ABORTION

Today, December 16, 2003, is an important day in the United States. After listening to numerous pro life doctors, bioethicists and leaders warn of the dangers of allowing the abortifacient pill "Plan B" to be sold over the counter, the U.S. advisory panel to the FDA voted to recommend allowing the "morning after" contraceptive pill to be sold without a prescription. The pill is intended for use by women within 72 hours after sexual intercourse to prevent pregnancy.

It's incredulous how these US advisors for the FDA could have made such an evil decision after having listened to the good Judie Brown, President of American Life League, testify that "these high doses of artificial hormones can and do terminate the lives of human beings after their lives have begun at conception/fertilization; these pills are dangerous for women, particularly adolescent women, and the damage to family life would be severe. Emergency contraception is not contraception...the Food and Drug Administration has a moral and ethical responsibility to assure, to the best of its ability, the health and welfare of every member of the human family. "

The USCCB read a statement before the advisory panel as well, saying that changing the abortion pill's status to an over-the-counter drug prevents any medical oversight that otherwise would be provided for by doctors and sends "the message that the drug is not medically or morally controversial." As the USCCB points out, such access, "may also increase risk-taking behavior and promiscuity," further endangering health and exposure to sexually transmitted diseases.

Illinois Leader's editorial team member Jill Stanek, testifying against the over-the-counter sale of these drugs said, "As a registered nurse, I have seen for myself the devastation when young girls have been sexually abused by older men," Stanek said while waiting for her plane to take off on Monday. "If these drugs are made available over the counter, criminal rapists and sexual abusers will be able to cover their crimes and continue their behavior. This is the point I will be making at the hearing tomorrow."

The 23-4 vote came after the advisers heard presentations from health experts, the companies and public testimony from both supporters and opponents of making Plan B available over the counter. Dr. David Hager, one of the four panel members who voted against the recommendation, said, "What we heard today was frequently about individuals who did not want to take responsibility for their actions and wanted a medication to relieve those consequences." Hager added that he worried the expanded availability of Plan B would have an effect similar to the birth control pill, which he said brought "a new day and age for the expression of sexuality among young people" (New York Times, 12/17).

Because this abortifacient drug is an experimental drug, what happens to the human baby who survive this murderous attack? Aren't women tired of the constant medical assaults and experiments being made upon their bodies and their babies by so-called doctors and pharmaceutical companies? Numerous documentations have been submitted to the FDA showing the treacherous assault this poisonous pill inflicts upon the 'mother' as well as murdering her human baby. Memories of Dr. Josef Mengele come to mind, the infamous doctor of Auschwitz, commonly referred to as the "Angel of Death" who was indicted by the Frankfort Court for crimes against humanity for experimentation, medical atrocities, dissection, decompression chambers, lethal injections and selection inflicted especially on human twin children. One can not help but wonder what kind of a person could ever consider doing things so horrible, much less carry them out. Who could ever kill an innocent child by injecting chloroform into their heart, causing the blood to coagulate and kill the child. Who could ever imagine sewing a set of twins together to try and make siamese twins? These acts just seem to be out of the human realm. Really? Our U.S. government, yielding to pressure from women's groups and giving them what they want, is not so different than Dr. Mengele.

Were these twenty-three FDA appointed advisors not listening? How could they so easily refute the scientific and medical facts regarding this murderous, evil drug? Why were these truths so unintelligible to the FDA's advisory panel? It's because these Godless people, knowing well that what they do is wrong, still, perversely, reject these moral teaching (teachings that they have had written in their hearts since God created them in womb) and because the sinful will reject the moral teaching of Christ and His Church. Those who commit these sinful acts don't really think that what they do is good; they tell themselves that what they do is excused. Secular humanism.

Seeing things as God sees them, with the eyes of eternity, Pope John Paul II has said often: "This is the supremacy of the strong over the weak. If we continue to promote contraceptives, civilization will revert to barbarism."

Today reminds me of another time, not so long ago, of the horrific actions that our U.S. President Clinton committed just moments after the world famous speech that Mother Teresa gave before the President and US Congressmen, senators, State Heads and other dignitaries on February 3, 1994.

