Wednesday, August 12, 2020

The Morality of Birth Control

 

Introduction

There are few issues so disputed within the Church and between Christians of all kinds as the morality of birth control. Most commonly, the dispute is about whether or not artificial contraception is a moral means of regulating birth, but birth control is not exactly synonymous with contraception. Birth control is the regulation of the number and/or frequency of births. This is done for numerous reasons and by numerous means, both of which need to be evaluated morally. The debate among Christians extends beyond the means of birth control to which, if any, circumstances justify its use. Roman Catholic and Eastern Orthodox teachings on this issue differ on significant points, which presents unique pastoral problems to Eastern Catholics. This is in addition to the many problems universal to any who would take a moral stance on this issue.

The means

The means, techniques, or methods of birth control include 1) abortion and abortifacients 2) sterilization, 3) artificial contraception, which includes barrier methods such as condoms and hormonal methods such as “the pill,” 4) behavioral methods that limit sexual activity to infertile acts such as onanism, oral sex, et cetera, 5) periodic abstinence, the most effective method of which is known as natural family planning (NFP), and 6) total abstinence.

The Catholic Church has undertaken to evaluate morally each of these means of birth control. The Second Vatican Council, in its document Gaudium et Spes (GS), defends the competency of the magisterium of the Church to make this evaluation, stating: “Sons [and, presumably, daughters] of the Church may not undertake methods of birth control which are found blameworthy by the teaching authority of the Church in its unfolding of the divine law” (51.3). The teaching of the Catholic Church on the immorality of certain means is clear in forbidding all but the last two of the six methods listed above.

Drawing from a 13th-century manuscript of Pseudo-Apuleius's Herbarium
depicting a pregnant woman and another holding some pennyroyal. 
Pennyroyal was historically used as an herbal abortifacient.
1) Direct abortion is the willful taking of an innocent human life which began at conception and is an “unspeakable crime” (GS 51.3; CCC 2271). In his encyclical Humanae Vitae (HV), which, from a Catholic point of view, is a foundational document on the issue of birth control, Paul VI writes “Direct abortion... [is] to be absolutely excluded as lawful means of regulating the number of children” (14).

2) He continues, “Equally to be condemned, as the magisterium of the Church has affirmed on many occasions, is direct sterilization, whether of the man or of the woman, whether permanent or temporary” (HV 14). Sterilization, which mutilates a healthy body with the intention of disrupting its natural healthy functions, disrespects bodily integrity and consequently is against the moral law (CCC 2297).

3) Regarding artificial contraception, Paul VI unambiguously writes, “Sexual intercourse which is deliberately contraceptive [is] intrinsically wrong” (HV 14; CCC 2370). The primary reason that these acts are immoral is their deliberate disruption of one of the two primary ends of sex in marriage. There is an “inseparable connection, established by God, which man on his own initiative may not break, between the unitive significance and the procreative significance which are both inherent to the marriage act” (HV 12). Contraception is a deliberate denial of the procreative significance of sex. While it is true that sex is not only for making babies but also essentially for making love, it remains true that it is also essentially for making babies and that God created it for this great purpose also. For this reason, “each and every marital act must of necessity retain its intrinsic relationship to the procreation of human life” (HV 11).

4) Recent documents of the Church have said little about behavioral methods of birth control. However, for exactly the same reasons as those presented against contraception, the consistent teaching of the Church opposes these methods as well. Their clear prohibition extends from biblical times into the twentieth century, as Pius XI demonstrated in 1930 in his encyclical Casti Connubii. Referring to patristic interpretation of the story of Onan in Genesis, he writes,
Holy Writ bears witness that the Divine Majesty regards with greatest detestation this horrible crime and at times has punished it with death. As St. Augustine notes, "Intercourse even with one's legitimate wife is unlawful and wicked where the conception of the offspring is prevented. Onan, the son of Juda, did this and the Lord killed him for it" (Casti Connubii 55; Gen 38: 8-10).
Some exegesis is necessary at this point. The story of Onan is the only direct description of birth control in scripture, and the method described is behavioral: “when he went in to his brother's wife he spilled the semen on the ground” (Gen 38:9). The story gives us both Onan’s means – coitus interruptus, sometimes also known as onanism – and his ends: “Onan knew that the offspring would not be his,” so he avoided conception, “lest he should give offspring to his brother. And what he did was displeasing in the sight of the LORD, and he slew him also” (Gen 38:9-10). Why did the Lord kill Onan in this story? Both St. Augustine and Pope Pius XI believe that Onan’s crime was his means of avoiding conception. However, Onan’s reason for doing so was also immoral – he did not want to fulfill the conditions of a levirate marriage. He selfishly did not want to sire heirs for his deceased brother. So perhaps this was his crime. I think, however, that it is most reasonable and consistent with Christian tradition to consider that both his reason and his means – “what he did” – were immoral and that the Lord punished him for both of these reasons.

