A wealth of scientific evidence
As a woman's menstrual cycle progresses, her endometrium gradually gets richer and thicker in preparation for the arrival of any newly conceived child who may be there to attempt implantation. In a natural cycle, unimpeded by the Pill, the endometrium experiences an increase of blood vessels, allowing an increased blood supply to bring oxygen and nutrients to the child. There is also an increase in the endometrium's stores of glycogen, a sugar that serves as a food source for the blastocyst (newly conceived child) as soon as he or she implants.
The statements in The Physician's Desk Reference, and others to follow, testify that the Pill keeps the woman's body from creating the most hospitable environment for a child, resulting instead in an endometrium that is thin and depleted, deficient in both food (glycogen) and oxygen. This deficiency may result in the child's death by starvation and suffocation. (Scientifically, one does not have to have a stomach to starve or lungs to suffocate.)
Typically, the blastocyst (new person) attempts to implant at six days after conception. If implantation is unsuccessful, she starves to death and is flushed out of the womb in an early miscarriage. (When the miscarriage is the result of an environment created by a foreign device or chemical, it is actually an abortion.)
The March 1996 issue of Fertility and Sterility presents significant research results, then states,
These data suggest that the morphological changes observed in the endometrium of OC users have functional significance and provide evidence that reduced endometrial receptivity does indeed contribute to the contraceptive efficacy of OCs [oral contraceptives]. (Somkuti, et al., "The Effect of Oral Contraceptive Pills on Markers of Endometrial Receptivity, Fertility and Sterility, Volume 65, #3, 3/96, page 488.)
In an extensive study, Chowdhury & Joshi point to the diminished capacity of the endometrium as part of the effectiveness of the Pill ("Escape ovulation in women due to the missing of low dose combination oral contraceptive pills," Contraception, 1980; 22:241).
In a study of oral contraceptives published in a major medical journal Dr. G. Virginia Upton, Regional Director of Clinical Research for Wyeth International (one of the major birth control pill manufacturers), says this:
The graded increments in LNg in the triphasic OC serve to maximize contraceptive protection by increasing the viscosity of the cervical mucus (cervical barrier), by suppressing ovarian progesterone output, and by causing endometrial changes that will not support implantation. ("The Phasic Approach to Oral Contraception," The International Journal of Fertility, volume 28, 1988, page 129.)
Dr. Goldzieher (Hormonal Contraception, page 122) says as a result of the combined Pill's action "possibly the endometrium in such cycles may provide additional contraceptive protection. ' (Note that the author redefines "contraceptive," which historically meant something which prevents conception, yet is used here of preventing implantation of an already conceived person.)
The medical textbook Williams Obstetrics (Cunningham, et al, Stamford, CT: Appleton & Lange, 1993, page 1323) states, "Similar to estrogens, progestins produce an endometrium that is unfavorable to blastocyst implantation."
Drug Facts and Comparisons says this about birth control pills in its 1996 edition:
Combination OCs inhibit ovulation by suppressing the gonadotropins, follicle-stimulating hormone (FSH) and lutenizing hormone (LH). Additionally, alterations in the genital tract, including cervical mucus (which inhibits sperm penetration) and the endometrium (which reduces the likelihood of implantation), may contribute to contraceptive effectiveness.
"The Pill: How does it work? Is it safe?" (The Couple to Couple League, PO Box 111184, Cincinnati, OH, 45211) states on page 4:
When the Pill fails to prevent ovulation, the other mechanisms come into play. Thickened cervical mucus may make it more difficult for the sperm to reach the egg: however, if the egg is fertilized, a new life is created. The hormones slow the transfer of the new life through the fallopian tube, and the embryo may become too old to be viable when it does enter the uterus.
If the embryo is still viable when it reaches the uterus, underdevelopment of the uterine lining caused by the Pill prevents implantation. The embryo dies and the remains are passed along in the next bleeding episode which, incidentally, is not a true menstruation, even though it is usually perceived as such.
A standard medical reference, Danforth's Obstetrics and Gynecology (Philadelphia: J.B. Lippincott Co., 1994, 7th edition, page 626) states this: "The production of glycogen by the endometrial glands is diminished by the ingestion of oral contraceptives, which impairs the survival of the blastocyst in the uterine cavity."
In her article Abortifacient Drugs and Devices: Medical and Moral Dilemmas (Linacre Quarterly, August 1990, page 55), Dr. Kristine Severyn states,
The third effect of combined oral contraceptives is to alter the endometrium in such a way that implantation of the fertilized egg (new life) is made more difficult, if not impossible. In effect, the endometrium becomes atrophic and unable to support implantation of the fertilized egg. . . . the alteration of the endometrium, making it hostile to implantation by the fertilized egg, provides a backup abortifacient method to prevent pregnancy.
