What Is Missing From Our Conversation About the Morning After Pill

On February 21 it was reported that the German Bishops of Trier released a statement announcing that emergency contraception known as the "Morning-after Pill" (MAP) can be used in cases of rape if it does not induce abortion. Politically progressive readers heard this news and rallied around these bishops for conceding to the use of artificial contraceptives. Critics of the bishops jumped at the chance to attack these bishops for the same thing or allowing a pill that does not exist, since the current MAPs on the market are all known abortifacients (abortion-causing). The problem is that hardly anyone is using clear language in this discussion. It seems at times like no one is making necessary distinctions. So, for the sake of shedding light on the matter, educating the masses about authentic Church teaching, and explaining the ethics behind the bishops' decision, I want to explain the components involved.

Church teaching:

Rape is never acceptable.

It does injury to justice and charity. Rape deeply wounds the respect, freedom, and physical and moral integrity to which every person has a right. It causes grave damage that can mark the victim for life. It is always an intrinsically evil act. Graver still is the rape of children committed by parents (incest) or those responsible for the education of the children entrusted to them. (CCC 2356)

Steven Mosher, explains:

In the strictest sense, rape is not a sexual act at all, but is rather a violent assault where the victim has the right to self-defense. To put it bluntly, the rapist has no right to have his sperm fertilize the eggs of the woman he has raped. It is therefore permissible to prevent his sperm from doing so by removing them from the body of a woman who has been thus violated.

Mosher goes on to qualify this statement by saying, "If there were a pill that acted only to prevent conception in cases of rape, then it would be licit to use it." The assumption he is making is that because of certain effects of MAP it prevents use in every case. What the bishops have said is that MAP is acceptable in order to prevent conception without causing abortion. So, breaking it down scientifically, MAP is an abortifacient in as much as it could possibly prevent the implantation of an already conceived embryo, thereby preventing "pregnancy" by medical standards. This would amount to "abortion" by the Church's standards. The Church teaches that life begins at the moment of conception, in other words, at fertilization of the ovum by the sperm. What is present after this moment is a human person and is due all the rights and dignity of a human person. The prevention of the implantation of the embryo is not the only effect of MAP. MAPs can also prevent the ovulation of the ovum so that conception cannot take place. So, MAPs work in two ways, by either preventing ovulation or by preventing implantation. Only one method of contraception out of these two is morally illicit in the case of rape. As Mosher accurately pointed out, the rapist has no right to have his sperm fertilize the eggs. To use the language of Bl. John Paul II's Theology of the Body and Pope Paul VI's Humanae Vitae, the marital act has already been negated by the removal of any unitive meaning in the case of rape and does not require, for that reason, an openness to procreation. Therefore, contracepting by preventing ovulation is not a sin against purity or the Sacrament of Matrimony. MAPs are never acceptable once a woman has ovulated, because of its abortifacient effects. If we can establish that a rape victim has not yet ovulated, an MAP can be acceptably and licitly used to prevent conception.

The proper procedure:

There are a couple different methods by which we can establish whether or not a woman has ovulated. First, practitioners of Natural Family Planning (NFP) keep and monitor certain aspects of a woman's cycle and can, with great accuracy, know when a woman has or is going to ovulate. So, NFPers out there are in a better position to request MAP if the very unfortunate and heinous crime of rape should ever occur. Secondly, knowing the exact date of the start of a woman's last cycle can also help establish the approximate date of ovulation. Ovulation usually occurs within a certain period of time after the start of a woman's cycle. This sort of dating is not as accurate as NFP and the next method I am going to mention is also more accurate and should be preferred over this method. Finally, when a woman ovulates, her body has an accompanying fluctuation in lute inizing hormone (LH). A simple urine test can determine the presence of LH. If LH levels are elevated then it can be established that the victim has ovulated, and it cannot be established whether or not the ovum has yet been fertilized. The National Catholic Bioethics Center (NCBC) has outlined four essential conditions that must be met before administering an MAP. They are:

1. The woman is not already pregnant from prior, freely-chosen sexual activity.
2. The woman has been sexually assaulted.
3. The woman has not yet ovulated (i.e. has not released an egg from her ovary into the fallopian tube where it could be fertilized by the attacker’s sperm).
4. The morning-after pill can reasonably be expected to prevent her from ovulating.

It should also be noted that spermicidal washes are not abortifacient and also permissible in cases of rape. Within just hours of the incident, sperm may have already traveled into the fallopian tubes, and spermicidal washes are limited in their efficacy, further complicated by the duration of time that sperm can survive in the body. Spermicidal washes may prevent further sperm from moving past the cervix. However, even in cases where ovulation has occurred, physicians may deem it appropriate to minimize the chances for conception by administering spermicides. It may even be beneficial to administer a spermicide as early as possible even before determining ovulation, if rape has been established. Therefore, the only condition that must be met for spermicide to be administered is sexual assault.

Concluding thoughts:

The majority of articles on the bishops' statement have not sufficiently made clear the distinction between preventing conception, preventing ovulation, and preventing implantation. The bishops were not wrong in issuing their statement and enforcing Church teaching in response to the unfortunate event that occurred where a rape victim was turned away. Any hospital that refuses to help a victim of such an abominable crime should be ashamed and does not deserve the title of Catholic. Beyond medical procedures, a variety of assistance ought to be offered including counseling and legal advice. The physical, emotional, psychological, and spiritual trauma suffered by sexual assault victims far exceeds anything imaginable. Caring for them is essential to our Catholic identity. So also, however, is caring for the most defenseless person involved, the child conceived through rape. Protecting their rights and dignity is as essential to our Catholic identity as assisting the rape victim. A child conceived be rape is an innocent bystander, and he should never become a “second victim” through abortion. Providing women who conceive a child by rape with full and loving support during and after their pregnancy is also part of our Catholic identity, and the only proper and sensible response to such insensible acts. For more on MAP in cases of rape, click here.