Contraception

Contraception, unlike many everyday matters, has been a matter of theological and ethical debate, largely among Christians. There is good reason for this: it is concerned with something profoundly awesome, the conception of a human being. Contraception, or birth control, is the voluntary prevention of the conception of a child by human intervention. In this article we will explore the matter scientifically, scripturally and theologically.

Methods of Contraception

Today there are a number of methods of contraception available to people. The most primitive method is coitus interruptus, in which the male withdraws before ejaculation. This method has a 20 to 30 percent success rate in avoiding pregnancy. Next are the barrier methods, which employ creams, foams, jellies, caps, diaphragms or condoms to prevent the sperm from reaching the ovum. These methods are about 75 percent effective in pregnancy prevention. Hormone-based contraceptives include oral contraceptives, which contain fixed or variable doses of synthetic estrogen and progestin, Depo-Provera injection, and Norplant, which is a sustained-release contraceptive system implanted under the skin that acts continuously for five years.

The hormonal contraceptives all work through one of the following mechanisms: (1) by thickening the viscosity of the cervical mucus, making it hostile to sperm, (2) by inhibiting ovulation via interruption of a crucial feedback loop between the pituitary gland and the ovaries, or (3) by making the lining of the uterus hostile to the implantation of any newly fertilized ovum that “breaks” through the first two lines of defense. The current low-dose pills most likely operate through this third mechanism, making them in fact abortifacient (that is, they achieve birth control through early abortion). Other examples of abortifacient methods are surgical abortion, IUDs and RU-486 (mifepristone); these are not considered contraceptive devices, because a new human life in the form of an embryo is being destroyed. The use of low-dose hormone pills does carry high moral risks. Hormonal birth control has a theoretical effective rate of 99 to 100 percent and a 97 percent user-effective rate.

Permanent sterilization procedures are often performed for contraceptive purposes. For the female, two procedures are available: (1) tubal ligation, in which the fallopian tubes are tied and severed so that the sperm will not reach the ovum, and (2) hysterectomy, which makes conception impossible by removal of the womb. For the male, the method of permanent sterilization is vasectomy, tying the vas deferens (a small tube that transports the sperm from the testes to the prostate gland) to block sperm from entering the ejaculate. Tubal ligation, vasectomy and hysterectomy have a 99 to 100 percent pregnancy prevention success rate. Tubal ligation and vasectomy can be surgically reversed with a 30 percent and 50 percent success rate, respectively, in achieving a subsequent pregnancy.

Recently a new educational approach to birth control called Natural Family Planning (NFP) has been advocated primarily by those who do not want to engage in pharmacological or surgical contraception. It is a day-to-day method based on self-diagnosing the day of fertility in the woman’s cycle, giving the married couple the choice to abstain from or enter into sexual intercourse at that time depending on their intention with regard to possible pregnancy. This is considered a true method of family planning in that it can be used to achieve or to avoid pregnancy. Some couples report a recurring honeymoon effect with this method. Four studies in the United States and two in the Third World claimed a 96.4 percent and 99.2 percent effectiveness rate, respectively, in using these methods to postpone, delay and avoid pregnancy.

Attitudes Toward Contraception

Even though contraception was known in ancient Egypt and throughout the ancient world some four millennia ago, it was not widely practiced. Both the Hebrew and the Chinese cultures highly valued childbearing, and contraception had very little, if any, appeal. Greeks and Romans encouraged reproduction in order to populate the state, and contraception was specifically condemned by the Stoics. The question of the legitimacy of the use of contraception arose in the early church, when Christian free women who married Christian slaves wanted to avoid pregnancy in order not to bring more slaves into the world. The church responded by condemning contraception as sinful while affirming the basic equality of all human beings in the eyes of God, in whose image every man and woman is created. Historically, opposition to contraception has basically been the position of the church until the twentieth century. Church leaders including Augustine, Aquinas, Martin Luther, John Calvin and John Wesley are all on record as condemning contraception. The Comstock Act of 1873 in the United States, prohibiting the distribution of birth control information, reflected the rejection of contraception by North American Protestants. These laws were not repealed until the 1960s.