It was the annual National Prayer Breakfast in Washington, D.C., held at the elegant Shorham Hotel. Although the participants were mainly Christians, the event is always inter-religious and open to adherents of all faiths. Hundreds of our government's brightest, sans pareil, were in attendance. This was a time in our nation when the culture of death was promoted by the highest levels of government.

By the grace of God my husband and I saw this hour long event live on CSpan. We will never forget the demeanor of that saintly, tiny, consecrated nun nor her memorable address that rocked an audience of powerful politicians. Mother Teresa, always so humble, so wise, graciously refused the invitation to sit on the dais with President Clinton and Hillary, VP Gore and his wife and with many other 'distinguished' politicians, where so-called 'honorary' seating is always reserved for the event's keynote speaker. Mother preferred to remain hidden behind the stage, without the benefit of having had anything to eat.

When they introduced Mother, then age 83, to come to the podium, she humbly approached from behind a large heavy curtain backdrop behind the dais. In her simple white linen sari trimmed in blue, which cost $l in India, this holy diminutive nun was barely visible to the several hundred in the audience over the top of the podium. I thought of the scripture verse: "For all who exalt themselves will be humbled, and those who humble themselves will be exalted." (Lk. 14:10a, 11)

Mother Teresa didn't care that in America it's not PC to criticize the President and VP about their policies of killing babies in their mother's wombs...she didn't care that she might shock the nation's leaders and take on the 'culture of death' in Washington, D.C..... she spoke as Jesus would expect any faithful follower to speak. "The greatest destroyer of peace today is abortion. Abortion never solves problems, it just leads to more abortion," the living saint said. For Mother Teresa, who devoted her life to the succor of the sick, the outcast, the lonely, the unwanted, earthly opinions meant nothing to her. She spoke without notes and pleaded for America to save the babies, not throw them away, "Please don't destroy the child; we will take the child." Her entire address is given below.

Many in this audience were caught up in the historic moment with sustained applause. They gave her three thunderous ovations. Mother Teresa dared to say what no one there dared to say. Most gave her three thunderous ovations, but, President Clinton and Vice President Gore & their wives did not. They just sat there, unresponsive, in stony silence. No American President and First Lady had ever been more vocally pro-abortion than Bill and Hillary. Our President and Vice President clearly resented Mother Teresa and hated even more her warning message. (A VHS copy of this event can be purchased from C-SPAN.)

Immediately following this incredibly powerful speech by Mother Teresa, Clinton takes the podium and spoke briefly, praised the founder of the Missionaries of Charity, but did not directly respond to her statements on abortion. Instead, he thanked her for her "moving words and, more importantly, for the lifetime of commitment" that he said she had "truly lived."

"If Christ said we would all be judged by how we treated the least of these -- the hungry, the thirsty, the naked, the strangers, the imprisoned -- how can we meet that test in a town where we all spend so much time obsessed with ourselves and how we stand on the totem pole and how we look in the morning paper?" Clinton said. "It is important to reaffirm that in this nation where we have freedom of religion, we need not seek freedom from religion." Quoting from Professor Stephen Carter's book, "The Culture of Disbelief," the President stated that "we should all seek to know and to do God's will, even when we differ." What hypocrisy!

Here is something that few people know about, because only small mention of it was made anywhere in the World newspapers the next day. Incredulously, this is a factual account.

Clinton closed the meeting, and, get this, this terrible man then walked outside and crossed the street to the World Population Planning committee and signed a U.S. Presidential commitment to spend in the next year of l995, $500 million dollars of American taxpayers' money to International Planned Parenthood for abortion facilities in Third World countries, with the stipulation that if these third world countries did not accept these abortion facilities of Planned Parenthood into their nation's cities, the U.S. would withhold all monies promised to them to feed their hungry and clothe their poor. Incredible. Did Clinton not listen to the profound warnings, pleas and admonitions just minutes before from Saintly Mother Teresa?

The Pope a day later exclaimed that Clinton and the United States was the 'most evil of all evil imperialisms in the world' and the Pope denounced Clinton's actions. Clinton, who said he wanted to be remembered most as "the abortion President" did exactly what he promised his Democratic party he would do and the world stood by and watched with barely a whimper, except for the Vatican's condemnation. Let us remember this when someone tells us they hope Hillary runs for President.

