Mustn’t Upset the Pope!


This is the sort of thing that ought to result in careers and reputations going up in smoke, and maybe a few class action lawsuits, but that probably won’t happen. Besides, it’s thoroughly too late by now. I’m sure that’s a coincidence.

Perhaps some of you already know this: [wapo]

Last month, the British National Health Service issued new guidelines concerning contraceptive pills. Many common brands of birth control instruct women to take one pill each day for 21 days, then finish the month with seven days of placebo pills, to still have their period (or, more accurately, withdrawal bleeding that mimics a period).

The new British guidelines, however, are upending this decades-old pattern. Researchers and physicians have long said the seven-day “break” is not medically necessary, so the NHS has changed its recommendations to say that women can, in fact, take hormonal birth control pills continuously and safely, no dummy pills needed.

The part about periods not being necessary is something I learned about over a decade ago; I knew a young woman who had been throwing away the placebos for years because she understood the biology of the process and knew it was not necessary. When she told me about that, I was concerned because I naively assumed that the people who designed the pills and the process had determined that was the best way for them to be employed.

Nope.

It was just religious nastiness. Or, actually, worse: it was the assumption that nasty religionists would be less upset with birth control pills if women were still reminded of their place in the hierarchy of suffering that the christian death cultists worship.

In explaining the decision, John Guillebaud of the NHS’s Faculty of Sexual and Reproductive Health repeated a common refrain, telling the Telegraph that gynecologist John Rock concocted the break to win over the pope and thus anti-contraceptive Catholics. “Rock thought if it did imitate the natural cycle then the pope would accept it,” Guillebaud explained, before asking, “How could it be that for 60 years, we have been taking the pill in a sub-optimal way because of this desire to please the pope?”

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Comments

  1. lochaber says

    wow.

    I had also heard that about the placebos being in there for questionable reasons, and that they weren’t necessary, and that there are a lot of women out there who find skipping them to be beneficial.

    I had no idea they were included to appeal to religion, that’s absurd.

  2. John Morales says

    ‘Twas in local news recently:
    https://www.abc.net.au/news/2019-01-24/contraception-the-pill-and-the-pope/10746934

    [pullquote]

    This is because standard combined oral contraceptive pills — such as Microgynon, Rigevidon or Marvelon — are designed to be taken for 21 days, followed by a seven-day break, during which time the woman doesn’t take the pill and experiences vaginal bleeding. Pill-taking women therefore have what seems like a “period” every month.

    But this “period” is far from necessary. Shortly before his death in 2015 I attended a lecture given by Carl Djerassi, the “father of the pill”. He remarked that the seven-day break, and resultant withdrawal bleed, was designed into the pill in the late ’50s in an attempt to persuade the Vatican to accept the new form of contraception, as an extension of the natural menstrual cycle.

  3. says

    gynecologist John Rock concocted the break to win over the pope and thus anti-contraceptive Catholics

    the official banning of contraception by the church in 1968

    This is just so sad. Everybody bends over backwards just to please the pope, but he bans contraception anyway.

    I had already heard that it’s possible to take the pill for a prolonged period of time without any negative side effects. The story I had heard was that placebo pills were meant for the purpose of making women more comfortable. There was this assumption that some women might feel that having no periods for months was weird.

    By the way, that’s a belief I never shared, having no periods for months is amazing. I have PCOS (polycystic ovary syndrome), and that’s the best thing ever. My naturally elevated male hormone levels mean that I get periods a lot less frequently than other women. That’s cool. Not having a period for several months at a time is great. It’s also nice that my body is more hairy compared to women. I’m queer, I don’t see myself as female, so more testosterone in my body feels amazing. It’s funny how there’s this one thing I like about my body, yet gynecologists call that a syndrome, which needs treatment. Having PCOS is the reason why I decided not to use the pill. It’s cool that I have a naturally elevated levels of male hormones, and I don’t want to change that, I don’t want any more female hormones in my body. The only hormone I’d be willing to take is testosterone.

  4. Owlmirror says

    This article debunks the pope-pleasing story. Not that the reality is so much better.
     

    To understand where the seven-day break really came from, we need to know a bit about how this society-changing drug works: the combined hormones in the pill prevent ovulation by tricking the body into thinking it is pregnant. Perhaps unexpectedly, early trials of combined hormonal contraception started out among patients trying to conceive. A gynaecologist with a hunch suspected that patients with unexplained infertility might fall pregnant more easily once the body had experienced pregnancy. Therefore patients with infertility were given a combination of hormones for a few months. After they stopped taking the hormones a number later became pregnant.
     
