Funny looks. Crude jokes. Expression of serious “concern.” This is the common experience of those who reject the use of contraception.

Those of us in this position are fully aware that we are the odd ones. In America and the broader Western world, contraception is almost ubiquitous. At the average six-week follow-up appointment after the birth of a child, doctors often ask which form of the birth control will be used, not whether. In our broader culture, this is the only question worth asking. It’s the same for most evangelicals who roundly reject the traditional position on contraception. Often, you’ll hear the objection that the traditional position is “Catholic.” The irony is that (a) it is catholic in the sense that there is historical consensus on the issue and (b) only eight percent of Roman Catholics actually agree with their own church’s teaching on the issue.¹

Whenever we talk about history, it’s very easy to notice the blind spots of those who have gone before us. It is much more difficult to notice our own blind spots. And when we do, it’s often a Platonic cave experience. When light is shed on our blind spots, we often remain blinded, not by darkness but by light. So what I hope to do in this article is drag you out of the cave, and in so doing, I recognize that I will probably make you blind. Because of my own perspective on this, I find myself laying out these arguments often, and it is rare that anyone is immediately convinced. But that’s what happens when sight is restored–the eyes need to adjust. Christians need their eyes adjusted to wake us up from our stupor on this important issue. Over the past fifty years, we’ve done a good job in opposing more obvious evils like abortion, and even in recent days, Christians have become more firm in their opposition to morally questionable fertility interventions. But we still have a long way to go.

How we got here is a very long story, and once we get into the arguments, I’ll give several historical nuggets, but for the sake of space, we’ll keep things focused on the moral question. We’ll consider two things. First, we’ll look at the positive and natural moral imperatives which govern how the marital act is supposed to operate. Second, we’ll consider the harms associated with violating those imperatives.

State of the Question

There are a spectrum of Christian views on this issue, but I think we can reasonably divide them into two: those which reject contraception and those which permit it. Every other view falls into one of these two categories. For example, among those who believe that contraception is permissible, there is disagreement about which methods are acceptable. But that is not the question we are trying to address.

It’s also worth noting that we are discussing what is legitimate in principle. In other words, there may be exceptions to the rule, but as we all well know, the exceptions prove the rule. So from my perspective, there are situations where contraception would be acceptable, but only in pursuit of some end besides birth control. For example, if a woman requires a life-saving medical procedure that accidentally results in sterilization, then pursuing that procedure would not violate the principled rejection of contraception.

Furthermore, while I am simply defending my rejection of artificial contraception, I think a necessary corollary is the rejection of artificial conception. The same arguments laid out below can easily be used in the rejection of practices like in vitro fertilization.

The Purpose of Marriage

It is perhaps best to begin with the purpose of marriage and the marital act since this is the center of the justification for the permissibility of contraception. Andreas Köstenberger lists four purposes for sexual intimacy: procreation, personal union between the spouses, the public good, and pleasure.²

The first three are standard. If you’ve been to a traditional wedding service, you may have heard these listed before. For example, the 1662 Book of Common Prayer lists procreation, avoidance of sin (i.e., the public good), and mutual society as the three causes for marriage.³ The same purposes are listed in the chapter on marriage in the Westminster Confession of Faith. These, of course, have good biblical support. We find procreation and union as early as Genesis 1 and 2. Adam and Eve are called to fill the earth and are joined together as one flesh. With respect to the public good, Paul explicitly commends marriage as a way of properly ordering sexual desires in 1 Corinthians 7:9: “But if they cannot exercise self-control, they should marry. For it is better to marry than to burn with passion.”

I would, however, object to his fourth purpose, pleasure. In defense of this purpose, two passages of Scripture are cited: Proverbs 5:15-23 and the Song of Songs.² With regard to the Song, I would nearly reject his interpretation out of hand. In fact, as I read the Song, part of the point is that sexual pleasures are fleeting and need to be mastered and ordered under covenantal love. If you’re interested in reading more about that, I broadly agree with Miles Van Pelt’s interpretation.⁴ As for Proverbs 5, the purpose of that passage is to contrast appropriate marital relations with inappropriate extramarital relations. The exhortation is to delight in the sexual intimacy with one’s wife rather than another woman. It is inappropriate then to take this passage as implying that pleasure is an end in itself.

