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20 September 2010

The 'Personhood' Movement Is Anti-Life: Part 8

By Diana Hsieh

This post is drawn from Ari Armstrong's and my new policy paper: The 'Personhood' Movement Is Anti-Life: Why It Matters that Rights Begin at Birth, Not Conception. I'm currently posting the full paper as a series of blog posts. You can read the full paper in PDF format or HTML format.



The 'Personhood' Movement Is Anti-Life: Why It Matters that Rights Begin at Birth, Not Conception


By Ari Armstrong and Diana Hsieh, Ph.D
A policy paper written for the Coalition for Secular Government (www.SecularGovernment.us)
Published on August 31, 2010



The Destructive Effects of 'Personhood'



...

Bans of Common Birth Control Methods

While the most obvious and severe effect of Amendment 62 and comparable measures would be a total ban on abortion, they would also profoundly affect the day-to-day sex lives of couples by restricting birth control. If a newly fertilized zygote is a person with full legal rights, then any action that prevents a zygote from implanting in the uterus must be considered murder. Thus, if fully implemented, "personhood" measures would ban any form of birth control that could prevent implantation of a zygote, most notably, the birth control pill--the most popular type of birth control--as well as intrauterine devices (IUDs) and "morning after" drugs.

A ban on the birth control pill would affect most sexually-active couples. A report from the Centers for Disease Control shows widespread use of birth control, noting that, as of 2008, 99 percent "of all women who had ever had intercourse had ever used at least one contraceptive method," and 82 percent "had ever used the oral contraceptive pill." The report continues: "The leading current method of contraception in the United States in 2006-2008 was the oral contraceptive pill. It was currently being used by 10.7 million women aged 15-44 years."[94]

The reason for the pill's popularity is not difficult to fathom; it is not only easy to use but also highly reliable. With "perfect use," the pill is more effective than sterilization and condom use, the second and third most popular forms of birth control; only 0.3 percent of women on the pill experience an unwanted pregnancy within the first year of use, compared to 0.5 percent for sterilization and 2.0 percent for condoms.[95] So women forced to switch from the birth control pill to condom use due to Amendment 62 would, given perfect use, experience around seven times the number of unintended pregnancies. Although effective, sterilization is surgically invasive and permanent, and it exposes women to an increased risk of ectopic pregnancy and other problems.[96] Amendment 62 would require many thousands of women to scramble to find a new method of birth control, yet none is likely to be as convenient and effective as the pill.

Personhood Colorado endorses laws permitting only birth control "that prevents conception," understood as "the union of a sperm and an egg." Forms of birth control that instead result in the destruction of a zygote should be called "abortifacients," not contraception, the organization holds. "Barrier methods of contraception that prevent the union of the sperm and the egg will not be outlawed," the group states, and presumably the same logic holds for sterilization, but other forms of birth control would be banned.[97]

How would birth control pills, IUDs, and "morning after" drugs violate "personhood" laws?

While most often the pill acts to prevent fertilization, sometimes it can prevent a zygote from implanting in the uterus. The manufacturers of the popular birth control pills Ortho Tri-Cyclen(R) and Trinessa(R) state in their prescription information:
Combination oral contraceptives act by suppression of gonadotropins [hormones]. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium [the lining of the uterus] (which reduce the likelihood of implantation).[98]
Due to this potential for harm to zygotes, the birth control pill used by so many couples would have to be outlawed under "personhood" laws.

The IUD Mirena(R) also causes "alteration of the endometrium" and may "thin the lining of your uterus," which may inhibit implantation; moreover, the device may threaten pregnancies that do occur. The device is relatively effective at preventing unwanted pregnancy: "The reported 12-month pregnancy rates were less than or equal to 0.2 per 100 women (0.2%) and the cumulative 5-year pregnancy rate was approximately 0.7 per 100 women (0.7%)." (The device is intended for use for up to five years.) However, if the device fails the consequences can be serious. "Up to half of pregnancies that occur with Mirena in place are ectopic." Moreover: "Severe infection, miscarriage, premature delivery, and even death can occur with pregnancies that continue with an intrauterine device (IUD). Because of this, your health care provider may try to remove Mirena, even though removing it may cause a miscarriage."[99]

