Do Birth Control Pills Cause Abortions? An Ob-Gyn's Take

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Do Birth Control Pills Cause Abortions? An Ob-Gyn’s Take

Some people have claimed that birth control pills can cause abortions. But is that true? A doctor looks into the debate, and offers an unbiased—and perhaps surprising—rundown of what various groups believe.

[Editor's note: This article was originally hosted on MyFamilyDoctorMag.com, our sister site.
It's now featured here as part of our new general-health section.]

Do Birth Control Pills Cause Abortions? An Ob-Gyn's Take | The Survival Doctorby Susan Warhus, M.D.

Q. Do birth control pills cause abortions?

A. Gee, I didn’t realize how controversial this topic was until I started to do the research to answer your question!

Most everyone agrees that contraceptive barrier methods (condoms, diaphragms, cervical caps, spermicide) form a chemical or physical barrier that prevents the sperm and egg from getting together. Therefore, assuming contraception is effective, a fetus forming or an abortion occurring is essentially impossible.

The debate sparks up when other forms of birth control, such as the intrauterine device (IUD) and hormonal contraception (pills, injections, rings, patches, implants) come up.

How Different Types of Birth Control Work

When a woman becomes pregnant, first, fertilization happens—the sperm and egg come together. Then implantation occurs—the fertilized egg implants in the womb. Different groups disagree on whether pregnancy starts with fertilization or implantation. We’ll discuss that in a moment. But first, some background.

Some methods that prevent fertilization but not implantation:
  • Natural family planning
  • Condoms
  • Diaphragm
  • Cervical cap
  • Spermicide

Different types of birth control target fertilization and implantation in different ways.

  • The copper IUD (ParaGard) causes an inflammatory reaction within the female organs and lessens the sperm’s ability to fertilize. However, should fertilization occur, the uterine wall is too irritated to maintain a pregnancy (implantation).
  • The hormonal IUD (Mirena) and other forms of hormonal contraception share the following same basic mechanisms of action:
    1. Prevent ovulation. No egg means no fertilization.
    2. Thicken the cervical mucus so sperm can’t easily pass into the uterus (thus preventing fertilization).
    3. Thin the uterine lining. On the chance that ovulation and fertilization do occur, implantation becomes difficult or impossible.

We know how often women get detectably pregnant (with implantation) while on contraception, but we have minimal data on how often these therapies allow for fertilization but not implantation.

A few small studies involving IUDs suggest they work by using both prefertilization and postfertilization methods. A study to evaluate birth control pills and other hormonal forms of contraception is anticipated.

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What do you think?

Do birth control pills cause abortions? Share your views in the comments section below.

Is Preventing Implantation Abortion?

(And does that really happen with combination pills?)

Many in the medical and scientific communities, including The American College of Obstetricians and Gynecologists, presume that pregnancy begins with implantation. Therefore, they don’t view contraception as abortive.

Organizations that are pro-choice, including Planned Parenthood, agree that pregnancy begins with implantation and that contraception should be encouraged to avoid unintended pregnancy.

Pro-life groups, however, argue that pregnancy begins with fertilization. From that standpoint, preventing implantation of a fertilized egg is abortive. “We are as much opposed to the birth control pill as to abortion,” says Joe Scheidler, national director of the Pro-Life Action League.

The Christian organization Focus on the Family, which is pro-life, agrees that pregnancy begins with fertilization but is less conclusive about the contraceptive debate. Its position statement on the topic, last reviewed in 2005, concludes that contraceptives that use only the hormone progesterone (or progestin) “do not reliably prevent ovulation.” (The American College of Obstetricians and Gynecologists agrees.) Focus on the Family concludes that these types of contraceptives are “problematic for those of us who believe that human life begins at conception.”

However, for injections and pills that contain both progesterone and estrogen:

After two years of extended deliberation and prayer, [Focus on the Family's Physicians Resource Council] has not been able to reach a consensus as to the likelihood, or even the possibility, that these medications might contribute to the loss of human life after fertilization.

 You can download their position statement by clicking here.

The contraception decision is ultimately a personal one. It comes down to your attitudes concerning the definition of pregnancy, your conclusions about the facts, and your own moral and ethical beliefs.


After practicing medicine for about 18 years in the Phoenix area, board-certified ob-gyn
SUSAN WARHUS, M.D., now devotes her time to teaching and writing. Most recently, she wrote the book Fertility Demystified.