I am not suggesting that pleasure has no place in marital union. It certainly does, just not as an end. I concur with Thomas Aquinas’ assessment that pleasure is simply a movement of the soul toward a good.⁵ This is, by the way, what our catechisms mean when they say man’s chief end is to glorify and enjoy God forever; our purpose is to be perpetually moving into deeper communion with God. But with respect to the marital act, pleasure is a sensitive (as opposed to a spiritual) appetite that is fulfilled in the marital act, which is itself a spiritual good. Pleasure is not a purpose of the marital act itself.

Now, this is not a hair-splitting digression; it is an important element of the argument because I contend that any marital act must be ordered to all of its ends. The three purposes of marriage are inextricably united. All three purposes are bound up in the creation mandate:

“Be fruitful and multiply and fill the earth and subdue it, and have dominion over the fish of the sea and over the birds of the heavens and over every living thing that moves on the earth.” (Gen 1:28)

The first three commands are explicitly procreative, but they are not disconnected from the fourth. As Köstenberger notes, “The first man and first woman were thus charged to exercise representative rule in part by procreation.”² Another way of expressing the same principle might be to say that the purpose of personal union between the spouses is procreation. Eve was given to Adam because their personal union is the means by which procreation takes place. This also drives the need for marriage as a public good. Extramarital relations are naturally procreative, and illegitimate children are not conducive to the public good. Extramarital relations result in disorder in the world, as opposed to order. In other words, the world is not subdued through them.

So these three purposes of marital union are linked. Pope Paul VI summarizes this principle ably:

“This particular doctrine, often expounded by the magisterium of the Church, is based on the 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.”⁶

While I would, of course, disagree with Paul VI’s views on the authority of the Roman magisterium, I believe his natural and biblical reasoning in this matter is sound.

It is also notable that unlinking of these purposes has its roots in feminism, not in biblical reasoning. The primary reason feminists pursued birth control was to “uncouple” sex and reproduction so that women could continue to enjoy sexual relations without the natural result.⁷ This uncoupling has occurred with lightning speed. When John Murray published his Principles of Conduct in 1957, contraception was a category left unaddressed, and in fact, he simply assumed that sex and reproduction (or the unitive and procreative purposes) were inextricably linked, saying, “We cannot think of the duty of procreation in abstraction from marriage. And we cannot think of marriage apart from the dignity and privilege of the procreative acts and processes which are bound up with it.”⁸ His reasoning here is based in the biblical account of the creation ordinances in Genesis. But today’s evangelicals do not hold the same view; only four percent of evangelicals view contraception as morally wrong, and fifty-six percent think contraception is not a moral issue at all.¹

The central moral argument from this perspective is that Scripture does not prohibit contraception or, at least, does not require that the unitive and procreative ends of sexual union be present in every act of intimacy.⁹ In response, I would first note that in the history of interpretation, the story of Onan has been taken as a prohibition against the separation of the unitive and procreative. Consider this sampling of older commentators. John Calvin:

“The voluntary spilling of semen outside of intercourse between man and woman is a monstrous thing. Deliberately to withdraw from coitus in order that semen may fall on the ground is doubly monstrous.”¹⁰

Augustine:

“[Intercourse,] even with one’s lawfully wedded spouse, can take place in an unlawful and shameful manner, whenever the conception of offspring is avoided.”¹⁰

James Ussher lists “the horrible sin of Onan” as a violation of the seventh commandment.¹⁰ Martin Luther:

“For Onan goes in to her…and when it comes to the point of insemination, spills the semen, lest the woman conceive. Surely at such a time the order of nature established by God in procreation should be followed. Accordingly, it was a most disgraceful crime…”¹⁰

Matthew Henry calls Onan’s sin dishonoring and defiling to the body.¹⁰ Charles Provan’s book The Bible and Birth Control provides a litany of other examples. Modern commentators may take different approaches to this passage, but the historical view is clear.