    However, there was a problem – the early forms of the pill had significantly higher doses than today’s versions. This meant that women in this trial had early pregnancy symptoms, including morning sickness. This gave many distressing false hope. First they believed they were pregnant when taking hormones, and then discovered they weren’t when they stopped. So it was suggested that allowing the women on these early pills to take a monthly break could assure them they were not pregnant. Thus, the seven-day break was born – not, as Professor Guillebaud claims, because of any need to persuade the pope.
     [ . . . ]
    But by blaming the pope for 60 years of suboptimal contraception use, as Guillebaud suggested, we fail to ask the more important question: why did the seven-day break become such a mainstay of reproductive health for 60 years?
      [ . . . ]
    No one wondered whether women really had to go through the pain, discomfort or even inconvenience of a monthly bleed.
      [ . . . ]
    Studies have shown repeatedly that our medical system has an inherent bias against women. Women presenting with pain are more frequently given sedatives than painkillers, where men are given painkillers. Women with coronary heart disease have delayed treatment compared with men. And people even rate the perceived pain of a paediatric patient differently, depending on whether they are told the patient is male or female.
     
    We now have another clear example to add to the pile: women are exposed to unnecessary, inconvenient, uncomfortable and potentially damaging monthly bleeds for no reason other than that nobody thought to question whether those bleeds were necessary.
     
    Unconscious medical bias is a real phenomenon that we can, and must work to fix. Blaming the pope merely allows us to hide from the truth.

  5. says

    Owlmirror@#4

    Studies have shown repeatedly that our medical system has an inherent bias against women.

    Yeah, no kidding. In my country, theoretically any person who is at least 25 years old can request and obtain voluntary sterilization. In practice, only guys can get it. Anybody unlucky to be born with a female body must travel to Thailand as a medical tourist instead. When I asked for the surgery, a gynecologist literally kicked me out of her office.

    If somebody said straight in my face that they hate me and want me to suffer, I’d be a lot less annoyed compared to all this patronizing I’m forced to endure from doctors. They discriminate me, they mistreat me, and yet they dare to claim that this is for my own good. According to doctors, I must be stupid, childish, incapable of deciding for myself, and in need of a smarter doctor who will protect me from making the greatest mistake in my entire life.

    The amusing thing is that Latvian laws explicitly state that doctors are forbidden to discriminate their patients. What doctors did to me was illegal. Yet since they avoided me and kicked me out of their office verbally, I have no written proof that I was denied the surgery I requested. Thus I cannot even sue the damn hospital, because I cannot prove that I even went there and asked for sterilization.

  6. mynax says

    Owlmirror@#4,

    I don’t see where the article actually DEBUNKS the idea that part of the reason was to please the pope. It asks, but does not answer, “but could it really be the case that a doctor would add a superfluous and potentially harmful break in a contraceptive procedure purely to please the pope?”.

    It shows no research that Guillebaud was doing something like repeating an urban legend about it. The article linked by John Morales quotes one of the original researchers, too.

  7. voyager says

    Leva,
    I had my tubes tied in my early thirties. I was childless and the Dr. twice counselled me against the procedure. Too young, too permanent, hadn’t thought it through, unnecessary, blah-blah. Then, before he did finally condescend and agree to do it, he sought the consent of my husband. Bastard.
    Ditto, for any and all of the people who conspired and allowed women to suffer and bleed for no good reason. Bastards, the whole fucking lot of them.

  8. says

    Voyager @#7

    I wanted a hysterectomy instead of tubal ligation. I don’t see myself as a woman, and I suspect that transphobia was part of why doctors mistreated me so badly.

    Then, before he did finally condescend and agree to do it, he sought the consent of my husband.

    A guy goes to a doctor asking for a vasectomy. The doctor asks his wife for her consent. I wonder whether that has ever happened anywhere. Probably no.

    Bastards, the whole fucking lot of them.

    Yes, I can agree with this assessment.

    I noticed you said “he” when referring to your doctor. Where I live, medicine is a female dominated field. There are a lot of female doctors here. This is especially true for gynecologists—all the gynecologists I have ever spoken with were women. I can at least understand guys practicing misogyny; I can see how some might like the idea of women being subservient to them. What I don’t get is female gynecologists mistreated their female patients. Why? Just why? Why should a female doctor propagate sexist attitudes? Why would she want other women—her patients—to suffer pointlessly?

  9. Owlmirror says

    @mynax: Actually, the article linked by Morales (written by Susan Walker) has a further link that describes Djerassi’s role in the research. While Djerassi did the important work of synthesizing one of the hormones used in the pill’s final form, he was not actually one of the original researchers involved in setting the pill-taking regimen.

