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Misinformed Consent: Hormonal Contraception

May 19, 2026

Matthew 16:25, “”For whoever would save his life will lose it, and whoever loses his life for my sake will find it.”

By Nicole Kelm, DO

Part 1 of a two-part series

Photo courtesy of rawpixel.com

In recent years, there has been an increasing number of authors such as Carrie Gress and podcasters such as Lila Rose tackling this issue, seeking to show holistically the impacts of hormonal contraception and its ramifications to women, family, as well as society at large. There has been much propaganda regarding hormonal contraception present in society since the sexual revolution, but there exist little evidentiary evaluations of both the positive and negative aspects to the commonplace practice of using hormonal contraception. Reviewing underpublicized risks of hormonal contraception may help women make truly informed decisions.

The utilization of hormonal contraception in modern society is widespread.

Informed consent involves two parties – the patient and the physician. The physician provides their knowledge on the medication or procedure- risks, benefits and alternatives. The patient is asked to repeat back their understanding, ask questions and either decline or consent to the treatment. The contingency here is that the physician’s knowledge of the medication or procedure is the rate limiting step – what we are taught in medical school and residency is the information we use to educate our patients. But what if the information the physician has been taught is incomplete at best, or intentionally incorrect at worst?

It then becomes likely that the patient’s knowledge of their treatment is either incomplete or incorrect, subsequently implying that their consent is invalid. Why does this matter? Shouldn’t we just follow along with the common narrative of what society tells us is normal or best? As Catholics living as the Body of Christ, we must understand and protect the dignity of the human person from natural conception to natural death, unconditionally -neither race nor intellect, neither consciousness nor ability, neither age nor productivity can or should change this. That implication of our belief system begins with life. 

When does life begin? A valid question, and one we must identify the basis of truth within, especially when we begin discussing hormonal contraception and the stance of Catholic Social Teaching opposing it (1).

Our DNA became our own approximately 24 hours after sperm and egg met – the fusion of these gametes to create a genetically distinct and living zygote demonstrates that life for each of us began at fertilization (2, 3, 4, 5). Every part of DNA that comprises our very being today was created in that moment. There are arguments for how this creation of a genetically distinct, living entity is not the beginning of human life. Each of them falters at some point if confronted with the unconditional protection of the dignity of the human person.

The mechanism of action of hormonal contraception is contingent upon the type of exogenously provided hormone – estrogen and progesterone, or progesterone alone. Exogenously provided estrogen suppresses FSH, which should prevent development of eggs that could become mature and be ovulated. Exogenously provided progesterone suppresses GnRH, subsequently suppressing FSH and LH release.

The progesterone also acts to thicken cervical mucus and change the lining of the uterus (6). Ovulation occurs in 2% of cases with combined oral contraceptives (7). The most commonly prescribed progesterone only “mini pill” with the active ingredient norethindrone has a rate of ovulation of approximately 50% (8). Hormonal Intrauterine devices act primarily by changing cervical mucus and have rates of ovulation that increase with each year of use, to nearly 100% after three years of use (9). As the mechanisms and data show us, that means each hormonal contraception has the potential to disallow a fertilized egg implantation in the uterus.

So, what role does hormonal contraception play in the origins of life? In May 1960 the FDA approved the first oral contraceptive to be released in the United States market (10). At that time, the common consensus was still that pregnancy began with fertilization, and that narrative was not changed until 1965 when the American College of Obstetrics and Gynecology redefined pregnancy as beginning at implantation instead of fertilization (11).

Why is this relevant? If hormonal contraception is allowing for the potential of fertilization while preventing implantation of fertilized eggs, humans at their earliest and arguably most vulnerable time of life are not afforded their equal opportunity to life. This is abortion. Unless, of course, we conveniently redefine life to no longer include this voiceless population, in which case hormonal contraception is simply an exogenous interruption to a biological process.

it is important to remember that life begins at fertilization and all life created by God has its dignity bestowed upon it by the Creator and must necessarily have its dignity recognized and protected unconditionally.

Dr. Nicole Kelm is a Catholic psychiatrist working at Integrative Psychology Services in Des Moines, Iowa. She is also the president of the St. Pius X Guild in the Diocese of Des Moines. Additionally, she serves on three CMA committees, including the Catholic Social Teaching and Justice in Medicine Committee.

Sources:

  1. Catholic Church. Catechism of the Catholic Church: Revised in Accordance with the Official Latin Text Promulgated by Pope John Paul II. United States Catholic Conference, 2000.
  2. Ford N. Fertilization and the beginning of a human individual. In: When Did I Begin?: Conception of the Human Individual in History, Philosophy and Science. Cambridge University Press; 1988:102-131.
  3. Okada et al., A role for the elongator complex in zygotic paternal genome demethylation, NATURE 463:554 (Jan. 28, 2010)
  4. Keith L. Moore, The Developing Human: Clinically Oriented Embryology, 7th edition. Philadelphia, PA: Saunders, 2003. pp. 16, 2.
  5. Kaluger, G., and Kaluger, M., Human Development: The Span of Life, page 28-29, The C.V. Mosby Co., St. Louis, 1974.
  6. Schreiber, C., & Barnhart, K. (2019). Contraception. Yen and Jaffe’s Reproductive Endocrinology https://doi.org/10.1016/b978-0-323-47912-7.00036-6 
  7. Milsom I, Korver T. Ovulation incidence with oral contraceptives: a literature review. J Fam Plann Reprod Health Care. 2008 Oct;34(4):237-46. doi: 10.1783/147118908786000451. PMID: 18854069.
  8. Centers for Disease Control and Prevention. (n.d.). Progestin-only pills. Centers for Disease Control and Prevention. https://www.cdc.gov/contraception/hcp/usspr/progestin-only-pills.html#:~:text=Unlike%20COCs,%20which%20inhibit%20ovulation,time%20each%20day%20is%20important. 
  9. Apter D, Gemzell-Danielsson K, Hauck B, Rosen K, Zurth C. Pharmacokinetics of two low-dose levonorgestrel-releasing intrauterine systems and effects on ovulation rate and cervical function: pooled analyses of phase II and III studies. Fertil Steril. 2014;101(6):1656–1662. doi: 10.1016/j.fertnstert.2014.03.004.
  10. Christin-Maitre S. History of oral contraceptive drugs and their use worldwide. Best Pract Res Clin Endocrinol Metab. 2013 Feb;27(1):3-12. doi: 10.1016/j.beem.2012.11.004. Epub 2012 Dec 25. PMID: 23384741.
  11. American College of Obstetricians and Gynecologists Terminology Bulletin. Terms Used in Reference to the Fetus. No. 1. Philadelphia: Davis, September, 1965.