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Original article appeared in January/February 2008 issue of My Family Doctor magazine. Bio current as of that issue. This general health-care information is not meant as individual advice. Please see our disclaimer.

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  • Sara

    I’m sure this will sound bad but I actually think birth control makes healthier stronger babies. My mom got pregnant twice while on birth control. Me and my brother. And again with my sister after my dads vasectomy failed. Those are some strong sperm/egg combos.

    Not every sperm is destined to fertilize, not every fertilized egg is destined to implant. The woman’s immune system attacks sperm and fertilized eggs fail to attach before they die without nutrients. With or without the interference of birth control. To ensure survival of the baby and mother when pregnancy does occur.

    Birth Control only enhances this naturally occurring process of weeding out the weak. If birth control is an abortifacient than so is nature. Hewie dissolves Dewie all the time in the womb. People have miscarriages. So since pregnancy can occur and it doesn’t terminate pregnancy l don’t see how this interferes with Gods plan.

    • MillerJM

      There are some serious logic problems with your statements. “Birth Control only enhances this naturally occurring process of weeding out the weak.” One could easily make the same statement about eugenics, forced sterilization, or the termination of the handicapped. “If birth control is an abortifacient, then so is nature.” Nature also produces cancer, diseases, accidents, etc. So based on your logic, “If guns are kills people, then so does nature.”

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  • Repent America!

    When we look at life organisms whether they be microscopic such as bacteria, or larger such as mammals, one of the common links between all life forms is that their cells are actively dividing. Gametes which are the sex cells that combine to form an organism are not complete cells and are dormant, meaning that they don’t actively replicate and have no potential for life unless they are “joined” during fertilization. Once fertilized, a new cell is formed that starts to replicate quickly like any other living organism. Fertilization occurs within the uterine tube and within 8 hours has already replicated several times. The cell remains in the uterine tube for four days before entering the utereus for implantation. Before implantation occurs the embryo already has divided into over a hundred cells.

    Anything that we do knowingly ceasing that process is intentional. The intentional cessation of in uterine life is abortive. We can spin it however we like, but that’s the way it is.

    • Justin

      The problem with your entire argument is it takes more than dividing cells to be considered alive and an animal/organism. It you are going to get extremely literal here than you must understand. It has to react to stimuli, and it has reproduce, it has to search and find energy (food). And during that time a zygote does not do this. It may be argued that it can reproduce but it certainly does not react to stimulus is simple goes down until it implants itself. It does not find energy, it is given energy. its only function is to get implanted at that time. Much like a virus. It only has one function. and its not an animal/organism but a sickness. if you quote me as saying babies are viruses than you clearly did not read what i said.

  • Chaoticblu

    I appreciate that this article is non biased and is frank about how contraception works and why some people have a problem with it. I feel it’s important to note-though the article did explain this in a way- that whether the term ‘abortion’ applies to implantation or only post pregnancy surgery is kind of irrelevant. You can call it what you want, but it’s a matter of whether you are ok with possibly ending a life between conception and implantation, whether it’s called abortion or not. I think some people get confused or don’t understand what they are really asking when they ask if birth control types can cause an abortion. If we go by current terms, then no they do not because they do not end the biological life post implantation. Only the abortion pill or abortion surgery can do that. But if someone is just concerned about whether or not contraception types can end a life at any point, then that is a different story. So yes, it’s important to clarify the current definition of ‘abortion’ and ‘pregnancy’ to help one understand what they actually are asking, or what they mean to ask. But I would think if one is asking they would just be asking in general if and how birth control ends life. By knowing all the terms and what biologically constitutes life, one can decide how they feel about those concepts and make an informed decision about their birth control.

    • Chaoticblu

      I’ve also never personally heard anyone refer to pregnancy as when fertilization occurs (though I am aware that was the original definition). I’ve always heard people distinguish between fertilization/conception and implantation(pregnancy). This makes sense as the body may reject an embryo before it is implanted. The main thing to remember though is that pregnancy(by current definition) is NOT the start of new life. A single cell exhibits all the properties of life and life starts out as a single cell upon conception. Dr. Warhus must have talked to groups I am not familiar with then, which is completely possible as I tend to stick with my familiar ones. From what I understood, the concern/ debate isn’t on what constitutes pregnancy, but more if the term ‘abortion’ applies to pre implantation death of an embryo. That seems to be where people get into arguments about birth control.

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