Mangling, Mishandling, and Misrepresentation of Science in the Plan B Debate (Part I)

In an effort to inform people that the Journal of Medical Ethics needs greater scrutiny in the peer review process, I’ve been scouring the net for mentions of "rhythm method", "Plan B", "embryo death", "Bovens", and related topics. In the process, I have come across some startling bad statements regarding the scientific study of fertility – on both sides of the political spectrum. Let’s start with some MSM headlines related to Bovens’ article about an alleged relationship between the "rhythm method" and embryo death.

Rhythm method kills more embryos than condom use
Controversial rhythm method study revealed
Rhythm method linked to massive embryonic death
How Vatican roulette kills embryos
‘Rhythm’ method a killer of embryos

Notice a trend in these headlines? They all assume two things: that Bovens published the results of a scientific study and that study clearly implicated the rhythm method with embryo deaths. IT’S NOT A STUDY! It’s a sloppy polemical essay. JME should be ashamed for publishing it.

In the wake of this publication, there have been numerous examples of folks showing a poor understanding of fertility and an unwillingness to be corrected. I am certainly no expert in fertility, but I have attempted to do my homework. If you believe my following observations are incorrect or misleading in any way, do not hesitate to let me know.

In the liberal sector of the blogosphere, I’ve seen several attempts to say that Plan B is no more abortifacient than breastfeeding. This may be the case, but it’s not for the reasons typically sited. Here’s a representative example.

"Of course, proponents of NFP also favor "ecological breastfeeding, God’s own way of spacing babies." Which prevents conception by raising progesterone levels, exactly like Plan B."

‘[Former FDA official Susan] Wood compares Plan B to breastfeeding, which also changes a woman’s hormonal balance. ‘If you are breastfeeding, you are less likely to get pregnant,’ she says, and that’s because you have this elevated progesterone level in your body, which is exactly what happens when you have Plan B emergency contraception."

"But I don’t think I’ve heard anyone on the religious right object to a ‘breastfeeding abortion.’"

I’ve found no scientific backing for the claim that breastfeeding elevated progesterone levels. In fact, I’ve found just the opposite.

"Breast-feeding is associated with high plasma concentrations of prolactin, at least at the onset of lactation, the levels correlating to some extent with the number of suckling episodes. The prolactin response to suckling declines with time post-partum, but if suckling frequency is maintained at a high level basal levels may well remain above normal for 18 months or more."

"Blood levels of follicle-stimulating hormone IFSH) are necessary for ovarian follicular growth and development, and quickly return to normal menstrual cycle levels within a week or two post-partum. At no stage during lactational amenorrhoea do FSH levels appear to be inadequate for ovarian function. Pituitary levels of luteinizing hormone (LH) are very low immediately postpartum, but by 15 to 20 days blood levels have increased significantly and remain throughout lactation on the lower side of normal."

"During lactational amenorrhoea in fully breast-feeding women, the response of LH to GnRH stimulation is diminished, while the FSH response is normal. In the same situation, women fail to show a positive feed-back response, with an increase in LH and FSH to exogenously administered oestrogen, whereas they show an enhanced negative feed-back effect with prolonged suppression of LH levels in contrast to normally cyclic women. In lactational amenorrhoea, ovarian oestrogen and progesterone secretion is below normal, and is equivalent to that seen in post-menopausal women in spite of normal levels of FSH." [Emphasis mine]

"Complete weaning results in an immediate drop in the blood levels of prolactin and an increase in blood levels of LH and oestradiol, indicating a prompt resumption of ovarian activity. Actual ovulation usually occurs within 14 to 30 days. These results suggest that a maintained suckling stimulus, and the associated hyperprolactinaemia, suppress LH but not FSH post-partum and lead to both a failure of ovarian follicular development and lactational amenorrhoea. There is also some information that if ovulation does occur it results in a deficient corpus luteum function."