The comparison is too great not to be remembered. Today, December 16, 2003, great leaders in pro life movement gave factual testimony to the many reasons why the evil abortifacient "Morning After Pill" should not be allowed to be sold over the counter. Yet, within minutes, the FDA's advisory panel proclaims that they've OK'd the Pill to be sold over the counter. Were these government people not listening to the profound medical and scientific warnings and admonitions just minutes before? "If we continue to promote contraceptives, civilization will revert to barbarism," said John Paul II.

The greatest sin of the world, said Pius XII, is the "sin of the century." "The sin of the century," the Holy Father told a catechetical congress meeting in the United States in 1946, "is the loss of the sense of sin" (Pius XII, Radio Address to the United States Catechetical Congress held in Boston [26 Oct., 1946: AAS Discorsi e Radiomessaggi, VIII (1946), 288] ).

Mother Teresa died of a heart attack on September 5, l997, on the Feast of 'Mary, Queen of the Apostles.' At the time of Mother Teresa's death, the Sisters of the Missionaries of Charity numbered 3,914 members and were established in 594 communities in 123 countries of the world. Today, those numbers have greatly increased. Mother was elevated to Beautification as Blessed Teresa of Calcutta by Pope John Paul II in Rome on World Mission Sunday, October 19, 2003.

Barbara Kralis is a writer/editor from Howe, Tx. She and her husband, Mitch, co-direct the Jesus Through Mary Foundation. Barbara is also a member of the Catholic Media Coalition.

National Prayer Breakfast Address, February 3, l994, By MOTHER TERESA, MC (Missionaries of Charity)

"Come, enter the Kingdom. For I was hungry and you gave me food, I was thirsty and you gave me drink, I was sick and you visited me."

"Depart from me because I was hungry and you did not feed me, I was thirsty and you did not give me drink, I was sick and you did not visit me."

"When did we see you hungry, or thirsty, or sick, and did not come to your help?"

"Whatever you neglected to do unto one of the least of these, you neglected to do unto me!"

As we have gathered here to pray together, I think it will be beautiful if we begin with a prayer that expresses very well what Jesus wants us to do for the least. St. Francis of Assisi understood very well these words of Jesus and his life is very well expressed by a prayer. And this prayer, which we say every day after Holy Communion, always surprises me very much, because it is very fitting for each one of us. And I always wonder whether eight hundred years ago when St. Francis lived, they had the same difficulties that we have today. I think that some of you already have this prayer of peace, so we will pray it together.

Let us thank God for the opportunity he has given us today to have come here to pray together. We have come here especially to pray for peace, joy, and love. We are reminded that Jesus came to bring the good news to the poor. He had told us what that good news is when he said,

He came not to give the peace of the world, which is only that we don't bother each other. He came to give peace of heart which comes from loving - from doing good to others.

And God loved the world so much that he gave his son. God gave his son to the Virgin Mary, and what did she do with him? As soon as Jesus came into Mary's life, immediately she went in haste to give that good news. And as she came into the house of her cousin, Elizabeth, Scripture tells us that the unborn child - the child in the womb of Elizabeth - leapt with joy. While still in the womb of Mary, Jesus brought peace to John the Baptist, who leapt for joy in the womb of Elizabeth.

And as if that were not enough - as if it were not enough that God the Son should become one of us and bring peace and joy while still in the womb, Jesus also died on the Cross to show that greater love. He died for you and for me, and for that leper and for that man dying of hunger and that naked person lying in the street - not only of Calcutta, but of Africa, of everywhere. Our Sisters serve these poor people in 105 countries throughout the world. Jesus insisted that we love one another as he loves each one of us. Jesus gave his life to love us, and he tells us that he loves each one of us. Jesus gave his life to love us, and he tells us that we also have to give whatever it takes to do good to one another. And in the Gospel Jesus says very clearly, " Love as I have loved you."

Jesus died on the Cross because that is what it took for him to do good for us - to save us from our selfishness and sin. He gave up everything to do the Father's will, to show us that we too must be willing to give everything to do God's will, to love one another as he loves each of us. If we are not willing to give whatever it takes to do good for one another, sin is still in us. That is why we too must give to each other until it hurts.

