How Having an (Insurance-Covered) IUD is Saving My Life

I had no intentions of writing about the Supreme Court’s decision in the Hobby Lobby case. I tweeted my friend Laura Ortberg Turner’s short post on it, because I share her opinions and she wrote with good humor and admirable economy. I expected to leave it at that.

But while reading friends’ Facebook conversations, I noticed two troubling trends in some Christian responses to the Supreme Court ruling. The first trend was simple inaccuracy, as people argued that the case was primarily about Hobby Lobby not wanting to fund contraceptives that cause abortions. First, many would argue that this is not actually what the case was primarily about (for one take on what it was about, read Paul Horwitz’s New York Times op ed). Second, that contraceptives such as “morning after” pills and IUDs prevent implantation of fertilized embryos and thus cause abortion is simply not true. I’m not even going to link to evidence that these and other contraceptives interfere with ovulation or fertilization, not implantation, because it’s so easy to find that it would take me longer to copy and paste links than it would take you to find and read them on your own. (If you want something more fun to read than dry data, check out this post from my colleague the Slacktivist, who points out that fertilization doesn’t occur during or immediately after intercourse. Taking a pill such as Plan B in the day or two after having unprotected intercourse doesn’t abort an implanted fertilized egg; at that point, a fertilized egg most likely doesn’t exist, as sperm are still swimming around refusing to ask for directions. Rather, such medications prevent or delay ovulation or inhibit fertilization.)

The second, and to me more viscerally troubling, trend among some Christians rejoicing in Hobby Lobby’s victory was the characterization of the court’s decision as a dismissal of whiny women who want someone else to pay so they can have lots and lots of sex without worry, because they can have as many abortions-via-contraception as they need.

I can’t believe this point needs to be made, but contraceptives are actually not used solely, or even primarily, by women who want to have lots and lots of sex without getting pregnant. Contraception isn’t a mere “Get Out of Jail Free” card for the promiscuous. It’s a tool that can promote health—physical, psychological, individual, communal, and global. Propagating the idea that medications to halt infections, ameliorate mental illness, and prolong men’s erections are reasonable tools to promote health (and therefore covered by insurance, regardless of your employer’s opinions about the germ theory, the causes of depression, or erections), but contraceptives are a personal choice so that women can give their out-of-control libidos a regular workout without worry is, indeed, an act of aggression toward and dismissal of women.

Contraceptives don’t merely prevent pregnancy for women having lots, or even a little, sex. They support women’s physical, psychological, and emotional health. I’m not just talking about women taking birth control pills for conditions such as polycystic ovary syndrome or painful periods, or women whose circumstances dictate that a pregnancy could kill her or push her family more deeply into dire poverty.

I’m talking about me.

I have had an IUD for just more than eight years. I consider my IUD to be saving my life. I don’t mean that exactly literally, but I do mean it seriously. My IUD protects my sanity and my fragile physical health to such an extent that I consider it necessary to my, and my family’s, health and well-being.

I got my first IUD (I’m now on my second) three months after my third child was born. We didn’t want any more children. Underneath that simple statement are deep, jagged layers of anxiety, pain, and even terror—anxiety, pain, and terror that my IUD, which prevents pregnancy regardless of the timing of intercourse or my memory or the repair history of the condom factory’s equipment, almost entirely ameliorates.

Because of my IUD, I hardly get periods anymore. This is convenient, but it’s far more than that. My periods were horrible, painful, long, irregularly constant (as in, I would sometimes bleed all but three or four days a month), copious, clotty, hideous things. I am deeply grateful for the reproductive goings-on behind even my horrible periods, because they allowed me to conceive and carry three children. I am also deeply grateful to no longer have my vision narrow to a pinpoint in the throes of menstrual cramps or bleed out of my vagina more days of the month than not. (Sorry to be graphic, but I want you to understand from what sort of captivity I’ve been freed.)

More important, because of my IUD, I carry no anxiety about an unwanted pregnancy. My desire not to have another baby is not just because we have three beautiful kids and that feels like enough, just right. I don’t want another baby because I’m convinced that carrying and giving birth to another baby would damage me, and secondarily our entire family, in deep, perhaps irreparable ways.

