The Intrauterine Device (IUD) for Contraception and Christian Moral Considerations

Introduction

Contraceptive methods include the rhythm method (or Natural Family Planning), barrier methods (condoms, diaphragms, vaginal sponges, cervical caps, spermicidal foams, gels, creams), hormonal contraceptives (birth control pills, Depo-Provera, Norplant), intrauterine devices, and sterilization.  The RU-486 (or similar American version, Ella) is abortifacient in that it starves the foetus of nutrition, resulting in death. 

Several related Christian ethical considerations include:

·       Marital and sexual ethics (the right place of sex only in marriage; the purpose of marriage for procreation and/or spiritual/marital union, and/or avoidance of temptation)

·       Ethics of contraception

·       Ethics of abortion

·       Medical interventions for fertility/infertility (fertilization, sterilization)

·       Ethics of surrogacy

A broader, Biblical understanding of life, sex, and marriage undergirds Christian convictions about such topics.[1]  In this essay, I intend to focus on the moral issues of one means of contraception that blurs the line between contraception and abortion: the Intrauterine Device (IUD).

What is the Intrauterine Device and the Christian View on Its Use?

According to Human Life International, the IUD functions as a contraception[2] some of the time but also causes abortion (is an ‘abortifacient’).[3]  The device works by prohibiting implantation of a fertilized egg by irritating the endometrium (the uturus’s lining).  A fertilized egg does not implant immediately in the uturus, and so an IUD that is inserted after copulation even up to two days later will result in pregnancy only one in one thousand one hundred times.[4]

The debate over whether the IUD is or is not an abortifacient is not over how it functions but over whether a fertilized egg is a child or whether human life only begins at implantation.  Those arguing that the fertilized egg is not human also argue that most fertilized eggs—allegedly above 70%--never implant.  The implication is that, if this is so, then the loss of fertilized eggs is a natural process and should not be ascribed a moral dimension.    

In response to this argument, one might begin by examining whether the claim that human embryos naturally abort so often.  According to Gavin E. Jarvis (Department of Physiology, Development and Neuroscience at the University of Cambridge), ‘estimates for total prenatal mortality of 70% or higher are exaggerated and not supported by the evidence.’[5]  HLI replies to this argument that the fertilized egg is the same before and after implantation: the difference is not one of life but of hospitality.

What, then, is an abortion?  In the USA, the definition given by the US Department of Health, Education and Welfare in 1963 was

all the measures which impair the viability of the zygote at any time between the instant of fertilization and the completion of labor

Two years later, in 1965, when the American College of Obstetrics and Gynecology published their first guide to terminology, the definition of an abortion had changed to ‘Conception is the implantation of a fertilized ovum’.[6]

Apart from possible birth defects, pelvic infections, sterility, and miscarriages, certain types of IUD have also resulted in death.  Consequently, companies producing various versions of the IUD have discontinued manufacture: the Dalkon Shield in 1975, the Lippes Loop in 1985, and the Tatum-T IUD in 1986.  While over 70 types of IUD have been produced since their introduction in 1915 as a contraception, now ‘Because of widespread negative publicity, only 1% of women using birth control were on the IUD by 1995, but this number had risen to about 9% by 2017.’[7]

The Life in the Womb

Consider two contrasting statements in antiquity.  The first is Biblical.  In Ecclesiastes, we read:

As you do not know the way the spirit comes to the bones in the womb of a woman with child, so you do not know the work of God who makes everything (11.5).

This statement provides insight into a Biblical ethic, evident in various other texts (see below), about the life of the foetus.  The text removes from discussion a claim about when a foetus might be considered human.  This is the wrong question.  Instead, the foetus is considered God’s creative work.  Second, the passage rejects the notion that the foetus can be reduced to a mere collection of cells.  By speaking of ‘the way the spirit comes to the bones in the womb’, the text is not entertaining some ethic at which it is at some point just a collection of cells.  First, it does not say ‘when’ but ‘the way’ this happens.  Second, it says that the humanity of the foetus is to be assumed.  The ethics around the unborn, whether a typical child or one conceived in violence, threatening the mother’s life, or deformed in some way, begins with the acceptance that we are speaking of a human life.  Any attempt to dehumanize the foetus in order to justify its killing is no different from dehumanizing some other group, such as the Jews in Nazi Germany, to do the same.

