Contraception and extreme cases

[Anastasia13]

A discussion came up with cases where a woman should not conceive such as regularly taking medication that harms the baby and will cause birth defects or death and medication that is contraception but for other medical reasons.

So assuming mother or child might die if conception occurs, and thus some (non-abortificant) form of contraceptive would be desired for greater prevention than NFP alone:

Does the woman need remain single unless she enters a sexless marriage or is willing to commit sin?

Must a married couple remain without sex until menopause?

I have heard that there are times with rare cases where a priest would permit a couple to use contraception, but I also found this that would seem to indicate yes to both questions.

Pope Pius XII: “If, in your sure and experienced judgment, the circumstances require an absolute ‘No’, that is to say, the exclusion of motherhood, it would be a mistake and a wrong to impose or advise a ‘Yes’. Here, it is a question of basic facts, and therefore not a theological but a medical question; and thus it is within your competence. However, in such cases, the married couple does not desire a medical answer, of necessity a negative one, but seeks an approval of a ‘technique’ of conjugal activity which will not give rise to maternity. And so you are again called to exercise your apostolate, inasmuch as you should leave no doubt whatsoever that, even in these extreme cases, every preventive practice and every direct attack upon the life and the development of the new life is, in conscience, forbidden and excluded, and that there is only one way open, namely, that of complete abstinence from every performance of the natural faculty. Your apostolate in this matter requires that you have a clear and certain judgment, with a calm firmness.” (Pope Pius XII, Address to Midwives, n. 41.)

 

[1ke]

Does the woman need remain single unless she enters a sexless marriage or is willing to commit sin?

Must a married couple remain without sex until menopause?

What a married couple cannot do is contracept. What a single person cannot do is marry and contracept.

What the couple can do is use NFP, which can certainly be done successfully when there are serious reason to avoid without abstaining completely. However, it is always their perogative to abstain completely.

I have heard that there are times with rare cases where a priest would permit a couple to use contraception, but I also found this that would seem to indicate yes to both questions.

It is not possible for a priest to “permit” someone to use contraception. It is an intrinsic evil. No priest has authority to permit us to commit any sin.

There are certainly priests who ignore Church teaching, who are confused by it, who sincerely think they are doing good, or who otherwise give erroneous instruction to couples regarding contraception use. However, please note this does not constitute authority to give “permission”, it constitutes ignorance or willful disobedience on the part of the priest.

 

[katy]

PLEASE …remember that pills, etc. do not necessarily mean there will be no conception. I and many others have conceived anyway and were then told, “Well, in this case an abortion would certainly be understandable and OK.” Fortunately I did not listen, but many do, and that is how many abortions come about.

 

[Anastasia13]

What a married couple cannot do is contracept. What a single person cannot do is marry and contracept.

What the couple can do is use NFP, which can certainly be done successfully when there are serious reason to avoid without abstaining completely. However, it is always their perogative to abstain completely.

And if a woman has something where her cycle is screwy, she has to abstain for years despite 1 Corinthians 7 instructions to not abstain except for a limited time as prayer and fasting?

 

[twf]

If medication is prescribed for some reason other than contraception, but contraception results as a secondary, though unintended, effect, this is not sinful.

 

[1ke]

And if a woman has something where her cycle is screwy, she has to abstain for years despite 1 Corinthians 7 instructions to not abstain except for a limited time as prayer and fasting?

The question you asked was if a woman has a medical issue for which she is taking medication that contraindicates pregnancy, what her options are.

Her options are abstain periodically, abstain indefinitely, or not abstain at all depending upon what she and her spouse deem most prudent. She does not “have” to abstain for years.

What she cannot do is contracept.

I am not sure what exactly you mean by the woman “has something where her cycle is screwy”. Are you now changing your premise? Perhaps you can clarify.

 

[Xantippe]

Anastasia13 said:

“And if a woman has something where her cycle is screwy, she has to abstain for years despite 1 Corinthians 7 instructions to not abstain except for a limited time as prayer and fasting?”

St. Paul was a very sensible person. I expect that if you were able to ask him, he would add, “and in life-threatening circumstances or where the woman needs to take medication that would harm her unborn child.”

Note that a little later, he says “I say this as a concession, not as a command. I wish that all of you were as I am. But each of you has your own gift from God; one has this gift, another has that.” He’s not ordering married couples to have sex, but he is cautioning them not to overreach and fall into sin.

Presumably, in the first century, there would also have been cases where it was clear that pregnancy would be dangerous to the mother. Given that contraception was less effective in those days (and it’s not perfect in ours, either), the situation would be just as stark or starker than today–the married couple would have to either abstain completely or risk killing the mother, and there’d be no NFP to take the edge off the abstinence that would be necessary.

 

[Avocadomom]

According to the Church, there is no circumstance in which a couple can attempt to prevent pregnancy with anything but NFP or abstinence. There are no exceptions, even with extraordinary medical circumstances including those that are life-threatening.

As someone who might die if she becomes pregnant again, you can bet your bottom dollar I have a huge problem with this “teaching.”

 

[Anastasia13]

If medication is prescribed for some reason other than contraception, but contraception results as a secondary, though unintended, effect, this is not sinful.

Two examples of medication came up.

One was precription birth control-wouldn’t it better to use a method that though less than 100% effective in preventing pregnancy though still adding security to NFP if possible to lower the chance of conceiving and then killling the child?

