A post by Phantom Scribbler led me to this article from the New York Times on Contra-Contraception, by Russell Shorto.
The article discusses the links between abortion, contraception, and a person's view about sex itself. It highlights well the inconstency of being against a morning after pill like Plan B while supporting other forms of hormonal birth control, making the valid point that ALL forms of hormonal birth control, as well as the IUD, have a small chance of preventing the implantation of a fertilized egg.
But the paragraph that Phantom Scribbler pointed out is what really drew me in:
What's more, Dr. Trussell added: "There is evidence that there is a contraceptive effect of breast feeding after fertilization. While a woman is breast feeding, the first ovulation is characterized by a short luteal phase, or second half of the cycle. It's thought that because of that, implantation does not occur." In other words, if the emergency contraception pill causes abortions by blocking implantation, then by the same definition breast feeding may as well.
I found a website about ecological breastfeeding from a natural family planning standpoint that actually cites a study:
"Several studies have indicated that fertility and ovarian activity return step by step (Ellison 1996, p. 326-327):
- "Follicular activity without ovulation (No chance of pregnancy.)
1a. Menstruation without ovulation (This does not always occur--see below.)
- Ovulation without luteal competence (After the egg is released, fertilization may take place. During the luteal phase, the uterine lining is prepared for implantation as the egg travels down the fallopian tube and into the uterus. If the uterine lining is not adequately prepared for implantation, the implantation will probably not be successful.)
- Full luteal competence (Full fertility -- at this point breastfeeding no longer has any effect on your chance of pregnancy.)"
The site has a chart with information about these stages, including a notation that a study by Gray showed that 41% of breastfeeding mothers showed "First ovulation without luteal competence"--in other words, ovulation with likelihood of creating a fertilized egg that is unable to implant due to changes in the uterine lining from breastfeeding.
A little further down the page:
"Do I need to wean to get pregnant?
Probably not. If you are still transitioning to full fertility (as discussed above), breastfeeding may affect the success of implantation. Once implantation is successful, breastfeeding should not affect a healthy pregnancy (see A New Look at the Safety of Breastfeeding During Pregnancy for more information). "
An earlier article from the New York Times says,
"Trussell said he supports doctors who say women need to know it's possible that emergency contraception may affect embryo implantation. But that's true for nearly all methods of contraception, he added--including breast-feeding.
Breast-feeding, which can have a contraceptive effect up to six months after the birth of a child, also causes changes in the uterine lining. In that respect, it carries the same possibility of interfering with implantation.
"If you're talking about informed consent," said Trussell, "then it's not right to withhold evidence that breast-feeding may work in the same way."
Here's a summary of a study done on rats, looking at the relationship between lactation and ovulation. They found that if the timing was right, lactation did inhibit implantation of a fertilized egg.
Here's an interesting and thought-provoking paper by a group of Christian physicians that examines the studies and information about various forms of contraception. It analyzes the way hormone contraceptives work and compares that to the way a woman's fertility works when not on the pill. The paper makes the point that studies show "spontaneous pregnancy wastage" at 73% between fertilization and 6 weeks.
The article makes a pretty good case that hormonal contraceptives work primarily by preventing ovulation, then by thickening the cervical mucous, and also thin the uterine lining. There is a small theoretical risk of the pill preventing implantation of a fertilized egg, but numerically this doesn't seem to happen more often with the pill than it does without it.
So, essentially, it seems that progesterone is progesterone is progesterone, at least when it comes to avoiding pregnancy (we know the pill carries other health risks and side effects not entailed in breastfeeding). Breastfeeding apparently prevents conception in the same ways the pill does, because both methods operate by producing hormones that have the same effects. The pill is essentially designed to mimic the effect of pregnancy and/or breastfeeding on the body's response to ovulation and pregnancy.
The difference, of course, is that breastfeeding is almost never done solely for the purpose of contraception, although even Catholic organizations such as The Couple to Couple League actively promote its use and effectiveness as a contraceptive. The pill, though it is often used to treat other issues, and though it can have a positive effect on breastfeeding (causing better milk production, etc), is usually used with the goal of preventing pregnancy.
That seems quite relevant to our earlier discussion on Mark's blog about contraception and the relationship between sex and reproduction. As I mentioned there, if the desire to prevent a pregnancy is in itself wrong (which I don't think it necessarily is), then it could be equally wrong for a person to take an extra-hot bath to try to minimize chances of a successful pregnancy or to time intercourse only during infertile times to avoid having children.
That's quite debatable, as we previously established, and I know there's disagreement among members of this blog on this topic. I'd love to pick up the discussion again about whether intercourse can morally be separated from the goal of procreation or not.
I do tend to feel that purposely preventing the implantation of a fertilized egg is morally wrong, although this information is making me reconsider where I might draw the line on this issue. That has seemed a more clear-cut issue to me than the contraception debate in itself.
But, of course, it could be very difficult to draw a line there, too. There are so many things one could do that might inhibit implantation or cause early miscarriage--including overdosing on vitamin C or parsely, taking ginger or rosemary, having an eating disorder, taking drugs to treat rheumatic disease (such as lupus), having endometriosis, using acupressure/acupuncture, not to mention all the things that people think prevent implantation and really don't--like taking a hot bath or jumping up and down after intercourse. Any of those things would be very hard to regulate or prove damage from, and some are unavoidable.
Even if something is wrong, it is not necessarily right (or even possible) to regulate it by law. That's one of the reasons I see big problems with laws that would prosecute women for causing damage to their baby by taking drugs or drinking during pregnancy. If you're going to prosecute a woman for hurting her baby by drinking alcohol or taking drugs during pregnancy, where are you going to draw the line? Could a woman be prosecuted for drinking caffeine? Eating sushi? Not taking prenantal vitamins? Overexercising? Any of the other myriad things that could possibly be harmful during pregnancy?
Regulating things that prevent implantation is just as problematic. If we make Plan B illegal for that reason, we would also have to make the IUD and hormonal birth control illegal to be consistent. But if we did that, then what about breastfeeding or taking too much Vitamin C?
What do you all think?