All About Birth Control

For thousands of years, couples have practiced different kinds of birth control. Today, there are still dozens of options. What are they? How do they work? What risks am I taking? What are the moral and spiritual implications?

Many Christian couples have wrestled with birth control over the centuries. Some denominations openly condemn any artificial act of birth control at all, while others take a passive stance, leaving room for individual spiritual liberties.

A newly married friend of mine told me, “What’s the point? No method is 100 percent effective. If we do use birth control, and God wants us to have a child, we will. If we don’t use it, and He wants us to have a child we will?” It proves a tricky place for faith, and it opens a lengthy and important discussion for any couple getting ready to tie the knot, or couples whose knots are tied. Most pre-marital counselors strive to make sure that couples will hash out their opinions before their wedding day.

That said, let’s just look at the options and what experts have to say about them. The best decisions are informed decisions.

[ORAL CONTRACEPTIVES]

“The Pill” is the common phrase used to describe oral contraceptives. There really are several different types, though most work the same way. The primary goal of the birth control pill is to prevent ovulation from happening. The hormones in the pill (or the chemicals meant to control natural hormones depending on which pill), are primarily meant to stop a woman’s ovaries from producing an egg. Many pills though, have a little known side effect that can interfere with the traditional evangelical standpoint on human life. The estrogen produced by the pill may work to supplant ovulation, but it is not always stopped. Occasionally, an egg is released. The progesterone in the pill works with the estrogen to cause the lining of the uterus to thin out, preventing the fertilized egg from implanting. Some pills (the controversial “Morning After Pill” included) work specifically to prevent a fertilized egg from implanting, and can be taken even after sexual contact.

Many Christians believe that life begins the moment that a sperm cell meets the egg. Many others believe that life begins when that fertilized egg is implanted in the uterus. If your belief is the former, then oral contraceptives are not for you. If you believe the latter, oral contraceptives still may not be for you, if your belief system depends on how long the fertilized egg needs to be implanted in the uterus. The process of implantation takes several days. It’s important to weigh carefully these options, as an uninformed decision can bear some heavy consequences. Many doctors who are pro-life are unfamiliar with this dilemma, though a few of them, like Dr. Walter L. Larimore of Kissimmee, Fla., are changing their minds about prescribing the pill.

The pro-life activist organization Rock for Life is known for promoting the message that many forms of birth control are actually a form of abortion. Rock for Life is affiliated with the American Life League, a Catholic organization, but draws support from a very ecumenical crowd. Their largest concern is the moral implications behind contraceptives.

“Contraception facilitates the kind of relationships and even the kind of attitudes and moral character that are likely to lead to abortion. The contraceptive mentality treats sexual intercourse as though it had little natural connection with babies; it thinks of babies as an ‘accident’ of intercourse, as an unwelcome intrusion into a sexual relationship, as a burden.” —Professor Janet Smith, for Rock for Life

If you do decide to go on birth control pills, see your doctor several months before becoming sexually active, which hopefully would mean several months before getting married. It can take a few months for your regular cycle to adjust to the pill. The extra time assures that your body will begin to suppress ovulation before the risk of getting pregnant occurs.

The Good News:

Oral contraceptives are quite effective. The average rate of failure is between-three percent. If you decide to have children later, it may take a few months for the hormones to get back to normal. You may or may not conceive a child right after you stop taking the pill. Oral contraceptives rarely, if ever, have any permanent side effects.

The Bad News:

Other than the obvious implications regarding preventing implantation, it’s important to note that hormonal birth control is not for everyone. The pill must be taken at the same time every day. A missed dose, even by a few hours, could drastically alter the course of your life. Also, a few people suffer some serious health risks while using the pill, including heart attacks, weight gain, depression, dangerous blood clotting and more.

[OTHER CHEMICAL CONTRACEPTIVES]

Norplant, Depo-Provera, the Ortho Eva Patch and vaginal rings all are basically hormone treatments with the same side effects and risks as oral contraceptives. Some of them work to suppress ovulation; all of them work to prevent implantation of the fertilized egg.

The Good News:

These methods are much easier to manage than a daily pill. Once a month or even as seldom as every five years is the rate these methods need to be administered. Depo-Provera has a failure rate of less than half a percent, which is very effective.

The Bad News:

Some of these methods can be quite expensive. Norplant costs up to $800 to be administered, though it lasts for five years. All of these methods have the same side effects and health risks as oral contraceptives.

[IUDs]

 

IUD stands for Intra-Uterine Device. It is a small coil of plastic or metal placed in the uterus of a woman. Its sole purpose is not to suppress ovulation, but to prevent implantation by the irritating of the uterine wall. Once again, depending on your stance of when life begins, this type of birth control presents a moral dilemma.

The Good News:

Considering that IUDs are not all that effective, please skip on to the bad news.

