Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent.

     A groundbreaking study was published in the February 2000 edition of Archives of Family Medicine entitled "Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent." This study has far reaching ramifications for all pro-life individuals who believe life begins at conception, as well as the health care professionals who treat them.

     According to the authors, while the primary mechanism of oral contraceptives (OC's) is to inhibit ovulation, breakthrough ovulation (release of an egg) does occur. Analyzing journal articles on OC's published since 1970, they found breakthrough ovulation occurs between 1.7% to 28.6% for combination OC's and from 33% to 65% for progesterone only OC's.

     The authors show that OC's maintain a high effective rate by "postfertilization effects," which come into play after an egg is released and is fertilized. According to the authors, postfertilization effects involve one or more of the following: "(1) A postfertilization preimplantation effect would consist of a slower transport of the preembryo through the fallopian tube, preventing the preembryo from implanting in the uterus... (2) A peri-implantation effect would be the alteration of the endometrium, such that a preembryo that reached the uterus was unable to successfully implant into the endometrial lining of the uterus. (3) A postimplantation effect could result from alteration of the endometrium not sufficient to prevent implantation but unfavorable for maintenance of the pregnancy..."

     Most patients, for personal, scientific or religious reasons, identify the start of human life at conception. For some, a method of birth control that has the potential of killing their newly conceived child (an abortifacient) may not be acceptable. This would include all oral contraceptives, as well as Norplant, Depo-Provera, the morning after pill, emergency contraceptives, and RU486.

     According to the authors, "Since it would be difficult to predict which patients might object to being given an OC if they were aware of possible postfertilization effects, mentioning the potential for postfertilization effects of OCs to all patients and providing detailed information about the evidence to those who request it is necessary for adequate informed consent." Of course, "adequate informed consent" has legal ramifications beyond the question of medical ethics.

     For the pro-lifer, "postfertilization effects" is simply a medical term for early chemical abortions. How many pro-lifers are aware of these facts? Have they truly received "informed consent"? More importantly, why are our preachers and priests silent in the face of these chemical abortions, which far outnumber surgical abortions? The journal article is available online, at http://archfami.ama-assn.org/issues/v9n2/full/fsa8035.html