There’s this:

During my third baby’s c-section birth, the doctors had a lot of trouble getting my epidural in properly. I had epidurals with my first two children; the first was straightforward, the second less so. But the third was a nightmare. They were poking needles into my spine for 15 or 20 minutes, each time producing a painful burst of shock-like sensations up and down my spine. I endured silently, expecting that soon I’d be numb from the ribs down and ready to meet our son.

Except when they began cutting my abdomen, I could feel it, enough to produce both pain and panic. At that point, there was nothing to do about the epidural. The anesthesiologist, in my husbands words, began “throwing” meds into my IV and the mask over my nose, including nitrous oxide and various other cocktails. The point, the anesthesiologist explained, wasn’t to erase the pain. Nothing could really do that. The point was to make me loopy enough that I wasn’t fully engaged with the fact of my abdomen being sliced open without adequate anesthesia.

While I made it through the ordeal (obviously), I became shaky and agitated any time I thought about it. The thought of having another baby—another epidural, another c-section—didn’t just make me weary. It made me (makes me) panic.

And there’s this:

I tore cartilage in my knee toward the end of that third pregnancy. Who knows if that sped along my inevitable march toward arthritis or not? I do know that the injury, which occurred because of the extra weight I was carrying on my already precarious joints, was the beginning of something life changing. I no longer have much cartilage left in either knee, and take powerful opioids so I can function as a mother, wife, homeowner, and writer despite pain and impairment. I know, literally in my bones, that I could not carry another pregnancy without at least exacerbating the pain, and at most, permanently worsening the condition of my joints. I would also have to go without my medication for the duration, which would involve unpleasant withdrawal and worsened pain. And when it was all over, I suspect my ability to care for a new baby, three other children and our household, to cook and clean and walk the dog and take the kids sledding, would be either diminished or destroyed.

I might someday, even without another pregnancy and another baby, need a wheelchair for mobility, hired help for cleaning and cooking, or other aids. While I don’t relish those possibilities, I will make those decisions when the time comes. But I have reason to believe, and a tenacious hope, that such decisions are still years down the road.

Really, what it comes down to is this:

If I were to become pregnant again, there is enormous potential for another harrowing birth and permanent damage to my body and ability to do the things that I love, want, and need to do. That potential means that I would seriously consider having an abortion.

I don’t know if I would or not. But I know the question would be an open one. I know I don’t want to face that decision. I know that a tiny boomerang of hormone-infused plastic ensures that I haven’t had to, and won’t have to, make such a decision.

This is why I feel like my IUD is saving my sanity, my family, my life.

Our health insurance paid for both of my IUDs (they are replaced every five years), at a cost of $500 – $1,000 a pop for the device itself, insertion, and follow-up. If our insurance didn’t cover it, most likely we would have chosen a less expensive birth control method—one requiring more regular involvement, one feeling less sure.

That wouldn’t be a tragedy. I know that. But it would deal a real blow to my health.

That blow would largely take the form of much more anxiety around having another baby. As a Christian, a believer in God’s word made flesh, I understand health as incorporating body and mind and spirit. The state of our bodies dictates the state of mind and spirit, and vice versa. This is why I feel like my IUD, by protecting me and my family from the potentially ruinous consequences of another pregnancy as well as the deep worry about that happening in the first place, is saving my life.

Some Christians’ rejoicing in the Hobby Lobby decision is based on bad science about how contraception works. And some of it arises from graceless, inaccurate assumptions about why low-cost contraception isn’t merely a choice or a convenience for many women—including monogamous, responsible, married women like me—but a necessity. Contraception can be a life- and sanity-saver for women who want to be good stewards of the bodies and minds and spirits—our own and our families’—that God has entrusted to us. That’s something a so-called “Christian” employer might consider good.

For another important (really, more important) angle on why access to contraceptives is a vital tool for women’s health care, read this sobering post from Rachel Stone at OnFaith: “The Birth Control Debate We Shouldn’t Be Having”

******

A note if you’re planning to comment: The first 24 hours of comments have focused largely on the more minor of my two points—that science does not support the idea that contraceptives, including IUDs and Plan B, are definitively or even likely abortifacients (i.e., it’s neither definitive nor likely that these contraceptives prevent the implantation of a fertilized egg). The second point I made is more important to me and is the main point of the post (to quote: “The second, and to me more viscerally troubling, trend among some Christians rejoicing in Hobby Lobby’s victory was the characterization of the court’s decision as a dismissal of whiny women who want someone else to pay so they can have lots and lots of sex without worry, because they can have as many abortions-via-contraception as they need.”) Please think twice (or about forty-five times, perhaps) before commenting on the first point. The comment section is already full of opinions on that point, and I’m not interested in making this post a debate about abortion. (I have written about abortion, and formally debated my friend Karen Swallow Prior, elsewhere online. Google it if this is what you’re more interested in.) I welcome comments on the second point, which was the point I was more passionate about.

