how I learned to stop worrying and love the Pill, part two


Put in incredibly simple terms, hormonal birth control works thusly:

Step 1 : it prevents ovulation.

“Ovulation,” for the uninitiated, is when a mature egg is released from the ovary and become available for fertilization. “Prevents,” in this case, does not mean that the pill stops the egg from peaking its little head out of the ovary. It prevents because no egg develops to maturity. Simply put, there is no egg to come out of the ovary in the first place. This is one of the most important parts about hormonal birth control options, and something no one seems to pay attention to.

This is also the most important part for me. PCOS means that I get too many cysts developing at the same time, or they never stop developing, and I never experience a menstrual cycle. Ovarian cysts are normal– an ovarian cyst is where the egg matures. Hormonal birth control works to treat PCOS because it does not allow ovarian cysts to develop. An additional part of this process is that even if an ovarian cyst develops, there’s another chemical block in place that stops an egg from forming inside of it.

No ovarian cyst, no egg, nothing mature enough to be fertilized.

But, in the exceedingly rare case (if it wasn’t rare, it would be useless as a treatment for PCOS) where there is a cyst and an egg is developed, we move on to–

Step 2:  eliminate the possibility of fertilization

This is pretty straightforward, and it comes in two steps. The progesterone in hormonal birth control options thickens the cervical mucus– makes it insanely more difficult for the sperm to reach the egg, which is already difficult– and it makes the egg harder to fertilize. So, even if a cyst develops, and if an egg develops inside of the cyst, and IF the sperm makes it up through the thickened mucus and all the way up the fallopian tube, when it reaches the egg, it’s going to have a hard time fertilizing it.

At this point in the process, the possibility of an egg being fertilized is so vanishingly small it’s not even really worth talking about, but I’m a-gonna, because it’s where the pro-life movement starts lying their little tooshies off.

“Supposed” Step 3: prevent implantation

At this point, the egg is a zygote, which is just the technical term for “fertilized egg.” For a lot of people this is where “conception” happens (which, problems), so this is where people start thinking that hormonal birth control is Just the Most Evil Thing those Evil Doctors have Ever Invented.

The most frequent term you’ll find in information about how this works is that the uterine wall is “hostile” for the egg. This is a misnomer. The uterine wall is exactly the same as it ever was, just  thinner (hence, lighter periods). There’s no study that shows that the uterus becomes “hostile”– in fact, the scientific studies show that hormonal birth control options do not alter the uterine lining in any significant way except for making it slightly thinner, and are incapable of contributing to zygote failure (which I’ll explain).

This is the part where the pro-life movement lies. Because, at this point, they claim that this where the Pill murders babies. Literally starves them to death. Because it takes a baby (zygote), and then refuses it the opportunity to grow. It never grows, the woman’s body never receives the signal that she’s pregnant, and then the uterus expels the zygote and the uterine lining: therefore, MURDER.

Ok, folks, this is where I have All the Problems.

Let’s talk about the zygote, the supposed “great red herring” of the pro-choice movement.

The zygote is a single-celled organism, which through mitosis goes through stages (blastocyst, then embryo). Over fourteen days, it has to develop into an embryo, and the embryo has to develop the conceptus in order to attach to the uterine lining. The uterine lining, at this point, must transform from the decidua to the placenta.

Hormonal birth control methods are incapable of terminating a viable pregnancy. They are designed, in an unbelievable number of unnecessary steps, to prevent fertilization from ever occurring. Not by turning the uterus into a baby-killing machine. That’s patently false, and a bald-faced lie. If a woman’s body develops an egg, the uterine lining is unchanged. If there aren’t enough of the synthetic hormones present to prevent ovulation, there’s not enough of the hormones present to affect the uterine lining. If there’s no egg, then the uterine lining is thinner, possibly, and that’s the only real difference.

It’s a complete misunderstanding that in the case of supposed “breakthrough ovulation” that the uterine lining is still thinner. It’s not.

Here’s what the pro-life movement also refused to discuss:

All the medical studies I could scrounge up reveal that 60, 70, maybe 80% of all zygotes fail to implant on the uterine wall, when the woman is trying to conceive and is not on hormonal birth control.

Let me say that again: as many as 80% of all “babies” never implant in the uterus completely on their own.

For those that do manage to make it, another 30% don’t survive the first few weeks.