The change in attitude toward contraception came at the same time that people gained better understanding of the physiological processes involved in reproduction. Prior to the nineteenth century most people thought that new life was transmitted in the male semen and the role of women was to receive and nurture it. The ovum was discovered in 1827, and the relationship between ovulation (the production of a fertilizable egg) and the menstrual cycle was completely worked out in the late 1920s. As a result, the calendar rhythm method was introduced in 1932. This coincided with the growth of the birth control movement, which grew due to the perceived imbalance between population growth and available resources. For some Christians the break with the traditional opposition to contraception began at the Anglican Lambeth Conference in 1930, when the bishops recognized a moral obligation to limit parenthood and allowed for the use of contraception in certain limited circumstances.

The Roman Catholic Church responded with “On Christian Marriage” (1930) and “Of Human Life” (1968). These affirmed that the unitive meaning of the sexual act (in which the married couple grows in love and fellowship) and the procreative meaning of the sexual act (in which the potential of childbearing is actualized) are both inscribed by God into the very act of sexual intercourse and cannot be separated without serious moral consequences. Periodic abstinence is the only permissible course of action for couples who wish to delay conception.

Protestant writers, on the other hand, see “the completion of marital fellowship” as the “first essential meaning” of sexual intercourse; from the standpoint of this fellowship, then, it may not be generally and necessarily required that it should be linked with the desire for or readiness for children (Barth, p. 269), and readiness for children should include both procreation and education of offspring. Contraception is therefore acceptable as a means to achieve “responsible parenthood,” especially in cases where the mother’s physical and psychological welfare may be jeopardized as a result of getting pregnant or where other problems exist, such as an already overcrowded family. Such factors are held to preclude a decent environment to ensure a proper upbringing of the child as a gift from God.

Contemporary Responses of Christians

The first response, which we may call the majority position, accounts for 90 percent or more of modern Christian couples and favors the practices of temporary contraception and permanent sterilization. This response emphasizes the importance of human responsibility and takes stewardship seriously. It tends to downplay God’s sovereignty in this matter and clearly believes that the unitive and procreative meanings of the marriage covenant and act need not be maintained in every sexual intercourse.

A tiny minority, less than 1 percent of Christians (both evangelical and Catholic), rejects every form of contraception, sterilization and even Natural Family Planning. This second response we might call the minority or fundamentalist position. These Christians insist on God’s sovereignty in procreative matters and do not accord human responsibility and freedom any significant role in procreation within the sexual/marriage act. They do not see the unitive and procreative meanings of the marriage covenant and act as two separable aspects.

Third, a small but growing number (3 to 4 percent) of Christians are learning and practicing Natural Family Planning. This approach is seen to combine respect for God’s sovereignty and human responsibility, seeing that God’s love and our stewardship are meant to be intertwined. It is an acknowledgment of God’s gifts and our responsible stewardship of them. When sexual intercourse is experienced, it does not contravene the total openness of the marriage act but trusts in God’s providence for any outcome. And when sexual intercourse is abstained from for good reasons, the couple’s sacrifice and self-control are considered a gift of the Holy Spirit and an integral component of Christian life.

A Christian Evaluation of Contraception

Undoubtedly, contraception has brought many positive benefits. Many women have been able to relax during sexual intercourse without the fear of annual pregnancies. It has helped some couples take more responsibility for bringing children into this world. But there has been a downside as well.

Looking back at the promise being made for the different approaches to contraception, we must admit that they have not solved the population problems nor made happier marriages. In fact the divorce rate skyrocketed from 25 percent in 1960 to approximately 50 percent in 1975, when contraception had reached saturation levels in North American culture. In contrast, the divorce rate for those practicing Natural Family Planning is said to be approximately 2 to 3 percent. Furthermore, contraception has not decreased the demand for abortion. In fact, every country that has accepted contraception has had to pass abortion laws to take care of any failure in contraception, as there are no 100 percent effective contraceptive methods.