In its prohibition of these four methods of birth control, the Catholic Church is completely consistent with the fathers of the Church, who are universal in their opposition to such acts. However, the fathers went further than the Church does today and would also condemn what we now call 5) NFP. For the fathers, the only moral means of birth control was 6) total abstinence. 

A patristic understanding

Contrary to Eastern Orthodox theologian Paul Evdokimov, who writes in his book The Sacrament of Love, “In the age of the Church Fathers, the problem of birth control was never raised,” a study of the teachings of the early fathers of the Church quickly reveals that this controversy is nothing new and that the teachings of the Church on this issue have evolved over time (174). Sex, from a patristic view, is for making babies. For many of the fathers, this is not only its primary end, it is its sole purpose.

This utilitarian understanding of sex may have roots in the Old Testament's emphasis on procreation as well as in Stoic philosophy. At any rate, the patristic understanding more strongly echoes Stoic philosophy than it does Paul. (On this topic, see Roy Ward’s article, “Paul, How he Radically Redefined Marriage.” Bible Review 4:4 (1988) 26-31). When Paul writes, "It is better to marry than to burn," he is not talking about having children, but about having sex (1Cor 7:9). He never mentions children in this passage. Given the imminent eschatology of this letter, it is clear that Paul is not here concerned with progeny or posterity. This reveals that there is more to sex, in his view, than making babies. It keeps us who are weak from burning, whether this is from burning in sexual desire or burning in hell or both, he does not say. The point is that sex, for Paul, is a good thing in service of an end other than having children. The fathers of the Church did not maintain this New Testament understanding.

Icon of St. Justin Martyr, also called the Philosopher,
in the Katholikon of the Stavronikita Monastery.
With a clear preference for celibacy, St. Justin Martyr (c. 160) writes, “If we marry, it is only so that we may bring up children” (ANF 1.172, emphasis mine). Similarly, Lactantius (c. 304-313) writes, “Whatever is sought beyond the desire of procreation is condemned by God” (ANF 7.143). Among these fathers, then, the distinction between artificial contraception and NFP is therefore moot. While they would generally prefer that people remain virgins and therefore not have any children, these fathers oppose any form of birth control within a sexually active marriage. At face value, Justin’s claim that marriage has no purpose other than the begetting and rearing of children would even render total abstinence within marriage an unacceptable behavior (the example of Mary the ever-virgin spouse of Joseph notwithstanding).

Other fathers may not oppose total abstinence within marriage as a means of birth control, but they do oppose limiting abstinence to the periods of fertility, à la NFP, and even require abstinence during periods of infertility. For example, Athenagoras the Athenian (c. 175) forbids sexual activity during the infertile period of pregnancy. Referring to this, he writes,
After throwing the seed into the ground, the farmer awaits the harvest. He does not sow more seed on top of it. Likewise, to us the procreation of children is the limit of our indulgence in appetite” (ANF 2.146).
In reference to the same issue, St. Clement of Alexandria (c. 195) writes, “To… a spiritual man, after conception, his wife is as a sister and is treated as if of the same father” (ANF 2.503). Two activities recommended by some NFP teachers are having sex during menstruation and during pregnancy, both of which the earliest extant Church canons, the Apostolic Constitutions (compiled c. 390), specifically condemn:
When the menstrual purgations appear in the wives, their husbands should not approach them, out of regard to the children to be begotten. For the Law has forbidden it when it says: “You will not come near your wife when she is in her separation” [Lev. 18:19]. Nor, indeed, let them have relations when their wives are with child. For [in that case] they are not doing it for the begetting of children, but only for the sake of pleasure. Now a lover of God should not be a lover of pleasure (ANF 7.463).
It is interesting to note here that the two reasons for having sex acknowledged by the Apostolic Constitutions are procreation and pleasure, as opposed to contemporary Catholic theology, which generally recognizes unification and procreation as the two purposes of loving marital sex. There is no mention at all here of the expression of marital love as a purpose for sex. St. Augustine (c. 388) also understands sex in this manner. He offers a fairly accurate description of what we would now call NFP in his opposition to calculating and limiting sex to the infertile periods of a woman’s cycle, which was apparently a practice promoted by the Manichæans. He writes,
Is it not you [the Manichæans] who used to counsel us to observe as much as possible the time when a woman, after her purification, is most likely to conceive, and to abstain from cohabitation at that time…? This proves that you approve of having a wife, not for the procreation of children, but for the gratification of passion (NPNF 1.4.86).
Augustine here understands sex as done for pleasure only - “the gratification of passion” - if it is not done for procreation. This is typical of some of the fathers. He offers no mention of love or unification as aspects of the sexual embrace. Again, this is typical. For him, the pleasure of sex is tolerable only because of the good end of making babies. If that end is not present, sexual pleasure is reprehensible and he seems not to recognize the possibility of having sex with one’s spouse as an expression of love. The Church’s teaching about sex has evolved and, I believe, deepened.

