Contraception

I've had very few discussions with anyone I know about contraception. I've had some in-depth discussions with some people, but most people I know don't seem to want to raise the issue, and I don't generally bring it up. I know that a number of people in our congregation don't think contraception is a good thing. I'm not sure if they believe it to be morally wrong, but I get the impression that they think it's not a good idea. There are others in the congregation who have little problem with it (for a married couple anyway). We do have a number of large families in the congregation (quite a few with more than six kids, one about to give birth to a ninth, and one who had twelve). I'm not sure the number of children tracks with views on contraception, since most of these families place a high priority on children anyway and see families that our culture sees as large as a good thing and worth pursuing. That's consistent with thinking it's ok to use contraceptives. I do have a feeling more of the larger families are more conservative on the contraception issue, and I've heard a few people making comments here and there that seem to suggest such a view. I've been wanting to record my comments on such matters for a long time, and I'm finally getting around to it now.

First I want to say that I don't like the term 'birth control'. That sounds more like abortion to me. Abortion is preventing birth of someone already there and approaching birth. Contraceptives are intended to prevent pregnancy entirely. When people say they don't think abortion should be used as a form of birth control, they don't think about their words very hard. Abortion is birth control, plan and simple. What they mean is that they don't think abortion should be used because they failed to use contraceptives when they should have. In other words, it's not a fallback method for those irresponsible enough to conceive when they could have avoided it. That's what they mean. Abortion is birth control, no matter how you slice it. Technically, contraceptives are too but they are by being conception control, which is much more precise and therefore, I think, a better term. So I'll call them contraceptives, even if it means awkward formulations.
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I don't think the standard argument against contraception should carry much moral weight. The way I've usually heard it is that you're not trusting God for when he'll give you children if you use any contraceptive method. Some people apply this inconsistently when they use what's called natural family planning. This is the official Roman Catholic position. The idea there is to try to prevent conception by having sex only during infertile times. The intent is the same as using what such people call artificial contraceptives. The idea is to do something that will make conception much less likely. The difference seems to me to be a lot like the difference between deceiving something through saying something false and deceiving someone through saying something extremely misleading but literally true. Either is an attempt to deceive, and how it's done seems irrelevant. If it's not trusting God enough for your children to use a condom or some hormone-altering method to try to prevent conception, then it's not trusting God enough for your children to use natural family planning methods to achieve the same goal. The thing that wouldn't be trusting God enough is the attempt to put off or avoid having children, not the method of doing so.

So that leaves two options. Either trying to prevent conception is always wrong, or it's sometimes ok. The trusting God argument seems to me to fall short of establishing that it's always wrong. The same sort of reasoning lies behind the refusal of medical treatment among the practitioners of Christian Science (i.e. the followers of Mary Baker Glover Patterson Eddy, who have nothing to do with either science or Christianity). They say that you shouldn't use medications, because you're not trusting God with your health. Most Christians have no trouble saying that God gave us the chemical components of medicines and the ability to figure out what they do, and thus medical science itself comes from God. That's a good thing, and we should take advantage of it. I don't know how such a response doesn't also work against those who disagree with contraception.

Another argument is that we should only use methods God gave us and not concoct our own. This is really the Amish reason for avoiding technology. If you take it seriously, you have to avoid a lot more than they do, or else you can't really use it as an argument here, because any argument that allows medicine or computers on the grounds that God gave us the ability to develop such technology for our benefit could also apply to contraception. (Those opposed to cloning in principle for the same kind of reason need to think carefully about how this sort of issue will affect whether cloning could possibly ever be ok or even a good idea, but that's just a teaser for another potential post I might write at some point. The argument against cloning that I hear most, that it's playing God, seems to rule out a lot more than just cloning.)