Let’s do the math again: 72% to 86% of all zygotes, which the pro-life movement refers to as babies,diewithout any outside interference whatsoever. When a woman is not on the Pill, zygotes fail.

When a woman is on the Pill, there’s rarely ever a zygote, and when there is one, it faces the exact same rate of zygote failure as a woman who isn’t on the Pill. The upside? When a woman is using hormonal birth control, there are less zygotes. Somewhere in the ballpark of 98% less zygotes.

Let me make this more clear: if zygote failure is “murder,” and hormonal birth control options drastically reduces the number of zygotes, the number of failed zygotes (i.e.: “murder”) is also drastically reduced.

Tell me again how the Pill is evil?



I wanted to include some information I have that might clarify my basic argument in this post: that hormonal birth control options don’t interfere with implantation. I’ve already made it clear that hormonal birth control doesn’t make the uterus as “hostile” place for the zygote, but I thought it might be helpful to explain why, biologically, this is so.

A menstrual cycle is just that: a cycle. It goes through three steps, or stages. The first is the follicular phase, where the uterine lining is thin. Thin, in the same sense that it is thin while a woman is on hormonal birth control. It is not capable of of allowing the conceptus to attach.

However, part of the ovulation phase is that ovulation releases a trigger for the uterus to begin the luteal phase, where the lining becomes thicker and the conceptus is able to attach.

If a woman on the Pill ovulates, this releases the hormonal trigger, and the uterine lining thickens because it enters the luteal phase. If she does not ovulate, the uterus does not receive the trigger, and the uterine lining remains exactly the same as it ever was.

You can read about this on wiki. Seriously.

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  • thanks for spelling this all out and putting it out there. I’ve found the same as you in my research, and i am frustrated that i put off taking something that has helped me so much because of misinformation from people who blamed everyone else for lying. :/ do they intentionally lie in the name of Jesus?
    Nancy Campbell is where i got a lot of my information, btw. i mean, when i believed that BC was evil, it was from her teachings.

  • Reblogged this on Lana Hobbs the Brave and commented:
    a post detailing why the ‘evil pill’ is not actually evil and abortifacient. I’m sad i held off taking birth control pills – which have helped me with health problems – due to the misinformation. I’m angry that the myth of an abortifacient pill is still being spread.

  • I always wondered how the pill was supposed to help with my PCOS. I get it now. Thanks!

    Also you freaking rock.

    • Y’know, one of my favorite complements is “freaking rock.” I think it’s cuz I love P!nk. 😀

  • Just an FYI: there is a package insert which comes with the Pill, or any prescription medication. You’ve seen them; they are generally quite long and filled with all sorts of biological information about the structure of the med, how it works, and side effects. This is from the insert for Yasmin, which is the COMPANY’S explanation of how it works: “12.1 Mechanism of Action
    COCs [combination oral contraceptives] lower the risk of becoming pregnant primarily by suppressing ovulation. Other possible mechanisms may include cervical mucus changes that inhibit sperm penetration and endometrial changes that reduce the likelihood of implantation. ”
    So, it isn’t a lie that there are changes in the lining of the uterus which makes it more difficult for the fertilized egg to implant. The pro-lifers, like me, are not trying to deceive anyone. Personally, I do not care if women use the Pill for any reason. It is their choice. But these inserts are there to make certain that the patient has the ability to make an INFORMED choice about taking the Pill, or any other kind of medication. Please do not call pro-lifers “liars”. We get our information from the manufacturers of the Pill. Finally, I was raised in a fundamentalist church, and my mom was thrilled when the Pill came out. There was no prohibition about its use in that church. This is a very complex issue. Thanks for hearing me out. I love your blog. I am no longer a fundamentalist, either.

    • That is true– hormonal birth control options do affect the uterine lining. However, studies tend to indicate (we don’t really know that much about how the Pill ACTUALLY works) that if an egg is present, then the uterine lining is unchanged. Yes, the uterine lining is affected and the effect would make it harder for an egg to implant. But that is only true if there isn’t an egg to implant in the first place. The uterine lining is developing a the same time that an egg is maturing, so if an egg has been allowed to mature, then so has the uterine lining.

      It’s not the lack of information– it’s how the pro-life movement has repeatedly chosen to present this information.