Established fact even in the Seventies
One of the things that surprised me in my research was that though many recent sources testify to the Pill's abortive capacity, it has been well established for more than two decades. The following eight sources were all written in the 1970's. (Keep in mind that the term "blastocyst" refers to the newly conceived human being -- "it" is not a thing, but a person, a "he" or "she."
Dr. Daniel R. Mishell of the USC School of Medicine said,
Furthermore, they [the combination pills] alter the endometrium so that glandular production of glycogen is diminished and less energy is available for the blastocyst to survive in the uterine cavity. ("Current Status of Oral Contraceptive Steroids," Clinical Obstetrics & Gynecology 19:4, December 1976, page 746.)
[While serving as] president of the Food and Drug Administration (FDA), Dr. J. Richard Crout said this of combination birth control pills:
Fundamentally, these pills take over the menstrual cycle from the normal endocrine mechanisms. And in so doing they inhibit ovulation and change the characteristics of the uterus so that it is not receptive to a fertilized egg. (FDA Consumer, HEW publication number 76-3024, reprinted from May, 1976.)
In 1970, J. Peel and M. Potts's Textbook of Contraceptive Practice (Cambridge University Press, 1970, page 8) acknowledged,
In addition to its action on the pituitary-ovarian axis the combination products ["the Pill"] also alter the character of the cervical mucus, modify the tubal transport of the egg and may have an effect on the endometrium to make implantation unlikely.
In their book Ovulation in the Human, P.G. Crosignani and D.R. Mishell (Academic Press, Inc., 1976, page 150), stated that birth control pills "alter the cervical mucus . . . as well as affect the endometrium, reducing glycogen production by the endometrial glands which is necessary to support the blastocyst."
The 1977 sixth edition of the Handbook of Obstetrics & Gynecology, then a standard reference work, states on pages 689-690,
The combination pill . . . is effective because LH release is blocked and ovulation does not occur; tubal motility is altered and fertilization is impeded; endometrial maturation is modified so that implantation is unlikely; and cervical mucus is thickened and sperm migration blocked.
(Notice that in this case four mechanisms are mentioned, and the prevention of implantation is listed before the prevention of conception by the thickened cervical mucus.)
The book My Body, My Health (Stewart, Guess, Stewart, Hatcher; Clinician's Edition, Wiley Medical Publications, 1979, page 169-70) states,
In a natural cycle, the uterine lining thickens under the influence of estrogen during the first part of the cycle, and then matures under the influence of both progesterone and estrogen after ovulation. This development sequence is not possible during a Pill cycle because both progestin and estrogen are present throughout the cycle. Even if ovulation and conception did occur, successful implantation would be unlikely.
It was not just obscure medical journals and textbooks which contained this information in the 70's. The popular magazine Changing Times explained, "The pill may affect the movement of the fertilized egg toward the uterus or prevent it from imbedding itself in the uterine lining." ("What We Know About the Pill," Changing Times, July 1977, page 21).
Pro-abortionists know it: Why don't we?
If most pro-lifers have been slow to catch on to this established medical knowledge (I certainly have been), many proabortionists are fully aware of it. In February 1992, writing in opposition to a Louisiana law banning abortion, Tulane Law School Professor Ruth Colker wrote,
Because nearly all birth control devices, except the diaphragm and condom, operate between the time of conception . . . and implantation . . . the statute would appear to ban most contraceptives. (The Dallas Morning News, February 6, 1992, 23A)
Colker referred to all those methods, including the Pill, which sometimes prevent implantation.
Similarly, in 1989 attorney Frank Sussman, representing Missouri Abortion Clinics, argued before the U.S. Supreme Court that "The most common forms of . . . contraception today, IUDs and low-dose birth control pills . . . act as abortifacients" (New York Times, National Edition, April 27, 1989, pages 15 & B13). (Remember, by that time all Pills were "low dose" compared to the Pill of the 60's and 70's and 97% were low dose by recent standards, in that they had less than 50 micrograms of estrogen.)
This is such well-established knowledge that the 1982 revised edition of the Random House College Dictionary, on page 137, actually defines "Birth Control Pill" as "an oral contraceptive for women that inhibits ovulation, fertilization, or implantation of a fertilized ovum, causing temporary infertility." When the Pill successfully inhibits implantation of a fertilized ovum, it causes an abortion. (I'm not suggesting, of course, that Random House or any dictionary is an authoritative source. My point is that the knowledge of the Pill's prevention of implantation is so firmly established scientifically that it can be presented as standard information in a household reference book.)
I found on the World Wide Web a number of sources that recognize the abortive mechanism of the Pill. For instance, the "Marie Berry Archive" has an article called "Remembering to Take the Pill." It states matter-of-factly, "Combination oral contraceptives . . . inhibit two other hormones -- H and FSH -- preventing the lining of the uterus or endometrium from developing and thus not allowing ova implantation" http://www.escape.ca/~jdk/mb0996.htm .
