Recently, the Diocesan Commission For Life had the honor of interviewing Chris Kahlenborn, MD, author of the groundbreaking book, "Breast Cancer: It's Link to Abortion and the Birth Control Pill." Dr. Kahlenborn practices Internal Medicine in Altoona, PA, and is involved in ongoing research on Culture of Life issues. He is a widely recognized expert on the connection between breast cancer and abortion and the birth control pill, as well as the abortifacient effect of many modern contraceptive medications and techniques. He has lectured nationally and internationally on the breast cancer/abortion/birth control link, and has testified before the federal Food and Drug Administration regarding the link between breast cancer and the Pill.
The 2002 March issue of The Annals of Pharmacotherapy just published a study authored by Dr. Kahlenborn entitled "Postfertilization Effects of Hormonal Emergency Contraception." The first of its kind in the mainstream medical literature, this study outlines the abortive properties of the morning after pill (or MAP, also known as Emergency Contraception, EC) and ethical implications for the use of MAP in both secular and Catholic institutions. Dr. Kahlenborn is founder and President of TPRI, The Polycarp Research Institute, which is a non-profit research organization dedicated to the study of medical and clinical issues pertaining to the Culture of Life.
The Diocesan Commission for Life interviewed Dr. Kahlenborn for his perspective on several prominent Culture of Life issues that are being reexamined in light of recent medical developments and headlines in the popular culture.
Q: Dr. Kahlenborn, what is the connection between abortion and breast cancer?
Dr. Kahlenborn: A woman's breast is especially sensitive to carcinogenic (i.e., cancer producing) influences before she delivers her first child. When a woman becomes pregnant, a number of hormone levels increase dramatically in her body. Three especially notable ones are estradiol, progesterone (i.e., the female sexual hormones), and hCG (human Chorionic Gonadotropin). All of these hormones, especially the latter, serve to stimulate immature breast cells to mature into fully differentiated cells. If this process is artificially interrupted by way of an induced abortion, the hormone levels drop suddenly and dramatically, thereby suspending the natural process of maturation of many of the woman's breast cells. This is referred to as a "hormonal blow" by researchers. These cells are now "vulnerable" to carcinogens since they started the maturation process but were never able to complete it. (Cells that have fully matured are less vulnerable to carcinogens than cells that are in the process of maturation).
The bottom line is that induced abortions, by causing a radical shift in a woman's hormonal state, cause at least a 30% increased risk in breast cancer risk, which increases to 50% if a woman aborts her first baby. Currently 28 out of 37 studies show that induced abortion increases the risk of developing breast cancer. For more information see: www.Abortionbreastcancer.com
Q: How do hormonal "contraceptives" work?
Dr. Kahlenborn: Birth control pills (BCPs) are a combination of synthetic estrogen and progestin. Oral contraceptives "fool" the woman's body so that it produces less of the hormones needed for ovulation to occur. Therefore, BCPs suppress -- but do not eliminate-- ovulation. Oral contraceptives have two other main effects: 1) they thin the inner lining of the uterus (called the endometrium), and decrease its thickness. A thinner endometrium has a decreased blood supply. 2) They may thicken the cervical mucus, making it more difficult for the sperm to travel up through the cervix, but the evidence for this is weak.
In a normal cycle, the endometrium slowly builds up before ovulation and then is "ready for the newly conceived child to implant" when it reaches its peak a few days after ovulation. The blood flow increases, the size of the endometrial glands enlarge, and these glands contain important nutritional building blocks for the unborn child who is about to implant.
The BCP causes changes in this lining of the uterus including decreased blood flow, decreased endometrial thickness, and decreased glands containing the nutritional building blocks for the unborn child. Since we know that the birth control pill allows ovulation and conception to occur at times (because BCP's have a 3-10% failure rate), and the pill causes these unfavorable changes in the endometrium that make it difficult for the unborn child to implant, this would support the conclusion that it is an abortifacient. This information is documented in a recent AMA published journal article available online at www.http://archfami.ama-assn.org/issues/v9n2/ffull/fsa8035.html.
Therefore, BCPs work by inhibiting ovulation but also by causing early abortions. I estimate that a woman who is taking the Pill is experiencing one early abortion every 18 months. Statistically if 250 Catholic women are taking the Pill, which would not be uncommon in a large parish, one of those women will actually abort her baby during Mass each year.
Q: How does RU-486 work? (I.e., What is the progression of events after a woman gets the pill?)
Dr. Kahlenborn: RU-486 is an anti-progesterone. Progesterone is necessary for the continued attachment of the baby's placenta to the uterine wall. RU-486 prevents progesterone from working. Once RU-486 is given it is like a hormonal of chemical knife. It causes the death of the placental cells and consequently the placenta detaches from the uterus, killing the baby in the womb. Prostaglandins are usually given 48 hours later to cause the uterus to contract and expel the baby.
