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The Contraceptive Mandate

Posted by MDViews on January 8, 2013

Birth control. Who can be opposed to birth control?

Isn’t birth control just having the babies you want and no more? Isn’t that just common sense? Who can afford more than two kids anyway? Who wants more than two kids any way? Do you have any idea how expensive day care is? And who wants to clean some rug-rats bodily fluids off the leather seats in the back of your Beemer? Do you have any idea how the other passengers look at you if you take your kid on an airplane to go to the Bahama’s for a vacation? Besides, maybe you’re a teenager and a pregnancy would ruin you life. Shouldn’t you be on birth control? Come to think of it, maybe you should be required to take birth control. I mean, isn’t over-population a big problem? Shouldn’t we all have fewer kids, like China? And how are you going to climb the corporate/educational/governmental ladder if you have to worry about day care/dance lessons/soccer/after-school care? Kids! What a noose around your neck! Plus, what if you end up with some disabled kid who cost even more? Do you know what day care is for a kid with autism? (Well, I think they have homes you could put someone like that in, don’t they? I mean, you shouldn’t have to care for a kid like that, should you?)

Let the Duggers have 19 kids. Let those weird Catholics who actually believe Pope John Paul’s Humana Vitae use natural family planning and have 8 kids. (Is it legal to have that many kids? Maybe we should do something about that, too. )

And anything that’s as important as birth control should be covered by insurance, shouldn’t it? I mean, $4 a month at WalMart seems like a lot to me.

And so it goes. The arguments for birth control in general and the contraceptive mandate in particular.

But let’s separate some facts from the fog and see what this contraceptive mandate is really about.

First, define birth control, because you cannot separate birth control from abortion.  Most of you probably don’t know that the government, drug companies, IUD’s companies, birth control pill companies, progesterone-only birth control companies and the “morning-after” pill companies define abortion as pregnancy loss after implantation. That means an egg is fertilized, becomes an embryo, travels down the fallopian tube over 4 or 5 days, but then, instead of implanting in the wall of the uterus, passes through unnoticed because the “contraceptive” made the uterine wall hostile to implantation. One package insert said it prevents the “egg” from implanting in the uterine lining! To those entities above, that is birth control, not abortion. All of the package inserts for the birth control pill, IUD’s, progesterone-only birth control pills and shots and the “morning-after” pill companies list a hostile uterine environment as one of the mechanisms of action. (For birth control pills, the primary method of action is stopping ovulation, but it doesn’t stop ovulation all the time.)

For those of us who are pro-life, that mechanism of action means 1) possible, occasional abortion for the birth control pill, 2) likely abortion for IUD’s and progesterone-only pills and shots and 3) almost certain abortion for the “morning-after” pill.

I’m an OB/GYN doctor and have wrestled with these issues in my conscience for many years. I quit placing IUD’s shortly after I started in private practice, but did place them during my residency. I quit prescribing progesterone-only pills and shots many years ago and I quit prescribing the birth control pill two years ago. I feel good about all of those decisions.

So defining “birth control” helps us, I think, realize why the “contraceptive” mandate is a deep moral affront to pro-life people on its face. “Contraceptives” should be called “contra-gestational” agents, meaning they prevent a pregnancy from “gestating” or growing in the uterus, but don’t prevent “conception.” At least not all the time. In that regard, they are all potential abortifacients, some more than others.

Second, our devout Catholic friends, both patients and doctors, are required by the teachings of the Catholic church to only use periodic abstinence (natural family planning) to prevent pregnancy. I’m much more aware and informed of that teaching now that I work in a clinic with all Catholic physicians who hold to the teachings of the Catholic church. That means they advocate for natural family planning, (specifically NaPro Technology) and never prescribe any artificial birth control agents. It’s easy to see why the mandate would be unacceptable to them. Also, that means requiring a Catholic organization or a Catholic employer to pay for condoms, spermicides, tubal ligations and vasectomies in addition to those other forms of  “birth control” is a moral outrage and mocks our first amendment right of freedom to practice our religion as we choose.

One can argue that our taxes already pay for abortion in the United States, and that is true in some states (Minnesota, for one, where I live) through the Title 19 program.

But our tax dollars already fund program after program I find morally objectionable. I have no choice about paying taxes. When Jesus said to give to Caesar what is Caesar’s and to God what I God’s, the Roman empire was not exactly a morally upstanding place.

However, requiring payment for “contraceptives” by purchased private health insurance when health insurance is a voluntary fringe benefit offered to employees from an organization or employer bears no similarities to a tax. It’s the government interfering in a private fiduciary relationship between an employer and an employee.

It is clearly the heavy hand of government violating the first amendment right of freedom of religion for those organizations and employers who find “contraceptive benefits” morally objectionable.

As my little vignette above describes, the real reason secular people (and many evangelical Christian and Catholic couples) use birth control is, well, because they don’t understand the gift of life. Children are a de facto burden, not a blessing; a curse to be avoided, not a life to be cherished; a pet to be shown off when convenient then shuffled off to daycare, not an integral part of the family to be fully accepted, loved, valued and included; a carbon footprint to be viewed with a jaundiced eye, not a treasure created in the very image of God.

Pro-life Christians and Catholics are in cross-hairs of the liberal establishment because we embrace a morality from outside of who we are, a morality codified first in the tablets from Mt. Sinai and expanded by Jesus and the apostles in the New Testament. Liberals fly by the seat of their pants inventing their morality as they go along, mostly by what ever would increase their personal happiness at that moment in time, whether morally right or wrong (situational “ethics”, or a better description, situational lack-of-ethics). We now live in a liberal echo chamber in which the establishment has never met a death (embryo, fetus, handicapped baby, or elderly ill person) it didn’t like–except for those convicted of capital crimes in which death is a deserved punishment–those deaths they fight against always.

