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Emergency Contraception at Catholic Institutions: Bishops Can No Longer Claim Ignorance

Plan B Abortifacient Contraceptive
Photo courtesy of Mike Mozart.

The February 2015 Linacre Quarterly (the official journal of the Catholic Medical Association) features a groundbreaking study by Chris Kahlenborn, MD of The Polycarp Research Institute titled Mechanism of action of levonorgestrel emergency contraception. The study, contrasting the theoretical basis on which emergency contraception (otherwise known as “Plan B”) is claimed to function with the facts and statistics of the most recent research outlining the mechanism by which they cause early abortions, is sure to cause heartburn among Catholic bishops and ethicists who, based on scientific thought and bioethics theories several decades old, continue to permit their use in Catholic institutions.

The study’s abstract lays out the serious nature of the debate right up front:

… Proponents of LNG-EC have argued that they have moral certitude that LNG-EC works via a non-abortifacient mechanism of action, and claim that all the major scientific and medical data consistently support this hypothesis. However, newer medical data serve to undermine the consistency of the non-abortifacient hypothesis and instead support the hypothesis that preovulatory administration of LNG-EC has significant potential to work via abortion. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room protocols.

I interviewed Dr. Kahlenborn about his study for 1P5 via phone and email correspondence:

1P5: Dr. Chris, can you give us a quick overview of the study and its findings?

Chris Kahlenborn, MD: Our article is a review of the most recent medical data to date, which strongly support the assertion that Plan B is an abortifacient, especially when given prior to ovulation.   Two other recent papers also strongly support an abortifacient method of action of LNG-EC (Peck et al, 2013 and Raviele, 2014).  Simply put, the evidence supporting an abortifacient effect of LNG-EC is clearer and more compelling than ever before.  Certainly any claim of “moral certainty” regarding a non-abortifacient method of action no longer has credibility.  Indeed, given the strength of the most recent evidence, the nomenclature of emergency contraception should be changed to emergency contraception/abortion and this should be reflected in Catholic/pro-life and the secular literature as soon as possible.

1P5: Does Plan B ever act as a contraceptive?

Chris Kahlenborn, MD: Ideally, Plan B should be named emergency abortion/contraception instead of emergency contraception, because it has high potential of working as an abortifacient when given prior to ovulation.  We noted in our paper that when given prior to ovulation, Plan B frequently allows ovulation to occur and has no major impact on sperm flow or quality, yet one does not see any evidence of clinical pregnancy.  If both sperm and an egg are present and one does not see evidence of clinical pregnancy, then abortion is the most likely mechanism of action.  In the minority of cases, when Plan B truly stops ovulation, it likely works via a contraceptive method.

1P5: Your paper goes into great depth regarding the issue of when Plan B is taken, including the fact that taking it on the day of ovulation essentially renders Plan B completely ineffective.

Chris Kahlenborn, MD: Yes, it appears to be useless or actually may increase a woman’s risk of getting pregnant when taken on or after the day of ovulation, according to the data presented by Dr. Noe in her 2010 and 2011 studies (Contraception).  Other leading researchers such as Dr. Trussell and Davidoff also raise this very real possibility: “it even raises the counter-intuitive but undocumented possibility that Plan B used after ovulation might actually prevent the loss of at least some of the 40% of fertilized ova that ordinarily fail spontaneously to implant or to survive after implantation.” (JAMA, October, 2006).   In practical terms this means that while Plan B likely often works by abortion if given prior to ovulation, it has either no efficacy or actually could have a pregnancy enhancing effect if given on the day of ovulation or after.

1P5: What is the history behind the Church’s position on emergency contraception?

Chris Kahlenborn, MD: In 1995, then Bishop Myers, accepted what is known today as the “Peoria Protocol,” which, in a nutshell, states that it is okay to give Plan B to women who have been raped if it is given prior to ovulation, since it is based upon the assumption that Plan B consistently stops ovulation in this phase – which it clearly does not, as noted by the most recent research and even admitted to by the most notorious Plan B advocates/researchers (eg, Horacio Croxatto, MD and James Trussel, PhD).

