In calling attention to the common roots of contraception and abortion (“as fruits of the same tree”) in n. 13 of the Encyclical Letter Evangelium vitae, John Paul II stresses that this “connection” is not only cultural but also technical:

“the close connection which exists, in mentality, between the practice of contraception and that of abortion is becoming increasingly obvious. It is being demonstrated in an alarming way by the development of chemical products, intrauterine devices and vaccines which, distributed with the same ease as contraceptives, really act as abortifacients during the very early stages of the development of the life of the new human being”.

How close this “connection” is became apparent during a recent debate on the so-called “morning-after pill”: is it an abortifacient or a contraceptive?

The responses published by the press diverged: “these products are not abortifacient but work against implantation”; “the morning-after pill can be contraceptive or abortifacient”; “the morning-after pill is abortifacient”.. Of course, such a variety of answers can only create confusion: how ever can it be—we might ask—that contradictory opinions could be expressed about a fact that should instead be empirically demonstrable?

The term “morning-after pill” indicates a series of preparations based on oestrogens, oestroprogestogens or progestogens, which are given to a woman after but not more than 72 hours after (hence the name “morning-after) sexual intercourse that is presumed fertile. The oestrogens, oestroprogestogens and progestogens are synthetic hormones administered for the purpose of contraception and/or abortion.

Thus the “morning-after, pill” is one approach to so-called “emergency contraception” or “an interception” which also envisions the administration of danazol or the insertion of a coil as alternatives to the above-mentioned hormones.

The effective action of “emergency contraception”, and hence of the “morning-after pill”, is abortifacient in 80 per cent (oestroprogestogen or progestogen) to 100 per cent (oestrogen, danazol, coil) of the cases the embryo is prevented from being implanted in the endometrium after the alteration of its physiological development, and/or the blocking of the action of the corpus luteum, which produces progesterone, an essential hormone for the continuation of pregnancy.

We can not rule out the fact that, if oestroprogestogen or progestogen is administered before ovulation has taken place, the release of the egg cell can be inhibited with a true contraceptive effect, which occurs in 0 to 20 per cent of the cases.

So how can it be said that the “morning-after pill” or any “emergency contraception” is not abortifacient? Or that it merely prevents implantation? In fact, those who say that the “morning-after pill” is not abortifacient but prevents implantation do not realize that they are affirming its abortifacient nature when they say that it prevents implantation: since this action can only take place after fertilization and works by preventing the continued development of the embryo, it can only be abortifacient.

This is so true that, in order to deny its abortifacient action, those who are proposing its use have also had to redefine pregnancy. By calling into question years and years of scientific certitude on the basis of which the period from fertilization to birth has always been defined as “pregnancy”, some now maintain that pregnancy only begins after the embryo’s implantation in the uterine wall, therefore not before the sixth day at the earliest or before the l4th day at the latest. Thus, a product that prevents implantation could not terminate a pregnancy and could not be abortifacient!

Some, of course, are hesitant about this redefinition of pregnancy and, in order not to press the issue, will merely speak of a similarity between an action that prevents implantation and one that is abortifacient: but it is obvious in any case that this semantic manipulation has a precise purpose. In this way—as The New England Journal of Medicine says—it is possible to manipulate public opinion into accepting “emergency contraception”. Merely redefining contraception to include the prevention of implantation does not alter the fact that the prevention of implantation is problematic for some people (NEJM, 1993, 328/5, pp. 354-355).

What has been said by those who maintain that preventing implantation is not abortifacient is denied moreover by E. Beaulieu, who, as the inventor of RU 486, otherwise known as the “abortion pill”, surely cannot be accused of religiously-motivated opinions: “interruption of pregnancy after fertilization can be regarded in the same way as abortion” (“Il punto sull’RU486”, JAMA—Italian ed., 2 [1990], p. 12). A product which prevents implantation is therefore abortifacient.

Then there are those who, while recognizing that the “morning-after pill” is abortifacient, call attention to the fact that in up to 20 per cent of the cases it might also act as a contraceptive: this would only occur if it were taken before the release of the egg cell from the ovary. But is it likely that a woman who for various reasons takes a “morning-after pill” would know what precise point in her cycle she has reached, in order to determine whether the result will be abortifacient or contraceptive? Perhaps she should have an ultrasound to monitor the development of the ovarian follicule and a dose of hormones to predict the moment of ovulation; but this is neither the intention nor a realistic possibility for those who turn eagerly to the “morning-after pill”.

Furthermore, even if it is true that the woman who takes the “morning-after pill” may not be pregnant or that the abortifacient effect will not occur, the woman who requests the pill and the doctor who prescribes or administers it willingly accept the risk of causing an abortion. Indeed, had there been a pregnancy they would have opted precisely for abortion. In other words: we are dealing with a life (or—but we cannot foresee it—the possibility of life), which in any case is not accepted so that there is a readiness to resort to the risk of killing in 80-100 per cent of the cases.