The second statement is from Aristotle:

As to the exposure and rearing of children, let there be a law that no deformed child shall live, but that on the ground of an excess in the number of children, if the established customs of the state forbid this (for in our state population has a limit), no child is to be exposed, but when couples have children in excess, let abortion be procured before sense and life have begun; what may or may not be lawfully done in these cases depends on the question of life and sensation (Politics 7.XVI).[8]

Aristotle’s description of his ideal state would control its population’s size, using infanticide, eugenics, and abortion.  Yet he also says that this is to be done before the foetus has ‘life and sensation’.  He did not understand life in the womb, assuming that it was when movement could be sensed.  Termination of the foetus’s existence was to be done before this.

Today, we know that the foetus’s life begins at conception.  What the foetus is at this point is what it becomes.  Nothing is added.  All that is needed is the right hospitality in the womb to reach birth and the right care after birth for the child to reach independence.  So, what do we mean by ‘viability’?  Some use this to mean the viability of the foetus to live apart from the mother, but the foetus is viable in itself as long as it is not put to death.  An elderly person with Altzheimer’s who must be fed, or a quadriplegic with a fully functioning mind, is not ‘viable’ in the sense a foetus is not viable, but all three are viable if shown the care needed to sustain life.

Biblical Texts Affirming the Humanity of the Foetus

Biblical texts support the notion that the foetus is alive in the womb.  The focus is not on trying to determine some stage of viability.  Rather, what the Bible recognises is God’s providential  care of the life in the womb.  What God values, humanity should value.  Not only is the foetus a human life, it is also a God-given life.  The following texts suggest as much:

        Exodus 21:22-25  "When men strive together and hit a pregnant woman, so that her children come out, but there is no harm, the one who hit her shall surely be fined, as the woman's husband shall impose on him, and he shall pay as the judges determine.  23 But if there is harm, then you shall pay life for life,  24 eye for eye, tooth for tooth, hand for hand, foot for foot,  25 burn for burn, wound for wound, stripe for stripe.

A person unintentionally causing a woman to give birth early is to be fined when no harm results but life is paid with life if it does, according to the lex talionis.[9]

        Psalm 71.6 Upon you I have leaned from before my birth;
    you are he who took me from my mother’s womb.
  My praise is continually of you.

On the one hand, God providentially cares for the foetus.  On the other, the foetus leans on God’s providential care.  A caring relationship exists between God and the child before birth.

        Psalm 139:13-16  For you formed my inward parts; you knitted me together in my mother's womb.  14 I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well.  15 My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth.  16 Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there were none of them.[10]

God’s care for the unborn does not begin at birth or even some later time but exists throughout the time of the formation of the foetus.  The psalmist is saying that the celebration of the personhood of the foetus does not begin when it is fully formed but already while it is being formed.  God omniscience and predestination of the individual’s life covers the entire span of life, from conception to death.  In fact, the psalmist celebrates God’s presence in places beyond this life just as he celebrates God’s presence in the formation of the foetus: ‘If I ascend to heaven, you are there!  If I make my bed in Sheol, you are there!’ (v. 8).  Human personhood and worth is not limited to some notion of viability that we entertain.[11]

         Ecclesiastes 11.5 As you do not know the way the spirit comes to the bones in the womb of a woman with child, so you do not know the work of God who makes everything.

(See the comment, above)

        Isaiah 44.24a  Thus says the LORD, your Redeemer, who formed you from the womb....

To express His providential care of Israel, God speaks to the people in the singular—as ‘Jacob’, His servant—and of His work in both creation and redemption.  His care is like that of His care in the womb.  When providence is part of the notion of care, care is expanded beyond present existence (viability) to include God’s purposes, beginning from the moment of creation and passing through formation.  As Israel was sent into exile and redeemed by God, he was, one might say, also in God’s care when he was no longer viable.  The metaphor works for Israel only if it is also true regarding God’s care of the foetus above and beyond viability.

