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The pill and the Christian conscience

Over the counter contraception shows the need for careful Christian reflection

Proposed packaging for Perrigo’s birth control product Opill. Perrigo via Associated Press, file

The pill and the Christian conscience
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For the first time, the FDA has now approved a non-prescription hormone treatment to be made available over the counter for public consumption by women of all ages, including minors. It’s a significant moment to reflect on the resounding impact that contraception has had in shaping the public’s mind about sexuality.

The drug, known as Opill, is a hormonal birth control pill designed (like all hormonal birth control methods) to use synthetic hormones to trick a woman’s body into halting ovulation so it becomes less likely for an egg to be released. However, birth control drugs are also widely held to change the lining of the uterus to make it harder for a fertilized egg to implant, meaning hormonal birth control could have the unintended effect of causing an abortion when the contraception fails to prevent an egg’s release. Despite this, over 99 percent of evangelical women report having used contraception at some point as a method of family planning, the most popular of which is hormonal.

Christian acceptance of birth control hasn’t always been the norm, however. The Anglican Communion condemned artificial contraception in 1908 and 1920 at its Lambeth Conferences. The Southern Baptist Convention resolved in 1934 that widespread access to birth control would be “vicious in character and would prove seriously detrimental to the morals of our nation,” which has proven prophetic, as since that time we’ve seen a rise of divorce, delayed marriage, declining fertility, and even abortion. The predecessor to today’s Presbyterian Church in America (PCA) didn’t officially liberalize on birth control until 1960.

Historically, the church has opposed all forms of contraception, including barrier methods and withdrawal. While Scripture doesn’t explicitly address the issue of contraception, Christians throughout history have read certain passages (namely the passage in Genesis 38 about Onan and Tamar) as being anti-contraception. Christians have also extrapolated from God’s purpose for sex (unity and procreation) and command to “multiply and fill the earth” that intentionally blocking conception aside from abstaining from sex altogether is illicit for Christian practice.

What was once considered a serious moral issue with which all Christians had to contend is largely taken for granted, forgotten, simply not thought about at all.

Church history reflects a trend toward prohibition as well. Augustine says that “intercourse even with one’s legitimate wife is unlawful and wicked where the conception of the offspring is prevented. Onan, the son of Juda, did this and the Lord killed him for it.” Likewise, Calvin declared Onan’s sin as “wickedness … condemned by the Spirit,” saying that contraceptive acts were “rightly seen as an unforgivable crime.” Luther also considered contraceptive sex a “most disgraceful sin … far more atrocious than incest and adultery … a Sodomitic sin.”

Today, evangelical churches, by and large, take no stance on birth control, even as the methods for achieving the avoidance of pregnancy have become more advanced and widespread. Since the 1960s, contraceptive technology has exploded, with the birth control pill approval in 1960, the modern IUD in 1988, the injectable implant in 1990, the NuvaRing in 2001, and the patch in 2002. Few (if any) pastors counsel their congregants to avoid birth control so long as they try to have children at some point, and, according to the statistics, it’s clear that hormonal birth control is the norm for married Christian women.

Today, the issue of contraception within the evangelical church is left up to each couple’s consciences. That may represent a concession to worldly thinking without adequately understanding the radical consequences of severing sex from procreation. But contraception has ceased to be just that: an issue. The Anglican Communion has not mentioned birth control at its Lambeth Conferences since 1931, except to say in 1968 that it encouraged “responsible parenthood” and disagreed with the Roman Catholic position, which condemned all contraceptive practices apart from abstinence. The 2017 Nashville Statement on human sexuality and the PCA’s 2021 Report on Human Sexuality do not mention birth control at all. And no Protestant denomination has contended with the fact that contraception has evolved substantially since the advent of the pill in 1960, even to the point where scientists cannot confirm that hormonal contraceptives do not cause abortions or increase the risk of breast cancer in women who take them.

What was once considered a serious moral issue with which all Christians had to contend is largely taken for granted, forgotten, simply not thought about at all. But as advanced hormonal contraceptives continue to evolve and proliferate, and especially as new drugs are coming to market for over-the-counter use for all ages, including minors, it’s time for Christians to recognize contraception for what it is. Contraception is a deeply complicated moral issue that intentionally frustrates one of God’s intended ends for sex: procreation. The conversation should at least begin there.

Katelyn Walls Shelton

Katelyn Walls Shelton is a Bioethics Fellow at the Paul Ramsey Institute. She is a women’s health policy consultant who previously worked to promote the well-being of women and the unborn at the U.S. Department of Health and Human Services. She graduated from Yale Divinity School and Union University and lives in Washington, D.C., with her husband, John, and their three children.


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