertilization. So, in addition to 1 and 2,  “contraceptives” might also “work” by directly destroying an embryo; by interfering with the ability of the woman’s body to make progesterone, a hormone needed to carry a pregnancy; and/or by changing the lining of the uterus, a process that prevents an embryo from implanting.

Let’s look at those mechanisms of action for the IUD.

IUDs

The embryocidal mechanism of action of IUDs has been known for decades but obscured by spin. A careful examination of the data demonstrate that IUDs do not prevent ovulation. Even on the LNG IUD, which works by releasing small amounts of a form of progesterone, women release eggs only a little less often than normal.

The LNG IUD can interfere with the corpus luteum production of progesterone, which in turn interferes with the normal development of the endometrium, which in turn leads to an endometrium unable to accept an implantation and unable to sustain an embryo that has implanted.

Although IUDs can decrease the absolute number of sperm cells that reach the fallopian tubes, sperm are still capable of reaching the fallopian tube when copper IUDs and LNG IUDs are used. Sperm cells have been directly observed and recovered from the tubes of women using IUDs.

Fertilizations do take place in IUD users. Embryos have been directly recovered from the fallopian tubes of IUD users. In addition, the documented pregnancy rate of 0.1 to 1 percent proves that embryos can be created during the use of the IUD.

Embryos created during the use of the copper T IUDs develop abnormally owing either to toxic effects of the copper on sperm, to toxic effects on the egg, or to direct toxicity to the embryo.

The IUD changes the lining of the uterus, making implantation difficult. This is one of the most widely documented mechanisms of action of both copper IUDs and progestin IUDs. Pregnancies diagnosed during the use of the IUD are usually ectopic — that is, in the fallopian tubes — giving evidence that the embryos that survive to enter the uterus are selectively “lost.”

In a recent article, the author states that the IUD works by changing cervical mucus. If that were true, then one would expect that no sperm would be found in the fallopian tubes of IUD users. Yet studies have recovered both active sperm and embryos in the fallopian tubes of IUD users undergoing tubal sterilization. These studies prove that whatever “changes” happen to the cervical mucus, they are insufficient to prevent sperm from reaching the egg. So much for the “cervical mucus” theory. Neither is preventing ovulation the mechanism by which IUDs prevent pregnancy, the author admits. Unfortunately for the author, there are three options left, and all of them involve killing human embryos.

Remarkably, the author admits that IUDs change the lining of the uterus. Changing the lining of the uterus, by setting up an inflammatory reaction in the lining, is in fact the principal mechanism of action by which IUDs prevent embryos from implanting. And preventing an embryo from implanting kills the embryo. Thus the author contradicts the very claim that she is making. To say blithely that there is a higher “miscarriage” rate is to admit that the presence of an IUD causes loss of a pregnancy after implantation, which by any definition is called an abortion. So IUDs can end a human life, as the owners of Hobby Lobby and Conestoga Wood have claimed, and as the author admits.

What about Ella and Plan B?

Ella

The manufacturer of Ella claims that the drug prevents an egg from being released. And that is true, if Ella is taken at a certain time before the egg is released. If Ella is taken during the time of egg release or after egg release, however, Ella still works to prevent a positive pregnancy test. Obviously, more is going on here than delaying egg release.

In fact, Ella is the same kind of drug as the abortion drug RU-486: They are both of the same class of drugs, called progesterone blockers. And they both are equally potent in blocking the action of progesterone, a hormone that a woman’s ovaries make to be able to nourish a pregnancy. If a woman takes RU-486 or Ella and hasn’t released an egg, it can delay egg release. If a woman takes RU-486 or Ella after she releases an egg, however, it can cause the embryo to die, either by preventing a woman’s ovary from making enough progesterone or by blocking the action of progesterone on the lining of the uterus, causing the mother’s side of the placenta to disintegrate. In fact, RU-486 is used in China as “emergency contraception.”

The evidence that Ella can kill embryos, even after they have implanted, comes from the research submitted to the FDA when Ella was being considered for approval. Two of these research studies looked at what happened to the pregnancies of women who got pregnant after taking the drug. In the first, five of six pregnancies with known outcomes ended in “miscarriage” for women who did not choose to abort. In the second study, four of six women “miscarried,” and the remaining two were lost to follow-up. “Miscarriage” means an embryo died. That’s how RU-486 and Ella work. They kill embryos.

In fact, this evidence was so damning that one of the FDA advisory panelists, Scott Emerson, a professor of biostatistics at the University of Washington, raised the point that the low pregnancy rate for women who take Ella four or five days after intercourse suggests that the drug must have an “abortifacient” quality.

Plan B

Plan B is a lousy emergency contraceptive. It works only if a woman takes Plan B during a certain five days out of her cycle, beginning four days before egg release. If the process of egg release has already started, then Plan B taken immediately before that process has been completed does not stop it. Yet when researchers looked specifically at the pregnancy rate when Plan B was taken immediately before egg release, they found that eggs were released but that no pregnancies occurred. What happened?

Two things may have occurred: The Plan B interfered with the signal (LH) from the brain to the ovary, which causes the ovary to make progesterone. This blunted LH signal resulted in too little progesterone to support a pregnancy (luteal phase defect). When ovulation does occur after LNG has been given, then most of those ovulations show luteal phase defect. And, although changes in the endometrium with high-dose progestins are not as dramatic as with progesterone blockers like Ella, highdose progestins like Plan B can cause endometrial changes that can make implantation more difficult.

So, what the scientific evidence really shows is that the Green and Hahn families have good reason to be concerned that some FDA-approved contraceptives can end the life of a human being. And knowingly taking a human life is something that many people have a conscientious objection to doing.

— Donna Harrison is a board-certified obstetrician-gynecologist and is the executive director and director of research and public policy for the American Association of Pro-Life Obstetricians and Gynecologists.

Donna Harrison is a board-certified obstetrician and gynecologist, and executive director of the American Association of Pro-life Obstetricians and Gynecologists (AAPLOG).
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