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Christian Birth Control Options

As part of the Religion Saves and 9 Other Misconceptions sermon series, I answered the ninth question chosen by voters on January 6, 2008: "There's no doubt the Bible says children are a blessing, but the Bible doesn't seem to address the specific topic of birth control. Is this a black and white topic, or does it fall under liberties?" The entire sermon can be found for free at or at iTunes. Furthermore, a greatly expanded version of the sermon content will be published in 2009 by my friends at Crossway, along with the answers to the eight other questions chosen by majority vote for the series. Until then, I wanted to briefly summarize some the main points of the sermon and give some recommended resources for those Christians wanting to further study the issue of birth control.

This blog will summarize the various options that a Christian couple has to consider regarding birth control. I will distinguish between no birth control, contraception, which literally means "against (contra) conception" (such methods prevent conception whereby a sperm fertilizes an egg), and abortion, which terminates the life of a fertilized egg. There are five levels of birth control, ranging from no birth control to abortion. Levels 1-3 should be considered acceptable for Christian couples, level 4 is more complicated and requires prayerful consideration, and level 5 is forbidden and sinful. Lastly, there are sixteen undergirding aspects of a Christian worldview (such as the Bible's teaching on creation, life, gender, marriage, sexuality, and the blessing of children, including adoptive), which were included in the sermon but are not included here for the sake of brevity.

Level 1 - No Birth Control

Some Christian couples determine to only use prayer in their family planning. As a result, they simply enjoy normal marital sexual relations and trust that if God desires for them to have a child, He will provide according to His timing. When this is chosen as the course of action by a Christian couple, family planning by simply praying and trusting that whatever happens is God's good will is acceptable. The only problem is when this conscience preference is legalistically imposed on others as if it were the only acceptable option for a Christian married couple.

Level 2 - Natural Birth Control

Natural methods include any method of contraception where pregnancy is prevented by abstaining from vaginal sexual intercourse on days where the wife is likely to be fertile. The most popular natural method is the calendar-rhythm method, which has been replaced by more effective methods such as the symptothermal method and the standard days method. Fertility computers are a new development in contraceptive technology that makes these natural methods easier to use by telling a couple when sex will or won't result in pregnancy. Natural methods are approved for use by the Roman Catholic Church.

Furthermore, abstaining from sexual intercourse does not necessarily require abstaining from all sexual activity. Natural birth control methods have many benefits. Included among them are the fact that, unlike most forms of birth control, they involve the husband, are free, require no surgery, no chemicals, no devices, no drugs, no side effects, are safe, reversible, and can also be used with other methods such as a condom during fertile times. One of the potential difficulties is that they require discipline and planning, which not everyone is equally faithful to pursue. In conclusion, natural birth control is permissible for a Christian couple.

Level 3 - Non-Abortive Birth Control

Like the natural methods, non-abortive birth control methods also seek to influence the timing of conception but do so by taking either temporary or permanent additional measures. Temporary non-abortive birth control methods are generally barrier methods. Barrier methods of contraception include all methods that permit intercourse but prevent the sperm and egg from coming together. For husbands, this includes condoms. For wives, it includes the diaphragm, contraceptive sponges, cervical caps, and female condoms. Permanent non-abortive birth control methods are those chosen by couples who have decided not to have any more children. This can be achieved either by female sterilization, also called tubal ligation, or vasectomy for men.

Three things need to be mentioned regarding permanent non-abortive birth control methods. First, the heart really needs to be examined regarding motive on this issue; this method should never be used to abandon the blessing of children. Second, it is unwise for this decision to be made too early in life because it is not uncommon for a couple to later desire more children, or for someone to become remarried after being divorced or widowed and desire to have children with their next spouse. Third, there are Christians who are legalistic on this issue and declare that there is essentially never a good reason for such a permanent measure. However, life in a fallen world is complicated and painful. For example, a pastor and his wife who are good friends of mine suffered eighteen miscarriages before he had a vasectomy to stop what had become for them incredible physical and emotional pain.

To summarize, levels 1-3 are options for Christian couples to consider without concern that they may terminate a fertilized egg and thereby take a human life. At the next level we tread into more murky waters that are more difficult to discern for Christian couples.

Level 4 - Potentially Abortive Birth Control

The pill is a categorical term for more than forty types of oral contraceptives, which are also referred to as birth control pills and sometimes combination pills because they contain a mixture of estrogen and progestin. These hormonal contraceptives are designed to override the female body's normal cycle and "trick" the brain into believing she's already pregnant, thus preventing the release of an egg from the ovaries. Today, 50 to 60 million women worldwide take the pill each day and it is the most widely prescribed drug in the world.