Second, even if we granted that Onan’s story is irrelevant, it is inconsistent to suggest that the lack of a prohibition is the same as permission. I’m certainly not suggesting that we apply a strict regulative principle to all of life, but in this case, we have a positive command that regulates the marital act. Consider this example. If I give my daughter a twenty-dollar bill so that she can buy food, would it be disobedient of her to buy shoes instead? Of course! I don’t need to give my daughter a list of prohibited uses of the money, because I’ve already given her its purpose. Thus, it would be wrong for her to deviate from the purpose. The same applies here. There may be no direct prohibition against contraception in Scripture, but there is a positive command. That positive command renders the prohibition unnecessary, and that to a higher degree because of the law of nature!

Thus far, we have been speaking largely about biblical interpretation, but I think we can go even one step further back and ask, “What does nature teach us?” In Romans 1, Paul speaks on these very terms when he refers to “natural relations.” Now, this is a very familiar passage with respect to debates about homosexuality because of its clear condemnation of the practice. But we cannot neglect Paul’s reason for rejecting homosexuality, namely, that it is a violation of nature. By good and necessary consequence, we may conclude that any act which meets that criterion is sinful. Luther expounds this, saying, “Since to honor the body (at least in this one respect) means to be chaste and continent, or to use it properly, so the abuse of the body, by changing its natural use, means to dishonor it.”¹¹ So here is the million dollar question for applying natural law: what is the natural use of the reproductive system? Of course, it is reproduction first and foremost.

Adverse Effects of Contraception

The most popular form of temporary contraception in the United States is hormonal birth control. Twenty-six percent of women aged 15-49 in the United States are on some form of hormonal birth control, and hormonal methods account for forty percent of all contraception use.¹² Most commonly this takes the form of a pill, but there are other methods of administration available. Given its ubiquity, this is the form of birth control most doctors will recommend.

But despite its widespread use, hormonal contraception has serious adverse effects. For example, fifty percent of women using hormonal contraceptives report mood side effects, and thirty-eight percent report sexual side effects.¹³ Furthermore, when women attempt to get off of hormonal birth control, the physical side effects continue. Notably, it usually takes nine menstrual cycles, which are lengthened by hormonal shifts, for a woman’s body to recover from hormonal birth control use.¹⁴

These physical side effects also cause relational problems. Sexual attraction is largely driven by hormones, so changing those hormones can affect how a husband and wife relate to each other. For example, women who use hormonal birth control tend to prefer more feminine men than non-users.¹⁵ It has also been shown that hormonal contraceptive use contributes to women choosing partners whom they otherwise would not have chosen, as well as being unable to compete with non-users for their preferred partners.¹⁶ There is also evidence to show that use of contraceptives is correlated to less frequent sexual encounters in married couples.¹⁷

Sterilization is the second most common form of birth control after hormonal options; one in three women aged 35-44 have been medically sterilized.¹⁸ But it also has serious side effects. One major concern is that sterilization, male or female, significantly increases the chances of developing depression or anxiety.¹⁹ Sterilization also has one major disadvantage over other forms of contraception—it is irreversible.

All of this data also raises some serious ethical concerns. If you peruse all the articles cited above, you may notice that while they are looking at the same data we are, they are coming to very different conclusions. Most of the research in this area is done to help medical professionals convince women to pursue these birth control methods. Several articles above bring to light the problems associated with contraception but praise the benefits of contraception anyway. For example, one article concludes in this way:

Any such effects should be weighed against the multiple benefits that the invention of the pill has brought. This revolutionary contraceptive method has given women unprecedented control over their fertility with the possibility to sample different partners before reproduction, to control their number of children, to reach optimal birth spacing given circumstances or to end reproductive career before menopause if desired, which has had a considerable impact on their social life. For instance, a sharp increase in college attendance and graduation rates for women was observed after the pill was legalized. The ability to control fertility without sacrificing sexual relationships has facilitated women’s long-term educational and career plans, and many social scientists consider the widespread use of the pill to be key in creating women’s modern economic role.¹⁶