      I realized when I chose to use the word “lie” that I was choosing a word that can be taken as inflammatory and accusatory, and that’s part of the reason why I chose it. I debated about it for almost a month, actually. However, I think that the pro-life movement (as a whole) routinely uses misdirection, misinformation, deception in its efforts, so I decided to keep it.

      • Thanks for your clarification, and also thanks for listening to me. I’m pro-life, and I do not lie. Nor do I misdirect or obfuscate. I became pro-life after studying anatomy & physiology, as well as fetal development, in nursing school. I do respect those whose views differ from mine. I do not see a reason to lie–opposing points of view are common in the life arena, and I believe in civility. Anyway, thanks again for listening and responding. I’m now subscribed to your blog. I find that your arguments are well reasoned and well articulated.

        • [does a happy dance] I like listening, especially with civility.

          I’m in an interesting position, because I’m wrestling with this issue, grappling with it in a way I never have before. No matter where I stand, I believe that reducing the number of abortions in this country is a worthwhile and necessary goal– for everyone involved. My beef with the rhetoric of the pro-life movement is that it’s gotten hijacked by people with huge political agendas and those who are willing to say anything to get elected.

          • On that point, about the pro-life issue being hijacked by politicians, we agree! (happy dancing with you).

    • It’s a pretty sure bet that “other possible mechanisms may include endometrial changes” is something they choose to put on their labeling to protect themselves, not something that represents any measured statistical effects.

  • I am loving this series! I got on the pill when I was about 15 because of a hormonal imbalance that caused long, awful periods. When I finally told my mother (not something we chatted about frequently), she matter-of-factly said, “Why didn’t you say something sooner? You inherited this from me. I’m sorry. Let’s go see the doctor; she’ll get you on the pill and it should fix it right up.” No one made a big deal of it, not my mom, my dad (who really didn’t want to talk about periods in the first place), or my doctor. I had a problem, and the pill would fix it. I spent 2.5 years at a Southern Baptist university, and I was quickly trained that I needed to be secretive about taking my pill. I used to just whip out my bc pillbox whenever it was time for my pill. No more shame than when I took out ibuprofen or my inhaler. It was medication, and there was nothing wrong with that. In college though, it meant I was sexually active. It meant I had no morals. It meant I was disobeying God. Goodness gracious, I am so glad my parents had laid a confident foundation that there was nothing wrong with taking the pill (as medication or for birth control purposes), or college would have destroyed me! This is one area of the purity culture/crappy-ways-the-church-can-treat-women that I was, in large part, able to miss out on, but there are so many who didn’t. There are a ton of problematic things about the pro-life/pro-choice debate, but I think one of the most troubling is that a lot (definitely not all) of pro-lifers have caused women to fear a medication that can treat an ailment, be it something as basic as acne, an eternal period, or something as huge as PCOS. It is so important for women and girls to be truly educated on the pill, not just blindly trusting things they’ve heard. Thanks for writing this!

    • I agree with you 100%. I’m sorry for those women who fear taking the Pill in public because they think people will think they are sluts. It’s nobody’s business what medication your are on. Period. Glad you found help. My own daughter was on the Pill for a number of years because she inherited heavy, painful periods from me. But, let’s be real: you don’t have to justify taking the Pill for medical reasons. So what if people think it’s for birth control? Again, it’s nobody’s business that you are on the Pill, or for what purpose. I detest intrusion like that. The really sad part is that people will actually comment on what medication another person takes.

  • MyOwnPerson

    This is something I’ve tried discussing with anti-pill pro-lifers, usually in response to misinformation about the pill posted to Facebook. It usually ends with, even if the pill does greatly reduce the number of zygotes that fail to implant, the few that might fail to implant will be the woman’s fault because she took the pill. So, woman A doesn’t take the pill, 86 zygotes fail to implant, woman B takes the pill, 14 zygotes fail to implant, woman B has committed murder because of the tiny chance that the thinning of the endometrium is what caused the zygotes to fail to implant. It seems that pro-lifers who hold that position have had it ingrained so long that it’s difficult for them to see the pill favorably even when it’s explained to them.

    • I’ve run into this plenty of times, too. It just boggles me because they want to say that a zygote is a baby with a soul, but they’re completely and totally unphased by zygote failure.