In the recent debate on the “morning-after pill” in particular and on “emergency contraception” in general attention was drawn to only one situation which so many desperate persons are facing these days: violence to women in wartime. But watch out: campaigns for the “morning-after pill” do not only concern war zones and they do not only target women who have been raped.

If we look at what has happened in recent years, we can see certain events which are perhaps little known because they did not deeply. touch the “heartstrings” of human emotion as in the case of sexual aggression, and, one could say, have become part of the everyday life to which we are now accustomed.

Just think that, along with the many calls for all “emergency contraception” to be sold over the counter at pharmacies, that is, without a medical prescription, and to be readily available at all health-care centres for women and particularly for adolescent girls, there are also aid plans which envisage constant, programmed shipments of “emergency contraceptives” to developing countries and refugee camps.

It is in fact a routine practice of family planning organizations to send reproductive emergency kits, not only after a war—which suggests a concern for the woman who has just been raped, although no concern for the baby—but to those places where violent behaviour has not been curbed and so there is a desire to solve the situation in this way. See, for example, what was planned in 1996 for the Great Lakes region in Central Africa: at least $500,000 was allocated to promote reproductive health. The aid package included: family planning; the prevention of so-called unsafe abortions; “emergency contraception” for women who were victims of sexual violence or who had “unprotected” or unplanned sexual relations.

By forcing or tricking women into thinking they are choosing freely, but in fact by violating their personal freedom of choice, some people are working against human life, against women’s dignity and against the rights of the person.

Is a woman really respected when she is led to believe that by taking a “morning-after pill” she will not be killing her child? Is she not instead being reduced to another form of slavery, linked to the ignorance not of those who might not have the opportunity or ability to know, but of those who have been deliberately kept from knowing the truth? Is respect shown for an adolescent’s right to be educated, to know herself and to acquire the ability to earn respect when all assistance is reduced to prescribing and administering the “morning-after pill”?

The right to be educated: yes, because in this case, too, education is the only form of prevention. And to forestall the distribution of “emergency contraception”, women—and men—must be helped to realize the value of every new life called into being, to discover the true meaning and value of sexuality, to understand the meaning of responsible parenthood. This is the only way to go—certainly not that of advertising or dispensing contraceptives.

Abortion cannot be combated with contraception. This is because those who try to prevent pregnancy with barrier methods or hormonal contraceptives—moreover, the latter’s abortifacient action cannot be ruled out—will seek an abortion if contraception fails.

As we have said, the campaign to promote the “morning-after pill” also targets women who have been victims of sexual aggression.

Some have written that, in this case, conception was the result of a violent act, the most cruel, wicked and detestable (would that adjectives could fully express the brutality and inhumanity of this act) that a woman can suffer: refusal to accept the elimination of this life—it is said—would be a sin of insensitivity!

Given that the very idea of eliminating a life, even one that has just been conceived, is in itself an expression of great insensitivity, we would like to reflect on two questions.

The first: do those whose only concern for people who need everything (shelter, food, water, clothes, comfort, identity) is sending them reproductive emergency kits (from the “morning-after pill” to injectable progestogens, etc., etc.) believe they are being sensitive to the human tragedy of war and violence? And how many think that they are resolving the trauma of rape suffered by women by eliminating the “trace” of this violence? The second: does the nature of human life vary according to the circumstances in which it was conceived?

It is a fact that the after-effects of rape will never be erased from a woman’s memory, just as she will never be able to forget that someone treated her as an object, someone attacked her with a brutality unworthy even of animals. But not even abortion will erase this memory: those who suggest it, those who impose it, those who request it, answer violence with violence, not only towards the woman but especially towards the child, whose life should be respected like any other life conceived.

With abortion, wrote John Paul II in Evangelium vitae, n. 58, “the one eliminated is a human being at the very beginning of life. No one more absolutely innocent could be imagined. In no way could this human being ever be considered an aggressor, much less an unjust aggressor! He or she is weak, defenceless, even to the point of lacking that minimal form of defence consisting in the poignant power of a newborn baby’s cries and tears. The unborn child is totally entrusted to the protection and care of the woman carrying him or her in the womb”. Even to think of eliminating this life is thus another act of violence.

For the woman to accept this child growing in her womb, the child of someone who did not love her, can be extremely difficult: she must be given help and support, she and her child must be cared for. She needs affection, not a box of pills!

When the baby is born, the woman will decide whether to keep it or to give it up to others for care. With the one great certainty however: she has not added to that madness of destruction and death which tried in an instant to erase her dignity as a woman, her world, her aspirations, her hopes. In these cases, real understanding for the woman means practical help for her and for the life of her child.

Maria Luisa Di Pietro
Institute of Bioethics,
Catholic University of the Sacred Heart, Rome

Taken from: L’Osservatore Romano Weekly Edition in English 28 July 1999, page 6