J. Ginsburg, Dissenting: Part Two

Hobby Lobby dissenters overlook hundreds of deaths and thousands of serious injuries from contraceptive use.Religion and sex.

It’s the only way to explain the outraged reaction to the Hobby Lobby ruling.

Public policy debates over issues related to sexual expression or religion—must nativity scenes be flanked by wiccan pentagrams, for example—often begin at boiling point and heat up from there. And that’s understandable. They deal with how we define ourselves at the deepest level.

Because these issues are so personal, we’re quick to believe the “facts” and narratives that support our position and just as quick to reject facts that challenge our worldview.  

In Part I yesterday, I touched on Justice Ginsburg’s pro-Roe v. Wade view that there are some “populations that we don’t want to have too many of” and her statement that there’s a wealth of empirical evidence showing that (free employer-provided) contraception furthers public health and women’s well-being.  

The day after the Hobby Lobby decision was announced, we learned where that “wealth of empirical evidence” came from. The president of the American Congress of Obstetricians and Gynecologists (ACOG) sent a Special Message to members taking credit for ACOG’s having been “the key player in getting contraceptives covered under the Affordable Care Act” by offering their own preventive health care guidelines, “which the [Institute of Medicine] IOM accepted without changes. Literally, we wrote that part of the law.”

This is the same ACOG that redefined conception (the beginning of human life) as occurring at implantation rather than fertilization so that advocates of reproductive "rights" could state that no contraceptives are abortifacient, glossing over the fact that drugs and devices like Plan B and Paragard can end the life of a week-old embryo by thwarting implantation, among other means. (ACOG Terminology Bulletin No. 1 [Sept. 1965]).

This is the same ACOG that supported partial-birth abortion. In that procedure an intact unborn child is delivered alive to the point where the abortion provider is able to kill the child by, for example, inserting scissors into the base of the child’s skull and suctioning out the contents enough to collapse the skull, before completing the delivery of a now dead child.

Putting aside the shocking bias of ACOG leadership, the guidelines which IOM accepted without change that were enshrined in ACA regulations offer little in the way of evidence. What evidence is offered has been cherry-picked. So in the interest of full disclosure, here are some things the IOM Report failed to highlight in discussing the “benefits” of contraceptive use:

Paragard T-130 IUD: Meet Yolanda Hudson, a Florida woman, who had a Paragard IUD inserted in March 2008. A year later she sought medical attention for severe pain. The IUD had migrated out of her uterus and embedded in her colon. Yolanda required surgery to remove a section of her colon. After Yolanda’s story was posted, over 60 women who had used Paragard responded with their own sad stories.

Managing Contraception notes that the Centers for Disease Control (CDC) rate Paragard “2,” i.e., restricted (not recommended) for use in women under 20, women who have not given birth and women at risk of STDs (due to having more than one lifetime partner). This medical resource concludes, “Adolescents often do not meet all the criteria for IUD use” (at 84), yet adolescents are a target group of the mandate.

Problems encountered with both Paragard and Mirena (an IUD that releases the hormone levonorgestrel) include expulsions, malpositioning, perforations and migration of IUDs. K.P. Braaten et al. found that malpositioning can cause increased bleeding and pain, and injury or damage to surrounding organs in 15% of perforations. Expulsion occurs in up to 10% of IUD users in the first year, according to Contraceptive Technology, and is higher in teens and in women who’ve never given birth.

Although IUDs offer no protection against sexually-transmitted infections and diseases, condom use is dramatically lower among the partners of women using an IUD (less than 2%) than among women using the pill (almost 18%).

Contraceptive Technology states that between 6% and 50% of pregnancies occurring in the presence of an IUD are ectopic, thus potentially threatening to the mother’s life.

Lastly, Paragard is recommended for use as an emergency “contraceptive,” up to five days following ovulation, i.e., when the new embryo would begin to implant (Managing Contraception). This is clear evidence of Paragard’s having a potentially abortifacient effect.

Mirena: Drugwatch.com reports that a study published by the Department of Radiology at the Ronald Reagan UCLA Medical Center found that Mirena migration is a “frequently encountered complication.” When the IUD migrates, it “can perforate the uterus and enter the abdominal cavity, pelvis, bladder or blood vessels. It can cause pain, infection, and damage to intestines and other nearby organs. This is a serious condition and requires surgery to correct. In some cases, emergency surgery is necessary to prevent further damage.”

Here’s some context, courtesy of Bianca Wordley:
 

More than 2,000 lawsuits have been filed against Bayer AG for injuries caused by Mirena, and many thousands more are expected. Federal multidistrict litigation was established in 2013 and state cases are being heard in New Jersey.

Over 45,000 adverse event reports have been filed with the FDA alleging Mirena expulsion, dislocation, hemorrhage, perforation of the uterus, ectopic pregnancy, migration into the intestinal cavity, abscesses, peritonitis, and pelvic inflammatory disease.

Ortho Evra: Johnson and Johnson made $1.6 billion in sales of the birth control patch, but over 4,000 women, and the family members of over two dozen women who have died, have filed suit for wrongful death, strokes, heart attack and blood clots. Over $68 million has already been paid out in settlement of some claims. The patch is twelve times more likely to cause strokes and 18 times more likely to cause blood clots, compared to conventional contraceptive pills. 

Implanon: Here’s the story of one Implanon user:
 

In addition to potential complications related to insertion and removal, Implanon releases progestins into the blood stream, increasing the risk of blood clot-related strokes and heart attacks. It can also affect glucose concentrations, a danger for diabetics.

Depo Provera: The side effects of the injectable hormonal contraceptive Depo Provera are so unpleasant that in a Colorado study of 5,000 women’s  continuation rates, J. Westfall et al. found that only 23% of women continued to receive quarterly Depo shots for a full year. Nearly half quit after one injection. The main reason they gave for quitting Depo was “difficulty tolerating side effects.” A few of the undesirable side effects are the following: loss of bone mineral density, blood clots, breast cancer, ectopic pregnancy, depression, irritability, mood swings, unpredictable bleeding and excessive weight gain.

How and why does this happen? “The Boom and Bust Phenomenon” was described by Guttmacher researchers Heather Boonstra et al. They explained that pharmaceutical companies receive FDA approval on the basis of small scale studies (which don’t reveal the full extent of potential hazards). The drug company then markets the heck out of the latest/best-ever contraceptive, making billions as quickly as possible. By this time, with users in the hundreds of thousands or even millions, it becomes obvious that, in addition to the almost universal, very unpleasant side effects, the contraceptive also  produces relatively rare but life-threatening and even fatal side effects. When there’s a critical mass of liability claims from injured women and the families of deceased women, the drug manufacturer settles as quietly as possible for a fraction of its net revenues. A risk of death or permanent injury of one in 1,000 seems very small. But if 100 million  women worldwide are using the contraceptive, this business model will mean that 100,000 women may suffer death or serious injury from the contraceptive. A Boom or Bust business model may make sense financially, but morally, it is reprehensible.

So much for the vaunted health benefits for women!

Susan E. Willsis spirituality editor for Aleteia.