What people should know about the ‘once-a-month contraceptive pill’

The Guardian and other news outlets have highlighted a new journal article arguing that a ‘once-a-month contraceptive pill’ is ‘scientifically possible’.

Writing in the Journal of Family Planning and Reproductive Health Care, the researchers say such an advance would be welcomed by many women but the biggest hurdle to development is likely to be ‘political opposition’.

The new pill, they say, could be routinely used after, rather than before, sex. The idea would be that women wouldn’t have to take any precautions against pregnancy at all other than popping a pill whenever their period is delayed and they think they might possibly be pregnant.

What the Guardian doesn’t tell us is that such a pill would not be a ‘contraceptive’ (literally ‘against conception’) at all but rather an abortifacient (destroying an implanted human embryo). This is abortion and not contraception.

Nor does it tell us that a pill that acts in this way in the first few days after conception, ellaOne (ulipristal acetate), has already been available on prescription in the UK since 2009. Another similar drug, mifepristone (RU 486), is already used in Britain to procure medical abortions up to several weeks, but only under the auspices of the Abortion Act.

What is really being advocated is the deregulation of early abortion, by making it available over the counter. And there is no doubt that if such a move took place some women would stockpile the drugs and also use them in higher dose to procure their own later ‘do it yourself abortions’ at home. The thought of young girls disposing of their pregnancies at home – with all that might involve – is really quite horrifying. 

There are other huge dangers with such a strategy. British and American studies have already clearly demonstrated that  making emergency contraception available free over the counter without prescription leads to an increase in rates of sexually transmitted infections and does not decrease pregnancy or abortion rates. If this new pill were to be made available we would expect it to be at least as bad (see note on 'risk compensation below).

Britain already has the highest rate of teenage pregnancy in Western Europe.  Rates of sexually transmitted diseases are also rising. In 2009 there were 12,000 more cases than the previous year, when 470,701 cases were reported. The number of infections in 16-to 19 year-olds seen at genito-urinary medicine clinics rose from 46,856 in 2003 to 58,133 in 2007.

The availability of such pills would also expose women to greater risks of sexual abuse. The fact that one is not using contraception is a strong argument to avoid being coerced into having sex by a strong-willed boyfriend or someone wanting to cover up abuse. Having such a pill available for use by would-be abusers - ‘It doesn’t matter; if you miss a period you could just take this pill’ – actually makes women more vulnerable.

This latest ‘advice’ is not just another ill-conceived non evidence-based knee-jerk response to Britain’s spiralling epidemic of unplanned pregnancy, abortion and sexually transmitted disease. It is also an attempt to smuggle in even more abortion by the back door.

The best way to counter the epidemic of unplanned pregnancy and sexually transmitted disease is to promote real behaviour change. The government would be well advised to enter into dialogue with leaders of communities in Britain where rates of sexually transmitted diseases and unplanned pregnancy are very low, especially Christian faith communities, to learn about what actually works.

Note on risk compensation 

The phenomenon whereby applying a prevention measure results in an increase in the very thing it is trying to prevent is known as ‘risk compensation’. The term has been applied to the fact that the wearing of seatbelts does not decrease the level of some forms of road traffic injuries since drivers are thereby encouraged to drive more recklessly.

In the same way it has been argued that making condoms readily available actually increases rather than decreases rates of pregnancy and sexually transmitted infections because condoms encourage teenagers to take more sexual risks in the false belief that they will not suffer harm.

But whilst condoms offer some protection against sexually transmitted infections the morning-after pill offers absolutely none. Rather it encourages more risky behaviour in the false belief that one is safe.

Other blogs on related issues

What economics can tell us about teen pregnancy rates 
School contraceptives to 13 year olds 
Three false presuppositions about teenage pregnancies 

Guardian health editor jumps onto suicide promotion bandwagon

The Guardian this week has run the story of a man with motor neurone disease who wants to end his life.

Paul Chamberlain, 66, a former chartered accountant from Surrey, we are told, has obtained the drugs he needs ‘from overseas’.

Health editor Sarah Boseley (pictured) uses Chamberlain’s case to promote Lord Falconer’s Assisted Dying Bill, which has been drafted by Dignity in Dying (the former Voluntary Euthanasia Society) and is due to have its second reading in the House of Lords this autumn.

A Samaritans contact phone number is given for those who might be ‘struggling to cope’ but this is a largely empty gesture aimed at giving respectability to a piece of journalistic propaganda which suggests that it can be both right and reasonable for sick people to kill themselves.

Boseley also breaks key media guidelines on suicide prevention. 

The WHO international guidelines on suicide portrayal refer to over 50 published studies, systematic reviews of which have consistently drawn the same conclusion, that media reporting of suicide can lead to imitative suicidal behaviours.

This phenomenon is variably termed suicide contagion, copycat suicide, suicide cluster or the Werther effect.

Its recommendations to media professionals include the following:

· Avoid language which sensationalises or normalises suicide, or presents it as a solution to problems
· Avoid prominent placement and undue repetition of stories about suicide
· Avoid explicit description of the method used in a completed or attempted suicide
· Avoid providing detailed information about the site of a completed or attempted suicide
· Take particular care in reporting celebrity suicides

By portraying this unfortunate man as a hero who is taking a brave and reasonable course of action, and by failing to do justice to the wider context of the debate, Boseley is steering vulnerable people toward suicide.

In so doing she has also bought into the myth that we should consider suicide in people who are sick or disabled as somehow different from suicide for those with mental health problems or who feel their lives are no longer worth living for other reasons.