RU-486 causes hemorrhage, to varying degrees, which usually occurs at home. This hemorrhage alone can be life threatening, and there are other severe complications. In the medical literature there have been reports of complete cardiovascular collapse and death following administration of RU-486.
Q: How does the morning-after pill work?
Dr. Kahlenborn: Many people think the morning after pill or "Emergency Contraception" is RU-486. It is not. Emergency Contraception, (EC) consists of high dose birth control pills given within 72 hours of unprotected sex or rape. Like BCPs, it works at times by inhibiting ovulation and thickening cervical mucus, preventing conception. However, its abortifacient effect is even more prevalent than the BCP.
When EC is used before ovulation, ovulation may be inhibited in 55-75% of the cases, but the evidence to date indicates that EC does not always inhibit ovulation even if used in the preovulatory phase, before an ovum (egg) is released. It may unfavorably alter the endometrial lining regardless of when in the cycle it is used, with the effect persisting for days. The reduced rates of observable pregnancy compared with the expected rates in women who use hormonal EC are consistent with a postfertilization (or abortifacient) effect, which may occur when hormonal EC is used before or after an ova (egg) is released.
This interpretation of the cited literature has important ramifications, given the polarizing opinions about EC use. For example, many state laws contain conscience clauses in which medical personnel (e.g., physicians, pharmacists, nurses, physician assistants, nurse practitioners) cannot be forced to participate in, or refer for, any surgical or drug-induced abortions. Therefore, evidence in favor of a postfertilization effect may have legal implications for healthcare providers who either prescribe or have objections to prescribing these agents.
Emergency department protocols could also be impacted by evidence of a postfertilization effect. For example, emergency departments of Catholic hospitals usually allow either no use of hormonal EC in their rape protocols or limited use (i.e., preovulatory use of hormonal EC). Catholic hospitals that do allow hormonal EC use prior to ovulation may wish to reassess their policies given the findings that EC use does not consistently stop ovulation and has the potential of causing an early abortion effect even when used prior to ovulation. Most large secular hospitals have fewer limitations on the use of hormonal EC as part of their rape protocols. Nevertheless, evidence of a postfertilization effect from use of hormonal EC is important to physicians who must make a moral decision about prescribing or referring for a drug that can cause an early abortion. Finally, women have the right to fully informed consent. If the abortifacient effect of EC violates the morals of any woman, the failure of any physician or care provider to disclose this information would eliminate the likelihood that the woman's consent was truly informed. Q: Our last question, Dr. Kahlenborn: Why do we need Project Rachel? Dr. Kahlenborn: In my experience, I have treated women who suffer from some aspect of post-abortion syndrome. This is not only a psychological problem but also a spiritual problem. They often present with symptoms of depression, alcoholism, and somatization (real physical pain related to previous psychological trauma.) Project Rachel can address these psychological and spiritual aspects of post-abortion syndrome whereas a physician's time is limited.
I think what Gray Davis is did is wrong on so many levels. Putting aside the contraceptive issue for a moment, mandating that a private company provide a specific medication is wrong; demanding that an individual or person provide an abortifacent when they are morally opposed to abortion is wrong. Fortunately, I believe that this mandate is unconstitutionally and hope and pray that someone has the courage to challenge it.
For those of you who posted previous critical of my opinion on contraceptives, thank you for being civil. I think this article soundly addresses why I oppose contraceptives.
If, however, there is a 100% effective method of preventing pregnany, I would still oppose the use of contraceptives for spiritual and societal reasons. Below are some good points:
Father Lino Ciccone, Professor of Moral Theology:God bless.In our contemporary world, therefore, contraception has played and continues to play a primary role in furthering that rampant "culture of death" whose victims number in the tens of millions every year. This culture also debases human sexuality and perverts love even in its most sublime form of maternal love, when it grants a mother the absurd right to kill the child she is carrying in her womb. A culture moreover which is devastating and seeking to destroy those same values among economically poor and politically defenceless people, who are nevertheless rich in so many human values that have been widely disregarded for a long time in our wealthy countries.
Couples who choose contraception, whether consciously or not, are helping to consolidate and strengthen the roots of this culture. And this choice can only entail responsibilities whose seriousness and weight are difficult to assess but certainly enormous.
Humanae Vitae
Love is the communion of persons. If parenthood, and responsible parenthood, correspond to this love, then the way of acting which leads to such parenthood, cannot be morally indifferent. In fact, it decides whether the sexual activity of the communion of persons is or is not authentic love. "By safeguarding both these essential aspects, the unitive and the procreative, the conjugal act preserves in its fulness the sense of true mutual love..." (H.v. 12).