Periodic and total abstinence

5) Having acknowledged that the practice of periodic abstinence (NFP) to avoid conception does not square with patristic teaching, how are we to understand the Church’s current promotion and acceptance of the practice? In 1968, a Catholic commission examining married life and birth regulation awaited the publication of Pope Paul VI’s encyclical, Humanae Vitae. Speculations ran wild. Catholics of a traditional mind knew that the Pope could not contradict the teaching of the Church. Catholics of a progressive mind hoped for a sweeping reform of Catholic sexual ethics. This is what they received. So outraged were some that artificial contraception was not permitted that they failed to observe that this document does indeed represent a development of the Church’s doctrine about sex. What Paul VI approved, which we now call NFP, was specifically condemned by early Church teaching. Regarding NFP, Paul VI writes,
 Pope Paul VI in 1977
"If therefore there are well-grounded reasons for spacing births…, the Church teaches that married people may then take advantage of the natural cycles immanent in the reproductive system and engage in marital intercourse only during those times that are infertile, thus controlling birth in a way which does not in the least offend the moral principles" (HV 16).
Furthermore, his acceptance of such a method is based in part on his new emphasis on the goodness of marital sex as a means of unification and an expression of love, which was not often recognized in the early Church with its overemphasis on ascetic renunciation of pleasure for the sake of freedom from the passions. Such renunciation is laudable provided that it is freely undertaken and provided that it is not done in the spirit of condemning those who enjoy certain pleasures in this life. In recognizing the goodness of marital sex as a pleasurable expression of love, the Church has recovered the scriptural understanding of sex as having good ends other than procreation.

If the Church now acknowledges these good ends, why does she persist in forbidding artificial contraception? NFP is permissible while artificial contraception is not because NFP does nothing against the created nature of sex. Artificial contraception, regarded by its users as a form of health care, treats human fertility as one would disease, illness, or injury whereas NFP acknowledges the basic goodness of the created human physiology with all of its natural functions unimpeded. If contraception were health care, that would mean that natural human fertility would be an unhealthy state. NFP leaves intact and unaltered the healthy functioning of the human body whereas contraception attempts to interfere with natural and healthy human fertility. Periodic infertility is a healthy part of created human nature.

6) The most effective method of birth control – total continence – has never received criticism from the Church. All those in an unmarried state are morally obligated to practice total continence (CCC 2349). Furthermore, the Church has always acknowledged that some are called to perpetual continence in celibacy – which is recommended by Paul and exemplified by Jesus himself (1 Cor 7:8, 27, 38). Even within marriage, indefinite periods of continence are permissible – for prayer, as Paul writes (1 Cor 7:5). The Virgin Mary and St. Joseph, of course, were perpetually continent within marriage. Other married saints in the history of the Church have decided, after having had children, to live the rest of their lives in continence.

The ends

Having discussed the morality of various means of birth control, now it is necessary to discuss which reasons for limiting births are morally legitimate. Paul VI identifies “physical, economic, psychological and social conditions,” as in need of attention by spouses who would become responsible, prudent, and generous parents. The Compendium of Social Doctrine of the Church (CSDC) clarifies, that in weighing these issues,
The judgment concerning the interval of time between births, and that regarding the number of children, belongs to the spouses alone. This is one of their inalienable rights, to be exercised before God with due consideration of their obligations towards themselves, their children already born, the family and society (234).
Spouses are not to make this decision on this issue on whims or personal preferences, but according to “objective criteria” (GS 51.3). The question of what particular quantity or frequency of births is both responsible and generous is, however, particular to circumstances and so spouses must consider this prayerfully and under the guidance of their spiritual fathers or mothers.