        Jeremiah 1:5   "Before I formed you in the womb I knew you, and before you were born I consecrated you; I appointed you a prophet to the nations."

If we only had this verse to speak of God’s providential formation and consecration prior to birth, we might limit it to the special case of Jeremiah or a prophet doing God’s work.  Other passages already noted, however, show that the belief extended to all foetuses.

        Galatians 1:15  But when he who had set me apart before I was born….

In this passage, Paul applies the thought and wording in Jeremiah 1.5 to himself.

        Luke 1:41-44  And when Elizabeth heard the greeting of Mary, the baby leaped in her womb. And Elizabeth was filled with the Holy Spirit,  42 and she exclaimed with a loud cry, "Blessed are you among women, and blessed is the fruit of your womb!  43 And why is this granted to me that the mother of my Lord should come to me?  44 For behold, when the sound of your greeting came to my ears, the baby in my womb leaped for joy.

What has been said about the foetus’s status before God in other passages is now illustrated in the personhood and spirituality of John the Baptist and Jesus in the womb.

Christian Convictions on Contraception and the IUD

The Orthodox Church

While different views have been held in Orthodox circles about contraception, the Orthodox Church continues to hold the Early Church’s view that all abortion is wrong.  The following excerpts from For the Life of the World: Toward a Social Ethos of the Orthodox Church address teaching representative of the Orthodox Church (approved by the Ecumenical Patriarch in 2020) on contraception and abortion:

The Orthodox Church has no dogmatic objection to the use of safe and non-abortifacient contraceptives within the context of married life, not as an ideal or as a permanent arrangement, but as a provisional concession to necessity. The sexual union of a couple is an intrinsic good that serves to deepen the love of each for the other and their devotion to a shared life. By the same token, the Church has no objection to the use of certain modern and still-evolving reproductive technologies for couples who earnestly desire children, but who are unable to conceive without aid. But the Church cannot approve of methods that result in the destruction of “supernumerary” fertilized ova. The necessary touchstone for assessing whether any given reproductive technology is licit must be the inalienable dignity and incomparable value of every human life (For the Life of the World 24).[12]

A human being is more than the gradually emergent result of a physical process; life begins at the moment of conception. A child’s claim upon our moral regard then is absolute from that first moment, and Christians are forbidden from shedding innocent blood at every stage of human development. The Church recognizes, of course, that pregnancies are often terminated as a result of poverty, despair, coercion, or abuse, and it seeks to provide a way of reconciliation for those who have succumbed to these terrible pressures. Inasmuch, however, as the act of abortion is always objectively a tragedy, one that takes an innocent human life, reconciliation must involve the acknowledgment of this truth before complete repentance, reconciliation, and healing are possible. Moreover, the Church must be ready at all times—inasmuch as it truly wishes to affirm the goodness of every life—to come to the aid of women in situations of unintended pregnancy, whether as the result of rape or of consensual sexual union, and to come also to the aid of expectant mothers suffering from penury, abuse, or other adverse conditions, by providing them material and emotional support, spiritual succor, and every assurance of God’s love, both during and after pregnancy (For the Life of the World 25).[13]

The Church does recognize, however, that in the course of some pregnancies there arise tragic and insoluble medical situations in which the life of the unborn child cannot be preserved or prolonged without grave danger to the life of the mother, and that the only medical remedy may result in or hasten the death of the unborn child, contrary to all that the parents had desired. In such situations, the Church cannot pretend to be competent to know the best way of proceeding in every instance, and must commend the matter to the prayerful deliberations of parents and their physicians. It can, however, offer counsel, as well as prayers for the healing and salvation of all the lives involved. Furthermore, the Church laments the ubiquity of the loss of life in utero through miscarriage and stillbirth, understanding these experiences as particularly powerful forms of bereavement for the family, and it must revise those of its prayers that suggest otherwise, and rise to the sensitive and loving pastoral care that loss of pregnancy requires (For the Life of the World 26).[14]

The Roman Catholic Position on Contraception

Roman Catholicism is opposed to both abortion and all forms of contraception other than natural family planning.  As this article is about the IUD, which is a form of contraception that at times also aborts fertilized eggs, the Church is against its use.  Catholic teaching on both contraception and abortion is not simplistic but the articulation of theological and moral convictions as new developments arise.

