Definitions Matter: Pregnancy, Birth Control, Abortion

I see and hear many debates about Birth Control.  Recently the American Academy of Pediatricians recommended that Plan B or "The morning after pill" should be available to teenagers.

This brought about discussions about abortion.  Is Emergency Contraception abortion?  Are any other types of birth control abortive?

That takes us to the question of defining pregnancy.  When is someone technically pregnant?  

It's important to figure out when someone is pregnant, because any action to stop the process prior to that moment wouldn't be called an abortion.

Like condoms.  There may be people or religions that oppose birth control, but I don't think they would call the use of condoms abortion, right?

How about Birth control pills, IUDs, or the morning after pill? 

The answer is not nearly as Black/White as you may think.

Here's a Quick review of the steps of conception:


1. Intercourse : (unprotected) There is sperm in the reproductive tract.
2. Ovulation: An egg from the ovary is released into the fallopian tubes.  This can happen anytime from 1 day before intercourse to 5 days after intercourse and still result in fertilization.
3. Fertilization: Sperm meets egg - they fuse, making a zygote.
4. Implantation: about 5 days after the zygote has formed and started to grow it implants in the uterus, where it will grow and grow until the end of pregnancy.

Any questions?

Most people would say you are pregnant at the moment of fertilization.  There are some who would say you aren't pregnant until implantation because that step doesn't always happen, at which point the zygote never progresses to become a baby.

There are tons and tons of steps between fertilization and delivery.  Which means there are many moments at which things can stop progressing, and a baby will never be born.  There are so many reasons for miscarriage that I won't go into them here.

Back to the topic of Birth Control.

So - I'm assuming that for most people - anything done before fertilization would be defined as contraception and not abortion.  I also assume that for most people anything done after implantation to prevent a baby being born would be defined as abortion.  What about things that work between the two?

Let's look at how the different forms of birth control take their effect.
1. Abstinence - Prevents Steps 1.  No chance at sperm in the tract.
2. Family Planning/Rhythm - It doesn't prevent any step, but tries to avoid fertilization by making sure when ovulation happens there are no sperm present.  (doesn't work well in most cases, but I know few people who have actually made it work)
3. Barriers (condoms, diaphragms etc.)- Prevents Steps 1.  Blocks sperm.  There is no sperm in the tract, no chance at fertilization etc..
4. Hormone methods (the pill, patch, shot, ring) -  Prevents Step 2 (sometimes 3 & 4).  Depending on the hormones they mostly prevent ovulation.  Some also work to prevent fertilization if an egg is present, or to stop implantation once fertilization has occurred.
5. Implantable methods (IUD or subdermal rod in the arm) - Prevents Steps 2,3 & 4.  The rod releases a hormone which occasionally stops ovulation but usually prevents fertilization or implantation.  The IUD comes in two types:
     a. Copper T - Prevents Steps 3 or 4.  There is sperm in the tract and ovulation can happen.  Usually it prevents step 3 by stopping the sperm from ever reaching the egg.  If fertilization does occur, the IUD prevents implantation.
     b. Mirena (hormones) - Prevents steps 2,3 & 4.
6. Sterilization
     a. Female implant in the fallopian tubes - Prevents Stage 3 (fertilization) by never letting the egg and sperm meet.
     b. Surgical (female) #1 - Prevents Step 3 (fertilization) by clamping, cutting, tying, burning or doing all of the above to the fallopian tubes so the egg and sperm can never meet.
     c. Surgical (female) #2 - Prevents Step 2 or 3&4.  If you take out the ovaries, there are no eggs.  If you take out the uterus, there is no chance of fertilization or implantation.
     d. Surgical (male) - Prevents Step 1.  No sperm can make it out of the male, so no chance of the other steps.

Did I miss anything?

SOOOOOO - Now that I've covered all of that.  What does it mean?

Well, for many people I've talked to - this causes a potential problem.  I have many friends who support IUDs but don't support the morning after pill.  (I assume this is because they consider it abortion.)

Here is the problem.  The morning after pill prevents ovulation - so the egg and sperm never meet, there is no zygote, nothing to implant.
(The evidence that the morning after pill prevents fertilization or implantation is pretty iffy.  Most evidence shows that it stops ovulation.)

That means the "Morning After Pill" is no different than taking regular old birth control pills.

IUDs can prevent earlier steps, but they often don't even prevent fertilization, they prevent implantation.  So a zygote is formed, and starts growing, but never implants in the uterus.  (This is especially true with the Copper T.)

Sooooo....

What does it all mean?
NOTE - I am not defining abortion.  I am not telling women what kind of contraception to use.
(Yes, I fully support anyone choosing to use the Copper T. )

The point of this post is education.  Defining abortion is not so easy, because defining pregnancy is not so easy.  So let's calm down and have real discussions about birth control.  Let's talk about what they ACTUALLY do.

Thanks.


P.S. To anyone curious - I am a member of the LDS (Mormon) church.  I don't speak for the church,  my opinions are my own.