In other words, breastfeeding raises prolactin levels and lowers progesterone levels. Furthermore, increased prolactin levels only prevent ovulation and do not affect the lining of the uterus. Similar explanations can be found here and here. That’s just the first part of the claim that Plan B is like breastfeeding, though. The second part says that if they act by elevating the same hormone levels, they control birth similarly. Since Plan B is believed to sometimes interefere with implantation, and breastfeeding is mistakenly believed to elevate the same hormones, Plan B is allegedly no more or less abortifacient than breastfeeding. Obviously, if the first part fails, so does the second part. Don’t jump to any conclusions about that, though. Just because breastfeeding isn’t abortifacient, doesn’t mean Plan B is. In fact, that leads me to how the conservative sector of the blogosphere abuses or is ignorant of science.

Read Part II of "Mangling, Mishandling, and Misrepresentation of Science in the Plan B Debate"

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About Funky Dung

Who is Funky Dung? 29-year-old grad student in Intelligent Systems (A.I.) at the University of Pittsburgh. I consider myself to be politically moderate and independent and somewhere between a traditional and neo-traditional Catholic. I was raised Lutheran, spent a number of years as an agnostic, and joined the Catholic Church at the 2000 Easter Vigil. Why Funky Dung? I haven't been asked this question nearly as many times as you or I might expect. Funky Dung is a reference to an obscure Pink Floyd song. On the album Atom Heart Mother, there is a track called Atom Heart Mother Suite. It's broken up into movements, like a symphony, and one of the movements is called Funky Dung. I picked that nickname a long time ago (while I was still in high school I think), shortly after getting an internet connection for the first time. To me it means "cool/neat/groovy/spiffy stuff/crap/shiznit", as in "That's some cool stuff, dude!" Whence Ales Rarus? I used to enjoy making people guess what this means, but I've decided to relent and make it known to all. Ales Rarus is a Latin play on words. "Avis rarus" means "a rare bird" and carries similar meaning to "an odd fellow". "Ales" is another Latin word for bird that carries connotations of omens, signs of the times, and/or augery. If you want to get technical, both "avis" and "ales" are feminine (requiring "rara", but they can be made masculine in poetry (which tends to breaks lots of rules). I decided I'd rather have a masculine name in Latin. ;) Yeah, I'm a nerd. So what? :-P Wherefore blog? It is my intention to "teach in order to lead others to faith" by being always "on the lookout for occasions of announcing Christ by word, either to unbelievers . . . or to the faithful" through the "use of the communications media". I also act knowing that I "have the right and even at times a duty to manifest to the sacred pastors [my] opinion on matters which pertain to the good of the Church, and [I] have a right to make [my] opinion known to the other Christian faithful, with due regard to the integrity of faith and morals and reverence toward [my and their] pastors, and with consideration for the common good and the dignity of persons." (adapted from CCC 904-907) Statement of Faith I have been baptized and confirmed in the name of the Father, Son and Holy Spirit. I, therefore, renounce Satan; I renounce all his works; I renounce all his allurements. I hold and profess all that is contained in the Apostles' Creed, the Niceno- Constantinopolitan Creed, and the Athanasian Creed. Having been buried with Christ unto death and raised up with him unto a new life, I promise to live no longer for myself or for that world which is the enemy of God but for him who died for me and rose again, serving God, my heavenly Father, faithfully and unto death in the holy Catholic Church. I am obedient to the Magisterium of the Catholic Church. That is, I promote and defend authentic Catholic Teaching and Faith in union with Christ and His Church and in union with the Holy Father, the Bishop of Rome, the Successor of St. Peter. Thanks be unto Thee, O my God, for all Thy infinite goodness, and, especially, for the love Thou hast shown unto me at my Confirmation. I Give Thee thanks that Thou didst then send down Thy Holy Spirit unto my soul with all His gifts and graces. May He take full possession of me for ever. May His divine unction cause my face to shine. May His heavenly wisdom reign in my heart. May His understanding enlighten my darkness. May His counsel guide me. May His knowledge instruct me. May His piety make me fervent. May His divine fear keep me from all evil. Drive from my soul, O Lord, all that may defile it. Give me grace to be Thy faithful soldier, that having fought the good fight of faith, I may be brought to the crown of everlasting life, through the merits of Thy dearly beloved Son, our Savior, Jesus Christ. Amen. Behind the Curtain: an Interview With Funky Dung (Thursday, March 03, 2005) I try to avoid most memes that make their way 'round the blogosphere (We really do need a better name, don't we?), but some are worth participating in. Take for instance the "interview game" that's the talk o' the 'sphere. I think it's a great way to get to know the people in neighborhood. Who are the people in your neighborhood? In your neighborhod? In your neigh-bor-hoo-ood...*smack* Sorry, Sesame Street flashback. Anyhow, I saw Jeff "Curt Jester" Miller's answers and figured since he's a regular reader of mine he'd be a good interviewer. Without further ado, here are my answers to his questions. 1. Being that your pseudonym Funky Dung was chosen from a Pink Floyd track on Atom Heart Mother, what is you favorite Pink Floyd song and why? Wow. That's a tuffy. It's hard to pick out a single favorite. Pink Floyd isn't really a band known for singles. They mostly did album rock and my appreciation of them is mostly of a gestalt nature. If I had to pick one, though, it'd be "Comfortably Numb". I get chills up my spine every time I hear it and if it's been long enough since the last time, I get midty-eyed. I really don't know why. That's a rather unsatisfying answer for an interview, so here are the lyrics to a Rush song. It's not their best piece of music, but the lyrics describe me pretty well.