Catholic moral reasoning is evident in the Papal Encyclical of Pope Paul VI in 1968 entitled, Humanae Vitae (HV).[15]  HV begins by identifying new issues that had come into focus at the time and that relate to family planning and contraception.  First, it mentions challenges associated with the increase of population and pressures placed on our resources and economies.  This is not only a social concern but also a challenge within a large family.  A second issue identified is the dignity of women in society (apparently referring to the roles they play outside the family).  A third issue is the ‘value of conjugal love in marriage and the relationship of conjugal acts to this love.’   The fourth, new issue to consider is ‘man’s stupendous progress in the domination and rational organization of the forces of nature’ affecting ‘every aspect of his own life’, including the regulation of the transmission of life—contraception.

HV (10) argues that marital love entails responsible parenthood.  This means that reason and duty are exercised over biological forces, emotional drives, social and familial factors regarding procreation.  Each sexual act is purposive, having an ‘intrinsic relationship to the procreation of human life’ (11).  This procreative purpose of marriage is inseparable from the unitive purpose in marital intimacy (12).  These two purposes of marriage are God-given.  Thus, sex fulfilling a function of marital unity without also aimed toward the procreative purpose of sex frustrates God’s design as the Author of life (13).

Upon this reasoning, the Catholic Church condemns contraception and sterilization, whether temporary or permanent (14).  This does not rule out using reason in natural family planning and infertile periods for marital intimacy to express their love for one another (16).  Further considerations about birth control include how it opens culture up to infidelity and lower standards of morality, reduces a man’s reverence for a woman inasmuch as she becomes an object for his satisfaction and desires, and opens society up to government’s oversight in applying its standards to matters of family responsibility (17). 

An Evangelical Position on IUDs

In discussing Protestantism, the focus in this section will be on an Evangelical position.  Evangelicalism is not a ‘Church’ or denomination but a movement across a spectrum of theological traditions.  It is therefore difficult to speak of ‘the’ Evangelical view in the way that we can for the Orthodox or Roman Catholic Churches.  Yet it is a traditional movement on the same trajectory of historic, orthodox Christian faith. The mainline denominations of Protestantism, on the other hand, have progressively rejected historic Christianity on key theological and ethical issues in favour of the views and practices of contemporary culture.  The result is that, today, mainline denominations are open to abortion.[16]  These denominations are led more by adaptation to Western culture than by Christian teaching.  This essay on Christian reasoning about contraception, abortion, and the use of the IUD should pursue Christian ethics through the Evangelical writers, therefore.

One of the factors separating the liberal, mainline denominations (all declining since the 1960s and so no longer ‘mainline’) from Evangelicals is the stance taken on abortion, and therefore on certain methods of contraception.  As John Jefferson Davis notes, Protestants followed Catholics in rejecting contraception up to the early 20th century.  Only in 1930 did Anglican bishops say that contraception may be used, but not out of motives to do with selfishness, luxury, or convenience.[17]  The acceptance of contraceptives by Protestants was furthered in 1960 with the development of the Pill.[18] 

Evangelical Protestants (e.g., John Jefferson Davis,[19] Albert Moller,[20] Andreas Köstenberger,[21] Wayne Grudem[22], John S. Feinberg and Paul D. Feinberg,[23] Alvin Low[24]) follow Orthodox and Catholic ethics regarding the IUD as abortifacient and therefore morally wrong.  This is also the view of the Christian Medical Fellowship (CMF) in the United Kingdom[25] and the Christian Medical and Dental Association (CMDA) in the USA.  In ‘The Beginning of Human Life’ (16 June, 2006), the CMDA stated in its position paper that ‘The life of a human being begins at the moment of fertilization (fusion of sperm and egg).’[26]  It defines human life as follows:

