Do High Rates of Natural Loss Justify Induced Loss on Hormonal Contraception?
Most Protestants believe human life begins at conception, and once it begins, it must be allowed to develop naturally.
However, Protestants may be confounded to learn that a surprising number of pregnancies—when allowed to develop naturally—end in loss.
60-75% of pregnancies are lost.
(I’ll remind you that I always define “pregnancy” as beginning at conception)
If you’re shocked the number is so high, it’s understandable. That’s because 30-50% of pregnancies are lost prior to implantation and likely unrecognized as either pregnancy or loss.
Research shows that approximately:
- 30% of pregnancies are lost prior to implantation
- 30% of pregnancies are lost after implantation but before the missed menstrual period
- 15% of pregnancies are lost to miscarriage (early pregnancy loss—before 13 weeks)
Women are getting pregnant more often than they might think, and around half of those pregnancies will begin—and be lost—without their knowledge.
“Embryonic loss is thought to be fairly extensive. The accepted dogma is that 15 % of all conceptions end in recognizable fetal loss while 31 % survive to birth and the other 54% are presumed to be lost in early gestation but they remain undetected.”1 (Shahani, 1992)
“An estimated 30% of human conceptions are lost prior to implantation and a further 30% following implantation but before the missed menstrual period, that is in the third or fourth week of gestation. These are often termed preclinical losses [37] (Figure 1). Finally, the incidence of early clinical pregnancy loss is estimated to be 15% of conceptions with a significant variation according to age.”2 (Larsen, 2013)
Gavin E. Jarvis released a study in 2016 with a lower-end estimate of pre-implantation loss at 10-40%.3
A study by Wilcox, Harmon, Doody, Wolf, and Adashi in April 2020 estimated pre-implantation losses at 40-50%.4
Jarvis released an opinion article three months later in July 2020 repeating his lower-end estimates from 2016. (It would have been nice to see Jarvis address Wilcox et al., 2020, but he instead only references Wilcox research from 1988.)
Regardless, it stands that prenatal losses are rather high, and you can see the politics unfolding in both articles.
“Our findings underscore the fact that failure to conceive in a given cycle is due not only to the absence of fertilization, but to failure of the fertilized ovum to progress to implantation. An added aspect of these results is with regard to legislative efforts to rule that human life legally begins at the moment an egg is fertilized (see for example, H.R.586—Sanctity of Human Life Act,115th Congress, 2017–2018). There is no mention in proposed legislation of the large number of natural losses that occur after fertilization—by our estimation, up to twice as many as live births. Recognition of these losses may not affect the intended legislation, but quantifying preimplantation loss could help the general public better understand the natural events of pregnancy, and provide a better context for policies related to those events.” (Wilcox et al., 2020, p. 748)
The modest suggestion that the data might simply provide “better understanding” and “better context for policies related to those events” fails to mask the implication: that since many pregnancies are lost early, perhaps human life should not “legally begin” at conception.
The Jarvis 2020 article is an attempt to correct the record in regards to evidence presented in a 2002 proceeding in the UK about the morning-after pill.5 He argues that pre-implantation losses have been historically overestimated and that the “bad data” presented to Mr. Justice Munby in the case influenced his decision to continue to allow the morning-after pill to be prescribed over-the-counter.
Jarvis is clearly pro-life in his views, but his article also clearly illustrates the views of his opponents on the phenomenon of natural pregnancy loss:
“Natural human embryo mortality has often been linked to the ethical status of human embryos. For example, in their brief article, Roberts & Lowe state that ‘If Nature resorts to abortion … by discarding as many as 3 in every 4 conceptions, it will be difficult for anti-abortionists to oppose abortion on moral and ethical grounds.’12 Ronald Green, Professor Emeritus of Religion at Dartmouth College, points out, incorrectly, that ‘between two-thirds and three-quarters of all fertilized eggs do not go on to implant in the womb’ and asks: ‘In view of this high rate of embryonic loss, do we truly want to bestow much moral significance on an entity with which nature is so wasteful?’30 A report of the Ethics Committee of the Royal College of Obstetricians and Gynaecologists in 1983 states: ‘Knowing as we do that in the natural process large numbers of fertilised ova are lost before implantation, it is morally unconvincing to claim absolute inviolability for an organism with which nature itself is so prodigal’” (Jarvis, 2020, p. 12)
Why do pro-lifers care so deeply about protecting a process (pregnancy) that God allows to fail so frequently?
This question has given rise to what I call “natural loss” arguments for hormonal contraception (HC).
Natural Loss Arguments
One version is to say that pregnancies lost prior to a positive pregnancy test should have less value because the losses happen so early and so often. They don’t count because they don’t implant and can’t make a pink or blue line appear on a test strip.
The problem with natural loss arguments is that they appeal only to numbers and give no moral consideration to human agency. Death is now a part of the world God created. But killing humans should be avoided whenever possible. Human agency in that process matters.
I do not use the term “murder” in the context of HC. Murder is the intentional killing of an innocent, and I prefer to keep readers in the charitable light of ignorance rather than assuming foreknowledge or malice.