It makes sense, dear Christian friend. God is not surprised, fooled or unaware. Their behavior is nothing new. Read what the Psalmist says in Psalm 106:36-39 and see if it doesn’t describe the current state of our culture to you.

They served their idols,
which became a snare to them.
They sacrificed their sons
and their daughters to the demons;
they poured out innocent blood,
the blood of their sons and daughters,
whom they sacrificed to the idols of Canaan,
and the land was polluted with blood.
Thus they became unclean by their acts,
and played the whore in their deeds.
(Psalm 106:36-39 ESV)

And, we know that we will suffer for Christ’s sake if we take a moral stand. It’s a guarantee from God. Paul’s phrase from I Thessalonians 3:4 makes it clear he knew he was to suffer affliction and then did suffer affliction.

    For when we were with you, we kept telling you beforehand that we were to suffer affliction, just as it has come to pass, and just as you know.
(1 Thessalonians 3:4 ESV)

So the contraceptive mandate is not a surprise to God and should not be a surprise to us. In our culture, what’s right is what’s wrong and what’s wrong is what’s right. Since liberals control the reigns of power in government, entertainment, education and large corporate businesses, we are at the mercy of the laws they pass, the courses they teach, the movies and TV programs they make and the rules they make for employment as they employ many of us. But we don’t have to watch their movies and TV programs which always portray us a incompetent, stupid, bigoted troglodytes. We don’t have to buy the products of those companies actively supporting the goals of more birth control and abortion. We can home-school and choose to attend conservative colleges and universities. And when the laws become too onerous to follow, we can use civil disobedience (and go to jail? Yes, and go to jail). In the mean time, we must fight, protest, vote our hearts and throw every roadblock we can in front of them whenever we can.

Posted in Abortion, Family, Medical Issues, Politics, Pregnancy | 4 Comments »

You Will Die if You Conceive

Posted by MDViews on March 30, 2012

Behold, children are a heritage from the LORD, the fruit of the womb a reward. Like arrow in the hand of a warrior are the children of one’s youth. Blessed is the man who fills his quiver with them. Psalm 127:3-5a (ESV)

It was 2:30am as I placed some large, wet sponges over the open wound to keep it and the bowel moist. “Now, we wait to see if her bleeding slows,” I said to the OR tech across the table from me. I had just tied off the blood vessels feeding the uterus in an attempt to stop the hemorrhage. If that failed, hysterectomy was the next step.

My patient, 27 years old, had given birth just hours earlier. Nothing I had done helped slow the ensuing hemorrhage. Hemorrhage after or associated with childbirth can be so heavy, so much and so fast that it frightens the most seasoned OB doctor, and I was no exception. Women still die in childbirth and hemorrhage is a major cause. God was merciful to her that night. The bleeding slowed to a trickle. After several units of blood and a night in the ICU, she recovered completely.

“Can I have another baby?” she asked me on her day of discharge. I thought back to the horror of four nights earlier–my fear that she would die in my care, that I wouldn’t get the bleeding slowed in time to save her life. I got sweaty again just thinking about it. But, the bleeding did slow. The uterus still had plenty of blood flow to it in spite of the blood vessels I had ligated. I explained she could have more children, but that her risk of hemorrhage would be somewhat higher. And she did. Several more children, all without complications.

Several years ago, I was busy in the OR when my partner needed help with a patient hemorrhaging after childbirth. Since I couldn’t leave, they called someone else to help my partner. When I finished my surgery, my partner was already done and told me about the case. “I went right to hysterectomy. It was easier. Besides, she had three healthy kids already.” My partner had tried no conservative surgeries. Why? Possibly because of the severity of the hemorrhage (but I knew that not to be the case), or because of lack of skill to perform the more conservative operations (possible), or because my partner didn’t want the hassle of missing office with a long drawn-out affair in the OR when a hysterectomy could take care of the problem quickly and, besides, she had three healthy kids already.

Besides, she had three healthy kids already. My partner’s implication was clear. Time to stop. Three’s plenty.

Two times this week I’ve had consults with women who were told by their doctors to have no more children because of risk to their lives. After I reviewed the past records, I saw nothing with either that would preclude more children. The first patient hemorrhaged with her sixth and then told me the clincher. “My OB doctor told me six children was more than enough for anyone, anyway.” The other patient’s husband underwent vasectomy because the doctor told him his wife would die if she had another baby. How tragic.

I’ve done OB now for over 30 years now and I’ve cared for women experiencing about every complication that can occur related to childbirth. Hemorrhage, eclampsia (seizures), heart failure, kidney transplants, long-standing diabetes, uterine ruptures, fetal distress and severe infections to name a few. Many pregnancy complications are more likely to occur with subsequent pregnancies and can entail significant risk. When I counsel women on future childbearing, I never sugar-coat the risks. But, I’ve yet to tell a woman to never conceive again. I’ve yet to recommend a tubal ligation or hysterectomy because of pregnancy risk. (One of my patients underwent cesarean section seven times–so much for the “you can only have two or three cesareans” theory.)

Unfortunately, I see women again and again in my practice who have undergone a tubal ligation on the advise of their OB doctor, or been advised to stop childbearing because of excessive risk, or, as above, had a hysterectomy when a lesser surgery would have likely helped. Women who have received such advise should take it with a healthy grain of salt.

* Details of above stories altered to protect privacy.

Posted in Doctoring, Personal, Pregnancy | 3 Comments »