Many Bishops have accepted this protocol while others have remained skeptical.  Unfortunately, we now know from several large studies such as that of Dr. Croxatto (Contraception, 2004), that Plan B does not consistently stop ovulation.  Therefore, the entire Peoria Protocol is based on a faulty premise.

For years now, liberal theologians have given liberal Bishops the cover they need to permit this faulty protocol. In this age where so many Bishops are afraid to stand up for the Church’s harder teachings, it’s hard to believe that they will stand up based on the findings of our paper, especially since the press will try to paint courageous Bishops as “endorsing rape.”  But with the publication of this paper there is now something different.  Now, it is no longer a question of theology — actually it never was — but a simple matter of the science supporting an abortifacient mechanism of action.

1P5: Does this mean that Catholic hospitals who currently allow Plan B or other emergency contraception are allowing abortions to occur? 

Chris Kahlenborn, MD: The answer to this is almost certainly yes, and I say “almost certainly” because at this point in time it is difficult to measure the frequency of abortions, given the small size of the embryo when he or she dies in utero.

Obviously, this is a big, big problem….I mean, could the Devil be any happier?  Catholic hospitals allowing abortions?  If Catholic hospitals continue to allow this, given this overwhelming evidence, are they still Catholic?

Originally published on February 24, 2015.

35 thoughts on “Emergency Contraception at Catholic Institutions: Bishops Can No Longer Claim Ignorance”

  1. In spite of the fact that I know that bishops have allowed doctors to attempt to prevent the ovulation in rape victims, I have never been able to reconcile in my mind that this is not a violation of the universal prohibition of contraception by the Catholic Church which describes contraception as doing anything before during or after sexual intercourse for the purpose of preventing pregnancy.

    • Were it possible to prevent fertilization or ovulation without also producing the possibility of effecting the abortion of an already formed zygote, then it would be morally permissible in the case of rape (though abortion could never be permissible). While such a method would, as you say, prevent pregnancy, and would therefore be contraceptive, the Church’s proscription of contraception is not in fact “universal” (if, by that, you mean applicable to every theoretically possible case), because Her teaching assumes that the sexual act in question is consensual. The basis of doctrinal objection to contraception is that, by it, man seeks to introduce an artificial separation between sex and reproduction, so that he may seek the prior while refusing the later. In the case of rape, the woman seeks neither reproduction nor sex; both are potentially forced upon her, against her will. In this case, contraception, if possible, is permissible (be it before, during, or after the rape). Just as it is morally legitimate for a woman to choose to employ violence to resist the sexual act of the rape, it is also morally legitimate for her to employ means of preventing the reproductive component of the rape, so long as those means are not abortifacient (as the taking of an innocent life, for any reason, is intrinsically evil, and can never be justified).
      The issue highlighted by this article, of course, is that there exists very substantial possibility (even likelihood) that the most common means by which people currently seek to effect contraception following a rape, actually causes abortion (at least some of the time), which would render such means unacceptable.
      Hope that helps!

  2. What you are explaining is exactly the teaching I do not agree with.
    I think the teaching is wrong. This moral theology decision was based on the precedent of bishops allowing nuns to use internal devices to prevent pregnancy during a war in case they were raped. I also think that decision was wrong. I think a woman can resist as much as possible but I do not think it is allowable morally to do something to prevent conception after the act has taken place.
    Another problem with this teaching is that when it comes to deciding which women were actually raped , even if the medication were to only prevent ovulation, the physician would have to make a judgment that sometimes takes a court years to decide, or give the medication to any woman who claimed to be raped. In my opinion this decision by the bishops is erroneous. JMJT

    • Actually, my understanding is that we were NOT talking about any kind of internal device, but rather a hormonal contraceptive that does precisely what was talked about – prevents ovulation. The assumed precedent is incorrect, based on the moral theologians who have looked most at the case. Regarding your view on the decision, though, I would ask when is a woman to stop resisting? Once a man penetrates her? Her egg is still her DNA, and the rapist’s sperm is still his DNA; the two have not in any way become one. It would be morally permissible to keep that from happening in the non-consensual case of rape. Once it happens, though, then we have conception and a new living, innocent human being, which we are charged to guard. I’m not throwing stones, but I would simply ask you to consider where you draw the line, because there are very few objective places to draw it, but many subjective ones.