Also, if the abortion issue is important to you, let me save you wading through the comments below and summarize what I said and believe about that: 1) The most current available scientific data on how contraceptives such as IUDs and Plan B work indicate that they most likely interfere with ovulation and fertilization, not implantation. That is, these drugs are neither definitively nor likely to be abortifacients (i.e., to prevent implantation of a fertilized egg). 2) However, I understand and accept that for people who believe that human life is to be protected from the moment that sperm meets egg, even the unlikely possibility that a contraceptive would prevent a fertilized egg from implanting (i.e., act as an abortifacient) would make these types of contraceptives a poor choice. 3) I do not believe that the ability to get these contraceptives at low cost through insurance should be curtailed for all women based on some people’s moral qualms about them, especially given that those moral qualms are based on a possibility (of a contraceptive acting as an abortifacient) that is neither certain nor likely based on current scientific evidence.

 

 

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  • http://timfall.wordpress.com/ Tim

    “I can’t believe this point needs to be made, but contraceptives are actually not used solely, or even primarily, by women who want to have lots and lots of sex without getting pregnant.”

    And yet I appreciate you making the point, Ellen.

  • Karen Swallow Prior

    Because I believe that a unique human life begins when egg and sperm join and because I am extremely sympathetic to your condition/story, what I would do MYSELF in a situation like yours is ask my husband to have a vasectomy. If the IUD were needed to alleviate the other conditions, I would use that for those reasons (which would then not be “birth control”). I realize that you don’t share my convictions on this, Ellen, and I respect that. I guess I’m just saying that methods that might prevent implantation of a fertilized egg aren’t necessarily the best or only method of birth control. They certainly aren’t if one has pro-life convictions as I do.

    Thank you for sharing your story.

    KSP

    • Karen Swallow Prior

      I do resent the accusation that pro-lifers don’t know how contraception works when the IUD is clearly stated to work such that if an egg is fertilized, it won’t implant. http://www.webmd.com/sex/birth-control/intrauterine-device-iud-for-birth-control

      • Maria

        I am coming to this conversation late, so I cannot speak for others, but I do not automatically assume those advocating the pro-life position are ignorant on contraception. Indeed, I often believe different understanding being “for life” as the heart of the matter for many people, not simply ignorance. Perhaps that’s reductionist of me (and I don’t think the point of Ellen’s article), but it’s just a point of personal clarification.

        …According the American College of Obstetrics & Gynecology and the FDA, the IUD *prevents* fertilization (be it through a change in the uterine lining or the viability of sperm to reach the egg in enough time), rather than ending it. And it makes the lining of the uterus less able to produce and facilitate the release of an egg *to be* fertilized, which is what I got from the webmd article, as well.

        http://www.fda.gov/forconsumers/byaudience/forwomen/freepublications/ucm313215.htm#Implanted_Devices

        • Karen Swallow Prior

          Thanks, Maria. I appreciate your tone and good will. Again, it’s frustrating to me that from the very link you offer here, you omit this verbiage that appears for both the Plan B and IUD entries: “It works mainly by stopping the release of an egg from the ovary. It
          may also work by preventing fertilization of an egg (the uniting of
          sperm with the egg) or by preventing attachment (implantation) to the
          womb (uterus).” It’s right there. I copied and pasted it. I don’t understand why you, Ellen, the Slacktivist, and so many others omit this in the discussions.

          • Maria

            I just typed a response and accidentally deleted it. Agh! In brief, upon re-reading the article I concede that I did not give much credence to that explanation b/c of the phrase “may prevent.” It seemed less credible. That said, words matter, and I receive your point and the challenges it raises.