New World Man He's a rebel and a runner He's a signal turning green He's a restless young romantic Wants to run the big machine He's got a problem with his poisons But you know he'll find a cure He's cleaning up his systems To keep his nature pure Learning to match the beat of the old world man Learning to catch the heat of the third world man He's got to make his own mistakes And learn to mend the mess he makes He's old enough to know what's right But young enough not to choose it He's noble enough to win the world But weak enough to lose it --- He's a new world man... He's a radio receiver Tuned to factories and farms He's a writer and arranger And a young boy bearing arms He's got a problem with his power With weapons on patrol He's got to walk a fine line And keep his self-control Trying to save the day for the old world man Trying to pave the way for the third world man He's not concerned with yesterday He knows constant change is here today He's noble enough to know what's right But weak enough not to choose it He's wise enough to win the world But fool enough to lose it --- He's a new world man...
2. What do you consider your most important turning point from agnosticism to the Catholic Church. At some point in '99, I started attending RCIA at the Pittsburgh Oratory. I mostly went to ask a lot of obnoxious Protestant questions. Or at least that's what I told myself. I think deep down I wanted desperately to have faith again. At that point I think I'd decided that if any variety of Christianity had the Truth, the Catholic Church did. Protestantism's wholesale rejection of 1500 years of tradition didn't sit well with me, even as a former Lutheran. During class one week, Sister Bernadette Young (who runs the program) passed out thin booklet called "Handbook for Today's Catholic". One paragraph in that book spoke to me and I nearly cried as I read it.
"A person who is seeking deeper insight into reality may sometimes have doubts, even about God himself. Such doubts do not necessarily indicate lack of faith. They may be just the opposite - a sign of growing faith. Faith is alive and dynamic. It seeks, through grace, to penetrate into the very mystery of God. If a particular doctrine of faith no longer 'makes sense' to a person, the person should go right on seeking. To know what a doctrine says is one thing. To gain insight into its meaning through the gift of understanding is something else. When in doubt, 'Seek and you will find.' The person who seeks y reading, discussing, thinking, or praying eventually sees the light. The person who talks to God even when God is 'not there' is alive with faith."
At the end of class I told Sr. Bernadette that I wanted to enter the Church at the next Easter vigil. 3. If you were a tree what kind of, oh sorry about that .. what is the PODest thing you have ever done? I set up WikiIndex, a clearinghouse for reviews of theological books, good, bad, and ugly. It has a long way to go, but it'll be cool when it's finished. :) 4. What is your favorite quote from Venerable John Henry Newman? "Ten thousand difficulties do not make one doubt." 5. If you could ban one hymn from existence, what would it be? That's a tough one. As a member of the Society for a Moratorium on the Music of Marty Haugen and David Haas, there are obviously a lot of songs that grate on my nerves. If I had to pick one, though, I'd probably pick "Sing of the Lord's Goodness" by Ernie Sands.

