The Pope and The Pill

Karen Ross reviews Aline Kalbian’s Sex, Violence, and Justice

Aline Kalbian, Sex, Violence, and Justice: Contraception and the Catholic Church, Georgetown University Press, 2014, 160pp, $29.95

In 1968 the Catholic Church addressed the issue of artificial contraception in its encyclical Humanae Vitae (On the Regulation of Birth), issued by Pope Paul VI. The emergence of artificial contraception methods such as “the Pill” in the mid-20th century raised a new discussion as to whether or not religious traditions would allow for married couples to use these methods to regulate births. Other Christian churches, such as the Anglican Church and Lutheran Church, changed their attitudes about artificial birth control as an option for married couples at this time,  so many Catholics were anticipating that the Catholic Church would change its stance as well. Prior to Humanae Vitae, Pope Paul VI brought together a group of clergy and over twenty lay couples in order to study and discuss the issues of population, family, and birth. In a majority vote, the commission recommended that the Church amend its position on contraception by allowing for the use of artificial contraception. Contrary to this recommendation and to the surprise of many lay Catholics, Pope Paul VI took a firm stance against the use of artificial contraceptives by married couples. The encyclical justified the Church’s previously held prohibition on the use of contraceptives by affirming the natural structure of sexual relations laid out by God and its ultimate goal toward reproduction.

Since Humanae Vitae, the contraception debate has remained a topic of conversation amongst many Catholics, especially in light of various issues that have arisen since the encyclical was written. Among these issues is the question of whether or not emergency contraception can be administered in Catholic hospitals in the case of rape, a previously unexplored moral dilemma due to the emergence of the drug. Since the encyclical was written, the spread of HIV/AIDS throughout the world, particularly the developing world, has become a health crisis that demands the option of using contraceptives as a preventative measure. Finally, the issue of population control has taken on new dimensions since the 1960s, which has prompted the Church to respond to global efforts to regulate birth through the promotion of contraception. These issues prompted the Church to respond in different ways while still conserving their teaching, and Aline Kalbian’s Sex, Violence & Justice reveals how the contraception debate shapes the  moral discourse of the Church.

In her book, Kalbian provides a comprehensive and critical review of how the Catholic Church has responded to the moral issue of contraception amidst the various socio-historical movements described above. Rather than exploring the topic from a distinctly theological ethical perspective, Kalbian categorizes her research as religious ethics: she seeks to discover how a religious tradition (in this case, Catholicism) responds to various social and cultural forces rather than seeking to correct or resolve theological disputes within the tradition itself. The overarching question she seeks to answer is, “How does the Catholic community make and support moral claims about contraception against a background of emerging cultural facts?”

Throughout the book, Kalbian demonstrates that the debate regarding the morality of artificial contraception within the Catholic Church reflects broader contemporary moral issues concerning sex, violence, and justice in the world of sexual ethics and public health. Kalbian creatively provides three contemporary case studies in order to further examine each issue: 1) condoms and HIV/AIDS for sex; 2) emergency contraception in cases of rape for violence; and 3) contraception and population control for justice. For each issue she provides detailed historical background, the official Catholic teaching, and different voices of assent and dissent within the Catholic community on the topic. Kalbian illustrates that a seemingly straightforward teaching about sex becomes more complex when intercourse is viewed by the Church as sex (debates about HIV/AIDS), when it is viewed as violence (debates about emergency contraception and rape), and when it is viewed as a matter of justice (debates about population control). Thus, the distortions, inconsistencies, and complexities of the Church’s teachings are revealed by using sex, violence, and justice to reflect on Catholic teaching about contraception.