These facts have two main implications vis-a-vis "personhood" laws. First, because the IUD may prevent a zygote from implanting and may threaten a pregnancy if it does occur, the device should be banned, according to the logic of the measure. (A device that threatened the lives of up to half of all born infants, as the IUD does for zygotes by increasing the risk of ectopic pregnancy, would be banned as a public health menace.) Second, many women already use the IUD, and some might continue to use it (legally or illegally) after passage of a "personhood" law. In such cases, if pregnancy occurred a woman's doctor would face the threat of criminal prosecution for unduly threatening the life of the embryo. Because a doctor might damage an embryo either by removing the IUD or leaving it in place, some doctors might simply choose not to treat patients with IUDs and save themselves the associated legal risks.

Emergency contraception (or "morning after" drugs) also may prevent implantation of the zygote. The FDA discusses a common brand:
Plan B works like other birth control pills to prevent pregnancy. Plan B acts primarily by stopping the release of an egg from the ovary (ovulation). It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation).[100]
The FDA approved the new prescription emergency contraception drug "ella" on August 13, 2010. A representative of the drug's manufacturer said, "We are clearly in the realm of contraception. We're not in the realm of pregnancy termination."[101] However, the FDA states, "It is possible that ella may also work by preventing attachment (implantation) to the uterus."[102] Hence, Gene Rudd, senior vice president of the Christian Medical and Dental Associations, told American Medical News, "There will be plenty of doctors who won't provide the drug because it probably does cause abortion."[103]

Many religious opponents of abortion welcome the prospect that Amendment 62 and similar measures would ban the birth control pill, IUD, and "morning after" pill. They accept the logical implications of their belief that fertilization creates a human person with full rights, as seen in the following articles. In 2008 the Wall Street Journal reported:
The Bush Administration has ignited a furor with a proposed definition of pregnancy that has the effect of classifying some of the most widely used methods of contraception as abortion.

A draft regulation, still being revised and debated, treats most birth-control pills and intrauterine devices as abortion because they can work by preventing fertilized eggs from implanting in the uterus. The regulation considers that destroying "the life of a human being." ...

With its expansive definitions, the draft bolsters a key goal of the religious right: to give single-cell fertilized eggs full rights by defining them as legal people--or, as some activists put it, "the tiniest boys and girls."[104]
ProLife.com, which advocates "ending abortion," hosts an article by J. T. Flynn which begins, "Physicians across America--and around the world--are now confirming that the Pill, IUDs, Depo-Provera and Norplant cause early abortions."[105]

Dr. Walter Larimore considered the "postfertilization effect" of the birth control pill, and he decided on religious grounds to stop prescribing it:
Finally, after many months of debate and prayer, I decided in 1998 to no longer prescribe the Pill. As a family physician, my career has been committed to family care from conception to death. Since the evidence indicated to me that the Pill could have a postfertilization effect, I felt I could no longer, in good conscience, prescribe it...[106]
To put the possible "postfertilization effect" of birth control methods in perspective, consider that natural or spontaneous abortion is a routine occurrence. Many zygotes fail to implant, and they are flushed out of a woman's body. Due to the difficulty of detecting when a woman's body rejects a zygote, estimates of prevalence range widely. One researcher summarizes, "In humans, it has been estimated that between 30% and 70% of conceptuses are lost before or at the time of implantation, without women being aware that they were pregnant."[107] Even after a woman becomes pregnant with the implantation of the embryo, the risks of losing the embryo by natural causes still hover around 10 to 25 percent.[108] Moreover, as William Saletan observes for Slate, activities that may inhibit implantation include breast feeding, drinking coffee, and exercising.[109] Hence, nature is by far the greatest cause of death for zygotes and embryos. Yet notice that such natural deaths are not lamented, nor regarded as a public health crisis--not even by those who think of the embryos as persons. In essence, "personhood" measures would ban forms of birth control that mimic the body's natural processes.

If a newly fertilized zygote is a person, then birth control that blocks implantation even sometimes must be outlawed, with its use and distribution criminally penalized. The same would apply to any medication that might harm a zygote, regardless of the costs in pain and suffering to women. "Personhood" laws would thus profoundly impact the reproductive lives of women even before implantation, the common marker of the beginning of pregnancy.

Read the full paper in PDF format or HTML format.

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