      • I continue to disagree with the permissibility of preventing conception after rape. I do not believe that different norms exist for preventing conception after sexual intercourse by an unknown rapist, by a drunken spouse whom the wife refused, by a live in partner whom the woman refused, or even by a date rapist. I believe that contraception is wrong in all cases.

        • Understood. Contra (against) conception (self-explanatory). The Church’s teaching agrees with that, but you did not answer my question, please. When does the woman stop fighting her rapist – penetration, his ejaculation, etc.? I’m honestly just trying to understand whether you are going to point to an objectively observed point or draw an arbitrary line somewhere. I’ve given my motive away there, but it’s still a relevant question. I’m glad you feel strongly; we should all be passionate about the faith, especially regarding the right to life itself.

          I tend toward your line of thought, as well, but I understand why the Church holds the position that she does in this instance.

          • I am not sure I understand the question about resisting the rapist but if it is simply when to stop resisting the short answer would be when she is completely overpowered.
            I do not think this “position” by the church is universally held, nor infallible. There is good argument that it contradicts the constant teaching of the church on the intrinsic evil ( always evil regardless of circumstances) of contraception.
            I knew that some Catholic nurses in ER situations refused to administer medication to prevent conception after rape, even though it was the protocol of the Catholic Hospital, and I have known of priests who apparently did not agree with this
            “position” either.

          • Agreed – there is no “position” by the Church on this. “overpowered” makes sense, though it may be a bit nebulous, overpowered meaning that there is nothing left one can do, though many have considered preventing ovulation to be something that could be done, hence not leaving them powerless. Essentially, though, it seems as though this article by Steve, and the new evidence of an abortifacient action in the Plan B pill makes most of the argument null.

            If this was all published a year ago, why weren’t many paying attention then, since it pretty much eliminates the arguments made by so many regarding the nuns in the Congo, the nuns in the Balkans, etc.? Of course, those with reason would already have agreed that none of this had to do with Zika in any way at all. There is far too much confusion out there.

          • Yes , there is still something else one can do after being overpowered and inseminated by a rapist, and that is to then prevent ovulation if this were possible without using a substance which would not also cause and early abortion…but I do not believe that even this possible means of preventing conception would be without grave sin. The reason I think this is because all acts of sexual intercourse are used by God for procreation, and no matter how misused the “marital” act is, the preventing of conception is forbidden. In the case of rape, one must try to prevent the sinful act, but after insemination, the act is completed , and to do anything else to prevent the possible procreative consequence of the sexual act would be some variety of contraception, and therefore gravely sinful.

          • So what would you have told those four Yazidi preteen and teen sisters who were taken by ISIS and used as sex slaves. The girls could not stand to be victims of psychos, thus, they all went hand in hand to the edge of a cliff and killed themselves together, rather than having to serve at least a dozen men each day. Their mother I am sure must have gone insane knowing that, 1) her girls were being used by rapists and violated in a heinous and downright demonic manner, and 2) that violence on their body, mind and soul led them to take their own lives to avoid being used in a demonic manner. And you would deign to tell them that it was God’s will that they be raped? What kind of God do you believe in…allah? Surely not the most merciful and loving of all.