Kalbian orients the concepts of sex, violence and justice around the Church’s teachings on the topics in light of the Ten Commandments. Traditional Catholic teachings around sex are centered around the sixth commandment, Thou Shall Not Commit Adultery. The Church connects this commandment to the Gospel of Matthew in which Jesus instructs, “But I say to you that everyone who looks at a woman lustfully has already committed adultery with her in his heart.” The Church uses this passage to expand the commandment to include inappropriate and immoderate sexual desires, which includes sexual activity without the end purpose of procreation. The Church’s teachings about violence revolve around the fifth commandment, Thou Shall Not Kill, which accounts for the condemnation of physical harm done to others as well as the proclamation that all life is sacred. Finally, the Church’s teachings about justice stem from the seventh commandment, Thou Shall Not Steal, which include broader issues of social justice such as just wages, poverty, environmental degradation, and slavery. Kalbian’s primary argument is that one cannot talk about contraception as an insular issue of regulating birth within the nuclear family without engaging these broader concepts of sex, violence and justice. As Kalbian notes, “these examples show us that contraception is not just a private decision but also a deeply social, cultural, and political one, with profound global implications.”

Sex: Condom use and HIV/AIDS

When Humanae Vitae, the Catholic encyclical on birth control was published in 1968, the Church did not foresee condoms as preventative measures for sexually transmitted diseases, certainly none as deadly as HIV/AIDS. Catholic communities were forced to respond to the HIV/AIDS epidemic in the late 20th century by first addressing the official teaching that the use of condoms is always illicit regardless of the couple’s intention (preventing disease) or circumstance (high rates of infection within a particular community). As Kalbian discovered, the way in which the Church opposed the use of condoms in the broader context of the AIDS epidemic could not simply be described as a teaching about sexual morality, but also about larger discourses surrounding violence (harm in the form of disease) and justice. Local bishops (particularly in Africa) as well as some Catholic theologians expressed concerns about the prohibition of condoms in these cases due to fact that this issue was not just about sex, but about harm being done to already vulnerable populations. Nevertheless, Pope John Paul II, Pope Benedict XVI and the US Conference of Catholic Bishops maintained the Church’s prohibition on the use of condoms in light of the HIV/AIDS epidemic, citing the ineffectiveness of condoms and maintaining that sexual promiscuity is a major symptom of the “contraceptive mentality.” Kalbian concludes, “The Church believes that the AIDS epidemic will continue unless individuals radically alter their sexual behaviors, because, in its view, the root of the AIDS epidemic is promiscuity and infidelity.”

Violence: Emergency Contraception in Cases of Rape

Kalbian clearly illustrates that the distribution of emergency contraception for rape victims is an example of birth control use within a context of violence. As a Catholic feminist and sexual ethicist, I was surprised I did not know that the Catholic Church in the United States allows its hospitals to offer emergency contraception for rape victims, providing a few stipulations. In the case of rape, the U.S. Church allows for the use of emergency contraception in the form of levonorgestrel (commonly known by its brand name, Plan B) so long as the sperm has not already fertilized an egg. Kalbian explains:

Put briefly, the Church concludes that the act of preventing the aggressor’s sperm from fertilizing the victim’s egg does not count as an act of contraception because rape is not truly an act of sexual intercourse; thus a woman can legitimately “defend” herself from the unjust aggression of the rapist’s sperm. However, the Church holds that if the sperm has already fertilized the egg, then any attempt to destroy the embryo is illicit.

The act of sexual intercourse fundamentally changes, according to the Church, when consent is lacking, and therefore the act is viewed as one of violence. Within Catholic moral tradition, a victim of violence has the right to defend herself against an attacker; in this case, this involves “attacking” the sperm before it is able to fertilize the egg. Coinciding with the idea that rape itself is not sexual, the Church justifies the allowance for emergency contraception in these cases by classifying contraception as not truly contraception.

When emergency contraception became available in the late 1990s, the Catholic Church initially disapproved of its use because of concerns that it had the potential to destroy an already fertilized egg (the embryo). Although scientific studies have asserted that emergency contraception does not terminate an established pregnancy (like the RU-486 pill does), the Church is still concerned with whether it prevents an already-fertilized egg from being implanted. This is an important distinction because the scientific community categorizes the destruction of an embryo that is already implanted differently than it does the prevention of the implantation—for the Church, both of these acts are considered abortion. Thus, in order for the U.S. Church to justify the use of emergency contraception in the case of rape, Catholic hospitals must determine whether a woman is in the ovulation phase of her cycle, an approach referred to as the “Peoria Protocol.” Kalbian explains “If [the victim] is not ovulating, then one could presume that fertilization has not occurred, and no embryo is endangered.” This protocol ensures that the Church’s definitive teaching against abortion under any circumstances stays consistent.

