The different contraceptive methods and their abortive character
Contraception is usually female and can be:
- mechanical: douching (not efficient), barrier methods (male or female condoms, diaphragm, cervical cap);
- chemical: spermicide (usually combined with a condom);
- hormonal:
- combined hormonal contraception, oestroprogestogenic (the pill, second and third generation pills, intramuscular injections, the contraceptive patch);
- progestogen only contraception (the ‘mini-pill’, intramuscular injections every three months, subcutaneous implants, vaginal ring); - intrauterine device (with copper or a hormone);
- post-coital or emergency contraception:
- hormonal, oral: high dose of estrogens, Yuzpe regimen, high dose of levonorgestrel (‘Norlevo’);
- physical: intrauterine device.
These different contraceptive techniques can be abortive in two ways:
1. Interceptive techniques are wrongly called ‘contraceptive’. They in fact ‘intercept’ the embryo before its implantation in the uterus, prevent this implantation and cause the expulsion of the embryo (abortion). This is the case when:
- administering progestogen so as to make the uterine endometrium not receptive to the embryo (mini-pill, injections, implants);
- administering high doses of estrogens or progestogen (Levonorgestrel, Norlevo) just after a sexual intercourse presumed to have been fertile in the second part of the cycle (emergency contraception);
- inserting a intrauterine device that prevents the nidation of the embryo through a physical, toxic (copper) or infectious effect (endometritis).
2. Contragestive techniques lead to the loss of a barely implanted embryo. They are sometimes wrongly called ‘contraceptive’ and it is argued that an embryo is not an embryo before the primitive streak (first embryonic axis, which establishes bilateral symmetry) appears on the embryoblast. Contragestive techniques are always and exclusively abortive. They are:
- administration of an anti-progesterone such as RU 486 or mifepristone (followed by the administration of a prostaglandin such as misoprostol or cycotec);
- administration of methotrexate that leads to the death of the cells of the trophoblast (outer layer of cells of the embryo that attaches it to the uterus wall and allows it to be nourished) and causes the implanted embryo to detach itself;
- anti-human chorionic gonadotropin vaccines (they had little success and were never distributed on a commercial level)”.
The following are not contraceptive techniques:
- Sterilization: a person is made permanently infertile.
- Natural or “periodic abstinence” methods: they simply use the natural succession of fertile and infertile periods in the menstrual cycle and do not manipulate sexuality.