The only other argument I can think of for why contraception would be wrong in principle is that there's something special about reproduction that isn't true of other medical advances that we might avail ourselves of. Some people think this is true because of God's command to be fruitful and multiply and repeated statements that God opens and closes the womb and has complete control over human life from the very beginning. I don't deny any of that, and I think the very argument assumes God's control, which means he can override any of this stuff if he really wants a conception to occur, but that doesn't necessarily make contraception ok.

Still, I don't see how this is restricted to reproduction. If you're going to say this here you have to say it about other things. It seems pretty clear from the scriptures that God says the same sorts of thing about who is in control of governments and about whether someone's plan to go to a certain city tomorrow will actually happen. Yet in those cases it doesn't serve as an argument not to step in and do something that affects such situations. My not knowing that I will go to a certain city tomorrow means I should be careful in acknowledging that my plans may not bear out, but it doesn't mean not to seek to go there. My knowledge that God had placed Bill Clinton in power didn't give me any grounds against voting against him in 1996 or against speaking against his positions that I disagreed with, just as those who oppose Bush this election have no obligation to endorse him merely because God placed him in his position through his sovereign control over the electorate, constitutional authority over various electoral processes, the arguments in the various court cases in the recount process, and the ultimate thought processes of the members of the Supreme Court. Those who thought something immoral had taken place in that process had every right to express that, and those who like me believe that it went as constitutionally required have no right to say that such discussions shouldn't take place merely on the grounds that Bush came out winning.

Similarly, the fact that God is sovereign over reproductive matters doesn't provide a reason not to investigate whether his sovereign will might include our taking certain actions. We should have good reasons for those actions, which I'll get to in a bit, but if we have good reasons to do things then the fact that he is in control does not undermine such reasons in principle.

Now the one other element of this argument had to do with a command to be fruitful and multiply. I think being fruitful and multiplying is a good thing to do. I think it's a command worth obeying, for those who can. Those who have infertility problems need not avoid trying, though in some cases God has made it physically impossible or nearly so. I don't see that as reason not to pray or not to seek other methods that will perhaps increase the chances of conceiving, and the command can partially be fulfilled through adoption anyway. My main argument here, though, is that being fruitful and multiplying may be perfectly consistent with some contraception at some times. A particularly fertile couple who intend to have many children might realize that spacing their children out more than 10 months is a good thing for simple health reasons. They might then use some contraceptive methods in the intervening times. A temporarily financially-challenged couple might wait until they're a little better off financially to be able to care a little better for their children when they have them. I think this can be an excuse for some people just to avoid responsibility, which isn't exactly a virtuous attitude, but I know a number of people who if they just wait another year or two will be in a much better position to raise children. I'm not sure why that might be immoral.

So those are my arguments why contraception isn't necessarily wrong. I do want to give some reasons I don't like most contraception as it's used. Since I believe sex to be a unitive relation between people that existentially commits each to the other until one of them dies, I don't consider pre-marital sex to be a good thing. I therefore don't like the idea of contraception to allow people to have sex with anyone they feel like having sex with. Even within marriage, though, I have some worries, mostly due to motivation and somewhat due to effects, with one more serious moral issue. I already explained the motivation issues above, and I don't have a good sense how far-ranging, how common, and how severe these might be from person to person. I don't have a lot more to say on this unless I want to write a few more paragraphs, so I'll leave it at that.

The effects issue is important, and a lot of people aren't really aware of these issues. I don't see any effects issues with barrier methods of contraception unless they cause rashes or something, but hormonal contraceptive methods, which include the pill and the patch, can have severely negative effects. They're personality-altering through affecting emotional range and sometimes leading to roller coaster experiences, sometimes leading to severe depression. If you're putting that much hormone-altering stuff into your body, what do you expect? They also can lead to severe weight gain, though this varies from person to person. That doesn't help someone's emotional state either.

