Does your contraception only prevent fertilisation? Or can it also prevent implantation of a healthy embryo? Claire van Ryn shares about the moment she realised that she’d chosen the wrong contraception.

In 1972, a bunch of scientists and doctors decided to change the definition of conception, and the repercussions have been felt every single day since. They changed the definition of conception from meaning the time of fertilisation to the time of implantation. A difference of only a few days. But also the difference between cells and embryonic life.

Today, I want to share with you how that money-driven decision by some American Einsteins impacted on my own right to information and reproductive choice.

And I will preface this by saying, no judgement. Just truth. With bucketloads of love. Because I don’t think it’s loving if we know a truth and don’t share it. Agreed?

A conversation on contraception

Rewind nine months. I’d somehow dropped into conversation with a friend that, after our second was born, I’d opted for the Mirena intrauterine device (IUD) for contraception. I received an odd response. Like a long “oh?” hiking to a tonal summit. Then hanging there. Unresolved and sparking like rogue fireworks in my (often oversensitive) thoughts.

Did I overshare? Did they think contraception was wrong? Was it something about Mirena?

It completely unsettled me. I admire and respect this person, so I decided to do some research. I spoke with a midwife friend, had a chat with Dr Google and, most importantly, I dug into a book that’s been sitting on my shelf gathering dust for a while. Because, in truth, it reminds me of a university textbook. It’s called Fearfully and Wonderfully Made, by Dr Megan Best, and is sub-titled “Ethics and the beginning of human life”.

Dr Best is a medical doctor and bioethicist whose research is highly regarded, and who has been involved in the development of Australian legislation regulating the treatment of the unborn. I quickly flicked through to the chapter on contraception, and then to intrauterine devices; Mirena, also known as ‘intrauterine systems’ or IUS (bear with me, the terminology is important, you’ll see!).

“The IUS causes damage to both sperm and eggs, interfering with the way they function and reducing survival, and so decreasing the rate of fertilisation. It also lowers the chance of survival for any embryo that might be formed in the fallopian tube before it gets to the uterus. This last mechanism operates after fertilisation…”

There it was, in black and white.

Mirena can cause abortion.

My heart dropped to my heels and I thought back to when it was offered to me, at a post-natal appointment at the hospital. “We can insert it straight away,” she said. There was an urgency to it. I was told it was better to have it soon after birth while my cervix was still “soft”. I believe she outlined what it was, how it worked by releasing a hormone called levonorgestrel (similar to progesterone). At no point was it explained that Mirena can also prevent implantation of an embryo. But then, I also didn’t ask. I guess I just naively accepted that, if it’s called a contra-ception, then it must prevent conception. That is, fertilisation (the old definition of the word, you see). Silly me.

The point of realisation

It was like a light went on. I was so very grieved that I had made a decision like this, wilfully, that went against my belief, my knowing, that life begins at conception. How did this even happen?

I waited until the kids were tucked up in bed before I spoke with hubby about my findings. We were in immediate agreement: Mirena had to go. We used other precautions until the date of the appointment. And it was all made a wee bit more traumatic as I had to have it surgically removed, under full general anaesthetic, because my cervix likes to play hide-and-seek!

I distinctly remember the conversation I had with the OBGYN before I was wheeled into surgery. “Would you like me to insert another Mirena while you’re under?” No, I said, I’m no longer comfortable with it. “You’ll regret it,” she replied. “You’ll be back when you’re getting a full-blown period and all that.” I was a wimp. Didn’t tell her the real reason. But I didn’t feel particularly respected in my choice. I was also a bit flummoxed by her description of what is a woman’s natural bodily process. Note to self: don’t ask her to give my daughter advice on womanhood.

What’s this mean for you?

If you’ve read this far, I figure you might fit into one of these three camps:

  1. You are as shocked as I was and want to know more.
  2. You believe I’ve made a big deal of something unmeasurable.
  3. You knew this stuff (and maybe you’re surprised that I didn’t!).

I can speak to the first two, because I’ve bounced back and forth between those places. I have absolutely no idea how many times sperm might have fertilised egg and been prevented from implantation. No idea whatsoever. And I cannot find definitive data on that. All I know is that, as long as there is a slither of a chance that an IUD could prevent an already fertilised egg… an embryo… a budding life… to reach its full potential, I want nothing to do with it.

There is no doubt in my mind that I did the right thing. As soon as the truth was lit up before me, there was no other option. And that’s what life is about, right? Seeking out the truth and then acting on it. Also, not dwelling in the past. I didn’t know what Mirena was capable of, so I’ve forgiven myself and not allowed nasties like shame and regret to linger.

And if you fall into the third camp, maybe you can help people like me with awareness. There’s so much clamour in a new mum’s life. Decisions like this can be made without full comprehension. If you’re in the privileged position of doctor or other caregiver, please point this out. I wish someone told me.

The backstory

I want to sign off with the history to this. A while back, some medical sorts decided to change the definition of contraception to suit their dollar-driven agendas. Consider it the marketing strategy behind contraception, because we must remember that all contraception is produced by big companies wanting to increase their profit margins.

“After the introduction of the oral contraceptive pill (OCP) in 1958, Albert Rosenfeld was concerned that rather than only preventing the sperm from fertilising the egg (the classic definition of ‘conception’), the pill might also terminate embryonic human life by inhibiting implantation… Since such interference would occur after conception, he realised that some people would say this represented an abortion. He recommended the ‘solution’ to this problem suggested by Dr AS Parkes of Cambridge: “Equate conception with the time of implantation rather than the time of fertilisation – a difference of only a few days”. That is, he got around the fact that these drugs might cause termination of a pregnancy by changing the definition of when a pregnancy started… Following Rosenfeld’s logic, the subsequent printing of the American College of Obstetricians and Gynaecologist’s terminology text in 1972 saw a deliberate change of the definition of ‘conception’.”

(Source: Fearfully and Wonderfully Made, Dr Megan Best, p104)

You see? The deception is real. We need to ask ourselves if we’re ok with this. We need to be more inquisitive and careful of who and what we put our trust in. I know I certainly will.

When does life begin?

For me, the answer is very clear, “At conception.” Medical evidence is mounting to support this reality.
Then we must ask, “Does your contraception choice reflect this?”

If your stance is the same as mine, you might find this table useful.

Dr Best’s Summary of available contraceptives

*The above table should really be read in conjunction with Dr Best’s entire chapter on contraception. If it piques your intrigue, I suggest you grab yourself a copy.

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