Eastern Christian perspectives

While in most issues Eastern Orthodox theologians pride themselves on their consistency with the patristic witness, current disregard of patristic teaching against most forms of birth control is at least as widespread among Orthodox as among Catholic theologians. Some, if not most, of the Orthodox do permit most forms of contraception, so long as the motives are not selfish and the marriage as a whole includes the desire for children.

Paul Evdokimov holding a cat.
Eastern Orthodox theologian Paul Evdokimov presents an argument in favor of contraception in his work on marriage, The Sacrament of Love. His support for birth control in general is based on the point that love, and not procreation alone, is the primary reason for sex. Catholic teaching would agree with him, I think, up to this point. He rightly writes, “All reduction of Eros to procreation lowers it to the animal level,” and, “Love includes procreation, but the latter neither defines it nor in any way depletes it” (178). Since there is more to sex than making babies, it is morally licit, at times, for a married couple to have sex without directly intending the conception of children. At times “the intention of limiting birth is right” (178).

In discussing the moral means of controlling birth, however, Evdokimov sees an equivalency between what Catholics call NFP and forms of contraception. Of methods similar to NFP, he writes, “The act that becomes ‘safe’ by means of a computation of days or a by a mastery of the will is in every instance not natural, unless one plays with words” (177). He refers to methods similar to NFP as “mental contraceptives” and states, “The problem is not one of methods, but of the spirit with which one employs the methods” (177-178).

Interestingly, this is in agreement with one aspect of patristic teaching. The fathers oppose having sex without intending conception, regardless of the means used to avoid it. For them, it is not about means, but intentions. If we now say that it is morally permissible to have sex without directly intending conception, why should we introduce a distinction between means that the fathers would not have recognized? Augustine directly opposed what we now call NFP because he consistently opposed sex without the direct intention of procreation. If we now permit the use of NFP, why should we not accept other means of limiting birth while still having sex? These are questions Evdokimov raises, which challenge a Catholic reader. I believe the Catholic teaching given in a previous post has good answers to these questions, but they are coming from a different premise. While the Catholic teaching has maintained a prohibition of contraception and behavioral methods of birth control that the fathers would have approved of, the Orthodox teaching has maintained a patristic understanding of the equivalency of means. The contemporary teachings of neither the Catholic Church nor the Orthodox Church represent the patristic teaching on this issue. I doubt there are many Christians of any kind who believe and live as the fathers taught on this issue. Teaching about birth control has clearly developed in the Church over time.




Bishop Hilarion Alfeyev in his study
Not all of the Eastern Orthodox accept Evdokimov’s view. There are some few Eastern Orthodox opponents of contraception. For example, Bishop (now Metropolitan) Hilarion Alfeyev of the Russian Orthodox Church, in his Statement to the World Council of Churches in Geneva, on 13 February 2008, mentioned contraception among a list of evils such as abortion and euthanasia. Fr. Patrick Henry Reardon, an archpriest of the Antiochian Orthodox Christian Archdiocese, has made unambiguous statements against contraception (see video above). There are others opposed to it as well, but they seem to be in the minority.

More prevalent is the perspective expressed in the Orthodox Church in America (OCA) document, Synodal Affirmations on Marriage, Family, Sexuality, and the Sanctity of Life. It agrees with Catholic teaching, up to a point, when it states,
"The procreation of children is not in itself the sole purpose of marriage, but a marriage without the desire for children, and the prayer to God to bear and nurture them, is contrary to the 'sacrament of love'" (Orthodox Marriage Service; St. John Chrysostom, On Ephesians, Homily 20).

However, the teachings diverge when it comes to the issue of which means are morally appropriate for the responsible regulation of births. The document states, “Only those means of controlling conception within marriage are acceptable which do not harm a fetus already conceived.” On face value, this statement would appear to permit abstinence – periodic or total, behavioral methods, most forms of contraception – including some kinds of abortifacients, and sterilization. It would appear to forbid only direct abortion. However, I do not think that this is its intention. Elsewhere the document states, “Sexual love in marriage is to be chaste and pure, devoid of lewdness, lechery, violence, and self-gratification.” This may well be taken to exclude at least some behavioral methods of birth control and sterilization – which is a kind of violence to the body. However, this is an interpretation, and the document does not clearly prohibit these practices. The document’s use of the term “fetus,” which is usually understood as a person about eight weeks after conception, combined with its failure to identify conception as the beginning of human life brings into question whether or not it intends to forbid abortifacients along with other kinds of abortion. Concerning abortion, the document states,
Orthodox Christians have always viewed the willful abortion of unborn children as a heinous act of evil. The Church’s canonical tradition identifies any action intended to destroy a fetus as the crime of murder (Ancyra, Canon 21; Trullo, Canon 91; St. Basil, Canon 2).
Again, the persons protected by this statement are described as “fetuses.” If the OCA also morally opposes the willful destruction of embryos and zygotes, as I suspect it does, greater clarity on this teaching would be helpful.

