Thursday, October 29, 2009

Book Review: "The Contraception Guidebook: Options, Risks, and Answers for Christian Couples"

By William R. Cutrer, MD and Sandra L Glahn, Th.D.

This book was primarily written to discuss the specific ethical concerns Christians might have as they consider different birth control methods, written by an OB-Gyn/Theologian and a patient/theologian.

From the beginning of this book to its end, I was impressed with the humble attitude with which the authors approached these sensitive and controversial issues. Time and time again they acknowledged different perspectives in the Christian community with grace.

The chapter on “The Why of Sex” did a great job at succinctly summing up the viewpoints from two primary schools of thought that exist within the Christian community. The possibility that marriage’s (and thus intimacy’s) primary purpose being procreation is an idea commonly surfacing among Christians. Concerns I have heard from Christians are appropriately out of a humble desire to obey God fully, and the out of fear that treating intimacy in marriage as something that can be separated (by any method of birth control) from the possibility of procreation that would be in rebellion to His plan. I felt that this chapter made several good and helpful points concerning this matter, including the following:

-There are entire seasons in married life (after menopause, during pregnancy, etc) where married people are intimate despite the absence of potential for procreation

-The entire book of Song of Solomon is about the marriage relationship yet does not mention children.

-The very design of the human body also points toward purposes beyond procreation, and specific examples are given

In the beginning of part two, the authors detail methods of more “natural” birth control. I was impressed with his mention of newer and more sophisticated methods used by couples in tracking ovulation, specifically the use of urinary hormone monitoring at home. After recently hearing questions from several people about these methods, I did an extensive search of the medical literature regarding this practice in particular. Specifically it seemed that the ability to predict ovulation by hormonal changes several days prior would make it much more reliable than simple calendar-based plans. I found very little research had been done using home urinary hormone monitoring other than at Marquette University, and was impressed that he was aware of their technique (using the Clearblue fertility monitor) , though I would have liked to see a website for it listed in the back for readers to learn more, given the reliability of the method.

Another strength in this book is the straightforward and clear way in which he describes the female hormonal loops and their feedback. I wish I had read this back in medical school before getting into the more complicated texts. This is a useful section for laypeople, and necessary before they enter the section on specific types of hormonal contraception.

The chapter “Do Birth Control Pills Cause Abortion” was perhaps one of the most helpful parts of the book. I have talked to many women who have concerns about this issue, and rightly so. The authors again wisely handles this section with the grace to allow readers to make their own informed decision regarding it, yet without compromising concerning the sanctity of the life of an embryo. He described all angles of the issue in an easy to understand way, which I believe laypeople would be able to follow easily. The section of the chapter called “Is Any Risk Acceptable” did a good job of putting the concerns in perspective. That we do not routinely sequester pregnant woman from the risks of being out in public where they would possibly contract an illness which would cause fetal death, for example, is a good example of a risk routinely taken in pregnancy, as small as it is. That the best pro-life scientists differ in their views on how to use the information since we don’t exactly know the risk helps me personally dispense grace to Christians who evaluate the information and come to different conclusions.

He also discussed balancing intent with the weight of knowledge. Using the example of a person backing their car up without looking yet not intending to kill a neighbor was poignant. I think of previous generations that didn’t have the same kind of access we have now to information. With the internet and thus latest research being so readily available, we have an obligation as Christians to keep up to date with the latest findings in this area, and I appreciated him reminding his readers to keep up as new info comes out. I truly hope that more research is done in the near future that can provide us with the needed clarity to make better decisions about it.

He continues in his book to cover the other hormonal methods of birth control helpfully and then to discuss the surgical options for more permanent sterilization. From my knowledge of these techniques and procedures, he summed up the information and concerns for each technique quite well.

I found the chapter “The Future of Contraception” to be quite interesting. I had no idea some of these ideas were in the pipeline.

Part Three covered the biblical view of family and its purposes. He again addressed these issues with grace and biblical insight. The idea of having a huge family being something of an idol in some Christian circles was an interesting point. I have occasionally noted the unsaid implication that somehow the large family is more obedient. He discussed this in the context of Gen 1:28. I do wish, however, he’d spoken into the concept of evangelism as a way to obey God in this.

All in all, this was an incredibly well written guide for the Christian family, which I would recommend to friends, family, and patients.