The intersection of religion and sex has long made humans squirm. So it's no wonder that birth control — when or whether to practice it, what kinds of birth control are acceptable — continues to perplex people of faith.
"Be fruitful and multiply," the Bible says. But how fruitful? Is it OK to try to minimize the fruitfulness? Is it OK to minimize by using "artificial" methods? To these age-old questions are added new, nuanced ones as science develops more sophisticated ways to prevent pregnancy.
The fact that some of the science is inexact adds to the confusion, as does new terminology (the "morning after" pill and RU-486 — which can be taken up to five weeks after intercourse — are not the same contraceptive, but people continually confuse them. And neither of these are the same as the garden-variety birth control pill).
Increasingly, conservative religions as well as some members of the Christian Medical Association are speaking out against both the regular birth control pill and IUDs (intrauterine devices), calling them "abortifacients."
At the crux of the debate is the assertion that the pill, especially newer, low-dosage versions as well as progestin-only pills, aren't always successful in preventing ovulation. That would mean, in the cases where "breakthrough ovulation" occurred but pregnancy was still prevented, that either the egg was then prevented from being fertilized, or a fertilized egg may have been prevented from safely attaching to the endometrial lining of the uterus. That process of implantation begins five to seven days after fertilization and may last several days.
To those who believe that human life begins at conception, this distinction between "prefertilization effect" and "postfertilization effect" is crucial, says Joseph B. Stanford of the University of Utah's Department of Family and Preventive Medicine. Stanford, a member of The Church of Jesus Christ of Latter-day Saints, is among those researchers who are keeping the issue alive.
Stanford has co-authored several studies attempting to pin down how the pill and IUD work, in an effort to prove that women should be told by their doctors that these forms of birth control might be inconsistent with their religious beliefs.
Evidence that oral contraceptives sometimes rely on a post-fertilization effect (some doctors and much of the Christian right prefer the term "abortifacient") varies depending on the study, Stanford says. "We could identify few data that would assist in quantifying these postfertilization effects," he wrote in a study reported in "Archives of Family Medicine." Still, he wrote, "the medical literature does not support the hypothesis that postfertilization effects of (oral contraceptives) do not exist."
Likewise, IUDs also sometimes rely on a postfertilization effect, he reports. "While the majority of pregnancy prevention (with an IUD) occurs prior to fertilization, postfertilization effects make substantial and essential contributions to the effectiveness of all types of IUDs," he writes in a recent journal article. Most of this occurs in the fallopian tube, prior to the embryo entering the uterus, he says.
The former anti-abortion magazine the Life Advocate summed up its stand against the pill and IUD this way: "Are we consistently pro-life or only selectively pro-life? . . . Are we moral relativists and gradualists different only in degree but not in kind with those we call abortionists?"
Religions vary in their approach to birth control. Most religions disapprove of sex (and therefore birth control) outside marriage. Some religions condemn all forms of artificial birth control even within marriage. Others approve of some methods but not others. Others take no stand at all.
The science and the arguments may be more subtle now, but humans have been experimenting with birth control for millennia. The Egyptians used vaginal suppositories made of preparations as varied as honey and crocodile dung, according to Stanford. The Romans, he adds, used condoms made of goat bladders.
No Christian church approved of any kind of birth control prior to 1930, writes Stanford in an article on birth control in the "Encyclopedia of Christianity." In the United States laws prohibiting the mailing of "articles for immoral use" were used in the 1800s and early 1900s to prosecute people who distributed contraceptives or even information about contraceptives.
Secular efforts to make birth control available to the masses in both England and the United States in the early 1900s led the Church of England to take a revolutionary, although limited, stance in favor of contraceptives. Birth control, the church stated at its 1930 Lambeth Conference of Bishops, might be justified in certain, narrow circumstances "where there is a morally sound reason for avoiding complete abstinence."
That pronouncement "opened a floodgate over the next couple of decades," says Stanford, until virtually every Protestant denomination had officially approved birth control.
The Presbyterian Church, for example, encourages "the responsible use of birth control," says Marvin Groote, executive presbyter of the Presbytery of Utah. The impetus comes in part, he says, from a recognition that the world is becoming over-populated. The church has had "serious debates" over abortion and partial-term abortion, he says, but the issue of birth control, or the use of specific kinds of birth control, is not part of that debate.
For Lutherans, birth control "is not a major issue," says Pastor Kristian Erickson of Christ Lutheran, although motivation for using it might be. "If you're not wanting to have children because you're self-absorbed, that's probably not a good reason," says Erickson.
The Catholic Church has been steadfast and vocal in its opposition to any kind of artificial birth control. Today, says Monica Howa-Johnson of the Salt Lake City diocese, most Catholic churches require newly married couples to attend a natural family planning class. The church is against anything that "bars the natural cycle," she says.
Unlike the old "rhythm method," NFP teaches women how to predict ovulation and identify the fertile days of the menstrual cycle by monitoring their bodies' mucus discharge, with the optional additional check of basal body temperature.
"Most doctors don't tell women about modern natural family planning," Stanford laments, "or they give them misinformation about how unreliable it is." Intermountain FertilityCare Services offers NFP instruction and a Web site, www.intermountainfertilitycare.org. Planned Parenthood of Utah also provides NFP training, "but the requests are few," says Planned Parenthood chief executive officer Kerrie Galloway.
Despite the Catholic Church's disapproval of artificial birth control and its endorsement of NFP, many Catholics use birth control, according to Kathy Coffey in a 1998 article in "U.S. Catholic" magazine. "It's the 'little secret that no one talks about,' " she wrote, adding that a 1992 Gallup poll revealed that 80 percent of U.S. Catholics said they did not think birth control was wrong.
Islam is against any kind of worldwide program to control population growth, explains imam Shuaib-ud Din of the Khadeeja mosque. For individual Muslims, birth control within marriage as a way of spacing out a couple's children is "not totally prohibited but is discouraged," although ultimately it is the husband and wife's decision. Tubal ligation and vasectomies are prohibited. But which non-permanent birth control methods Islam allows isn't spelled out. Maysa Malas says she knows Muslim women who use birth control pills and IUDs — and she was surprised to learn that some conservative religions have taken stands against the methods.
Like Catholics, Orthodox Jews are cautioned not to use any form of birth control. The exception might be certain medical conditions of the mother, says Rabbi Yossi Mandel of Chabad Lubavitch of Utah, but even then the couple would need to consult "a rabbi proficient in medical areas."
Reform Jews, on the other hand, are supported in their right to use birth control, says Rabbi Joshua Aaronson of Temple Bar Shalom in Park City. "We don't believe it in any way violates any injunction or commandment from God." The LDS Church has shied away from specifics, too, and only occasionally are there pronouncements about birth control in general. The most recent, in a talk by President Boyd Packer, acting president of the Council of the Twelve, to college-age adults worldwide, seemed to imply that birth control is not sanctioned.
"You do not have to be commanded in all things," Packer reminded them. "Without having to have the church deliver a statement on it, you should know what the Lord's position is on abortion or cloning or same-gender marriage or birth control."
A 1995 talk by Elder J. Ballard Washburn of the Seventy at the church's general conference was more direct: "It is contradictory to this covenant (of marriage) to prevent the birth of children if the parents are in good health."
On the other hand, the less official 1992 Encyclopedia of Mormonism, edited by Daniel H. Ludlow, explains that "if, for personal reasons, a couple prayerfully decides that having another child immediately is unwise, birth control may be appropriate."
It goes on to add, however, that "regarding family size and attendant questions, members should desire to multiply and replenish the earth as the Lord has commanded."
E-MAIL: jarvik@desnews.com