The Bad News:

IUDs can sometimes cause serious health risks to women, including permanent infertility, ectopic pregnancies and pelvic inflammatory disease, and because some of them use progesterone, some IUDs carry the same side effects as oral contraceptives as well.

[STERILIZATION]

Both men and women can consider permanent or reversible surgical sterilization as a form of birth control. Tubal ligation, or “getting tubes tied,” is the method used to prevent sperm from reaching unfertilized eggs. The fallopian tubes are clamped, cut or tied off in a surgical procedure that can cost anywhere from $1,000 to $3,000 or more.

A vasectomy is a surgical procedure to cause sterilization in men. The vasa deferential, which are the tubes that carry the sperm cells form the testes to the prostate, are cut and sealed off.

The Good News:

Both procedures are very effective, though never 100 percent guaranteed. Both procedures cause little discomfort, and few if any sexual side effects. Men are often concerned about “shooting blanks,” but doctor’s have reassured men for years that things work the same way as before, just without sperm cells in their semen. Both procedures are often reversible, in the instance that the couple changes their mind about having children later on.

The Bad News:

Though the procedure is often reversible, it is difficult, and never guaranteed. If you are considering sterilization as a method of birth control and you have no children yet, it is not the best option, as the risk is great that you may not be able to have children later.

The procedures are both quite expensive, and not all health care providers will pay for them.

[BARRIER METHODS]

 

Male and female condoms, sponges, cervical caps and diaphragms are commonly used barrier methods. In fact, they are some of the oldest forms of birth control. Women in ancient Egypt would use a sponge soaked in vinegar, or a half of a lemon as a form of birth control. The ancient version was much less effective than today’s versions.

The function of a barrier is to prevent sperm from reaching the egg. Some denominations quote the “Sin of Onan” passage found in Genesis 38 as justification for not using condoms or other barrier methods. Other Christians believe that Onan’s sin was not “spilling his seed on the ground” as much as refusing to give his widowed sister-in-law a child. Once again, the moral decision will need to be made based on individual convictions.

Barrier methods are only 60-80 percent effective. This can be raised a bit when used in conjunction with a spermicide, or in conjunction with fertility awareness. The figures are based on proper use. If barriers are not used properly, there is no sense in using them. Read the directions on the package before use.

The Good News:

See Also

Condoms, diaphragms, sponges are relatively inexpensive. They are easy to use and do not raise moral questions about when life begins, even if it raises the topic of the Old Testament sin of Onan.

The Bad News:

Diaphragms and sponges require a bit of preparation before sex. No spur of the moment lovemaking is possible if this is your birth control. Some men complain that condoms decrease their sensation during sex, though some condoms are made thinner to accommodate.

[SPERMICIDES]

 

Spermicides function by killing the sperm cells before they ever reach the egg. Often available in a foam, cream, jelly or as an additive in lubrication, spermicides must be used each time that sperm is released.

The Good News:

Spermicides are relatively inexpensive, and they do not cause any known side effects to the fertilized egg if it fails to prevent it.

The Bad News:

Even when used properly, spermicides have an average failure rate of about 25 percent. In other words, when using spermicide alone, the chances of getting pregnant are pretty good. Many people use them in conjunction with a barrier method for increased safety. Spermicides have also been known to occasionally cause urinary tract infections in men and women, and occasionally people develop discomfort due to allergies to the spermicide.

[FERTILITY AWARENESS]

 

Fertility awareness, or natural family planning, is commonly used, though often ineffective. The basic premise is to predict the days of the month that the woman ovulates, and then either abstain from sex, or use a barrier method during that week. Some couples use barrier methods all the time, and then abstain all together during the ovulation week. This increases the effectiveness tremendously, though it also increases the expense.

Obviously, it’s a bit risky, especially for those who are bad with numbers, but there are several ways of tracking fertility, and with a little bit of effort, it can postpone pregnancy. If done carefully, it’s effectiveness is the same or better than barrier methods alone. Here is a guide to natural family planning.

The Good News:

Natural Family Planning is inexpensive, if not free. It grants a lot of freedom for couples by illuminating the days that the chances of getting pregnant are high. It also makes it easier when a couple decides to have a child.

The Bad News:

If a woman’s cycle is not regular, it is very difficult to track, and thus difficult to predict fertility. Occasionally, even a woman whose cycle is like clockwork may ovulate at a different time without knowing it.

Natural family planning often involves charting temperatures and keeping a journal, or calculating with a calendar. It involves a little effort separately and can sometimes get confusing.

The biggest thing to realize with birth control is that though there may be many methods, it comes down to a question of faith, sometimes a moral choice. Discuss these things with your partner. Pray about your choices. Educate yourself. Don’t just grab a method that is easy or popular. Take the time to learn about and weigh your options.

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