There are many factors involved in the alarming statistical trends we observe in today’s Western world. Near-perfect and universally available contraception is certainly one. There has been an explosion of abortion from below 50,000 per year before 1960 to 1.5 million per year in the United States today. The reality of unwanted children has not been eliminated either, as child abuse statistics have also skyrocketed in this time period. It is well known that the advent of contraceptive technology coincides with the devastating social consequences of unleashed sex outside of marriage, promiscuity, adultery, sexually transmitted diseases, infertility, value-free sex education and teenage pregnancy. Furthermore, many believe that contraception, by separating the unitive and procreative dimensions of the marriage covenant and act, has managed to reduce women and men to mere objects, seen as means of giving pleasure rather than as total persons with their fertility intact. This objectification of women is at the root of the increased abuse and violence against women in our society.

Toward Responsible Contraception

First, even if we do not agree with the Catholic Church’s position on artificial contraception as intrinsically immoral, it must be admitted that contraception has contributed a great deal to the immorality of our society. Any Christian endorsement of the use of artificial contraception must be accompanied by an unequivocal condemnation of those immoral consequences that run against all fundamental Christian teachings on humanity, sexuality and marriage. Teenagers especially must be taught that parental use of contraceptives does not amount to justification of premarital sex.

Second, even though the Bible does not directly address the subject of contraception, throughout the Old and New Testaments children are considered a great blessing from the Lord. In the Old Testament barrenness is considered to be a lamentable state. In Genesis 1:28 the command to be fruitful and multiply is seen to be integral to the meaning and stewardship (responsible parenthood) of the marriage union in creation. Eve’s statement “With the help of the Lord I have brought forth a man” (Genesis 4:1) reveals God as integral to the creation of each new life. In conceiving and bearing children we are cooperating with God. Every birth is a sign of God’s ongoing commitment to creation, work in redemption and extension of the kingdom. At the dawn of salvation history, it is the birth of a child that is proclaimed as joyful news, and the joy that accompanies the birth of the Savior is seen to be the foundation and fulfillment of the joy that should be experienced as every child is born into the world.

Third, in the light of New Testament teaching that other concerns, such as service to God’s kingdom, can take precedence over marriage and family (1 Cor. 7), the biblical injunction to be fruitful and multiply (Genesis 1:28) need not be interpreted to mean that parents always have to bear the maximum number of children. Rather, the objective of marital partners must include cultivating an environment that is conducive to the growth of partner-fellowship between the couple and an optimal number of children who may receive adequate nurturing, attention and education. If this involves the assistance of artificial contraception, we should use it responsibly and with caution.

Fourth, it is a different matter if a Christian couple decides at the beginning of their married life to be permanently childless by the use of contraceptive devices. Here caution must be exercised. Some argue that the decision to be childless is similar to the decision to be celibate in order to be freed for a higher calling and thus the use of contraceptives should be allowed. Others link sexual intercourse to the kingdom of God. “The line of reasoning goes this way: Families are for the Kingdom of God. Marriage is for families. And therefore, since sex is for marriage, sex is for the kingdom of God” (Smedes, p. 167). Even though we agree that the reproductive meaning of sexuality need not be fulfilled in every instance of the sexual act, the link between the unitive and procreative aspects of sexual intercourse should be respected by insisting that all marriages should be open to the hope of bearing children at some point.

» See also: Abortion

» See also: Birth

» See also: Conception

» See also: Family

» See also: Miscarriage

» See also: Parenting

» See also: Sexuality

References and Resources

C. Balsam and E. Balsam, Family Planning: A Guide for Exploring the Issues (Liguori, Mo.: Liguori, 1986); Karl Barth, Church Dogmatics 3/4 (Edinburgh: T & T Clark, 1961); R. A. Hatcher et al., Contraceptive Technology (New York: Irvington, 1994); J. T. Noonan Jr., Contraception: A History of Its Treatment by the Catholic Theologians and Canonists, 3d ed. (Cambridge, Mass.: Belknap/Harvard University Press, 1986); Pope Paul VI, Of Human Life (Humane Vitae) (Boston: St. Paul Editions, 1980); M. Pride, The Way Home: Beyond Feminism, Back to Reality (Westchester, Ill.: Crossway, 1985); C. D. Provan, The Bible and Birth Control (Monongahela, Penn.: Zimmer, 1989); L. B. Smedes, Mere Morality (Grand Rapids: Eerdmans, 1983).

—Edwin Hui and Michael Maloney