Ladies and gentlemen, we have a problem. I wrote about this problem at RH Reality Check, but in the days since it’s only gotten worse. (By the way, Katha Pollitt and I communicated about my linking of her article, and we see eye-to-eye on this---she, as I suspected, was under a column length crunch and couldn’t address every nagging detail. So I want you to say I’m not criticizing her, but simply pointing out that there’s a, let’s call it a “plot hole” in the pro-choice narrative.) The problem is that, in addressing anti-choice narratives around the personhood amendment and in explaining why such a thing can and probably will be used to restrict the birth control pill, feminists are giving air to an anti-choice misinformation campaign to redefine the pill as “abortion”. I strongly suspect that personhood amendments aren’t even really intended to win so much as to give anti-choicers frequent opportunities to claim the pill works by killing fertilized eggs. The long game, I believe, is to get that false belief ingrained in conventional wisdom, and then use it to apply existing abortion restrictions to the birth control pill. I especially suspect that the intention is to make sure that the Hyde and Stupak amendments are expanded to include the bill, meaning that the only way women will be able to get it is through out-of-pocket funding.
I realize that doesn’t make a lot of sense. Even if you buy the scientific misinformation that the pill works by killing fertilized eggs, that still wouldn’t make taking it an “abortion”, because pregnancy begins at implantation, not conception. The problem with making that point, of course, is that activists, legislators, and the courts aren’t beholden to the medical definition of an abortion. They argue life begins at conception, and so from their point of view, anything that interferes with that is an “abortion”. More importantly, you could call it a “tiddlywinks”, and they wouldn’t care. We aren’t really arguing about terminology here. They’re trying to claim the pill kills fertilized eggs, which are granted greater status in our culture than non-fertilized eggs, and they hope by doing so they can stigmatize the pill enough to start legislating against it. They probably wouldn’t even need to call it an “abortion” if they’re able to get the false story of how the pill works to spread far and wide. Already many abortion restrictions avoid talking about pregnancy and talk instead of “life at conception”; they’re poised to do this. Now they just need to get people to believe something that just has no evidence for it, that the pill works by killing fertilized eggs.
Luckily for them, they have feminists doing that job.
First, the facts. The fact of the matter is that the pill works by preventing ovulation. The original formulation---and I think this is still true for most forms of it, if not all---was to put your hormone levels where they would be post-ovulation. The reason for this is that after you ovulate, your body suppresses another ovulation in order to prevent a second conception. Some medical scientists have theorized that there may be secondary actions in play for the pill that make it work better. One of these theories, which has no evidence for it that I could find (or that Lindsay Beyerstein could find---she’s been looking, too), is that the thinning of the uterine lining might make it harder for fertilized eggs to implant. Because of all sorts of regulations and practices in the pharmaceutical industry, these theories are included in the packaging for pills, in the same way they have to include potential side effects, even if the researchers are 95% sure the side effects weren’t actually caused by the medication. For instance, your pill package probably includes “weight gain” as a potential side effect of the pill. That’s because it was a potential, if basically untested side effect. But extensive research has demonstrated that the pill does not make you gain weight. As weird as it may seem to a layperson, that something is on your info packet when you get a medication doesn’t make it true. That info packet isn’t a scientific document; it’s a CYA maneuver.
Now for the facts.
Fact #1: Many eggs slough off on their own, so even if you manage to fertilize an egg and it dies while you’re on the pill, there’s no reason to think that the pill is the cause. That said, women on the pill don’t ovulate much! If you take it perfectly, probably never. Or even somewhat imperfectly. But even if you have a tendency to skip 4 or 5 days here or there, and you do ovulate, you’re still doing it less than someone who uses nothing at all. So you’re simply killing fewer fertilized eggs than the good Catholic who uses nothing and is constantly pregnant. Odds are high I’ve never had a fertilized egg die on me, but Rick Santorum’s wife has probably killed dozens, if not more.
Fact #2: No evidence that the pill works this way. Not only that, but it’s been known for awhile that we don’t have any reason to believe that this theory of the pill’s function is true. Writing for RH Reality Check, Cristina Page said:
Prompted, in part, by the growing efforts of anti-abortion groups to define birth control as abortion, the American Journal of Obstetrics and Gynecology in 1999 reviewed the available research on "the mechanism of action" of the contraceptive methods that so dismay pro-lifers……
The researchers consider the question and report , "No direct evidence exists showing that implantation is prevented by progestin-only methods" and "The evidence does not support the theory that the usual mechanism of action of IUDs is destruction of fertilized ova in the uterus," say the authors. After reviewing all the research available on the modes of action of all contraceptives in question the authors summarize their report by explaining that "Even though the precise mechanism of action of modern contraceptive is not yet fully known, scientific evidence suggests the main mechanisms of action for each method. Inhibition of ovulation and effects on the cervical mucus are the primary mechanisms of the contraceptive action of hormonal methods. Evidence indicates that the primary mechanism of action of IUDs is the prevention of fertilization."
It’s a widespread belief that emergency contraception works by killing a fertilized egg. Actually, it’s just high dose birth control pills that prevent ovulation. If anything, emergency contraception is less likely to have the uterine lining effect that anti-choicers claim.