Another article, "Oral Contraceptives: Frequently Asked Questions," says "The combined oral contraceptive pill . . . impedes implantation of an egg into the endometrium (uterine lining) because it changes that lining" (http://www.nau.edu/~fronske/bcp.html). Again, most sources on the web are not authoritative, but these two articles, both carefully written, do reflect what is a widespread consensus about the abortive action of the Pill. (This reality does not present a problem to most of these researchers and writers, because of their belief systems.)
For years proabortionists have argued that if the Human Life Amendment, which recognizes each human life begins at conception, was to be put into law, this would lead to the banning of both the IUD and the Pill. When hearing this I used to think, "As usual, they're misrepresenting the facts and agitating people by pretending the Pill would be jeopardized by the HLA."
I realize now that while their point was to agitate people against the Human Life Amendment, they were actually correct in saying that if the amendment was passed and taken seriously, the Pill would violate it because it takes the life of an already conceived human being. They never claimed condoms or diaphragms would be made illegal by the Human Life Amendment. Why? Because when they work, those methods are 100% contraceptives -- they never cause abortions. It's because they know that the Pill sometimes prevents implantation that prochoice advocates could honestly make the claim that an amendment stating human life begins at conception would label the Pill as a product that takes human life.
Breakthrough ovulation & backup mechanisms
One of the most common misconceptions about the Pill is that its success in preventing discernible pregnancy is entirely due to its success in preventing ovulation. If a sexually active and fertile woman taking the Pill does not get pregnant in 97-99% of her cycles it does not mean she didn't ovulate in 97-99% of her cycles.
Many months the same woman would not have gotten pregnant even if she wasn't using the Pill. Furthermore, if the Pill's second mechanism works, conception will be prevented despite ovulation taking place. If the second mechanism fails, then the third mechanism comes to play. While it may fail too, every time it succeeds it will contribute to the Pill's perceived contraceptive effectiveness. That is, because the child is newly conceived and tiny, and the pregnancy has just begun six days earlier, that pregnancy will not be discernible to the woman. Therefore every time it causes an abortion the Pill will be thought to have succeeded as a contraceptive. Most women will assume it has stopped them from ovulating even when it hasn't. This illusion reinforces the public's confidence in the Pill's effectiveness, with no understanding that both ovulation and conception may have in fact not been prevented at all.
In his article "Ovarian follicles during oral contraceptive cycles: their potential for ovulation," Dr. Stephen Killick says, "It is well established that newer, lower-dose regimes of combined oral contraceptive (OC) therapy do not completely suppress pituitary and ovarian function" (Fertility and Sterility, October 1989, page 580).
Dr. Thomas Hilgers, renowned fertility expert, personally heard Dr. Ronald Chez, a scientist with the National Institute of Health (NIH), publicly state that the pills of today, with their lower estrogen doses, allow ovulation up to 50% of the time. Dr. Chez was at that time the head of the pregnancy research development branch of the NIH. (Having read this, I sought direct confirmation from Dr. Hilgers; I have a letter from him acknowledging that he did in fact hear Dr. Chez say this.)
Dr. David Sterns, in "How the Pill and the IUD Work: Gambling with Life" (American Life League, PO Box 1350, Stamford, VA 22555), states that "even the early pill formulations (which were much more likely to suppress ovulation due to their higher doses of estrogen) still allowed breakthrough ovulation to occur 1 to 3% of the time." He cites an award winning study by Dutch gynecologist Dr. Nine Van der Vange in which she discovered in Pill-takers "proof of ovulation based on ultrasound exams and hormonal indicators occurred in about 4.7% of the cycles studied."
To check this out myself, I obtained a copy of Dr. Van der Vange's original study, called "Ovarian activity during low dose oral contraceptives," published in Contemporary Obstetrics and Gynecology, edited by G. Chamberlain (London: Butterworths, 1988). On pages 323-24, Dr. Van der Vange concludes,
These findings indicate that ovarian suppression is far from complete with the low dose OC . . . Follicular development was found in a high percentage during low-dose OC use. . . . ovarian activity is very common for the low dose OC preparations. . . . the mode of action of these OC is not only based on ovulation inhibition, but other factors are involved such as cervical mucus, vaginal pH and composition of the endometrium.
This means that though a woman might not get measurably pregnant in 98% of her cycle months, there is simply no way to tell how often the Pill has actually prevented her ovulation. Given the fact that she would not get pregnant in many months even if she ovulated, and the fact that there are at least two other mechanisms which can prevent measurable pregnancy (one contraceptive and the other abortive), a 97% apparent effectiveness rate of the Pill might mean only a 70-90% effectiveness in actually preventing ovulation. (We could go much lower if we took the 50% figure stated by Dr. Chez of the National Institute of Health, but to be conservative I am choosing the higher rates of ovulation.) The other 7-27% of the Pill's "effectiveness" could be due to a combination of the normal rates of nonpregnancy, the thickening of the cervical mucus and -- at the heart of our concern here -- the endometrium's hostility to the fertilized egg.
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