But the idea that suicide should be promoted in the former group but prevented in the latter creates a false distinction and is actually profoundly discriminatory.

In reality most sick and disabled people do not want and to die and most people who do wish to die are neither sick nor disabled.  

Our response to all suicidal ideation should not be to hand over a poisoned chalice but to ask how we can manage the underlying problem better.

There are about 5,000 people in the UK with motor neurone disease (MND). About 1,000 die with the condition each year, three every day.

The vast majority do not want so-called ‘assisted dying’ (a euphemism for being poisoned with lethal drugs) but rather ‘assisted living’ until they die naturally.

But Boseley’s article gives no voice to this silent group. Nor are we told anything about the care available for people with MND.  No one representing the majority of those with the disease (like Alistair Banks) is given an opportunity to put a contrary view.

We also learn nothing about the rapid escalation of euthanasia and assisted suicide cases in the Netherlands, Oregon, Switzerland and Belgium which have legalised the practice but instead, without any evidence, are assured that such problems are imaginary.

Is it mere coincidence that this story follows hot on the heels of the visit of campaigner Philip Nitschke (aka Dr Death) who has just run a seminar in London advising attendees about how to obtain lethal drugs over the internet?

Thus far over 50 people in his native Australia have killed themselves with a drug which he promotes. One third of these were people in their 20s and 30s. Was it Nitschke, I wonder, who is also ‘helping’ Chamberlain?

Assisting suicide is illegal in Britain for good reasons.

First, any change in the law to allow assisted suicide or euthanasia would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed.

Second, persistent requests for euthanasia are extremely rare if people are properly cared for so our priority must rather be to ensure that good care addressing people's physical, psychological, social and spiritual needs is accessible to all.

Third, hard cases, like that of Paul Chamberlain, make bad law. Even in a free democratic society there are limits to human freedom and the law must not be changed to accommodate the wishes of a small number of desperate and determined people.

In accepting that suicide is sometimes right and that there is such a thing as a life not worth living Boseley crosses two critical and dangerous rubicons.

Her propaganda and Falconer’s bill should be given similar short shrift. 

Biblical teaching on marriage and sexuality – a quick overview for Guardian readers

I was amused to read an editorial in the Guardian today titled ‘Gay marriage: torn asunder from reality’. It made the extraordinary claim that ‘it is surprisingly hard to find in the Bible a consistent endorsement of heterosexual marriage as we now understand it’.

I will return to a full fisk of the editorial piece later (now available here) but for the benefit of Guardian readers here is a quick overview of biblical teaching on marriage and sexuality.

Marriage is a divine invention. It was God who first said that it was ‘not good for man to be alone’ and who created the unique complementarity of the marriage relationship for companionship, pleasure, procreation and the raising of children – ‘one man, one woman, united for life’ (Genesis 2:24).

Marriage is also in this way illustrative of Christ’s own self-giving abandonment to his bride the church (Ephesians 5:31, 32) and points to a greater richness of human relationships beyond the grave of which the very best on earth are but a pale shadow (1 Corinthians 2:9, 10).

The Bible is full of references to sex and marriage -from the first chapter of Genesis to the last chapter of Revelation (Gn 1:28, Rev 22:17).

The one man and one woman for life pattern is an Old Testament creation ordinance, upheld by Jesus and Paul in the New Testament (Gn 2:24; Mt 19:3-12; Eph 5:22-33).

Sex in the context of marriage (Gn 2:24, Mt 19:3-12)
...is viewed as the good gift of a good creator (Pr 5:15-20, Song 4:11-16)
...and a sign of Christ’s coming marriage with the church (Eph 5:32, Rev 19:7)

Anything outside this context is seen as a disaster (2 Sa 11, 2 Sa 13, Gn 34)
... offensive to God (Lv 18:6-30, 20:7-21; 1 Cor 6:12-20)
... and accordingly judged (Lv 18:29; Dt 22:20-22, Rev 21:8)

All wrong patterns are spelt out specifically in detail (Lv 18:1-30; Lv 20:1-27; Ex 22:16-19; Dt 22:13-30) and include all homosexual acts (Lv 18:22, 20:13; Gn 19:1-29; Jdg 19:1-30; Rom 1:24-27; 1 Cor 6:9-11; 1 Tim 1:8-11)

God’s people are called to be ‘set apart’ in sexual behaviour (1 Thes 4:3-8; Mt 5:27-32)

Scripture is accordingly replete with love stories which affirm marriage: Isaac and Rebecca (Gen 24), Jacob and Rachel (Gen 29:16-30), Boaz and Ruth (Ru 3)… and similar narratives about how sex and marriage can be distorted – some examples:

Shechem and Dinah (Gen 34) - rape
Judah and Tamar (Gen 38) - prostitution
Amnon and Tamar (2 Sa 13) - incest
David and Bathsheba (2 Sa 11) – adultery
Zimri and Cozbi (Nu 25) – fornication
Sodom and Gibeah (Gn 19; Jdg 19) – homosexuality

Polygamy, whilst tolerated and permitted in Old and New Testament times (but with strict rules of faithfulness), was never endorsed or commanded and I am struggling to think of a single instance where it did not have serious consequences for the families involved in terms of jealousy, favouritism, rivalry, apostasy and family breakdown.

Lifelong, heterosexual monogamy is the consistent pattern.

Guardian readers are of course entitled to their opinions about what they think of biblical teaching but they should be aware of what the Bible actually says and similarly aware that Guardian editors are about as adept with scripture as 'a fool is with a proverb' or 'a paralysed man is with his legs' (Proverbs 26:7).