Wednesday, November 30, 2016

Elevator Speeches

Here are my quickie explanations for some of my countercultural choices. If someone really wants to know what I think, I tell them without holding back, in a way I think they'll understand.

Not prescribing contraceptives
Credit: euthman
I counsel about everything, but there is enough cell biology to make me think human organisms form at sperm-egg fusion that I don't like the post-fertilization effects of hormonal contraceptives. Barriers are harder to find a problem with, to be honest, but sex at its best is a total gift of one person to another, and barriers block some of that gift. I know it's not a perfect world, but (not to be crass) I want everyone to have sex at its best and I think not having that has bigger ripple effects than we think.

Opposing abortion
There are a lot of people personally affected by abortion, and I don't know where you stand. I can't pretend I understand any particular person's story but I can at least speak to the science that I tried to delve into. There is enough cell biology to make me think human organisms form at sperm-egg fusion, but that's the easy part. If we think there's an organism with human DNA formed at fertilization, the hard question is, when do we protect it like we protect the mom? When we're potentially talking about--ending of millions of protectable human life--I say we should be cautious. 

Offering NFP
I really think women should learn about all their options, and the quality of the evidence that supports each of them. There are fabulous numbers attached to several fertility awareness-based methods, but we need to acknowledge that these studies haven't passed through the rigors of statistical significance, peer review, and FDA approval.

Being a Christian
I believe there is a truth, something objective that exists and that is right and wrong. If you think that, you realize that truth has staying power, which is why fads and memes slip away so fast. One of the things with the greatest staying power is a two thousand year old story of a man who reportedly rose from the dead to save sinners. I'm a sinner, and I thought that staying power was something worth looking into. The rest can't fit into an elevator speech.

Being a Catholic
History leads to Catholicism. You can tell that men writing in the early decades and centuries A.D. were very identifiably Catholic. The reason why I'm Catholic isn't because I love the customs, the people in the hierarchy, or the feelings I get. It's because I love Christ and I see that this is the Church He founded.

Being a consecrated virgin
The Jewish idea of the people of God as the bride of God really flowered within the Catholic faith, and in the early centuries there were women married permanently to God. That rite is used today, and it's a beautiful life.

This post was a draft for a long time, because it takes me a lot of introspection and lived experience to encapsulate things that are this controversial and this important to me. Hope this is helpful!

Tuesday, November 15, 2016

A Licit Device to Prevent Pregnancy?

Every few years the story about the "nuns in the Congo" that a pope (usually it's Bl. Pope Paul VI) said could take birth control resurfaces. Inevitably there are debunkers and rebunkers. It's very hard to find original documentation on this question, even in the age of the internet, because it was apparently all internal memos from theologians.

The story causes lots of confusion, but probably shouldn't because A) there was more estrogen in pills back then, so they probably were all truly anti-ovulant, B) it wasn't known that pills could even be contra-gestive or abortifacient, and C) emergency contraception (i.e. anti-ovulation or anti-fertilization in nonconsensual intercourse) is even now viewed as legitimate in Church teaching.

Nevertheless, every time the story arises, I think to myself: what sort of intervention could be licit in such a situation?

The problem is this: I need effective pregnancy prevention without post-fertilization effects. An ideal intervention would be anything that prevented fertilization only, such as something that inhibited cervical fructose production, capacitation, or the acrosome reaction. Of questionable permissibility would be something to inhibit the zona reaction (preventing the thick rind of chemicals around the egg from hardening), which would allow polyspermy and lead to a nonviable embryo. If life begins at sperm-egg fusion (which I find compelling) then allowing polyspermy would allow some viable embryos to become nonviable due to increased chromosome content.

But none of that technology exists. Just considering existing technologies, the most effective preventative devices are hormonal, but the only licit ones are barriers, and those mostly rely on male cooperation (or don't prevent STDs, like the diaphram). Hormonal strategies are illicit because they have post-fertilization effects. Going back to the doses of estrogen that pills contained in the time of Pope John XXIII is unsafe for women.

What I'm about to say does not come from an ethicist, a Church official, or even someone with a real degree in theology. 

A diaphragmJust for clarity: the Catholic Churchis very clear that barrier contraceptives like
diaphragms are gravely sinful in marriage.
So, I guessed, maybe I need a barrier with hormonal-but-not post-fertilization effects. Maybe (this sounds really uncomfortable but hang on) a diaphgram plus or minus a cervical extension designed to go to (but not past) the endocervical os. The device could have a very, very low concentration of  levonorgestrel in it, so low that it had only autocrine effects on the cervical crypts only, and not on endometrial tissue or ovaries. Perhaps levonorgestrel would have too long a half life, and we'd have to synthesize a shorter-acting progesterone or one that had a long half life in an inactive form, then a short half life in an active form.

The result would probably be a ton of mechanical cervicitis. But (maybe) no postfertilization effects and effective pregnancy prevention. You could decrease the rate of cervicitis by using it only during your fertile window. (And maybe the diaphragm part of it could include a BBT thermometer component so that the device itself could tell you when to take it out, or an app connected to the device.)

But is this a good thing? Is it a crutch that would just act like another LARC, or would it help women (especially those who learned to chart so that they could use it only 5-10 days a month)? Would it drive us even deeper into the culture of death by helping people in absurd states (e.g. these women and this woman), or would it help lift us out, until we're more ready for the ideal of everyone-married-and-using-NFP?

And where do I go now? The patent office, or the confessional?