 

A living human being is a self-directed, integrated organism that possesses the genetic endowment of the species Homo sapiens who has the inherent active biological disposition (active capacity and potency) for ordered growth and development in a continuous and seamless maturation process, with the potential to express secondary characteristics such as rationality, self-awareness, communication, and relationship with God, other human beings, and the environment.[27]

 

In other words, a fertilized egg is a human being before implantation in the uterus.  Moreover,

It is artificial and arbitrary to use other proposed biological “markers” (such as implantation, development of a primitive streak, absence of potential for twinning, brain activity, heartbeat, quickening, viability, or birth and beyond) to define the beginning of human life.[28]

Dr. Al Moller, president of the Southern Baptist Theological Seminary, notes that Evangelicals at first were uncritically open to birth control technologies, including the IUD.  Writing in 2004, he noted that this was changing as Evangelicals thought more seriously about this.[29]  This trend began before then as medical professionals came to understand how the IUD worked.  Realising that it was not just a contraception but also an abortifacient, Evangelicals have come to reject the IUD.  Franklin E. Payne, Jr., Associate Professor at the Medical College of Georgia, says,

... abortifacients are not an ethical choice. These methods include surgical abortion by various means and at various stages of fetal development, the intrauterine contraceptive device (IUD), the “mini pill” (containing a progestin only), subcutaneous injection of estrogens and progestins, the “morning after” pill (a high dose of estrogen or progestin), and the new French abortifacient, RU-486.[30]

Moller concludes:

For evangelicals, much work remains to be done. We must build and nurture a new tradition of moral theology, drawn from Holy Scripture and enriched by the theological heritage of the church. Until we do, many evangelical couples will not even know where to begin the process of thinking about birth control in a fully Christian frame. It is high time evangelicals answered this call.[31]

The development of an Evangelical position on IUDs took several decades.  This was due to more than one factor.  The broad acceptance of the use of contraceptives by Protestants from the 1960s required both differentiation regarding what the different methods entailed and consensus building across groups making up the fraternity.  The separation of Evangelicals from mainline Protestant denominations that increasingly rejected historic Christianity played out over the same decades and led to opposite views on the morality of abortion—and therefore different views on abortifacient contraceptives.  Another factor pressuring Evangelicals to come to a view on contraceptives was the legalisation in Western countries of abortion.  Evangelical consensus is also difficult to come by inasmuch as many so-called Evangelical churches are non-denominational and independent. Forming an ‘Evangelical position’ can at times be rather like herding cats. Finally, during the 20th century, medical researchers increasingly clarified what the science of different contraceptive methods entail. Just how the IUD operates was for a long time uncertain.  Even so, we can say that there is a fairly strong and consistent view among Evangelicals today that abortion is immoral as it is the taking of a human life, that the IUD can work as an abortifacient technology, and that the IUD is therefore not a moral option.[32]

A brief overview of the history may be helpful.  In 1970, the Christian Medical Society produced a statement entitled, ‘A Protestant Affirmation on the Control of Human Reproduction’ that affirmed the use of contraceptives.  Sex was and is understood to be morally proper only in marriage (between a man and a woman, of course), and it was understood to have several purposes: the consummation of marriage, procreation, the expression of love within the covenant of marriage, and enjoyment and pleasure.[33]  The latter two reasons allow for the use of contraceptives to prevent pregnancy, whereas the procreative reason for sex in marriage allows a couple to regulate their family for various reasons (number of children, spacing of children, finances, transmission of inheritable diseases, etc.).[34]  

The early, 1970 statement did not distinguish types of contraception and did accept use of the IUD.  With the Patient Protection and Affordable Care Act, passed in 2010, free contraception became available to women, whether married or not.  This forced Evangelicals to consider the ethics of contraception in greater depth, and they voiced concerns that Christian institutions were being forced to pay health insurance covering immoral sexual acts and forms of contraception that disregarded the sanctity of the foetus’s life.[35]  One form of unacceptable birth control that sometimes aborted a fertilized egg was the IUD.

