Intrauterine devices

Is the use of intrauterine devices biblically acceptable as a family planning measure? This procedure prevents the implantation of the fertilized egg. Isn’t this equivalent to abortion?—Boaz Adegu, University of Nairobi, Kenya

Intrauterine devices (IUD) are used to prevent conception. Placed directly into the uterus and left over an extended period of time, they cause a low-grade inflammatory process in the uterus that prevents (in most situations) any fertilized ova from implanting on the uterine wall, thus preventing a pregnancy. For those who believe that life begins at conception, this is problematic since it is denying an “individual” life, and could be classified as an “abortion.”

In understanding the issue, however, one needs to look at the events that establish a viable pregnancy. Conception is not an event but a process with various stages. When the sperm has released its genetic material in the ova (egg) and the ova begins to divide into multiple cells, there is a period of time when the ova is called a “pre-embryo.” More than 50 percent of the time, the pre-embryo is “aborted”—without intervention or birth control. It is simply passes from the body and never implants.

Also, the pre-embryo may implant in the uterus, but later spontaneously abort and no pregnancy is established.

Furthermore, the pre-embryo is undifferentiated; its destiny undetermined. It can divide and produce two or more pre-embryos, each capable of producing a viable pregnancy (and thus separate individuals). As demonstrated in animal studies, two pre-embryos (from two separate fertilized ova) can fuse and become one. Because of the undifferentiated characteristics of the pre-embryo, it is the opinion of some that it is not yet a “person” and thus is viewed differently than a mature embryo whose cells have differentiated into the precursors of the human organs.

Many assume that the “pill” (oral contraceptive containing hormones) acts prior to fertilization and therefore is not problematic since it does not cause an early “abortion.” Contrary to this misconception, oral contraceptives act in two ways. First, they prevent or reduce ovulation (the release of eggs from the ovary). However, viable ova may still be released and fertilized by sperm. Second, oral contraception also acts on the lining of the uterus and thus prevents implantation. It is not usually possible to know which of these actions occurred during any given menstrual cycle. If one concludes that there is a moral problem with IUDs, one would also have to conclude that there is a moral problem (in some instances) with oral contraception.

Having discussed some of the physiology of contraception, it would be well to point out that proper moral action should not be based on biology phenomena that are unknown or are difficult to understand. Christ taught that sin begins in the mind. In the context of abortion, there is a vast difference between the desire to limit the number of children in the family and the willful choice to destroy an established pregnancy. The more significant moral decision begins with the mind, and subsequent choice should not depend upon complex physiologic phenomena.

Albert Whiting (M.D., Loma Linda University) is the director of the Health and Temperance Department at the General Conference of Seventh-day Adventists. His address: 12501 Old Columbia Pike; Silver Spring, MD 20904; U.S.A.