Questions From Readers

◼ Is it compatible with Bible principles for a Christian married couple to use birth control pills?

The Scriptures do not clearly say that Christian couples are obliged to have children or, if they do, how many. Each couple should privately and responsibly determine whether to try to regulate the size of their family. If they agree to practice birth control, their choice of contraceptives is also a personal matter. However, they ought to consider​—in accord with their understanding of the Bible and their conscience—​whether using a certain method would show respect for the sanctity of life.

The Bible indicates that a person’s life begins at conception; the Life-Giver sees the life that has been conceived, “even the embryo” that will thereafter develop in the womb. (Psalm 139:16; Exodus 21:22, 23a; Jeremiah 1:5) Hence, no effort should be made to end a conceived life. To do so would be abortion.

Birth control pills are widely used around the world. How do they prevent childbirth? There are two major types of pills​—the combination pill and the progestin-only pill (minipill). Research has clarified their primary mechanisms for preventing births.

The combination pill contains the hormones estrogen and progestin. According to the U.S. Food and Drug Administration, “the primary mechanism” of the combination pill is “inhibition of ovulation.” It seems that when taken consistently, this type of pill almost always prevents the release of an egg from the ovary. When no egg or ovum is released, conception cannot occur in the Fallopian tubes. While this type of pill may also cause changes in “the endometrium [lining of the womb] (which reduce the likelihood of implantation),” this is considered a secondary mechanism.

In order to reduce side effects, combination pills containing lower doses of estrogen have been developed. Apparently, these low-dose combination pills allow more activity in the ovaries. Dr. Gabriel Bialy, chief of the Contraceptive Development Branch of the National Institutes of Health, says: “The preponderance of scientific evidence indicates that even with the low-estrogen pill, ovulation is blocked, not 100 percent, but most likely around 95 percent. But the mere fact that ovulation occurs is not tantamount to saying that fertilization has occurred.”

If a woman misses taking the combination pill according to its designed schedule, there is an increased possibility that the secondary mechanism will play a role in preventing births. A study of women who missed two of the low-dose pills found that 36 percent had “escape” ovulations. The journal Contraception reports that in such cases the “effects of pills on the endometrium and cervical mucus may continue to provide . . . contraceptive protection.”

What of the other type of pill​—the progestin-only pill (minipill)? Drug Evaluations (1986) reports: “Inhibition of ovulation is not a prominent feature of contraception with progestin-only minipills. These agents cause formation of a thick cervical mucus that is relatively impenetrable to sperm; they may increase tubal transport time and also cause endometrial involution [which would hinder the development of any fertilized ovum].”

Some researchers claim that with the progestin-only pill, “normal ovulation occurs in over 40% of users.” So this pill frequently allows ovulation. The thickened mucus at the cervix may block passage of sperm and thus not permit conception; if not, the hostile environment that the pill creates in the womb might prevent the fertilized ovum from implanting and developing into a child.

It can be appreciated, then, that when used regularly for birth control, both main types of pills seem to prevent conceptions from occurring in most cases and thus are not abortive. However, since the progestin-only pill (minipill) more frequently permits ovulation, there is a greater possibility that it sometimes prevents a birth by interfering with the implantation in the womb of a conceived life that has begun. Scientific studies indicate that normally (with a womb unaffected by birth control pills) “sixty per cent of fertilized eggs are . . . lost before the first missed period.” That this happens, though, is quite different from choosing to use a method of birth control that is more likely to impede implantation of a fertilized ovum.

Hence, there are definite moral aspects to consider if a couple discuss with a physician the matter of using birth control pills. Christians should resolve even private and personal questions so as to maintain a “perfectly clear conscience” before our God and Life-Giver.​—Acts 23:1; Galatians 6:5.

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