The other was a medication that would harm and possibly kill the child if conceived. Wouldn’t it be better to do everything possible to avoid this?

 

[Anastasia13]

According to the Church, there is no circumstance in which a couple can attempt to prevent pregnancy with anything but NFP or abstinence. There are no exceptions, even with extraordinary medical circumstances including those that are life-threatening.

As someone who might die if she becomes pregnant again, you can bet your bottom dollar I have a huge problem with this “teaching.”

99% effective still ain’t 100. That gives you 99 times you can have sex with your husband. Use wisely lest one of you be tempted to fall into sin.

I share your sentiment.

 

[Xantippe]

Anastasia13 said:

“99% effective still ain’t 100.”

99% effective is all you can really hope for with regard to birth control. Even sterilization for women carries something like a 1 in 200 risk of pregnancy. It sounds like a vasectomy has a 1 in 500 risk of pregnancy in the first year.

If 99% isn’t good enough, is 99.5% or 99.8% good enough?

As long as a woman still has all the relevant organs and they are functioning, there’s never going to be 100% certainty of no pregnancy.

 

[twf]

To back up my earlier post, this is what Pope Paul VI says in Humanae Vitae:

Lawful Therapeutic Means

1. On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever. (19)

There are potentially cases where drugs typically used as “birth control” could be used for other therapeutic reasons in which case contraception becomes a secondary and undesired, even if foreseeable, consequence.

 

[Rau]

If medication is prescribed for some reason other than contraception, but contraception results as a secondary, though unintended, effect, this is not sinful.

This is true, but - as I understand the OP - not applicable to the scenario under discussion (viz.: “So assuming mother or child might die if conception occurs…”)

 

[Avocadomom]

Anastasia13 said:

“99% effective still ain’t 100.”

99% effective is all you can really hope for with regard to birth control. Even sterilization for women carries something like a 1 in 200 risk of pregnancy. It sounds like a vasectomy has a 1 in 500 risk of pregnancy in the first year.

If 99% isn’t good enough, is 99.5% or 99.8% good enough?

As long as a woman still has all the relevant organs and they are functioning, there’s never going to be 100% certainty of no pregnancy.

the 1 in 500 risk of pregnancy in the first year of vasectomy is because some men do not follow the physician’s orders for periodic checkups to ensure that sperm count is at 0. It’s a hassle, so they go a year without a sperm analysis and whoops!

The “99%” stat for NFP is for PERFECT use (no mistakes or misjudgments.) Since NFP can be exceedingly complex depending on the woman’s health and body norms, the actual failure rate is much higher.

 

[maryjk]

Deleted my post.

Sorry, but you have been discussing this exact issue in another thread that was closed. I don’t want to participate in this one.

 

[Rau]

the 1 in 500 risk of pregnancy in the first year of vasectomy is because some men do not follow the physician’s orders for periodic checkups to ensure that sperm count is at 0. It’s a hassle, so they go a year without a sperm analysis and whoops!

The “99%” stat for NFP is for PERFECT use (no mistakes or misjudgments.) Since NFP can be exceedingly complex depending on the woman’s health and body norms, the actual failure rate is much higher.

The “typical” failure rate for NFP is 1 in 55. The perfect use failure rate is around 1 in 150.
en.wikipedia.org/wiki/Comparison_of_birth_control_methods

By adopting a more conservative approach than the methods define, these rates can be vastly improved.

 

[Xantippe]

Avocadomom said:

“the 1 in 500 risk of pregnancy in the first year of vasectomy is because some men do not follow the physician’s orders for periodic checkups to ensure that sperm count is at 0. It’s a hassle, so they go a year without a sperm analysis and whoops!”

There’s also the issue of “recanalization,” which is kind of freaky.

“The primary reason for vasectomy failure is recanalization-- when the cut ends of the vas deferens spontaneously reconnect.”

nytimes.com/health/guides/surgery/vasectomy/vasectomy-surgery.html

 

[Avocadomom]

Avocadomom said:

“the 1 in 500 risk of pregnancy in the first year of vasectomy is because some men do not follow the physician’s orders for periodic checkups to ensure that sperm count is at 0. It’s a hassle, so they go a year without a sperm analysis and whoops!”

There’s also the issue of “recanalization,” which is kind of freaky.

“The primary reason for vasectomy failure is recanalization-- when the cut ends of the vas deferens spontaneously reconnect.”

nytimes.com/health/guides/surgery/vasectomy/vasectomy-surgery.html

Well, right. That’s why the sperm count has to be periodically checked. To ensure that the vas deferens has not reconnected. A lot of times the first sign that this has occurred is a surprise pregnancy! My sister’s husband had a vasectomy after their fourth child, and they still use condoms “just in case” because she is terrified of becoming pregnant again!

 

[Burt_Macklin]

They should seek the counsel of a spiritual adviser; it isn’t possible to deal with these kind of cases in the abstract.

I view it the same way I view my alcoholic brother. He should stop drinking but he isn’t capable. It is certainly better that he only gets a little bit drunk. I don’t want to approve of constant drinking, so I don’t want to tell him to get a little bit drunk… It is up to him and his spiritual adviser to discern how much he is capable of doing.

Maybe the couple can practice heroic virtue and abstain completely; do what they need to do. Maybe they can’t. All I can tell them is to seek the counsel of a priest.