Conclusion

This essay on Christian ethics and the use of the intrauterine device (IUD) demonstrates that there is a consensus among Orthodox, Roman Catholic, and Evangelicals that the IUD is not an option for Christians.  The reasoning rests on the convictions that a fertilized egg is a human being and that the termination of human life is morally wrong.  Around the edges of this conviction, some further moral questions arise.  For example, what is the ethics regarding abortion when the mother’s life is in danger, or when a woman is raped, or when there is incest?  Such moral quandaries lead to various views among Christians (not discussed here), but they are not to be considered apart from the conviction that the fertilized egg is a human being, not just a mass of cells.  Throughout the history of the Church, abortion has been regarded as immoral, the taking of a human life.  As the mechanism by which the IUD operates has come to be better understood, its occasional function as an abortifacient has led Christians to agree that it is morally unacceptable.

 

Addendum

Other Statements on Use of the IUD

Assemblies of God, ‘Sanctity of Human Life: Abortion and Reproductive Issues,' General Presbytery, August 9-11, 2010

‘The Assemblies of God, finding no clear scriptural mandate, does not take an official stand on the appropriateness of contraception within a heterosexual marriage for purposes of regulating the number of children, determining the time of their birth, or safeguarding the health of the mother. These are matters of personal conscience  as godly spouses prayerfully covenant with God about the growth of their families. While there are important ethical issues in determining to have a family, the prevention of pregnancy is understood to be qualitatively different from the termination of pregnancy since the sperm has not fertilized the ovum and human life has not yet begun. The biological processes themselves teach us that in God’s creative design not every sperm or ovum is intended to survive and unite. It should be remembered, however, that some methods commonly regarded as contraception, such as the IUD and the morning-after pill, are actually agents that abort, rather than prevent, pregnancy’ (https://ag.org/Beliefs/Position-Papers/Abortion-Sanctity-of-Human-Life).

Southern Baptist Convention, 'On the Ethical Realities of Reproductive Technologies and the Dignity of the Human Embryo,' June 12, 2024

‘Every human being is made in God’s image (Genesis 1:27-28) and is thus to be respected and protected from the moment of fertilization until natural death, without regard to developmental stage or location...’ (https://www.sbc.net/resource-library/resolutions/on-the-ethical-realities-of-reproductive-technologies-and-the-dignity-of-the-human-embryo/). 



[1] Cf. Rollin G. Grams, A Biblical Catechism on Sex and Marriage (e-book; available on Bible and Mission Blog Bookshop); online: bibleandmission.blogspot.com.

[2] Fertilization can be prevented by an IUD when ions interfere with the process, sperm is inhibited, and cervical mucus is thickened.  Cf. Human Life International; https://www.hli.org/resources/abortifacient-brief-intrauterine-device/ (accessed 23 August, 2024).

[3] Ibid.

[4] Ibid.

[5] Gavin E. Jarvis, ‘Early Embryo Mortality in Natural Human Reproduction: What the Data Say,’ Version 2 (25 November, 2016); published online at https://f1000research.com/articles/5-2765/v2 (accessed 23 August, 2024).

[6] Human Life International, Ibid.

[7] Ibid.

[8] Aristotle, Politics, trans. H. Rackham (London and Cambridge, MA, 1967).

[9] Contrast the Code of Hammurabi, which distinguishes the life of the unborn from the woman and the class of the woman in the following laws.

209. If a man strike a free-born woman so that she lose her unborn child, he shall pay ten shekels for her loss.

210. If the woman die, his daughter shall be put to death.

213. If he strike the maid-servant of a man, and she lose her child, he shall pay two shekels in money.

214. If this maid-servant die, he shall pay one-third of a mina.

The Code of Hammurabi, trans. L. W. King (1915); online: http://avalon.law.yale.edu/ancient/hamframe.asp (accessed 27 March, 2018).