9 thoughts on “Mangling, Mishandling, and Misrepresentation of Science in the Plan B Debate (Part I)

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  2. Richard

    I too was surprised at the statements about progesterone levels, fertility and breasfeeding, since my understanding is that progesterone drops rapidly following birth. But here is a scientific paper that shows a relationship between postnatal progesterone levels and the supression of menstruation in breastfeeding women. “The association of progesterone, infant formula use and pacifier use with the return of menstruation in breastfeeding women: a prospective cohort study” Ingram et al. European Journal of Obstetrics & Gynecology and Reproductive Biology Volume 114, Issue 2 , 15 June 2004, Pages 197-202.
    To quote from the paper:
    “Our study shows that for this group of 85 breastfeeding mothers, the return of menstruation is associated with several factors including the introduction of formula
    feeds, the early use of pacifiers (both of hich affect the frequency of breastfeeds)
    and lower postpartum progesterone levels.”

    And elsewhere:

    “Again, postnatal progesterone was the only hormone associated with return of menstruation, the significant negative coefficient indicating that higher
    concentrations were associated with less chance of the return of menses and hence a
    longer period of amenorrhoea (P=0.012).”

    Of course, correlation does not mean causality, as suggested by the analogy to Plan B. Still, scientific articles like this could be the basis of the proposal that breasfeeding mimics Plan B in some way.

  3. Stuff

    Regarding breastfeeding specifically, the study cited by Richard seems to be in complete harmony with the conclusions in the post. The correlations that I personally have seen between breastfeeding and progesterone have suggested that ecological breastfeeding is responsible for *higher* levels of progesterone – high enough to cause amenorrhea. Not that I’ve read the study, but it seems to be saying that progesterone only returns during breastfeeding when an infant begins to be weaned (through use of formula, pacifiers, etc.). The whole idea of ecological breastfeeding is that the infant if fed AND comforted (“pacified”) *only* at the breast – meaning a mother will be nursing her child anywhere from every 30 minutes to every 3-4 hours. Breastfeeding works by means of a sort of supply/demand feedback mechanism – the more you breastfeed, the more your body is stimulated to produce the hormone prolactin, responsible for milk production (and suppressed ovulation, as cited in the post). The less the infant demands (because of receiving formula, pacifiers, solid food, etc.), the less prolactin and milk. It seems that the only time progesterone enters the picture is when weaning begins, so it would seem to me that it is not breastfeeding but lack thereof that is responsible for any progesterone-related anything!

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  5. Pingback: Ales Rarus - A Rare Bird, A Strange Duck, One Funky Blog » Mangling, Mishandling, and Misrepresentation of Science in the Plan B Debate (Part II)

  6. Pingback: Investigating NFP: The Great Embryo Killer? (Update) | Science

  7. Pingback: Generations for Life » Blog Archive » Does NFP Lead to “Massive Embryonic Death”?

  8. Curiously_Confused

    Wait, I’m confused. Prolactin lowers progesterone levels? I thought it lower estrogen levels. So, since it lowers progesterone levels that (as I understand it) are necessary for implantation, wouldn’t that suggest that breastfeeding is actually an abortifacient? On the other hand, boosting one’s progesterone levels while lactating is considered acceptable. If prolactin opposes progesterone, how could these treatments be compatible with breastfeeding then? And what about the deficient corpus luteum function that the study says can be brought on by lactation? Wouldn’t that be considered an abortifacient effect? Seems to me like the case against breastfeeding is stronger than the case against the pill. Very confusing. I mean, try to imagine the, Nation Pro-life Anti-Breastfeeding Association. As nice as it is to be right, in this particular instance, it’d be nice if someone could prove me wrong.

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