The debate over hormonal birth control, particularly birth control pills, is whether or not it results in the taking of a life by destroying a fertilized egg. Randy Alcorn, Christian author and teacher, has addressed this issue in an article called "Does the Birth Control Pill Cause Abortions?" Alcorn refers to the Physician's Desk Reference (PDR), saying:

The Physician's Desk Reference is the most frequently used reference book by physicians in America. The PDR . . . lists and explains the effects, benefits, and risks of every medical product that can be legally prescribed. The Food and Drug Administration requires that each manufacturer provide accurate information on its products, based on scientific research and laboratory tests. As you read the following, keep in mind that the term "implantation," by definition, always involves an already conceived human being. Therefore, any agent which serves to prevent implantation functions as an abortifacient. This is the PDR's product information for Ortho-Cept, as listed by Ortho, one of the largest manufacturers of the Pill: Combination oral contraceptives act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus, which increase the difficulty of sperm entry into the uterus, and changes in the endometrium which reduce the likelihood of implantation. The FDA-required research information on the birth control pills Ortho-Cyclen and Ortho Tri-Cyclen also state that they cause "changes in . . . the endometrium (which reduce the likelihood of implantation)." Notice that these changes in the endometrium, and their reduction in the likelihood of implantation, are not stated by the manufacturer as speculative or theoretical effects, but as actual ones. They consider this such a well-established fact that it requires no statement of qualification. Syntex and Wyeth, the other two major pill-manufacturers, say essentially the same thing about their oral contraceptives.

In summary, Alcorn argues that there is not one but rather three purposes for birth control pills. First, the pill exists to inhibit ovulation, which is its primary means of birth control. Second, the pill thickens the cervical mucus with the effect that it becomes more difficult for sperm to travel to the egg. Third, the pill thins and shrivels the lining of the uterus so that it is unable or less able to facilitate the implantation of the newly fertilized egg.

The bottom line is this, the first two purposes for birth control pills are contraceptive in nature and therefore acceptable for use by a Christian couple. However, the third use of birth control pills is potentially abortive in that it seeks to disrupt the ongoing life of a fertilized egg. That potentiality is incredibly controversial; thus, faithful Christians who are staunchly pro-life and believe that life begins at conception are divided over the issue. Even Focus on the Family and the Christian Medical and Dental Associations (CMDA) are undecided on the issue.

Therefore, whether or not a Christian couple should use birth control pills is a very complicated issue on which faithful pro-life Christians and doctors disagree. As a result, it seems legalistic and inappropriate to declare that use of the pill is sinful. Yet, at the same time it seems that Christian couples need to be informed of the potential abortive nature of birth control pills so that they can study the matter further and prayerfully come to an informed decision according to their own conscience and the leading of God the Holy Spirit.

Level 5 - Abortive Murder

Abortion is the taking of a human life through the killing of a fertilized egg. Biblically, it is also known as the sin of murder. Abortions include medical procedures of various kinds as well as RU-486 or the morning-after pill. Other items that cause abortion are the intrauterine device (IUD) and Norplant, which do not prevent conception but prevent implantation of an already fertilized ovum. The result is an abortion, the killing of a conceived person. Dr. Thomas W. Hilgers of the Mayo Graduate School of Medicine in Rochester, Minnesota, says that "the primary action of the IUD must be classified as an abortifacient." (Thomas W. Hilgers, "The Intrauterine Device: Contraceptive or Abortifacient?" Marriage and Family Newsletter, January--March 1974, 14). Focus on the Family has also issued this statement:

birth control pills which contain only the hormone progesterone do not reliably prevent ovulation (the release of the egg from the ovary). This is also true of Norplant, a device implanted under the skin which slowly releases progesterone. With these methods, the pregnancies which do occur have a greater chance of being ectopic--that is, outside of the uterus. This may be evidence that these contraceptives act in some cases to disrupt normal implantation of an early pregnancy and not merely to prevent conception. Thus, the use of Norplant and the progesterone-only pill is problematic for those who believe life begins at conception.

It may seem odd for me, as a pastor writing primarily for Christian readers, to include this level as a form of birth control. Yet, tragically, many people, including Christians, use abortion as a form of birth control. Undoubtedly, there are very rare cases where even the most devoutly Bible-believing, pro-life Christians are caught on the horns of an ethical dilemma involving abortion (e.g., when the mother's life is at stake), but for the purposes of this blog I am speaking of abortion in its majority sense as a murderous form of birth control. Regarding abortion, a division of Focus on the Family says,

The Alan Guttmacher Institute is a nonprofit corporation for reproductive health research and policy analysis. The Institute is also a public education arm of Planned Parenthood. It reports that one in six women who have had abortions are evangelical Christians. Based on these statistics, 5.6 million women in our churches have chosen abortion as a way out of an unwanted pregnancy. Each year, 1.5 million American women have an abortion. This means 250,000 evangelical Christian women could choose to abort a child this year.
  • Women ages 20 to 24 obtain 32 percent of all abortions. Teenagers obtain 20 percent.
  • Forty percent of women ages 15 to 44 have had at least one previous abortion.
  • Fifty percent of women who have abortions use it as their sole means of birth control.
  • Fifty-eight percent of abortion patients say they used birth control during the month of conception.