          • Sin does not come from God nor does he will evil.
            Evil came into the world because man did not listen to God but to Satan. Some “religions” beliefs are not from God. God forbids sexual activity outside of heterosexual marriage but God allows us to use our free wills to choose choose God. Our reward for this obedience to God is eternal happiness with him. Our punishment for grave unrepented sin is eternal damnation.
            When applied to the question of whether to allow contraception, which does not prevent rape itself , to prevent pregnancy from occurring, the rationale is that God forbids contraception because the conjugal act is a procreative act, and God apparently prefers procreation to the interference with the biological consequences of the forbidden rape because the conjugal act is apparently important to Him as the means He uses to call more human beings into existence and ultimately to eternal happiness with him.
            It is a pity that “religions” advocating rape and killing of those who refuse to convert are allowed to continue.

          • This is sleight of hand. When the woman contracepts, she is no longer fighting the rapist. She is contracepting – she working towards the prevention of life.

            You can liken it to someone who thinks she might be raped by this man so proceeds to kill the man to stop it from happening.

            There is a story of this admirable woman (I think she is Dutch) who was made a comfort women by the Japanese in Singapore. Every time she conceived from the constant rape, she would hide it so that she would not be forced to abort the baby. But all the time she gets found out and they would forced her to have a pill so that she will lost the life in her womb.

            As I mentioned in another post, rape is certainly an evil act.

            But is the creation of life an evil act? Is life not good? Once we say that we must prevent life that is born of rape, then there is no reason not to kill that life that we say should have been prevented.

            The life that is formed after rape is probably the only good thing that comes out of it.

          • “The life that is formed after rape is probably the only good thing that comes out of it”.——-Fail to see how a psycho’s DNA which resulted from 1,400 years of inbreeding could bring about the ideal life you claim always happens when a sperm does its thing.
            Further, from just a common sense/rational point of view, God has given men millions of sperm, whereas women only have around 400 eggs…a hugh difference in my opinion. I have always felt that quality is preferable to quantity, no matter if you are speaking of material goods, money, or having children for that matter. It seems to me that the blessed mother chose to have only one child, for quality was infinitely better than quantity.

          • Ergo, according to you the child conceived in rape is sub-human and are of less quality.
            Your reasoning is sick.

          • Per usual, Cory puts her/his own spin on a topic after NOT reading what a commenter said. I suggest you read again C.
            I was referring to the thousands of rapes by moes now going on in Europe, Australia, Canada, the middle east— the very rapes that the pope disregards while praising Islam as peaceful.

            It is high time you do some studying on not just the so called religion of Islime/NOT, but the inbreeding which has gone on for 1,400 years. What part of that do you not understand, or does it not bother you what incest/inbreeding does to mental faculties.
            The real subhuman is not the baby who didn’t ask to be born, but the perp/rapist/sicko which you’re defending..your type of thinking is more than subhuman….it’s downright godless.

          • It is you who do not know how to read. Or maybe you just don’t get logic.

            All these rapes that you are referring to from which comes a child: So what are these children? Are they somehow sub-human because their father is a rapist? Are they somehow less than human because their rapist father is a Muslim?

            You are really sick if you think that.

            And the father who is a rapist is not sub-human. They remain human beings. Evil yes. But human beings none the less.
            And if you think that the rapist father is sub-human, would not that sub-human dna be passed on to the child?

            You really are cuckoo if you think that.

      • Fr Ken,
        What you have written here is so much mental gymnastics.
        No one ever questioned whether the woman’s egg is hers or the rapist’s sperm is his. But ultimately, the life that is formed when the 2 meet is God’s.
        If we believe that everyone is a thought of God and that one’s life was authored by God, then it was God who desired that the egg and sperm shall meet and become one. If we prevent that wilfully, then we are saying to God “Non Serviam”.