It is not enough for us to say, "I love God." But I also have to love my neighbor. St. John says that you are a liar if you say you love God and you don't love your neighbor. How can you love God whom you do not see, if you do not love your neighbor whom you see, whom you touch, with whom you live? And so it is very important for us to realize that love, to be true, has to hurt. I must be willing to give whatever it takes not to harm other people and, in fact, to do good to them. This requires that I be willing to give until it hurts. Otherwise, there is no true love in me and I bring injustice, not peace, to those around me.

It hurt Jesus to love us. We have been created in his image for greater things, to love and to be loved. We must "put on Christ," as Scripture tells us. And so we have been created to love as he loves us. Jesus makes himself the hungry one, the naked one, the homeless one, the unwanted one, and he says, "You did it to me." On the last day he will say to those on his right, "whatever you did to the least of these, you did to me," and he will also say to those on his left, "whatever you neglected to do for the least of these, you neglected to do it for me."

When he was dying on the Cross, Jesus said, "I thirst." Jesus is thirsting for our love, and this is the thirst for everyone, poor and rich alike. We all thirst for the love of others, that they go out of their way to avoid harming us and to do good to us. This is the meaning of true love, to give until it hurts.

I can never forget the experience I had in visiting a home where they kept all these old parents of sons and daughters who had just put them into an institution and, maybe, forgotten them. I saw that in that home these old people had everything: good food, comfortable place, television - everything. But everyone was looking toward the door. And I did not see a single one with a smile on his face.

I turned to Sister and I asked, "Why do these people, who have every comfort here - why are they all looking toward the door? Why are they not smiling?" (I am so used to seeing the smiles on our people." Even the dying ones smile.) And Sister said, "This is the way it is, nearly everyday. They are expecting - they are hoping - that a son or daughter will come to visit them. They are hurt because they are forgotten."

See, this neglect to love brings spiritual poverty. Maybe in our family we have somebody who is feeling lonely, who is feeling sick, who is feeling worried. Are we there? Are we willing to give until it hurts, in order to be with our families? Or do we put our own interests first? These are the questions we must ask ourselves, especially as we begin this Year of the Family. We must remember that love begins at home, and we must also remember that "the future of humanity passes through the family.

I was surprised in the West to see so many young boys and girls given to drugs. And I tried to find out why. Why is it like that, when those in the West have so many more things than those in the East? And the answer was, "Because there is no one in the family to receive them." Our children depend on us for everything: their health, their nutrition, their security, their coming to know and love God. For all of this, they look to us with trust, hope, and expectation. But often father and mother are so busy that they have no time for their children, or perhaps they are not even married, or have given up on their marriage. So the children go to the streets, and get involved in drugs, or other things. We are talking of love of the child, which is where love and peace must begin. These are the things that break peace.

But I feel that the greatest destroyer of peace today is abortion, because it is a war against the child - a direct killing of the innocent child - murder by the mother herself. And if we accept that a mother can kill even her own child, how can we tell other people not to kill one another? How do we persuade a woman not to have an abortion? As always, we must persuade her with love, and we remind ourselves that love means to be willing to give until it hurts. Jesus gave even his life to love us. So the mother who is thinking of abortion, should be helped to love - that is, to give until it hurts her plans, or her free time, to respect the life of her child.

The father of that child, whoever he is, must also give until it hurts. By abortion, the mother does not learn to love, but kills even her own child to solve her problems. And by abortion, the father is told that he does not have to take any responsibility at all for the child he has brought into the world. That father is likely to put other women into the same trouble. So abortion just leads to more abortion. Any country that accepts abortion is not teaching the people to love, but to use any violence to get what they want. That is why the greatest destroyer of love and peace is abortion.

Many people are very, very concerned with the children of India, with the children of Africa, where quite a few die of hunger, and so on. Many people are also concerned about all the violence in this great country of the United States. These concerns are very good. But often these same people are not concerned with the millions who are being killed by the deliberate decision of their own mothers. And this is what is the greatest destroyer of peace today: abortion, which brings people to such blindness.

And for this I appeal in India and I appeal everywhere: "Let us bring the child back." The child is God's gift to the family. Each child is created in the special image and likeness of God for greater things - to love and to be loved. In this Year of the Family we must bring the child back to the center of our care and concern. This is the only way that our world can survive, because our children are the only hope for the future. As other people are called to God, only their children can take their places.