            By way of a response (and one that is not intended to be tit-for-tat) as I understand it, there are three main types of IUDs. The two approved in the US are hormonally based and prevent fertilization. The Inert IUD, which may prevent the implementation of a fertilized egg, is not approved for use in the US. Wikipedia explains this better than I can (with verified sources to boot). That said, as a historian, I can’t believe I am recommending Wikipedia. In any case, these are some tough questions; amidst differing beliefs, I am grateful for the conversation.

          • http://ellenpainterdollar.com/ Ellen Painter Dollar

            I understand why it seems disingenuous for me to set aside the possibility that IUDs or morning-after pills prevent implantation. I’m going to try to explain a bit further and respond to some other things that have been said here. And then I suggest that you and I perhaps continue this conversation privately, because abortion isn’t the main topic of the post–the characterization of women as whiners (and in some cases, slutty whiners) and failure to see birth control as an essential tool for health, was the main point.

            General information sources on contraception, such as WebMD, are going to paint with a wide brush. So they list all the possible ways that contraceptives might work. Their facts are accurate. How these contraceptives work is not 100% proven. The FDA includes the possibility of implantation prevention on contraceptive labels because that’s the way labeling works–they hedge their bets, they include lists of all potential side effects for medications (including, say, “death,” even if dry mouth is the only side effect experienced by a majority of people, etc.) According to the NYT article, the FDA admits that the labeling for Plan B was “speculative,” including all possible means of efficacy, even if they weren’t proven.

            Such sources, because they are so general and speculative and cover-our-butts-oriented, shouldn’t be the sole source of information. They are factually accurate (anything is “possible”) but incomplete. If you take two minutes to dig a little deeper, you can easily find reputable sources (Mayo Clinic, NYT, medical association web sites, NIH, etc.) that address that important “however….”–the data we DO have indicates a higher probability that these contraceptives prevent fertilization, not implantation.

            Now, I think it’s absolutely reasonable for someone who believes that the act of fertilization is definitive, and who therefore opposes any and all methods of interfering with that life, to say that even the remote possibility that a contraceptive prevents implantation takes it off the table for you. I don’t think it’s reasonable, however, for people to go around saying that Hobby Lobby didn’t want to pay for abortifacients. That IUDs or morning after pills are abortifacients is 1) unproven and 2) unlikely. Speaking of them as if they cause abortions fails to take seriously the current scientific consensus. Fred Clark’s tone is over the top, but I think his point was valid—that some Christians talking about morning-after pills as abortifacients seem to believe that taking a pill to prevent pregnancy after intercourse automatically spells ABORTION when, given what we know about the meds as well as how and when fertilization happens, these pills most likely keep sperm and egg from meeting at all.

            I tend toward Pam’s view that implantation is a more significant marker of life than fertilization, for scientific reasons (a blastocyst remains a blastocyst without a womb to nourish it, pregnancy isn’t defined by sperm meeting egg, it’s defined by when the embryo implants and the woman’s body starts nurturing it) and more theological/spiritual ones (that life can only take root in intimate relationship with another human being). This is the accepted perspective in Jewish reproductive ethics. Tangent: One of the developments I most fear in reproductive technology is artificial wombs because of their potential to allow us to sever the nurturing of life from bodily human relationships.

            I think it’s completely reasonable for a pro-life person to avoid contraceptives whose mechanisms of efficacy are not definitive, to avoid the remote possibility that preventing implantation is one way they work. I don’t think it’s reasonable to call these contraceptives abortifacients and to make law based on the belief that they are.

            Can I suggest that we continue this conversation privately if there is more to discuss? My main point wasn’t the science of contraception (although it’s important enough that I wanted to include it). My main point was how dismayed I’ve been by online chatter painting women who want access to insurance-subsidized contraceptives as whiners who want other people to pay for their careless and hedonistic desire to have lots of sex.

      • http://ellenpainterdollar.com/ Ellen Painter Dollar

        I just noted how you phrased this: “the IUD is clearly stated to work such that if an egg is fertilized, it won’t implant.” So do you read it as saying, essentially, that an IUD can work in a bunch of ways?, As in, it can prevent or delay ovulation; and then if that doesn’t work, it can mess with sperm; and then if that doesn’t work, it can prevent implantation? I’m not sure if that’s what you assume, but the way you stated it here makes me wonder if it is? That would be a huge misreading of what the information means. There isn’t a known, guaranteed step-by-step mechanism for how these contraceptives work. Rather, the data indicate that they do work, and the data further indicate that they most likely work by interfering with ovulation and fertilization. That they might also work by sometimes interfering with implantation is a hedging-our-bets addition to the information on these contraceptives, to cover all possible (not probable, not proven, but possible) mechanisms by which they work. It’s not a description of what will happen if initial attempts to mess with ovulation, sperm, and fertilization won’t work. That may already have been clear, and if so, forgive me. I just read what you said here more clearly and wondered if there was an assumption in what you said that we hadn’t addressed.