        • Talk about mental gymnastics…’then it was God who desired that the egg and sperm shall meet and become one’. Oh really??? If that is the case, then I take it that rape means nothing at all. And what if it is a girl who has been raped by her father, brother or uncle…is this God’s will too? This happens 24/7 in Islime and I fail to see that the God we believe in, would say ‘no prob kiddos, all is good..doesn’t matter if the mother conceives and has to spend the next 20 years of her life dealing with a potential psycho who has the bad DNA from 1,400 years of inbreeding.
          Now you are starting to sound like la papa who tells us that all is good….don’t judge gays..and you tell us now not to judge a rapist and the violence done to the woman. What makes anyone think the violence might in fact, extend for 20 years for the woman if the psycho rapist carries psycho genes? It truly takes more than mental gymnastics and a spin to believe that God does in fact, endorse any/all pregnancies, no matter who the perp is, or how much the woman suffers for a couple decades?
          And why should it matter to any male, as they are not the ones who have to carry the child, give birth to that child and take care of it for at least 18 years….so easy to talk the talk when you don’t have to walk the walk. I seriously doubt that God wants a woman to be the victim of incest or rape, and if He does, I question the mercy of such a God that enjoys inflicting suffering/violence in any way possible to victims.

          • Rape is evil. But since when has the creation of life been evil?
            If life is evil, so are you. The circumstances by which we are conceived does not make one evil. Our deeds and thoughts is what makes us evil.

          • The creation of life in the setting the good Lord intended is never evil. What is evil are those who think that women should be a rapist’s victim, be he a Hitler type or a drug fueled savage with inbred genes from 1,400 yrs.
            Hitler would have adored you for agreeing with him that women should be willing victims for madmen, be they dictators or garden variety rapists.
            As for the circumstance which one is conceived does not make one evil, I concur…no child asks to be born. So with that self evident truth that being born does not equate to being evil, perhaps you can explain why the church would not baptize me as a baby, as I was born out of wedlock?
            Seems to me that your favorite buds/ clergy would beg to differ with you.
            I would hope that such evil thinking is no longer going on, but not holding my breath on that seeing the evil now emanating now from the Vatican.

          • The creation of life in the natural manner is never EVIL period – regardless of whether that happened through rape. Human Life is good. No ifs or buts.

          • As usual like most liberals I know you fail to see what I wrote or to address the salient fact that priests decades ago would not baptize a child who was the result of being born out of wedlock.
            So now you tell me that it is the kid’s fault if they were born and the church being downright dogmatic much like you was the final judge of who can be baptized…all sheer poppycock in my book!
            Nowhere did I say I was the result of rape, so why in your remark do you bring up rape….I get the sense you don’t read that well.

          • I did not address the other bits about your dribble because they were irrelevant. You like going on and on, blah blah blah, regardless of whether the thought cavorting in your brain is pertinent to the subject at hand.

            And here you go again with “Nowhere did I say I was the result of rape”.

            Nowhere did I imply you were.

            As for why I brought up rape, well my dear if you will actually read before you jump in, THAT IS THE TOPIC!! The article is about emergency contraception in the case of rape and so is the discussion!!!

          • And you don’t think that rape cannot result in a pregnancy to an unwed mother..and then the church can deny that baby baptism as it was not conceived in wedlock? Oh really?? So what I hear you saying is that rape should never be interfered with as it gives new life, even if it is the product of defective DNA from 1,400 years of inbreeding/incest and was violently imposed on a woman without her consent and will, BUT although this takes precedence over the women’s psychic, physical and emotional wellbeing, the church still has a right to deny the baby baptism?

            This is crazy and reminds me of when I attended an all girls catholic college decades ago. The senior president and all A student was pregnant in her senior year, at which point, the school told her she would not be allowed to graduate. So you tell me why the school had a right to deny her graduation due to her pregnancy or would she have been better off by aborting so that the school never knew, hence she could have graduated.

            There is something nefarious going on, when a woman who is victim of violence/rape is told she MUST carry that baby, but then the church determines the baby not being born within a marriage has no right to be baptized…and then with the female student who was going to be married after graduation but found herself pregnant before the wedding was denounced as some sort of whore by the church. Just who in the hell has any right to play God, other than God, and who are you or anyone else possessing the right to tell anyone they are defying God if they refuse to be a victim. It seems to me that your outlook is uncannily much like that of Islime where women are always given the shaft by judges.