But what does God say to us? He says, "Even if a mother could forget her child, I will not forget you. I have carved you in the palm of my hand." We are carved in the palm of his hand; that unborn child has been carved in the hand of God from conception, and is called by God to love and to be loved, not only now in this life, but forever. God can never forget us.

I will tell you something beautiful. We are fighting abortion by adoption - by care of the mother and adoption for her baby. We have saved thousands of lives. We have sent word to the clinics, to the hospitals, and police stations: Please don't destroy the child; we will take the child." So we always have someone tell the mothers in trouble: "Come, we will take care of you, we will get a home for your child."

And we have a tremendous demand from couples who cannot have a child. But I never give a child to a couple who has done something not to have a child. Jesus said, "Anyone who receives a child in my name, receives me." By adopting a child, these couples receive Jesus, but by aborting a child, a couple refuses to receive Jesus.

Please don't kill the child. I want the child. Please give me the child. I am willing to accept any child who would be aborted, and to give that child to a married couple who will love the child, and be loved by the child. From our children's home in Calcutta alone, we have saved over 3,000 children from abortions. These children have brought such love and joy to their adopting parents, and have grown up so full of love and joy! I know that couples have to plan their family, and for that there is natural family planning. The way to plan the family is natural family planning, not contraception. In destroying the power of giving life, through contraception, a husband or wife is doing something to self. This turns the attention to self, and so it destroys the gift of love in him or her. In loving, the husband and wife must turn the attention to each other, as happens in natural family planning, and not to self, as happens in contraception. Once that living love is destroyed by contraception, abortion follows very easily.

I also know that there are great problems in the world - that many spouses do not love each other enough to practice natural family planning. We cannot solve all the problems in the world, but let us never bring in the worst problem of all, and that is to destroy love. This is what happens when we tell people to practice contraception and abortion.

The poor are very great people. They can teach us so many beautiful things. Once one of them came to thank us for teaching them natural family planning, and said: "You people - who have practiced chastity - you are the best people to teach us natural family planning, because it is nothing more than self-control out of love for each other." And what this poor person said is very true. These poor people maybe have nothing to eat, maybe they have not a home to live in, but they can still be great people when they are spiritually rich. Those who are materially poor can be wonderful people. One evening we went out and we

picked up four people from the street. And one of them was in a most terrible condition. I told the Sisters: "You take care of the other three; I will take care of the one who looks worse." So I did for her all that my love can do. I put her in bed, and there was a beautiful smile on her face. She took hold of my hand, and she said one thing only: "Thank you." Then she died.

I could not heip but examine my conscience before her. I asked, "What would I say if I were in her place?" And my answer was very simple. I would have tried to draw a little attention to myself. I would have said, "I am hungry, I am dying, I am cold, I am in pain," or something like that. But she gave me much more - she gave me her grateful love. And she died with a smile on her face.

Then there was the man we picked up from the drain, half-eaten by worms. And after we had brought him to the home, he only said, "I have lived like an animal in the street, but am going to die as an angel, loved and cared for." Then, after we had removed all the worms from this body, all he said - with a big smile - was: "Sister, I am going home to God." And he died. It was so wonderful to see the greatness of that man, who could speak like that without blaming anybody, without comparing anything. Like an angel - this is the greatness of people who are spiritually rich, even when they are materially poor.

We are not social workers. We may be doing social work in the eyes of some people, but we must be contemplatives in the heart of the world. For we must bring that presence of God into your family, for the family that prays together, stays together. There is so much hatred, so much misery, and we with our prayer, with our sacrifice, are beginning at home. Love begins at home, and it is not how much we do, but how much love we put into what we do.

If we are contemplatives in the heart of the world with all its problems, these problems can never discourage us. We must always remember what God tells us in the Scripture: Even if the mother could forget the child in her womb - something that is impossible, but even if she could forget - I will never forget you. And so here I am talking with you. I want you to find the poor here, right in your own home first. And begin love there. Bear the good news to your own people first. And find out about your

I had the most extraordinary experience of love of a neighbor from a Hindu family. A gentleman came to our house and said, "Mother Teresa, there is a family who have not eaten for so long. Do something." So I took some rice and went there immediately. And I saw the children, their eyes shining with hunger. (I don't know if you have ever seen hunger, but I have seen it very often.) And the mother of the family took the rice I gave her, and went out. When she came back, I asked her, "Where did you go? What did you do?" And she gave me a very simple answer: "They are hungry also." What struck me was that she

knew. And who were "they?" A Muslim family. And she knew. I didn't bring any more rice that evening, because I wanted them - Hindus and Muslims - to enjoy the joy of sharing.