      • MyOwnPerson

        Yeah, I’m pro-life and I don’t understand that either. I’ve asked how in this case saving many zygotes theoretically at the expense of the few is different from other real-life trade offs. Like how people die from air pollution yet using energy isn’t murder because it saves more lives than it costs. They say it’s different because if you lose a zygote on the pill it’s murder because you actually wanted that baby to die. It’s majorly confusing. I think it just distills down to them not being able to change their emotional reaction to the pill.

  • Really excellent job laying all this out in a clear and accessible fashion. Good to have it all in one place, that’s for sure! I suspected there was a connection somewhere between the uterine lining issue and the ovulation issue….now I know. Do you have a source for that, just so I can keep it on hand?

    Often, anti-pill pro-lifers will leave out Mechanism 2, the inhibition of fertilization, and jump straight to Mechanism 3 so they can pretend the pill’s effectiveness is due to blocked implantation.

    But let’s say that implantation CAN be inhibited (just for discussion).

    Know what else inhibits implanation? Aspirin. Coffee. Alcohol. Tea. MSG. Salt. Ginger. Licorice. Aspartame. Cheddar cheese. Chicken. Fish. Figs. Sausage. Hot dogs. Chocolate. Sour cream. Shrimp. Yogurt. Ice cream.

    Every single one of these contains enzymes that can function a vasoconstrictors, reducing blood flow to the endometrium. This reduced blood flow causes wall thinning and a decreased chance of implantation. Do the pro-lifers expect sexually active women to abstain from every one of these foods on the off chance that they might prevent the implantation of a zygote? I should hope not.

  • The Religious Right’s opposition to birth control pills (and emergency contraception such as Plan B) is silly, as you’ve pointed out. I want to scream every time some anti-abortion activists calls Plan B an “abortion pill”, because it does not abort existing pregnancies. The Religious Right really needs to do its research into reproductive facts.

  • Pingback: How I Learned to Stop Worrying and Love the Pill – Part 2()

  • This is excellent; thank you. I simply cannot believe that God allows 80+% of human beings to die before they even become embryos. So I don’t think “life begins at conception” can be true. Not if “life” means “full human life with a human soul.”

  • Hi, I’m a little late to the party, but I’m just discovering your blog and I have spent most of the evening browsing the archives.
    I’m a homeschool graduate, oldest-of-seven, ex-fundamentalist. Now a midwife, PhD student, and feminist. I’m still finding my way on a lot of these issues, so I appreciate your honest perspective.
    Midwifery was really my gateway drug to feminism, and leaving fundamentalism. 🙂
    And as a midwife, I really respect your treatment of this subject. The incredibly horrid scare tactics that most of the right uses to frighten and manipulate women on the issue of birth control absolutely make me crazy. I love helping women make informed decisions that are congruent with their beliefs, but I know that informed decision making is dependent on true information. At that point each woman and couple can make good decisions for their own family.
    Reading these posts with a box of tissues by my chair.
    Keep pressing on, my sister. 🙂

  • Just ran across your blog and have been reading through some of the posts. I appreciate this one quite a bit. Yay, science! When my husband and I got married, I read up on birth control methods (and spent quite a while reading “Taking Charge of Your Fertility” which is fantastic because, even if you don’t want to use NFP, it’s a good thing to understand your cycle and your body) and picked one that I felt would be easiest for us to manage. I didn’t go with the pill because I tend to pick up annoying side effects from medication (e.g., anti-nausea meds make me nauseous), and I didn’t want to deal with taking a pill everyday. We ended up with a barrier method that’s worked fairly well for us (nearly six years of marriage, only 1 kid–she was a surprise but not an unwelcome one at that point, since she arrived just before our fifth anniversary), and we’ll be doing something permanent so birth control won’t be an issue for much longer. Of course, that’s anathema in some Christian circles, too. I have a lot of friends for whom the pill has been an excellent choice of birth control, and others for whom it hasn’t been such a great fit and who’ve ultimately ended up using other methods. I’ve only occasionally run into “the pill kills babies!” rubbish and never really understood where they were coming from with that. A lot of it seems to be based on a misunderstanding of how biology works. It’s not as if you conceive as soon as you have sex, after all, but that seems to be a common misconception (pun not intentional).

  • carter

    Thanks for the clear and concise post. That kind of misinformation kept me off the pill for years! Along with the kind of misinformation Christians love to spread about the pill being ineffective, unhealthy, and harming fertility. Reality: when you find the right form of birth control for you, it can be pretty frickin’ great.