Here we have a scientific journal blurring the lines between science and ethics. The contraceptive pill is being touted, not as an effective medical intervention, but as a social good. These are too numerous to cite here, but the medical journals are full of articles discussing the importance of introducing these interventions into second- and third-world countries for the purpose of exporting postmodern Western ideals about marriage and family. One of the more egregious examples of this kind of activity was the mass sterilization of Puerto Rican women in the 50s and 60s, usually without their consent. The documentary La Operación tells this story effectively.²⁰ And this is not even to mention that the vast majority of funding for these research projects comes from the very pharmaceutical companies which produce the contraceptives, as well as non-profit organizations devoted to encouraging contraception and other forms of sexual deviancy.

In all of this, it is women who bear most of the weight. It is women who suffer the severest side effects, it is women who deal with the most medical interventions, and it is women who are the subject of experimentation. And it makes sense, does it not? If we took away any other bodily function, would it not cause great suffering? What happens if we stop digestion, breathing, eyesight, or circulation? Would it not immediately cause great pain and suffering? Eyesight is not an essential function, but what blind man doesn’t want to see? Contraception is analogous. We wouldn’t cut out our own eyes, but we freely pursue sterilization. We wouldn’t chemically block our optical nerve, but we chemically inhibit ovulation. We wouldn’t walk around everywhere with a blindfold on, but we introduce barriers into the marital bed. The fact of the matter is that there are consequences for defying the laws of nature. There are inescapable trade-offs associated with exchanging our natural relations with unnatural ones. That is no small matter.

Isn’t NFP just another form of contraception?

This is an objection very commonly raised against the traditional position on birth control. This is one of John Frame’s objections: “If reproduction is an essential purpose of sex, then we should never interfere with it, by any means at all.”²¹ Thus, says Frame, a distinction between natural and artificial means is irrelevant.

I think there are a couple things Frame is missing here. Most importantly, he’s missing what the natural law argument entails. The difference between natural methods and artificial methods is that the former works in, with, and through nature while the latter defies it. Pope Paul VI comments:

“Neither the Church nor her doctrine is inconsistent when she considers it lawful for married people to take advantage of the infertile period but condemns as always unlawful the use of means which directly prevent conception, even when the reasons given for the later practice may appear to be upright and serious. In reality, these two cases are completely different. In the former the married couple rightly use a faculty provided them by nature. In the later they obstruct the natural development of the generative process.”⁶

The key difference is that NFP is stewardship of existing natural processes, like a farmer tending his animals, while artificial methods are abuses and disruptions of those process, like abhorrent factory farming practices.

This is, by the way, a distinction that the medical community is aware of:

“[Hormonal contraceptives] cause the total blockade of fertility by inhibiting the normal functioning of the hypothalamic-pituitary-gonadal axis in a reversible way. Therefore, they can be fully considered as contraceptives. On the contrary, natural methods do not inhibit the natural fertility of the woman, but only aim to control and predict its cyclicity. Therefore, they can be called ‘fertility control methods’ instead of contraceptive methods.”²²

A contraceptive, by definition, prevents conception. But in NFP, there is no active attempt to prevent conception. By way of analogy, we may consider end of life questions. Most Christians recognize a moral distinction between euthanasia and hospice care. Euthanasia is wrong because it actively disrupts the normal functioning of the human body to induce death. Hospice care, on the other hand, simply stewards the natural death process in a way that eases pain and suffering for the afflicted. I contend that if we are able to recognize this distinction at the end of life, we should be able to do the same at the beginning of life.

Conclusion

Most of us step into this question without much thought. We do what’s easy. We do what’s normal. We assume it will be simple and symptom-free. But it isn’t. So why the pressure? Why are we pushed toward certain methods? Why are the downsides rarely explained? And the heaviest question of all: how many lives are quietly lost while we are told there’s nothing to worry about? My hope is simple. Think about it. Take a harder look at the methods you’re considering. Don’t just ask what God might allow. Ask what God intends. Not, “What may I do?” but, “What ought I do?”