Camilla Hersh: Birth control facts and fallacies

WORLD Magazine’s Jan. 23 issue includes an interview with Dr. Camilla Hersh, a board member of the American Association of Pro-Life Obstetricians and Gynecologists. Here are additional questions and answers concerning birth control.

What about long-acting forms of birth control, which are sold as ways to make abortion rare? Probably most are morally neutral. There is a device called Nexplanon, which is a matchstick-size plastic silicone material that is slipped under the skin and it lasts for three years. For the first two and half years, it generally blocks ovulation. In the last half a year, it does look like the ovaries wake up and they ovulate and then we worry about whether its action at that point is more from the effect of the progesterone on the lining of the uterus, too thin for the baby to implant, or from the effect of the mucus that acts like a plug. If someone is thinking of that, I tell them to think of changing after two years. Waiting for that third year you may miscarry some children. Most people want to avoid pregnancy by not getting pregnant in the first place and avoiding a miscarriage.

Sperm blockers? There are a number of intruder devices. Some are simply a piece of plastic wrapped with copper. Some are a piece of plastic embedded with a type of progesterone. They work as a biological spermicide for the most part. If you look at an IUD that’s been in a uterus, sometimes one has lost the little string and we have to go into the uterus with a camera and look around and find it. So the IUD is surrounded by white blood cells. Think of it like a large splinter. You know you’ve had a splinter in your finger and you can tell there’s pus because it’s yellow and weird. It works as a biological spermicide, which kills the sperm. Occasionally very valiant sperm gets past the red raw environment inside the uterus and occasionally conception can occur, but the little fertilized embryo has no safe place to implant, so it passes as a very early miscarriage.

Is there a moral problem here? An intruder device with progesterone works mainly as a biological spermicide. But because they have progesterone they make the lining of the uterus thinner and they also make the cervical mucus thicker and act like a barrier. People discuss the abortifacient factor. I think it’s too hard to figure out so I don’t participate in the use of those. When I describe the whole splinter and pus thing, people decide on something else. Even if you didn’t care about life issues, many of our illnesses relate to chronic inflammation, so medically it’s not a good idea purposefully to put a chronic inflammation in your body.

Do you see a link between birth control in general and breast cancer? No. A study in the 1960s showed a link, but the dose of birth control pills then was eight times higher and there was a rather high incidence of heart attack, blood clots, stroke. In the studies done since then, there hasn’t been shown an increase.

Do women who come to you for birth control care whether the particular method can cause abortion? I think two-thirds do not care. I softly help them understand their bodies and I say, “Let’s talk about all the methods there are. You can use time as a barrier—natural family planning. You can use a physical barrier. You can use a medication that stops you from ovulating. You can have an implant that stops you from ovulating for a couple of years—but you can’t change your mind that easily. We have to make an incision and cut it out of you.” Everyone is shocked and very much upset that they should have an incision to remove it. They often have luscious tattoos and I go, “You can’t tell me you’re afraid of needles if you’re covered in tattoos.” But I keep my face plain and talk to them about the pus and the splinter, and no one wants that. One of my roles is to help everyone, regardless if they’ve thought much about life issues, to understand their body better. Good medicine is also pro-life.

Over five days, Jan. 18-22, WORLD’s website is running other responses from Dr. Hersh.