    Norethisterone continues today to be the mainstay for the progestogen component of oral contraceptives and moreover, most other progestogens used for contraception resulted from minor chemical modifications. It is noteworthy that the research activities of Djerassi’s original team were not specifically focused on oral contraception. This was being investigated simultaneously and independently in Massachusetts by the biologist Gregory Pincus in collaboration with John Rock, a Catholic gynaecologist, who justified the application of modern forms of naturally occurring sex hormones as merely prolonging the safe period – a variant of the rhythm method. These “big three males” have, at one time or another, each been perceived as being the ‘father of the pill’. But Djerassi denied paternity: feeling that birth was more important than conception, he preferred to be known as the ‘mother of the pill’. He went much further by crediting Ludwig Haberlandt, from Innsbruck in Austria, with the title of ‘grandfather of the pill’ for having demonstrated, in 1921, the value of progesterone for contraception, thereby attracting the pharmaceutical industry to contraceptive development long before World War II.

    Whereas the article I linked (written by Alice Howarth) links to a long description of the development of the pill; the decades-long multiple trials by Pincus and Rock, which is summarized.

    Now, Rock, as a Catholic, may well have used the fact that there was a pill-free week to support his arguments in favor of the pill as contraception to other Catholics, but the essay linked to and summarized emphasize that this was done after the fact. The pill-free week was decided upon for reasons not having to do with Catholicism or the pope per se.

  10. Owlmirror says

    @Ieva Skrebele:

    I noticed you said “he” when referring to your doctor. Where I live, medicine is a female dominated field. There are a lot of female doctors here. This is especially true for gynecologists—all the gynecologists I have ever spoken with were women.

    Would a hysterectomy be performed by the gynecologist alone, or would she refer you to a surgeon? And are surgeons also mostly female?

    I’m just wondering if at some point a man might be involved, who could refuse to do the surgery if he didn’t think it was warranted.

    What I don’t get is female gynecologists mistreated their female patients. Why? Just why? Why should a female doctor propagate sexist attitudes? Why would she want other women—her patients—to suffer pointlessly?

    Don’t underestimate the capacity of people in general to do things that harm others of groups they belong to. Female genital mutilation is enforced and carried out by women on their female children, just as male circumcision is enforced and carried out by men on their male children. And of course there are the closeted homosexual politicians who promote anti-homosexual policies.

  11. says

    Owlmirror @#10

    Would a hysterectomy be performed by the gynecologist alone, or would she refer you to a surgeon?

    The doctor who kicked me out of her office was qualified to perform surgeries. In that hospital there were several doctors who would have been qualified to perform a hysterectomy, all of them were female.

    And are surgeons also mostly female?

    In Latvia, many surgeons are women. Statistically, majority of doctors are women here. It’s not just female nurses; this trend goes all the way up to surgeons. Of course, there are plenty of male doctors here, it’s just that they make up less than 50% of all doctors.

    I’m just wondering if at some point a man might be involved

    No, not in that hospital where I got refused.

    Don’t underestimate the capacity of people in general to do things that harm others of groups they belong to. Female genital mutilation is enforced and carried out by women on their female children, just as male circumcision is enforced and carried out by men on their male children. And of course there are the closeted homosexual politicians who promote anti-homosexual policies.

    Of course, I’m aware that this is happening. People have also explained to me the reasons why this is happening. Yet, on some level, I just cannot fully understand it. Despite all the explanations I have gotten, it still seems illogical for me, it just doesn’t make sense. I cannot truly comprehend it.

    Some things are easy to understand for me. When a person belongs to some privileged group, it’s rational for them to abuse and exploit members of other underprivileged groups, because there’s an opportunity for direct personal gain. Selfishness is something I can easily understand. Oppressing somebody else for selfish gain makes sense.

    What doesn’t make sense is pointlessly making other people suffer when you gain nothing from it. How does one woman benefit from forcing another woman to suffer under patriarchy? What’s in it for her?

    For me there seems to be two levels of understanding other people’s thoughts and actions: (1) truly and deeply understanding what they feel and do, because I have felt the same thing or I have been in the same situation; (2) being logically aware that some other people do this thing that seems alien for me, because I have never experienced anything similar; even when other people’s motivations are explained to me, in such situations I still fail to truly grasp what’s going on in their minds.

  12. jrkrideau says

    @ 9 Owlmirror
    The pill-free week was decided upon for reasons not having to do with Catholicism or the pope per se.
    Ah yes, when in doubt blame the Pope if you cannot blame the Russians.