Kalbian acknowledges the obvious about this exception in cases of rape: it seems to violate the Church’s teaching against birth control. Kalbian highlights the fact that in this case, the categories of violence and harm carry much more weight since the violence of rape changes the very nature of the act. Rape is no longer a “proper sexual act” and so interference in this act is not going against nature in the way that birth control would in a natural sexual act. By redefining the sexual act as one of violence, the conversation surrounding birth control and rape shifts from the moral sphere of sexuality to the spheres of violence and justice.

Justice: Population Control Debates

By highlighting the current discussions about population control and global development as her final case study, Kalbian demonstrates that one cannot talk about sexual ethics without addressing public health issues, particularly demographic concerns. Many public health campaigns have advocated for the use of birth control as a way in which to prevent overpopulation and to offer family planning options to women. Kalbian introduces the topic as such:

Since the early twentieth century, when anxiety about population explosion began to escalate, the Catholic Church has consistently opposed the use of contraception and/or sterilization to respond to perceived population problems. In the contemporary period, the Church is in the minority in actively discouraging artificial contraception and also in its skepticism about the problem of overpopulation.

The Church, she notes, takes a “pronatalist” approach, which means that it will always encourage couples to reproduce. At the same time, within Catholic social tradition, the idea that all members of a society ought to be treated justly is called the “common good,” and demographic concerns directly affect this principle. For example, it is important that there are sufficient basic resources to supply to all members of the population. It is also important that women’s health is taken into account, particularly in developing countries where there are fewer resources available to women. Even though the Church prohibits the use of artificial contraceptives in light of population concerns, they advocate for “responsible parenthood” in which couples may practice natural family planning methods (known as NFP) to space out the birth of their children.

Population and development concerns addressed by the promotion of contraception, Kalbian contends, is not just a private matter belonging in the sexual realm but is part of a broader conversation about social justice that engages the Catholic social teaching principle of the common good. In order to justify its prohibition of artificial birth control, the Church claims that providing artificial contraception does not directly solve the problems that overpopulation may cause, such as poverty. Turning to its teachings about social justice, the Church calls all people to think of an “integral” development that includes not just economic growth, but also spiritual and moral growth where all members of society are called to take care of one another and distribute their resources equitably. National campaigns that promote birth control do not accomplish this goal, but rather threaten “true and authentic human development” taking place in the family, the Church states. By turning to the principle of the common good, the Church is able to maintain its prohibition of artificial contraceptives while still promoting human flourishing in light of various social concerns about poverty and reproduction.

Contraception as an Issue of Sex, Violence, and Justice

In her book, Kalbian artfully and thoroughly portrays the contraception debate as one that reshapes moral discourse about the broader issues of sex, violence, and justice. What at first glance may seem like a narrow conversation, the birth control debate within the Catholic moral tradition calls attention to a world affected by the social forces of HIV/AIDS, rape culture, and population and development concerns. When one attempts to speak about artificial contraception, one also addresses public health issues such as women’s reproductive health, violence against women, scarcity of resources, disease, and poverty, to name only a few. This book is a sound resource for graduate students or any scholars who are curious to uncover the layers of complexity behind the issue of contraception in the Church. Kalbian puts it well in her conclusion:

While this study does not settle the many moral complexities surrounding contraception, it does highlight an important point; that like many moral issues, contraception must be understood as nested within a group of issues that are shaped by cultural forces.

As she masterfully demonstrates throughout her book, beliefs about the morality of artificial contraception are always revolving around beliefs about proper sexual activity, violence and harm, and social justice.  Interestingly, this book demonstrates how the Church has responded to contemporary moral problems about birth control in a “more fluid and more revisable [way] than many would presume” due to the intersection of beliefs around human life.

Karen Ross is a PhD Candidate in Theology and Ethics at Loyola University Chicago, with a specialization in Catholic Feminist and Sexual Ethics.  She received her B.A. and M.A. in Theological Studies at the University of Dayton.

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