Informed Consent and the Pill

Like many women, when I was given the birds and bees talk, I was told about hormonal birth control pills as a common method of contraception. Indeed, 14 percent of women take the pill.

There’s plenty of controversy to be had around this drug. And to be clear, this is not an anti-contraception article; I personally have no problem with contraception. While opinions on birth control vary, the aim of this article is twofold: to open the conversation about informed consent within the medical industry and to talk about how oral contraceptives actually work.

When it comes to the pill, women are left in the dark regarding how this medication works. We’re often simply told it prevents pregnancy or ovulation. But this is only part of the picture. The full picture holds an unnoticed truth: The pill is abortive.

Considering how shocking this is, especially for the pro-life crowd, we might think it would be mentioned more often. And for anyone who’s been given the typical explanation of how the pill works, this will come as a surprise—despite the touted importance of informed consent by major medical organizations. So, how does the pill really work? What’s the full story? And why does this even matter?

How Does the Pill Work?

Hormonal birth control pills stop pregnancy in two ways. First, the pill prevents an egg from becoming fertilized through a variety of means (depending on the type of pill). This is the way that the pill was initially explained to me, and given this description, to me, there wasn’t anything wrong with this form of contraception.

However, the second way the pill stops pregnancy is by thinning the endometrium (the lining of the uterus) to prevent a fertilized egg from successfully implanting in the womb.

From my perspective, and the perspective of many pro-lifers, life begins upon fertilization. An embryo, implanted or not, constitutes a unique human life. As a result, by preventing the embryo from implanting and thus developing and growing through pregnancy, the pill aborts that human life. Once again, whatever your stance on contraception, this is important information about how the pill works.

By all accounts, the pill is not treated or viewed this way by many women and doctors. And many pro-life women aren’t even aware oral contraception acts this way, so they may see nothing wrong with or even questionable about the pill.

Informed Consent

Beyond the pro-life issue at play here, this topic has wide-reaching impacts for all women. Knowing how the pill works is a matter of informed consent. Whether pro-life or pro- or anti-contraception, women should know what the drugs they are taking can do to them and a potential baby.

The simplistic explanation of “the pill prevents pregnancy” does not fully capture what this drug is really doing. It’s a watered-down version, and it doesn’t tell women what this drug does to their bodies. Taking a medication solely on the basis that we should just trust the experts’ opinion without explanation is a leap backward in medical ethics. Obviously, there’s always an element of trust when taking a drug: We have to trust our doctors aren’t lying to us, for instance. However, the ideal we should strive for is an environment where we are able to make decisions with all the available information.

This is only one case in a host of informed consent issues plaguing today’s medical system. With the COVID-19 vaccines, information is still coming out that reveals the pharmaceutical companies lied (outright or by omission) to the public about these drugs.

More broadly, when informed consent is ignored repeatedly, trust in the medical system degrades. If we’re constantly lied to, why would we continue to trust those who lie? As I previously wrote:

“In 2022, only 38 percent of Americans had a ‘great deal’ or ‘quite a lot’ of confidence in the medical system, according to a Gallup poll. Another 38 percent of Americans had ‘some’ confidence in the medical system, and nearly one quarter of the population had ‘very little’ confidence in the medical system.”

And if we can’t trust the system that is meant to prevent and heal everything from strep throat to broken bones to chronic disease, then we are in dire straits.

Is There Hope?

In these situations, the expression “knowledge is power” is particularly relevant. A dearth of information—or outright censorship—is one reason we’re in this predicament. By having these conversations about the pill with our daughters, female friends, and other women in our lives, we can give people the information they need to make an informed choice. And more generally, by exposing the lies in the medical system, we can open a conversation to reforming the industry so it can return to its true purpose: healing people.

Image credit: RawPixel, CC0 1.0