Some will argue that there is a difference between a child in a mother's womb and one outside, yet the early church saw both as equally living people and the taking of life in either state as equally murderous. Their convictions were based on Scripture, which uses the same word (brephos) for Elizabeth's unborn child John the Baptizer in Luke 1:41, 44, as is used for the unborn baby Jesus in Mary's womb in Luke 2:12, and also for the children brought to Jesus in Luke 18:15. Simply, in the divinely inspired pages of Scripture, God reveals to us that a child in the womb and a child singing and dancing around Jesus in worship are equally human beings who bear the image of God and thankfully Mary did not abort the "tissue" in her womb because He was God (see Charles H. H. Scobie, Ways of Our God: An Approach to Biblical Theology (Grand Rapids, Michigan: Eerdmans, 834).

Thankfully, Jesus can forgive any sin, even the sin of murder, as he did while hanging on the cross and asking God the Father to forgive those who murdered him. Furthermore, pro-life ministries are devoted to extending the love, grace, mercy, compassion, and support needed for men and women who have suffered from abortion to experience healing and new life. In our church this includes a ministry to post-abortive women run by female deacons who were once sexually active, fornicating feminists who aborted their own children only later to meet Jesus, repent, experience new life, and become godly wives, mothers, and church leaders.

In summary, as a pastor I would support Christian couples practicing levels 1-3 of birth control, urge those considering level 4 to prayerfully and carefully reflect on their decision, and oppose any Christian couple considering level 5, unless there were extremely weighty extenuating circumstances. In eleven years as the pastor of Mars Hill Church, which has seen hundreds and hundreds of weddings and pregnancies, I have not yet faced such circumstances and by God's grace pray I never do. Should that occasion occur, I would work with the family, aided by prayer from our church, counsel from my fellow elders, and outside expert medical counsel to arrive at a decision based on carefully examining all of the variables involved.

For Further Study On Marriage and Family

God, Marriage, and Family by Andreas J. Kostenberger is a significant and thorough biblical examination of everything from gender to singleness, sexuality, marriage, children, parenting, and divorce. Chapter 7 in particular deals with birth control. In my estimation, this book is the finest to date covering a breadth of issues related to gender, marriage, sexuality, and family.

On Birth Control

The Contraception Guidebook by William Cutrer and Sandra Glahn is the best book I have seen for helping couples decide which, if any, birth control method is best for them Does the Birth Control Pill Cause Abortions?by Randy Alcorn is a thoughtful treatment of the issues discussed in level 4 birth control. Free summarized versions of this book along with articles on abortion, birth control, and related issues can be found here. "Should Christians Use Birth Control?" by H. Wayne House is a very helpful article from which much of my research was taken. A History of Contraception by Angus McLaren is a helpful historical overview of birth control methods. The Reproduction Revolution: A Christian Appraisal of Sexuality, Reproductive Technologies, and the Family edited by John F. Kilner, Paige C. Cunningham, and W. David Hager is a more technical examination from Christian thinkers on issues ranging from sexuality to in vitro fertilization, human cloning, abortion, and whether or not the birth control pill causes abortions.

On Abortion

Helpful introductory articles on abortion can be found at the following online locations:

Politically Correct Death: Answering the Arguments for Abortion Rights by Francis J. Beckwith is a helpful book by a highly regarded Christian philosopher. Pro-Life Answers to Pro-Choice Arguments by Randy Alcorn is a helpful resource that equips pro-life advocates to winsomely and wisely defend their biblical convictions. Abortion: A Christian Understanding and Response by James K. Hoffmeier

On Christian Ethics

Evangelical Ethics by John Jefferson Davis includes a chapter on birth control along with a chapter on abortion. Ethics for a Brave New World by John S. Feinberg and Paul D. Feinberg includes material on contraception and abortion.

On Christian Sexuality

Fidelity by Douglas Wilson is designed for men and is a straightforward discussion of what is acceptable and unacceptable sexual practice for God's men. Intended for Pleasure by Ed Wheat is a very practical book for both husbands and wives. A Celebration of Sex by Douglas Rosenau is the Christian book regarding nearly every conceivable sexual question and issue. The Wounded Heart by Dan Allender is a very helpful book for victims of sexual abuse to experience healing and transformation. Intimate Issues by Linda Dillow and Lorraine Pintus is a very helpful book for Christian women who need a biblical understanding of sexual freedom as God intends. Intimacy Ignited by Joseph and Linda Dillow and Peter and Lorraine Pintus is a helpful exploration of the Song of Songs for married couples. Sex, Romance, and the Glory of God by C. J. Mahaney is a book for Christian husbands. God on Sex by Daniel Akin is a helpful exploration of the Song of Songs.

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