    I fail to see why the argument of /s a pill-free week would support his arguments in favor of the pill as contraception to other Catholics . I certainly cannot see how it would affect the Pope and his theologians.

  13. John Morales says

    I think Owlmirror has it most plausibly right (“The pill-free week was decided upon for reasons not having to do with Catholicism or the pope per se.”) — all I intended to express was that the story had done the rounds already (“Perhaps some of you already know this”), not that I gave it credence.

  14. John Morales says

    leva @11,

    What doesn’t make sense is pointlessly making other people suffer when you gain nothing from it. How does one woman benefit from forcing another woman to suffer under patriarchy? What’s in it for her?

    Satisfaction. Security. Success.

    Where you fail in that analysis is in considering the actions to be pointless and/or gainless. Expand the scope beyond the actions themselves.

    (Or: Consider a Catholic nurse at a Catholic hospital; how long would that nurse remain a a Catholic nurse at a Catholic hospital if their actions were contrary to what a Catholic nurse at a Catholic hospital is supposed to do?)

  15. Owlmirror says

    @jrkrideau:

    I fail to see why the argument of /s a pill-free week would support his arguments in favor of the pill as contraception to other Catholics .

    With the understanding that I have not read Rock’s actual argument, the summary by Alice Howarth (which links to a book review of what Rock wrote, rather than any text from the book itself) states:

    They reasoned that the pill makes use of hormones that the body itself produces – the ingredients and the way they prevent pregnancy is arguably as natural as the rhythm method, which the Catholic church already allowed.

    I would guess that the analogy with the rhythm method is stronger if there exists an actual rhythmic cycle of rising and lowering hormones (in this case, the lowering being the result of not taking the pill), punctuated by actual menstruation. The rhythm method of course relies on noting on a calendar when menstruation occurs, as a proxy for tracking natural changes in hormones associated with ovulation.

  16. says

    John Morales@#14:
    how long would that nurse remain a a Catholic nurse at a Catholic hospital if their actions were contrary to what a Catholic nurse at a Catholic hospital is supposed to do?

    How much would could a woodchuck chuck, if a woodchuck could chuck wood?

    Sorry, jet-lag.

  17. jrkrideau says

    @16 Owlmirror

    They reasoned
    Actually they made some wil/d-assed assumptions. Essentially they seem to have said, “Let’s pretend that there is no difference between the natural contraception and the new oral contraception approaches and hope the Vatican or whoever else we are conning falls for it. Apparently lots of people, for decades, have fallen for it.

    One may or may not like the Catholic Church’s teachings but the theologians, etc, are not stupid and used logic even if we may think that some of the initial premises are just a bit dubious. I doubt that the Vatican would have fallen for it. The Vatican would have the time, resources and experts to actually examine the issue.

  18. voyager says

    .leva @#8

    I’m sorry you had to bear that treatment. That is a much more serious aggression than my birth control issue. I still had lots of other options, but you certainly didn’t. It’s so strange that our society glorifies plastic surgery, even drastic body sculpting for cosmetic reasons, but when it comes to necessary gender reassignment surgery (I hope that’s the correct term) society isn’t supportive of it. I would expect better from a Dr., especially a female Dr.

  19. Owlmirror says

    @jrkrideau:

    Essentially they seem to have said, “Let’s pretend that there is no difference between the natural contraception and the new oral contraception approaches and hope the Vatican or whoever else we are conning falls for it. Apparently lots of people, for decades, have fallen for it.

    Actually, I suspect that lots of people, for decades, have simply not given a damn what the pope has to say. I have seen little indication that Rock’s book was ever popular enough to have had much influence with most Catholics.

    A review of Church policies over time shows that what is or is not doctrine has changed. Rock’s book is not mentioned as having had any particular influence in modern attitudes towards contraception.

    One may or may not like the Catholic Church’s teachings but the theologians, etc, are not stupid and used logic even if we may think that some of the initial premises are just a bit dubious.

    I have seen what passes for “logic” in Catholic theolology, and I am nearly entirely convinced that while theolologians may not be stupid, theology itself is a collection of the stupidest word games ever played by smart people.

    The Vatican would have the time, resources and experts to actually examine the issue.

    There was in fact a Pontifical Commission on Birth Control. The majority of the commission came to the conclusion that birth control was OK. The minority of the commission argued that the church changing her mind on the matter would undermine the claim of ecclesiastical and papal infallibility on faith and morals. The pope went with the minority report.

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