As for intrusive devices and such, I wonder if that's any different. Do we even know all the effects of altering someone's cycle in such ways? That's what I worry about. My basic concerns with most of these methods have nothing to do with a moral argument against preventing conception. It's more like my concerns with playing around with the DNA of things we eat. I don't think there's anything wrong with that, no more than playing around with DNA through selective breeding. It's just a faster method. [I should note that my earlier cryptic reference to cloning refers to a similar view. In principle there shouldn't be anything wrong with it once you realize what's really going on. However, we know little about it and its long-term effects, but we do know enough bad things about the proposed methods that it probably shouldn't be done with humans for a long time. I really do intend to save that issue for another post, though, so I'll stop.]

The thing I don't like is that we don't know all the effects of it, and we do know some bad effects of it. That gives some presumption against using such methods, particularly if pursuing health and well-being are important considerations for the moral life (and I think they are).

There's one effect of barrier methods that I don't like. If something is coming between two people having sex, particularly something that affects sensation as condoms do, it not only has some effect on the extent or quality of pleasure but also has some effect on the sense of joining involved in this unifying act. I think one of the primary purposes of sexual connection is to bring two people together in a way that is at the very least symbolic of a deeper unity between two people who are one flesh. Barrier methods reduce the subjective feel of unity that sexual contact can bring when a man's most sensitive organ is immersed within a woman to make intimate contact with her most sensitive organ. There's something incredibly powerful just about the imagery of that, never mind whatever kind of effect it can have on them. Barrier methods reduce that, I think. That doesn't count as an argument against using them, but it does give reason to want to reduce it or avoid it unless there's a really good reason.

Finally, there's one moral concern I have with oral contraceptives and other similar hormonal methods. Not everyone believes a human embryo before implantation has rights or should be a moral concern, but those who do (and most pro-life people, though not all, do) should worry about hormonal contraception, which is designed to prevent conception but isn't limited to that in its effect. Sometimes it fails in its intention of preventing conception, and a sperm and egg will combine. These particular hormonal combinations the way they're administered can prevent implantation at that point. In other words, they have the risk of functioning not just as a contraceptive but as an abortifacient. Most people who take them don't know this. It's not the same morally speaking as taking an abortifacient pill for the purpose of preventing implantation of an already fertilized egg, but it can have that result, and that's something many pro-life people don't want to risk. That's a reason many pro-life people shouldn't be too thrilled about that kind of contraception. [Update: Apparently this isn't so clear. Thanks to Bonnie for pointing this out. The link she posted in the comments no longer works, however.]

I should say something about permanent sterilization. I know someone right know who is going to pursue something like that due to having a third unexpected pregnancy when the first two had many problems, including a couple potentially life-threatening issues. To prevent conception in this kind of situation seems to me to be a good idea and a good use of the abilities God has provided us with. I have a hard time thinking permanent sterilization is the best option if it's not that kind of situation. I know people who have done it, and I don't think they deserve a lot of blame. I just don't know if you can really know that it would be that bad idea ever to have any more kids unless you know there are serious health risks. Others may have a different attitude toward it, but I guess this parallels my conviction that a later you may have a very different attitude toward it than you do right now, which should be an effective argument against tattoos as well (not that most people wanting tattoos think about this). Any permanent effect is something to be very cautious about, and it applies especially when it involves altering one's very body.

All in all, my basic point is that I don't see any absolute argument against contraception, particularly if people are excited to have children if it turns out they do conceive but doing what's in their power to try to achieve better circumstances before they have them. At the same time, I worry about some of the common contraception methods we have developed. Some of them have more serious moral concerns if the pro-life position about embryos is correct. Some have less serious (but more convincing for pro-choice people) concerns having to do with health or reduced unitive elements. I haven't said what I would recommend to anyone as a result. I think different people might agree with pretty much everything I said and still have different views on what the best response might be.

[There was a lively and detailed conversation in the comments of the original post. Some of that seems to me to be productive and allows for some clarifications and a chance to make some further points, so you might find it worth reading. You can find it in the Wayback Machine archive of the original post.]