        • Karen Swallow Prior

          Why don’t we cut and paste the exact wording from the label. That’s how I assume it works. And that’s the basis for the entire Hobby Lobby case which never would have made it to the Supreme Court if that understanding has as little basis as you, Fred, and the NYT claim. I understand how these methods work is not entirely certain. But if they may work as abortifacients (not the same as abortion), I don’t see why it’s wrong to use that language to distinguish from the contraceptive effect. At this point, I’m ready to continue privately if I have more concerns since you see these points as deviating from your original post (though I see them as the basis of the entire case). Thanks for engaging so graciously!

          • http://ellenpainterdollar.com/ Ellen Painter Dollar

            From the current Mirena patient info: “Mirena may work in several ways including thickening cervical mucus, inhibiting sperm movement, reducing sperm survival, and thinning the lining of your uterus. It is not known exactly how these actions work together to prevent pregnancy.” I wish I had saved mine because I clearly recall reading something in the info I got saying that messing with ovulation and sperm was more likely than messing with implantation. That was an important thing for me, even given how I think about abortion and when life begins and all that. Also, it’s worth reading up on the history of FDA labeling of contraceptives to put this into perspective. But the way IUDs work is not a definitive step-by-step thing. And I still think it’s reasonable for someone who is pro-life as you are to avoid them because of the inconclusive data.

          • http://ellenpainterdollar.com/ Ellen Painter Dollar

            Or to put it in different language, as I explained it to another friend, It’s not 1) they do this and then 2) they do that and then 3) they do this. It’s “they potentially do some or all of these things, and somehow the combination of these things they might do prevents pregnancy, and we’re pretty sure that the things they mainly do is prevent fertilization by delaying ovulation and thickening cervical mucus, but since they also thin the lining of the uterus, preventing implantation is also a possible effect, though not probable. And because we’re the FDA, we’re including all speculative info on what might or might not occur, even though it’s doubtful that preventing implantation is the way they work. We’re going to say it might work that way just the same way that we say you might, you know, die from taking a medication whose only consistent side effect is a dry mouth.”

          • Karen Swallow Prior

            Oh, I understand it’s not step by step. It could only possibly work one way, thereby negating the other ways. Either ovulation, conception, or implantation is prevented, not all three and most likely not the last.

          • http://ellenpainterdollar.com/ Ellen Painter Dollar

            Oh good. OK. I just wasn’t sure and wanted to make sure we were reading the info the same way. Good.

          • Karen Swallow Prior

            Earlier I was referring to the order of effects on the labelling not the order of events. :)

    • Pam Mathews

      Why is her husband cutting off (literally) all potential for ANY life EVER more “pro-life” than having an IUD to prevent implantation? If you want to be truly “pro-life”, once you mess with the process at all, it’s “anti-life.” Personally, I believe either a vasectomy or an IUD for a couple who is done building their family is fine. I do not think that one is morally or spiritually or theologically superior to the other.

      • Karen Swallow Prior

        The difference is between theoretical/potential life and an actual human life–which I believe a fertilized egg is. I suspect one doesn’t have to be against abortion or abortifacients in order to see such a distinction?

        • http://ellenpainterdollar.com/ Ellen Painter Dollar

          We initially chose the IUD over a vasectomy because 1) we were not yet 40 and my husband just had a visceral reaction to definitively ending the possibility of fatherhood while he was still a young man (which I respected…I’m all about the gut feelings) and 2) an IUD is reversible. Given my post traumatic stress after the last birth, and the knee surgery when my son was three months old, I was 90 percent sure we were done. But we used to be 90 percent sure we were done after two. And then it was clear that we weren’t. Permanent sterilization was a frightening prospect for us. So I got an IUD and it was easy for me to get it changed out after five years rather than sending my husband to the OR.