It has been demonstrated that LNG-EC acts through an effect on follicular development to delay or inhibit ovulation but has no effect once luteinizing hormone has started to increase. Thereafter, LNG-EC cannot prevent ovulation and it does not prevent fertilization or affect the human fallopian tube. LNG-EC has no effect on endometrial development or function. In an in vitro model, it was demonstrated that LNG did not interfere with blastocyst function or implantation.
Over time, birth control pills thin the lining of the uterus. It has been hypothesized that a thinner endometrium is less receptive to fertilized eggs, but this conjecture has never been tested. This seems unlikely, given how easy it is for women to get pregnant by taking the birth control pill sporadically. Missing a couple of pills won't undo the chronic changes in the uterine lining, but skipping pills during the critical window can easily allow an egg to escape. If a thinner endometrium was such a barrier to pregnancy, we'd expect the pill to be even more reliable than it is.
I hope this has convinced you that we don’t need to repeat the claims that the pill kills fertilized eggs. There’s no scientific evidence for that claim, and there is scientific evidence against it. We should insist on sticking to the science instead of being dragged into the anti-choice “what if” game.
But not only have I seen feminists make the understandable mistake of accepting the fertilized egg theory as a third mechanism---the information that this is un-evidenced is very hard to get in a sea of anti-choice misinformation---I’m beginning to see inexcusable examples of feminists suggesting that “killing fertilized eggs” is how the pill works. Which is what anti-choicers want you to believe. A woman confronted Mitt Romney about his support of a personhood amendment, and her misinformation got wide hearing:
I don't know if you want to have some staff look into this, but hormonal forms of birth control work a little differently. They actually prevent implantation, not conception.
I saw this exchange posted everywhere with absolutely no correction of this blatant (if unintended) misinformation. Even Jezebel’s write-up unfortunately implied that killing fertilized eggs is an evidenced mechanism of the pill, and that it happens frequently, which it doesn’t. They made it worse by making fun of Mitt Romney for not knowing how the pill works. The problem with that is he actually showed a better understanding of it than either the woman asking him a question or the Jezebel writer. If you make fun of someone for being wrong, but they’re actually right, then you’re the one with egg on your face.
I get why feminists are allowing anti-choice misinformation to find home in our mouths. We want to tell people that personhood amendments are intended to ban the pill, because they are! The easiest way to say that is to accept the false premise that the pill kills fertilized eggs. And that will win us a short term victory, but lose us the long term war. Plus, bad science is bad science, and you shouldn’t give air to it.
There is a way to make it clear that the right is using this to ban the pill without giving credence to their misinformation. One way I’ve gone about doing this is to say, “Anti-choicers hope that misinformation about how the pill works can be used to ban it.” Irin Carmon did a great job of parsing the scientific misinformation and the legal issues in her Salon piece on Mississippi personhood.
If this initiative passes, and fertilized eggs on their own have full legal rights, anything that could potentially block that implantation – something a woman’s body does naturally all the time – could be considered murder. Scientists say hormonal birth-control pills and the morning-after pill work primarily by preventing fertilization in the first place, but the outside possibility, never documented, that an egg could be fertilized anyway and blocked is enough for some pro-lifers.
I would also add that right wingers get all sorts of misinformation into the law all the time, as anyone who follows the creationism wars will tell you. Because the “pill kills” thing is untrue doesn’t make it less of a threat. All you need is a few people with some letters after their name to present themselves falsely as experts to the court, a judge with a right wing agenda, and the law can be kept in place. If you want evidence of how this works, consider that Carhart v. Gonzalez was decided in part on a big, fat lie: that women who have abortions have “post-abortion” syndrome. This isn’t even playing loose with the facts. Anti-choicers just made that shit up, presented it as evidence, and the idea of it was all over Kennedy’s decision.
There’s also the understandable fear of conceding the argument that fertilized eggs are people. No need to do that, either. I think one thing pro-choicers need to highlight as much as the pill thing is fact that these laws will almost surely be used to prosecute miscarriages. If anything, they’re more likely to be used for that at first than to ban the pill, which will be a separate legal battle that will take years to fight. You can start prosecuting miscarriages right away; you can even do so while leaving abortion legal. Prosecuting miscarriages is an especially attractive fight for anti-choicers because you can target the most vulnerable women in our society for that abuse. We know this, because women are already being thrown in jail for stillbirth. They tend to be poorer women, women of color, and immigrants, exactly the sort of women that don’t get a lot of defenders, especially if they live less than perfect lives. Particularly in Mississippi, I expect that a personhood law would immediately result in miscarriage arrests and investigations. I’m guessing you will quickly see women who go to hospitals for miscarriages grilled about whether they’ve had a drink, worked at a job requiring physical labor, and tested for drug use---and if any of these things are true, out come the cuffs. Sure, there may not be any scientific information linking her miscarriage to these activities, but anti-choicers have never really been that enthusiastic about science in the first place. Additionally, expect it to become illegal for doctors to perform emergency D&Cs on women who are miscarrying, leaving those women to die, and doctors may also be required to let a woman’s fallopian tube burst rather than give her drugs to terminate ectopic pregnancies.