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What We Talk About When We Talk About 'Birth Control'

Widespread acceptance in our culture of all forms of birth control, including abortion, makes it harder for the Christian to discern if, when, and how to incorporate such practices into one's own life, as well as what place personal convictions have in community and in public policy.

I suspect one of the greatest obstacles to constructive dialogue on the questions about birth control raised by the Hobby Lobby case is the imprecision of the terms being discussed. Perhaps, then, the first step toward finding agreement—or at least correctly identifying at the points on which we can agree to disagree—is to employ common definitions.

The debate around the Hobby Lobby case, birth control methods, and insurance coverage illuminates not only how deeply divided Christians are on these matters but also how ill-defined the central questions are. Questions of conscience are matters for all believers to respect in each other even amidst disagreement. If Christians cannot engage with each other with clarity, respect, and good faith on difficult questions, how will we do so with those outside the church?

In an effort to bring clarity to an otherwise muddled war of words, here are some of the questions central to this conversation. They're not as simple as we might assume.

How does the medical community define pregnancy?

At the heart of the debate is the question about whether or not certain birth control methods prevent pregnancy or terminate pregnancy. Part of the problem in answering even this basic question is that even the term pregnancy is not agreed upon universally and has undergone numerous changes, due less to scientific debates than semantic ones. While the American College of Obstetricians and Gynecologists says pregnancy begins with implantation, most U. S. doctors surveyed say it begins when the sperm fertilizes the egg. Thus, the oft-repeated claim that debated birth control methods do "not disrupt an established pregnancy" might be misleading. Here's why: The phrase "established pregnancy" refers to post-implantation, which does not preclude the interruption of a newly formed life. However, marking pregnancy at implantation makes sense. Pregnant describes the woman's condition, but new human life can exist apart from pregnancy, as evidenced by countless fertilized eggs that don't implant—whether naturally or intentionally—and the thousands of frozen embryos known as "snowflake babies."

A more precise term than pregnancy, perhaps, is gestation, which, according to the National Institutes of Health, describes the period between conception (fertilization of the egg) and birth. It's noteworthy, though, that even the term conception is used in a variety of ways, sometimes meaning the moment of fertilization, other times to describe several stages of gestation. The different meanings of the terms conception and pregnancy obviously affect, in turn, the meaning of the word contraception.

What is birth control?

The NIH definition states, "Birth control, also known as contraception, is designed to prevent pregnancy." This would seem to go without saying, but the colloquial misuse of the phrase "birth control" as though it were a proper name muddies the waters. One is "using birth control" if one is using the method with the intention of preventing pregnancy. A woman who is receiving treatment solely to alleviate menstrual irregularities or other medical problems is not "using birth control" any more than a woman who undergoes a hysterectomy due to cancer is "using birth control." To advocate for "birth control" under the guise of other medicinal uses only sets the cause of birth control—and women—back by communicating obfuscation and perpetuating ignorance about female sexuality and reproductive health. If medications should be covered by insurance for off-label uses, that's an argument to be made intelligently on its own merits.

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What We Talk About When We Talk About 'Birth Control'