What Catholic Social Teaching Says About the Status of Embryos Part Two

Part Two: Chemical Abortifacients and the Human Embryo

By Angela Lanfranchi MD, FACS

It is estimated that about 53% of all induced abortions in the U.S. and 60% of all abortions completed before 10 weeks gestation are caused by abortifacients. An induced abortion of an embryo or fetus up to 11 weeks is achieved under different protocols. This can be done using the progesterone antagonist mifepristone and the prostaglandin E1 analogue, misoprostol, in combination with mifepristone or by misoprostol alone.

Interestingly, experiments in rats that undergo medically induced abortions using mifepristone also undergo similar behavioral changes as post-abortive women such as depression, withdrawal from normal social behavior, and signs of despair.

Emergency contraception (EC), known as the “morning after pill,” can also act as an abortifacient if a woman had already ovulated and an ovum was released into the fallopian tube near the time of sexual intercourse. In 1999, this was acknowledged by the scientific arm of the largest abortion provider in the U.S., the Guttmacher Institute, which stated “as is the case with all hormonal contraceptive methods (EC) also may prevent pregnancy either by preventing fertilization or by preventing implantation of a fertilized egg in the uterus.”

Embryos are also denied life through the abortifacient effects of hormonal contraception. This is more than a theoretical argument based upon the evidence that women can become pregnant while taking hormonal contraception and that some of these embryos might not be able to implant and grow successfully into a fetus. Nor is it just based upon the fact that “the Pill” gives women light periods, i.e. an endometrium too thin for implantation. The endometrium doesn’t thicken very much before what is thought to be menses in the last week of a 4-week Pill pack used for contraception. It is actually withdrawal bleeding that is experienced by women while taking the week of “dummy” pills containing no hormones and is assumed to be the onset of menstrual bleeding.

Ironically, it was IVF studies that largely provided the data to know that estrogen-progestin hormonal contraception in all its forms (pill, patch, ring, implant, injection or IUD) is abortifacient to embryos. There are multiple physiologic consequences through multiple chemical pathways that cause all hormonal contraception, whether estrogen-progestin combination or progestin only contraception, to be abortifacient. The death of human embryos results from being chemically thwarted from implanting into the uterine wall through multiple mechanisms. Only one example of a chemical mechanism will be given here regarding integrins.

Integrins are molecules that allow for the proper orientation of the mature blastocyst to adhere to the uterine wall with its outer cells that become the placenta so that the inner cells which become the body of the fetus can grow properly. As  Australian pharmacist John Wilks  states in his classic paper, The Imapct of the Pill on Implantation Factors-New Research Findings, “Integrins are cell-adhesion molecules found in a ‘mirror’ fashion on both the human embryo and the lining of the womb. These integrins bind onto each other, via gluco-proteins (e.g. fibronectin). The success or otherwise of this binding process is intimately linked to the ongoing success or otherwise of the pregnancy.” Integrins allow proper orientation of the blastocyst much like the space shuttle needs proper orientation to link up with the international space station at the docking station as Wilks so aptly puts it.

It is known from IVF studies that for implantation to occur, there is a minimum thickness required of the endometrium which is about 8.5 mm. In about 90% of conceptive cycles of women with normal ovulation the endometrium achieved 10 mm thickness. A recent 2023 study in the journal Human Reproduction showed hormonal contraception “as significant independent risk factors for a thin endometrial lining” and is associated with miscarriage.

Please note that in this article concerning Catholic Social Teaching, factual definitions of when pregnancy begins and the stages of human development in the womb are those that were in place in standard embryology texts when I studied embryology as a medical student in the mid 1970s. The new official government sanctioned terms came with and continued after the advent of hormonal “contraception” in the 1950, its more widespread use in the 1960s and during the sexual revolution of the 1970s. These changes were necessary so that these powerful sex steroidal drugs, dissimilar to our own natural hormones, would be more willingly consumed if they weren’t known to be abortifacient. Therefore, the beginning of pregnancy was redefined to be implantation, not conception. For example, the use of the term “contraception,” which this author also uses, is a misnomer.  The word evokes a belief the drug is against conception i.e. prevents conception.  However, reading medical journal articles printed at the time of their introduction reveals that pharmaceutical research scientists and Ob-Gyns who prescribed them knew one of the mechanisms that made “the Pill” efficacious was the prevention of implantation of the blastocyst by the thinning of the endometrium rather than just preventing conception of an embryo. This mechanism was in addition to thickening cervical mucus impeding sperm and the prevention of ovulation. It should be noted that since the advent of the first commercially available hormonal contraceptive, Enovid, estrogen levels were lowered due to fatal adverse effects such as venous thrombosis causing pulmonary emboli, stokes, and heart attacks. The estrogen levels in early formulations of the Pill required supra physiologic levels of estrogen than found in normal menstrual cycles to prevent ovulation. Today’s formulations don’t prevent ovulation in all cycles. For example, women ovulate 50% of the cycles while taking the progestin only minipill and therefore has more likely an abortifacient outcome despite the intent to prevent pregnancy.

Protecting the Human Embryo, No Matter How Small

Catholic Social Teaching demands the reverence and care for all human life, no matter its temporal stage of development. Parents are co-creators with God of each unique human life. Each human being has the same eternal soul throughout its life whether that soul is in the habitus of embryo, fetus, infant, child, tween, teen, adult or elder stage of his or her one life.  Human physical bodies change over a continuum. Even though early embryos are microscopic, inside a woman’s body hidden from sight, unseen by the naked eye in a petri dish or frozen in a test tube, they have an eternal soul and God given human dignity. They should be protected from unintended or intentional death whether in petri dishes or in-utero. Embryos should not be forgotten no matter the intention of the person taking a drug or undergoing a procedure, whether to create, prevent or destroy nascent life.

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If you missed the first part of this two-part series, you can read it here.

Dr. Angela Lanfranchi is a breast cancer surgeon and is the president of the Breast Cancer Prevention Institute, which she co-founded. She is also a Clinical Assistant Professor of Surgery at the Rutgers-RWJ Medical School in Piscataway, New Jersey. Dr. Lanfranchi is an active member of the Catholic Medical Association, serving as the New Jersey State Director and is a member of the only guild in the state, the South Jersey Catholic Medical Guild of the Diocese of Camden. She is also a member of CMA’s Catholic Social Teaching on Justice in Medicine Committee.

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