Pregnancies lost naturally are completely different morally than a woman choosing unnecessarily to use HC knowing it may cause her to lose a pregnancy.
Another natural loss argument is that since many pregnancies are lost, using HC is a moral good since they lead to less pregnancies and loss than occur naturally. There are a few problems with this.
First, that’s like saying it’s better to have one person killed than to have 60-75 natural deaths. Second, the absolute number of pregnancy losses might be lower, but the percentage of pregnancies that end in abortion increases from 60-75% to 93-99% except now the mother shares in the culpability by unnecessarily choosing to use HC.
Some have even argued that it wouldn’t matter if HC is abortifacient unless it causes more abortions than occur naturally (as in Fields, 2020 quoting Sullivan, 2006). The full Sullivan quote is worth mentioning here:
“The baseline failure rate for implantation is an important statistic in this regard. A full 70% of fertilized ova fail to proceed to a full-term pregnancy, with three-fourths of these due to failure of implantation.22 Against this failure rate, the rarity of breakthrough ovulation makes statistical comparison of Pill- users against non-Pill users difficult. Contraceptive opponents must make a difficult statistical case: (1) In instances of break- through ovulation (a rare event), a significant number of sperm must penetrate the thickened cervical mucous (presumably a rare event), thus evading both truly contraceptive effects of COCs; and (2) If fertilization does occur, an embryo must fail to implant in an endometrium at least somewhat pre- pared for it, or if it implants, fail to continue to term, and this failure rate must be greater than the 70% that occurs naturally.”6 (emphasis mine) (Sullivan, 2006, p. 192)
This is just bizarre. How could you ever assess the effects of HC apart from loss that occurs naturally? This difficulty is described by Han, Taub, and Jensen in 2017:
“Studies of contraceptives face the challenge of separating the effects of the administered agent from the natural cycle-related changes.”7 (Han, Taub, Jensen, 2017)
Sullivan’s numbers argument misses the point and the question entirely, which is: “Is it wrong to use HC if it worsens pregnancy outcomes?”
People assume when they don’t have a baby, they were never pregnant. But that’s not what the data show.
People further assume if they’re using HC, they won’t conceive. But the data say sometimes they do. That’s why it’s so important to learn exactly what kind of environment HC is creating in a woman’s body.
Finally—and a difficult thing to process—is that using HC might not only prevent some embryos from implanting or thriving, but it might also allow some embryos to implant and gestate that otherwise would be “selected” by the endometrium for rejection.
I will be arguing that any death caused by effects induced by HC would be wrong. And the reason it’s wrong is because the mother now shares the responsibility. If HC increases spontaneous abortion by 20-25%, you shouldn’t use it.
The fact that natural pregnancy loss rates are 60-75%, and HC is reported to be 93-99% effective is strong evidence that when conception occurs on HC, there is an increased chance of induced abortion.
High natural loss rates are an uncomfortable reality, but they in no way justify accepting contraceptive related induced proliferative and luteal effects (CRIPLE) caused by HC which ensure an even higher chance of spontaneous abortion when pregnancy occurs.
Read more on the CRIPLEing effects of HC here.
- Shahani, S. K., Moniz, C., Chitlange, S., & Meherji, P. (1992). Early pregnancy factor (EPF) as a marker for the diagnosis of subclinical embryonic loss. Experimental and clinical endocrinology, 99(3), 123–128. https://doi.org/10.1055/s-0029-1211152 ↩︎
- Larsen, E. C., Christiansen, O. B., Kolte, A. M., & Macklon, N. (2013). New insights into mechanisms behind miscarriage. BMC medicine, 11, 154. https://doi.org/10.1186/1741-7015-11-154 ↩︎
- Jarvis G. E. (2016). Early embryo mortality in natural human reproduction: What the data say. F1000Research, 5, 2765. https://doi.org/10.12688/f1000research.8937.2 ↩︎
- Wilcox, A. J., Harmon, Q., Doody, K., Wolf, D. P., & Adashi, E. Y. (2020). Preimplantation loss of fertilized human ova: estimating the unobservable. Human reproduction (Oxford, England), 35(4), 743–750. https://doi.org/10.1093/humrep/deaa048 ↩︎
- Mayor S. (2002). Court rules that emergency contraception is lawful. BMJ (Clinical research ed.), 324(7344), 995. https://doi.org/10.1136/bmj.324.7344.995/b ↩︎
- Sullivan, D. M. (2006). The Oral Contraceptive as Abortifacient: An Analysis of the Evidence. Perspectives on Science and Christian Faith, 58 (3), 189-195. https://digitalcommons.cedarville.edu/cgi/viewcontent.cgi?article=1050&context=science_and_mathematics_publications ↩︎
- Han, L., Taub, R., & Jensen, J. T. (2017). Cervical mucus and contraception: what we know and what we don’t. Contraception, 96(5), 310–321. https://doi.org/10.1016/j.contraception.2017.07.168 ↩︎