What role does religious belief play in contraception?

A person's religious belief will often influence or direct that person's behavior. If a person's religion teaches that God forbids sexual activity that is for any purpose other than procreation, that person may not use contraceptives.

However, religious belief does not always predict conformity of behavior. It is more likely that those who are more involved in a religious community and more committed to the values of that community are also more adherent to their belief system.

Of Human Life (Humanae Vitae), the encyclical letter written by Pope Paul VI reiterates official doctrine on the regulation of birth. The following description, and quotes, were obtained from that document.

Roman Catholic doctrine reserves sexual intercourse between a woman and a man in marriage. The sole justification for sexual intercourse is the procreation of children. This teaching is said to be "willed by God and unable to be broken by man [sic] on his [sic] own initiative."

Since the procreative act is governed by divine law, Church teaching enumerates the "grave consequences of methods of artificial birth control." These include: "conjugal infidelity" and "the general lowering of morality;" and "the loss of respect for the woman by a man who as a result of using contraceptives, uses her as a mere instrument of selfish enjoyment."

The encyclical expresses particular concerns for the young who are vulnerable to the use of contraceptives and identifies their "need of encouragement to be faithful to this moral law."

Not all Catholic theologians and Catholic ethicists oppose the use of contraceptives. Some break with Roman Catholic doctrine and accept contraceptives as a method of family planning and population control. They raise health related concerns, however, regarding the side effects in the use of oral contraceptives, as well ethical concerns about the use of contraceptives which may encourage irresponsible and impersonal sexual activity. They uphold the official doctrine that sexual relations must be viewed exclusively in the context of a committed, heterosexual relationship. However, they would argue that if a person, especially a young adult, is engaged in casual sexual activity they should use contraceptives to avoid pregnancy.

In fact, most Roman Catholic adults do not comply with the teachings of the encyclical. It is reported in "Catholics and Reproduction: A World View," that 82% of Catholics in the United States disapprove of the statement that using artificial birth control is morally wrong.¹ Some Catholics use natural family planning whereby the married couple limits sexual intercourse to those times when the woman is most likely not ovulating. Others use the range of artificial contraceptives available to prevent pregnancy.

Religious education occurs in all religions and often begins when children are very young. Maria and her parents are Roman Catholic. Maria attends Catholic high school. In the first year of Catholic high school, courses are usually taught in marriage, family, and Christian vocation. By now, Maria has most likely taken several courses that guide the formation of her faith through standards of moral living articulated by the Catholic Church. Guidance is provided to develop decision-making skills needed to make sound moral judgements and to encourage the formation of a Christian conscience consistent with official Roman Catholic teachings. The goal of this education is to enable young Roman Catholics to apply the rules of morality to contemporary moral issues.

Maria is, however, sexually active. Because of the education she has had, there may be some conflicts that arise for her.

When religious values interface with medical decision-making conflicts can arise. There may be ethical dilemmas raised for Maria, specifically, the conflict between official Roman Catholic doctrine and the need to allow teens, who have already made the decision to be sexually active, to be safe from unwanted pregnancy and sexually transmitted diseases. The problem of unmarried teenage pregnancy and an epidemic of sexually transmitted diseases are serious among adolescents.

Public health and moral concerns remain under addressed by the Roman Catholic Church. This problem should not be ignored by the physician.

Regardless of the religious affiliation of the physician, or in cases where the physician has no religious affiliation, respect for the religious values of a patient must be foremost. The decision to treat must be based on sound medical judgement and consonant with the wishes of the patient.

A physician should never use her/his faith to influence or coerce a patient. She or he can refuse to treat a patient if the patient's wishes are in conflict with their own religious or moral beliefs. A referral to another physician would be appropriate.

The official Roman Catholic doctrine forbids premarital sexual activity and the use of contraceptives. The expectation is that all Roman Catholics, especially the young, will develop the moral conscience and practical skills necessary to "just say no." Despite these factors, Maria Hernandez, like many adolescents, has chosen to be sexually active. Maria's choice should not preclude the importance for physicians to 1) to discuss contraceptives, pregnancy and sexually transmitted diseases (knowledge she most likely will not learn in school nor from her parents) and 2) to explore her religious beliefs and those of her parents.

Questions about her religion are asked not with the expectation of changing Maria's behavior, but to identify the conflicts the decision to be sexually active may have created in Maria's life. When adolescents are already sexually active, religion is rarely an antidote to peer pressure and personal psychology. It is probably more true to say that an adolescent will not engage in sexual activity because they have had comprehensive sexuality education, than to say that they will cease being sexually active because of religious prohibition.²

Furthermore, it is often true that parents are not the first persons sought out by teens when they are in need of support or when something goes wrong. Though clinics encourage teens who use their services to talk with parents about their sexual relationships and sexual activity, strict moral teaching further imperils that process of communication. This is especially true if the teen's parents are observant Roman Catholics who feel obligated, regardless of their own personal beliefs and practices, to secure the moral education of their children.

Though a physician cannot directly reconcile these conflicts, the physician can intervene by referring Maria to a clergy person, social worker or other professional who can support her and, possibly, help her evaluate her decision to be sexually active.

¹Hume, M. Catholics and Reproduction: A World View. Catholics for a Free Choice. 1997. p.10.

²Haffner, D.W. "Just Say No?". Conscience. 19:7-10. 1998.

Clippinger, J.A. "Adolescent sexuality and love." Journal of Religion and Health. 18:276-286. 1979

Connelly, R.J. "Letter to my children about sex and the Catholic church." Journal of Religion and Health. 33:259-267. 1994.

Goldscheider C. and Mosher W.D. "Patterns of contraceptive use in the United States: The importance of religious factors." Studies in Family Planning. 22:102-115. 1991.

O'Donnell, T.J. Medicine and Christian Morality. Alba House, NY, 1976. pp.238-257.

Sorensen, R.C. "Adolescent sexuality in contemporary America: Personal values and sexual behavior ages 13-19." Christian Century. 91:80-82. 1974.

Disclaimer: Clinical information is provided for educational purposes and not as a medical or professional service. Persons who are not medical professionals should have clinical information reviewed and interpreted or applied only by appropriate health professionals.