The Russian Orthodox document, Bases of the Social Concept of the Russian Orthodox Church, presents a clearer total opposition to abortifacients: “Some contraceptives have an abortive effect, interrupting artificially the life of the embryo on the very first stages of his life. Therefore, the same judgments are applicable to the use of them as to abortion” (XII. 3). This seems to be a more complete expression of the Orthodox teaching on this matter.

Regarding non-abortifacient types of contraception, this Russian Orthodox document agrees with the OCA document that they are permissible and “cannot be equated with abortion in the least” (XII. 3). However, it uses stronger language in support of the essential relationship between marriage and procreation and it particularly recommends periodic abstinence as a means of birth control.

This document further emphasizes an important aspect of moral behavior in this area of life, perhaps neglected by official Catholic teaching: “Clearly, spouses should make such decisions mutually on the counsel of their spiritual father” (XII. 3). Spiritual direction has an essential role to play in the application of objective moral standards regarding birth control to the myriad subjective situations in which spouses find themselves. It is spiritually and morally unhealthy to “go it alone” on such important moral issues and it is necessary to seek personal spiritual guidance from the pastors of the Church. While the CSDC may be right that only the spouses themselves can ultimately make decisions about the proper use of birth control in their particular situation, the Eastern tradition is also right to point out the essential relationship spouses must maintain with the Church community in every aspect of their lives, even the most intimate. If our communion with the Church is not with us at all times, even in our bedrooms, then we are not truly in communion with the Church.

While there is much information from the Eastern Orthodox and the Roman Catholic perspectives on this subject, there is none, that I have been able to find, from a specifically Eastern Catholic perspective. On an issue like this, where there is such significant disagreement between the Eastern Orthodox and the Roman Catholics, this is a problem. Many times in my experience, the Byzantine Catholic faithful do not know who to listen to on this issue. In my opinion, the pastors of the Byzantine Catholic faithful owe it to those faithful to be conversant in both viewpoints on this issue, while also needing to defend the Catholic teaching faithfully.

Commonalities

There are a few teachings about birth control consistently maintained by the fathers of the Church, the contemporary Catholic Church, and the contemporary Eastern Orthodox Church: 1) Procreation is a good and essential purpose of married life. 2) There are times for avoiding conception. 3) Abortion by any means is an immoral method of birth control. For the fathers of the Church, the only moral means of birth control is total abstinence. Current Catholic teaching would also permit periodic abstinence. The Orthodox are less clear, but, in addition to periodic abstinence and total abstinence, they would overwhelmingly also permit non-abortifacient contraception.

1) Those who would enter into Christian marriage must never do so with an attitude completely closed to having children nor indeed without the hope of having children. Without some desire for children in a marriage, there is arguably no reason to marry. Loving each other is enough, but marital love necessarily includes the desire for children.

2) Every month in the life of a marriage between the physically healthy and sufficiently young presents an opportunity for conceiving a child, if one has not already been conceived. The couple, under the guidance of the Holy Spirit and their spiritual fathers or mothers, must prayerfully and reasonably discern whether they are called to seek the fulfillment of that opportunity each time it is given. In making this determination according to the dictates of their consciences, they must seek to live in the balance between generosity and responsibility.
One recognized method of avoiding conception for
the unmarried is to wear standard issue BCGs. 

While the married should sometimes avoid conception, the unmarried should always avoid conception. The moral teaching of the Church has always required the unmarried and the celibate to practice the most effective form of birth control - complete continence.

3) No one should ever resort to an abortion regardless of the difficulty of the situation, whether they are married or unmarried, whether they are rich or poor. If a conception has taken place, the question about whether or not it was God’s will to conceive a child has already been answered. God creates no children that he does not love and want to live. It is therefore the couple’s moral responsibility, after conception has taken place, to love and provide for the newly conceived person even as Christ has first loved them.

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