But there were those children, radiating joy, sharing the joy and peace with their mother because she had the love to give until it hurts. And you see this is where love begins: at home in the family. God will never forget us, and there is something you and I can always do. We can keep the joy of loving Jesus in our hearts, and share that joy with all we come in contact with. Let us make that one point: that no child will be unwanted, unloved, uncared for, or killed and thrown away. And give until it hurts - with a smile.

Because I talk so much of giving with a smile, once a professor from the United States asked me, "Are you married?" And I said, "Yes, and I find it sometimes very difficult to smile at my spouse - Jesus - because he can be very demanding - sometimes this is really something true. And there is where love comes in - when it is demanding, and yet we can give it with joy.

One of the most demanding things for me is travelling everywhere, and with publicity. I have said to Jesus that if I don't go to heaven for anything else, I will be going to heaven for all the traveling with all the publicity, because it has purified me and sacrificed me and made me really ready to go to heaven. If we remember that God loves us, and that we can love others as he loves us, then America can become a sign of peace for the world. From here, a sign of care for the weakest of the weak - the unborn child - must go out to the world. lf you become a burning light of justice and peace in the world, then really you will be true to what the founders of this country stood for.

Spare you the piety? What a strange thing for a “Christian” to say. Don’t let the reality of the situation disturb the level of comfort you have regarding the killing of the unborn.

Not strange at all. For some people this issue is the very most important one in the world. They are very quick to say, "if you don't see it my way you are obviously not a Christian". For the next "Christian" it's divorce, for the next it's drinking, for the next it's child abuse. All of them use the most pious and emotional of language to describe the realities of their issue.

A person in church once commented that they had spend endless effort on teen chastidy. Then they said "I'm tired of sending drug free virgins to hell". I don't subscribe to that entirely but atleast they are seeing that salvation is the biggest issue.

Have you no concern for the souls of those inducing abortions?

That's much closer to what I'm talking about.

So at what point, in biblewonk’s theology, does one become human and therefore "worthy" of life?

I asked you to spare me the piety. Such language throws contempt on the whole subject and Christian conversation.

I disagree that anyone on the Pill is killing babies. I don't think there is evidence to prove that the low dose combination hormonal contraceptive pills - which result in hormonal changes that are less than those caused by the hormones produced by the corpus luteum after ovulation - cause abortions. One example is the amount of normal pregnancies on these pills.

Do you see the obvious contradiction in this statement? Think about it. (Hint, compare your last sentence to the first. If there are live births as well as contracepted births, is it not possible that a percentage of the prevented full term births were due to failed implantation of released and fertilized ova? If they can be released and fertilized and born, as the failure rate proves, why is it not possible they can be released and fertilized and not born?)

See Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent in "Archives of Family Medicine", February 2000, Volume 9 Number 2, Pages 126 - 133:

Our analysis of the evidence involved a review of the abstracts of all studies of OCs published since 1970 available on MEDLINE that discussed the commonly used OCs, including low-dose (<50 µg of estrogen) phasic combined oral contraceptives (COCs), low-dose monophasic COCs, and progestin-only OCs (progestin-only pills [POPs]).