[10] Nebuchadnezzar says: ‘As soon as he had created me, the lord, the god who created me, the god Marduk, fashioned my form inside (my) mother (so that) when I was born I myself was (fully) formed.’  See: http://oracc.org/ribo/Q005473/.

[11] A 14th c. Egyptians letter from Amarna similarly says, ‘Something else: Look, as for us, my eyes are upon you. “Whether we go up to the heavens, whether we go down into the underworld, our head is in your control’ (EA 264).

[12] ‘For the Life of the World: Toward a Social Ethos of the Orthodox Church,’ eds. David Bentley Hart and John Chryssavgis (Brookline: Holy Cross Orthodox Press, 2020); https://omhksea.org/wp-content/uploads/2020/06/Preface.pdf (accessed 23 August, 2024).

[13] Ibid.

[14] Ibid.

[16] I discuss this in Rollin G. Grams, ‘Abortion, Culture, and the Church: Moving from Questions of Viability  to Concerns for Vulnerability,’ in Christian Ethics and Abortion: Sources, Contexts, and Arguments (e-book, 2024: https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:df3c21bf-166f-4a6a-9471-1af6b1c5f9bf). 

[17] John Jefferson Davis, Evangelical Ethics: Issues Facing the Church Today (Phillipsburg, New Jersey: Puritan & Reformed Pub., 1993), pp. 35-36.

[18] Dennis P. Hollinger, ‘The Ethics of Contraception: A Theological Assessment,’ JETS 56.4 (2013), pp. 683-696.

[19] Ibid., pp. 20-21, 39-41.

[20] Albert Moller, ‘Can Christians Use Birth Control?’, blog (March 30, 2004): https://albertmohler.com/2004/03/30/can-christians-use-birth-control-3/ (accessed 24 August, 2024).

[21] Andreas J. Köstenberger, with David W. Jones, God, Marriage, and Family: Rebuilding the Biblical Foundation, 2nd ed. (Wheaton, IL: Crossway, 2010), pp. 121-129.

[22] Wayne Grudem, Christian Ethics: Living a Life that is Pleasing to God, Rev. ed. (Wheaton, IL: Crossway, 2024).  See ch. 21: ‘Abortion’ and ch. 29: ‘Birth Control’.

[23] John S. Feinberg and Paul D. Feinberg, Ethics for a Brave New World, 2nd ed. (Wheaton, IL: Crossway, 2010), ch. 6: ‘Introduction to the Ethics of Human Sexuality: Sex and Birth Control’.

[24] Alvin A. Low, The Pursuit of Ethical Excellence (Biblical Ethics) (Morrisville, NC: Lulu Press, 2007), pp. 62-63, n. 22.

[25] Rick Thomas, ‘Contraception,’ Christian Medical Fellowship (2018); online: https://www.cmf.org.uk/resources/publications/content/?context=article&id=26815. (accessed 25 August, 2024).

[26] The position statement is available on the website of the Christian Medical and Dental Association’s website at https://cmda.org/policy-issues-home/position-statements/ (accessed 25 August, 2024).

[27] Ibid.

[28] Ibid.

[29] Albert Moller, Ibid.

[30] Franklin E. Payne, Jr., ‘Birth Control,’ Journal of Biblical Ethics in Medicine 6.2; online: https://bmei.org/birth-control/ (accessed 25 August, 2024).

[31] Albert Moller, Ibid.

[32] The IUD can be inserted after intercourse and prevent implantation of a fertilized egg.  Thus, it is used to prevent birth in the case of rape or incest.  Any moral reasoning as its use in such a situation must proceed with the understanding that the fertilized egg is a human being.

[33] This is also Dennis Hollinger’s argument for contraception, including that the mandate to steward creation and not be at the mercy of nature.  Ibid.

[34] Cf. David Fletcher, Chapter 20: ‘Contraception: Protestant Evangelical Perspectives,’ The Oxford Handbook of Religious Perspectives on Reproductive Ethics, ed. Dena S. Davis (Oxford: Oxford University Press, 2024), pp. 372-386.

[35] Ibid., p. 380.

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