            It is in fact, you who are irrational when you set yourself up as a judge greater than God Himself and make arbitrary judgments for which you are not obviously equipped. Are you sure you are not sister to some Saudi..they seem to hate women as much as you do…and also judge them bigtime. And in fact, they give legitimacy to being violent with women on the basis that women are LESS than men, hence no soul.


  3. Given Pope Francis/Fr. Lombardi utterances on contraception, the confusion in Church teaching on contraception seem to have risen from considering contraception in the face of the threat of rape or contraception after rape to prevent conception, thus giving the impression that there is exception to Church Teaching regarding contraception being an intrinsic evil.
    I belive a post tackling this will be of great help.

  4. The first time I heard about the nuns being allowed by some bishops to use contraceptives was in the 1980’s and I do not know in which country or when this occurred, but it was not pills, but diaphragms they were wearing to prevent pregnancy in case of rape. This became the precedent for the use of medications in Catholic Hospital ER’s to prevent ovulation. There was an article to this effect in the early 2000’s by Msgr. Smith, a USA moral theologian who taught in NYC and is now deceased. I think the article appeared in a diocesan newspaper, probably from NYC or Arlington, VA.
    There are 2 points that also have not been mentioned as far as I know, and that is that if some Bishops also allowed pills to be used when they became available, the early birth control pills prevented ovulation. The second point is that I asked the priest teaching our class why not the lay women and only the nuns were permitted to wear the diaphragms, and his answer was that it was on account of their vows, and the fact that they were nuns. I could not help but think, “Sorry sisters, but we are all in this together.” ..In a rare prudent moment, I refrained from offering this comment.

    • “[…] and his answer was that it was on account of their vows, and the fact that they were nuns.”
      Ridiculous! Do they even mull over what they say before they say it?

  5. A few questions for consideration. What does the Church say to people who have conceived via rape? Does She not, with all compassion and charity, tell them that God is the author of All life, human and Divine? And that God would not have permitted this child to be conceived if it were not His Loving response to the violence that they suffered? That this is His Holy way of making straight the crooked line, by bestowing the blessing of a child on them to love, which will heal the violence that they have suffered? That He is blessing them and giving them Hope for the future, including eternal life for them and their child? That He can and is bringing about His willed good through an evil that man has done?

    Yes, that is what She says, for it is the absolute Truth.

    So, is it for man to decide when God will bestow His blessing?

    Is it for man to tell God No?

    Are we to believe that God does not directly will every Human life into existence?

    Are we to, now, occasionally, accept the clockwork theology of the Deity?

    Are we, now, being asked to abandon redemptive suffering?

    Are we, now, being called to reject the Cross as the Divine remedy for Evil?

    Are we, now, being required to hold a negative prejudice, or allow for it, towards certain conditions of human life being willed by God, a priori, to conception?

    And all based on theological speculation, that at least, appears to ignore all of the above?

    And please, let know one explain the difference between willful consent to sexual intercourse and rape to me. I am not unaware of the ‘logic’ behind the argument for allowing contraception as a contraceptive for cases of rape. I am simply posing some questions that do not appear to have been admitted to the argument in the first place. I’m simply saying that there may very well be a false premise at work here in the ‘logic’ employed by the many to justify contraception as a contraceptive and not as a therapeutic remedy for some other ailment that requires sexual abstinence while it is being employed.

    • One way they argue for one such ‘logic’ is by restricting the meaning of the “conjugal/marital act” to be the “sexual act between spouses” when it also means “the sexual act reserved for marriage”.

    • Bravo Father!
      This is exactly what I have been saying in all these contraception debates. Contraception is contraception is contraception.
      We delude ourselves if we somehow think that something that is intrinsically evil somehow becomes a good.

      Bishops and bishops conferences who have argued and taught otherwise are nothing more than wolves in sheep’s clothing. It is all mental gymnastics to avoid the truth.


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