        • Pam Mathews

          I suspect that I simply see the distinctions differently than you do. Which has nothing to do with what I think about abortion. Having had a partial hysterectomy (meaning I could still produce an embryo) relatively young, if I believed that every fertilized egg was an actual life, I would have to believe that my husband and I are mass murderers. So no, I don’t believe an egg or a sperm or a fertilized egg/embryo is an “actual life” until it implants and continues to divide. Another way to look at it is that biology tells us that 50-80% of fertilized eggs never make it from fertilization to implantation. Yet as a Christian community, we do not mourn this massive loss of life that is happening daily. That is what I believe, and, yes, it is different from what you believe.

    • http://ellenpainterdollar.com/ Ellen Painter Dollar

      Just to clarify facts: The insert that came with my IUD says that while mechanisms of efficacy are not 100 percent understood for the device, the most likely mechanisms are the prevention of ovulation, delay of ovulation, and creating a hostile environment for sperm. The small amount of progesterone in the device also thins the uterine lining, which would make implantation difficult if an egg was fertilized, but available data indicate that it’s more likely to prevent fertilization than implantation. This is also true, I believe, of Plan B and Ella, although it’s been a couple years since I did the research. Prevention of implantation is a possibility but an unlikely one.

      http://www.nytimes.com/2012/06/06/health/research/morning-after-pills-dont-block-implantation-science-suggests.html?pagewanted=all&_r=0 “Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say. Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized, and some pills also thicken cervical mucus so sperm have trouble swimming. It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work.”

      • Karen Swallow Prior

        Yes, I keep reading this verbiage on pro-choice blogs but don’t see it put that way by the drug manufacturers or medical web sites such as the one I linked to above. I really would like to see it from such sources. It would move the discussion along so well!

        • http://ellenpainterdollar.com/ Ellen Painter Dollar

          But that link (above) and verbiage are not from a prochoice blog? Also, I think this was the point Fred (Slacktivist) was making: It’s normal for scientists to say it’s possible for such and such to happen, even though we’re pretty sure that’s not the way it happens, and that’s how my IUD’s manufacturer represents the possibility that the device prevents implantation rather than fertilization.

          From Fred’s post: “But isn’t it still maybe possibly conceivable that, in some rare cases, emergency contraception could possibly maybe interfere with a fertilized egg?

          Scientists will answer yes. It’s not probable. It’s not likely. All the evidence strongly suggests that can’t and won’t happen. But scientists, being scientists, will always answer “yes” when you frame a question that way.

          Ask Neal DeGrasse Tyson if a radical increase in atmospheric CO2 will result in climate change and he will answer, unequivocally, Yes. But if you ask him whether it’s possible — not likely, just possible — to imagine that some other unforeseen factor could possibly alter that result, and he’ll say that, yes, that’s technically possible. Tyson is a scientist — ask him to disregard likelihood and spin out possible imaginable scenarios and he could go on forever. But it would be either foolish or dishonest to conclude therefore that Tyson doubts the link between CO2 and climate change. And it’s just as foolish and/or dishonest to grasp at the slender straw of imaginable possibility as “evidence” that emergency contraception is an abortifacient.”

          Read more: http://www.patheos.com/blogs/slacktivist/2014/07/01/sex-ed-for-the-religious-right-conception-does-not-occur-at-ejaculation/#ixzz36MRwNKOy

          • Karen Swallow Prior

            The New York Times? Fred? Both are offering opinions/analyis. I’m looking for information–facts–from the medical community. I posted some above.

          • http://ellenpainterdollar.com/ Ellen Painter Dollar

            Well, Fred, yes, of course! Sorry, I wasn’t referring to him as a factual source but as someone who was taking widely accepted facts about the likely mechanisms of action and basing an opinion on that information. I liked his point but his tone is more strident than I’d go for. I consider the NYT a news source (sorry, I don’t buy the “liberal media bias” stuff). And sure, places like WebMD (which my librarian husband would tell you is a terrible place to find medical information–PubMed and Medline are better, or Mayo Clinic) and product inserts will, for the reason mentioned in my previous comment, include all POSSIBLE mechanisms of action. But it’s not hard to find reputable sources stating that prevention of fertilization is more likely:

            http://www.arhp.org/Publications-and-Resources/Patient-Resources/fact-sheets/IUC-Myths
            “IUC prevents pregnancy. ParaGard, Mirena, and Skyla work by keeping a woman’s egg and a man’s sperm from meeting. With ParaGard, copper repels sperm, so they don’t have a chance to fertilize an egg. The hormone in Mirena and Skyla thickens the mucus in the cervix, and that keeps sperm from reaching the uterus.”

