Catholic OBGYNs oppose over-the-counter contraceptives

By Christine M. Williams
Special to The CFP

American women could someday soon find artificial hormones an aisle over from allergy medicines and cough syrup. In December, the largest body of obstetricians and gynecologists recommended that birth control pills be sold over the counter.
Through a committee opinion, the American Congress of Obstetricians and Gynecologists said that unintended pregnancy remains a major public health problem in the United States, accounting for half of all pregnancies. The solution, they say, is wider access to hormonal contraceptives.
That figure ignores the fact that not all unintended pregnancies are unwanted and fails to account for the number of unwanted conceptions that occur despite the use of artificial birth control.
More than 90 percent of American OBGYNs are board-certified through ACOG, but the committee opinion represents a small group of the congress’ members. Moreover, a November survey suggests that they are in the minority.
Of the 638 OBGYNs and family practitioners interviewed in “Physician Attitudes Toward Over the Counter Availability for Oral Contraceptives,” the vast majority - 71 percent - came out against over-the-counter hormonal contraceptives. More than 90 percent cited safety as their primary concern.
ACOG fellows with a dissenting opinion include Catholic physicians who do not prescribe contraceptives like Dr. Kathleen Raviele, an OBGYN in Atlanta and former president of the Catholic Medical Association.
She warned that birth control pills can raise blood pressure and cause strokes and heart attacks. The World Health Organization has declared them a Class I carcinogen.
“A woman on a strong medication like that without a physician’s supervision could be very dangerous,” she said.
The ACOG committee stated that the risks associated with birth control pills pose no greater risk than acetaminophen, the generic term for Tylenol.
Dr. Ryan Welter, a family physician based in Taunton said that acetaminophen poses risks when overused. Hormonal contraceptives, on the other hand, pose significant health risks at their normal dose. He called selling them over-the-counter a “bad medical decision.”
In the past, ACOG has promoted other positions at odds with Catholic physicians. In 2007, the organization said OBGYNs had an “ethical duty” to refer for abortions and perform them in situations where no other physician is readily available.
The ACOG also pushed for the approval of the morning after pill, also known as Plan B, to be sold over-the-counter in 2006. Anyone 17 and older can purchase the drug, a high dose of artificial hormones, without a prescription. Anyone younger still needs a prescription. Advocates said the change would decrease unplanned pregnancies.
Many studies have found that making Plan B more widely available does not decrease the number of abortions and could be linked to an increase in sexually transmitted diseases. One of the most recent studies, conducted in the United Kingdom and released in January 2011, found no change in pregnancy rates but a 12 percent increase in the STD rate among teens who had access to free Plan B at pharmacies. The study is entitled “The Impact of Emergency Birth Control on Teen Pregnancy and STIs.”
According to the Catechism of the Catholic Church, contraceptives are “intrinsically evil.” The only acceptable means to space births is through Natural Family Planning, which involves interpreting a woman’s bodily signs to determine fertility.
Joanne Bangs, an NFP witness in the Diocese of Fall River called NFP the “best kept secret for a good marriage.” That method of birth control treats intimacy as a sacred act. It strengthens marriage by placing “everything in right order,” she said.
She added that the pill is the most beautifully packaged lie that our generation has swallowed.
Dr. Lester Ruppersberger, a Catholic OBGYN in Pennsylvania, said that the pill does not treat or cure any disease. “It is one of the few pharmaceuticals that is for nothing other than lifestyle and personal choices,” he said.
Dr. Ruppersberger said that being a NFP-only OBGYN is difficult because many women expect their doctor to prescribe them contraceptives. Though he is morally opposed to the distribution of birth control pills, approving them for over-the-counter sale could come with some benefits.
“It would take the onus of prescribing hormonal contraception, which is the most-used contraceptive, and put it into the hands of individual women and pharmacists,” he said. “Catholic OBGYNs would not need to materially cooperate with evil.”
Patients could still ask NFP-only physicians for internal contraceptive devices and sterilizations, he added.
Since insurance providers do not generally cover over-the-counter medications, the approval of birth control pills for over-the-counter sale could also remove the requirement for Catholic employers to pay for such pills. More than 100 organizations are currently suing the United States government in order to lift that requirement, imposed by the Department of Health and Human Services.
The move could also save health insurance companies the close to $8 billion they spend annually on hormonal contraceptives, Dr. Ruppersberger said.



PHOTO:When first introduced, the birth control pill was heralded as a development that would lead to fewer divorces and a steep decline in the number of unwanted pregnancies and in the number of abortions. Fifty years later cultural evidence shows those expectations to be unfulfilled. (CNS/Nancy Wiechec)