...If the action(s) of OCs on the fallopian tube and endometrium were such as to have no postfertilization effects, then the reduction in the rate of intrauterine pregnancies in women taking OCs should be proportional to the reduction in the rate of extrauterine pregnancies in women taking OCs. If the effect of OCs is to increase the extrauterine-to-intrauterine pregnancy ratio, this would indicate that one or more postfertilization effects are operating. All published data that we could review indicated that the ratio of extrauterine-to-intrauterine pregnancies is increased for women taking OCs and exceeds that expected among control groups of pregnant women not currently using OCs. These case-controlled series come from 33 centers in 17 countries and include more than 2800 cases and controls.72-77 The odds ratios in these studies ranged from 1.7 (95% confidence interval [CI], 1.1-2.5)72 to 1.8 (95% CI, 0.9-3.4)73 to 4.3 (95% CI, 1.5-12.6)74 to 4.5 (95% CI, 2.1-9.6)75 to 13.9 (95% CI, 1.8-108.3).76 The letter by Job-Spira et al74 seems to represent the same data set of 279 cases and controls as the study by Coste et al.76 The meta-analysis by Mol et al73 includes 2 of the publications,72, 75 but one of these may include women taking POPs.72 Therefore, of the 5 publications, only 2 allow review of the association of COCs with ectopic pregnancy.75, 76 These 2 studies from 7 maternity hospitals in Paris, France, and 3 in Sweden involved 484 women with ectopic pregnancies and 289 pregnant controls and suggest that at least some protection against intrauterine pregnancy is provided via postfertilization preimplantation effects. We recognize that studies that have used nonpregnant controls have not shown a risk of increased ectopic pregnancy for users of COCs. In our review, we restricted our analysis to studies using pregnant controls, because we concur with researchers73, 76 in this field that " . . . when considering the situation where a woman became pregnant during contraceptive use, one should focus on pregnant controls."73 Therefore, COC use seems to be associated with an increased risk of ectopic implantation or unrecognized loss of preembryos. We considered this level II.2 (good to very good) evidence (Table 1). Ectopic pregnancy is a particular form of postfertilization loss that involves substantial risks to the woman, and thus the absolute risk of ectopic pregnancy for women taking OCs will be of interest to clinicians and patients. Converting a relative risk of ectopic pregnancy to an absolute risk has many inherent difficulties that have been reviewed elsewhere.78 Nevertheless, adapting the method suggested by Franks et al78 would allow one to predict that the ectopic pregnancy rate for women taking OCs would be the product of 3 factors: (1) the overall pregnancy rate per 1000 woman-years among those taking OCs, (2) the proportion of extrauterine pregnancies compared with all pregnancies for a comparable control population not taking OCs, and (3) the relative risk for ectopic pregnancy in women taking OCs compared with the control population, which may be estimated by the odds ratio from case-control studies. For factor 1, Potter29 suggests 40 for good compliers and 80 for poor compliers. For factor 2, the proportion of ectopic pregnancies in the 1990s is estimated to range from 1 in every 5679 to 6480, 81 pregnancies (0.0156 to 0.0179). A reasonable range for factor 3 would be 1.1 to 13.9, based on the studies discussed above. This model would predict an absolute risk ranging from 0.7 (40 X 0.0156 X 1.1) to 19.9 (80 X 0.0179 X 13.9) ectopic pregnancies per 1000 woman-years. We could only find one study, from Zimbabwe, which reported an absolute risk of ectopic pregnancy in women taking OCs of 0.582 per 1000 woman-years. The risk of ectopic pregnancy is higher with POPs, and ectopic pregnancy has been discussed at length by a number of investigators as a clinically significant potential complication of POPs.82-84 The odds ratio of an extrauterine pregnancy for a woman taking a POP (compared with pregnant controls) was reported in only one study and was 79.1 (95% CI, 8.5-735.1).74 Assuming an overall clinical pregnancy rate of 30 to 70 per 1000 woman-years, this equates to a predicted absolute risk of 4 to 99 ectopic pregnancies per 1000 woman-years ([30 or 70] X [0.0156 or 0.0179] X [8.5 or 79.1]) in women taking POPs. This is reasonably concordant with absolute rates of ectopic pregnancy in women taking POPs, which have been reported to range from about 382, 83, 85 to about 2084, 86 per 1000 woman-years. Data from case-controlled series demonstrate that women with clinically recognized pregnancy are no more or less likely to miscarry based on whether they were taking an OC after their pregnancy was clinically recognized.87-90 However, the epidemiology, biology, and recognized risk factors of clinically recognized embryo or fetal loss (spontaneous abortion after clinically recognized pregnancy) do not seem to apply to early (unrecognized) preembryo or embryo loss, as the available evidence suggests that the mechanisms of early establishment and maintenance of pregnancy and later maintenance of pregnancy are qualitatively and substantially different.90

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