            http://www.mayoclinic.org/tests-procedures/morning-after-pill/basics/why-its-done/prc-20012891

            “Morning-after pills do not end a pregnancy that has implanted. Depending on where you are in your menstrual cycle, morning-after pills may act by one or more of the following actions: delaying or preventing ovulation, blocking fertilization, or keeping a fertilized egg from implanting in the uterus. However, recent evidence strongly suggests that Plan B One-Step and Next Choice do not inhibit implantation. It’s not clear if the same is true for Ella. Keep in mind that the morning-after pill isn’t the same as mifepristone (Mifeprex), also known as RU-486 or the abortion pill. Mifeprex terminates an established pregnancy — one in which the fertilized egg has attached to the uterine wall and has already begun to develop.”

          • Karen Swallow Prior

            Right. “Pregnancy” refers to post-implantation. A woman isn’t pregnant at the moment of conception. “Morning after pills do not end a pregnancy THAT HAS IMPLANTED.” … may act by “KEEPING A FERTILIZED EGG FROM IMPLANTING IN THE UTERUS.” I am reading the “however,” but this information still supports the pro-lifers’ concern (about what happens to a fertilized egg) far more than you or Fred are acknowledging.

          • Karen Swallow Prior
    • Terri

      Karen- do you support the death penalty? Do you foster children or support the welfare system? Because if your answer to either of these questions is NO, the you are not pro-life, you are just pro-birth, you don’t care about what happens AFTER that little life takes it’s first breath, which is really when life begins. Did you even read the article? IUD’s prevent sperm from reaching the egg, therefore NO fertilization, therefore no little zygote that will at some point become a living breathing human.

      • http://ellenpainterdollar.com/ Ellen Painter Dollar

        A reminder that this post is actually not about abortion, so isn’t a place for debating these terms . And Karen is a friend whom I respect deeply, so I won’t let this thread become about putting her on the spot. I appreciate your point of view, but want to keep the discussion on topic, and neither abortion nor Karen are the main topic. Thanks for understanding.

  • Maria

    I am grateful for your ability to illustrate how so-called political matters have a profound impact on individuals, communities, and the embodiment of our faith. As one who relies on contraceptives for reasons other than the prevention of pregnancy, I appreciate how you gracefully addressed the misinformation surrounding this case and how quickly people can misappropriate scientifically supported information through sound-bites, selective interpretation, and, in my opinion, a subjective and narrow definition of what it means to be “for life.”

  • pastordt

    Oh, well done. Thank you, Ellen.

  • Thinking Out Loud

    Is $8.50 per month really a financial decision that you would be unable to make otherwise. I think you are stretching on the impact that insurance has on this decision. In fact, the flow through price without insurance (ie – pay cash) would actually be lower.

    • http://ellenpainterdollar.com/ Ellen Painter Dollar

      Um. $8.50 a month? Not sure what you’re referring to there. I made the point in my post that we would have chosen a less certain/reliable and more user-intensive method (such as the pill, perhaps) if the $500 – $1,000 cost of the IUD (now multiplied by two, since I’m on my second) weren’t covered by insurance. And as I said, I know that an alternate form of contraception wouldn’t be a tragedy, but it would not provide as many benefits to my psychological and physical well being.

  • texassa

    I appreciate this perspective, and I think it is incredibly relevant, BUT I hate that (in general) women and proponents of this viewpoint have to tiptoe around it and make “health reasons” arguments to try to legitimize their stance. Yes, this woman’s struggle and need are important. But so are contraceptives being used as contraceptives! Health care is meant to improve our lives. People can eat like shit, drink, smoke, take risks doing extreme sports, abuse their bodies, etc., and still have the expectation to receive medical care they need. Men can reasonably expect treatment for their flaccid dongs so they can do the needed sexytime. And we reward women who procreate with – yes – medical care for their pregnancies and offspring. Yet somehow women having non-procreative sex is somehow a luxury beyond everything else in life. This whole issue is disgusting.