Sex and Contraception in a Christian Marriage

Nota Bene: This is a discussion of human sexuality, including sex, contraception, and other related topics. If you are offended by such topics, you may choose to exercise abstinence and refrain from reading any further. On the other hand, if you choose to engage in further reading, some context for this discussion may be found in “There Is No Sex in the Church”—a collection of essays by Fr. Sergei Sveshnikov published in 2013.

The question of contraception within marriage is not new by any means. Perhaps the earliest biblical mention of birth control comes from the story of Onan and Tamar in which coitus interruptus was used to prevent conception (Gen. 38). No doubt, this time-honored method of contraception has been employed by couples since the time of Onan–approximately, three-and-a-half thousand years ago^[1]–and to the present day. Other contraceptive techniques were also used throughout the centuries and are continued to be used in present times (a pious reader above a certain age, no doubt, will be able to imagine some of the sexual techniques that are incompatible with conception).^[2]

In recent decades, humans have been enjoying “better living through chemistry” (as well as a better understanding of physiology), and a wide variety of contraceptive pharmaceuticals and devices have appeared on the market. These new advances in contraception have been employed both by non-Christian couples (who are not the subject of this discussion) and Christian couples alike—with or without the blessing of the Church. The stance of the Orthodox Church on every type of sexual behavior which differs in any way from the so-called “missionary” position was quite clearly formulated by monastics and celibates in the Middle Ages.^[3] Regardless of whether mediaeval monastics and celibates should ever be viewed as experts on spousal intimacy, medical advances (as well as many other factors) of the twentieth and twenty-first centuries forced the Church to re-evaluate its positions on sex and contraception within a Christian marriage. As Breck notes, “Orthodox bishops and priests today usually acknowledge that married couples may need to practice a form of family planning that includes some method of birth control.”^[4] The Holy Synod of Bishops of the Orthodox Church in America issued the following affirmation in 1992:

Married couples may express their love in sexual union without always intending the conception of a child, but only those means of controlling conception within marriage are acceptable which do not harm a fetus already conceived.^[5]

The Russian Orthodox Church included the following statements in its Basis of the Social Concept:^[6]

Among the problems which need a religious and moral assessment is that of contraception. Some contraceptives have an abortive (sic.) effect, interrupting artificially the life of the embryo on the very first stages of his life. Therefore, the same judgements are applicable to the use of them as to abortion. But other means, which do not involve interrupting an already conceived life, cannot be equated with abortion in the least. In defining their attitude to the non-abortive contraceptives, Christian spouses should remember that human reproduction is one of the principal purposes of the divinely established marital union (see, X. 4). The deliberate refusal of childbirth on egoistic grounds devalues marriage and is a definite sin.

At the same time, spouses are responsible before God for the comprehensive upbringing of their children. One of the ways to be responsible for their birth is to restrain themselves from sexual relations for a time. However, Christian spouses should remember the words of St. Paul addressed to them: «Defraud ye not one the other, except it be with consent for a time, that ye may give yourselves to fasting and prayer; and come together again, that Satan tempt you not for your incontinency» (1 Cor. 7:5). Clearly, spouses should make such decisions mutually on the counsel of their spiritual father. The latter should take into account, with pastoral prudence, the concrete living conditions of the couple, their age, health, degree of spiritual maturity and many other circumstances. In doing so, he should distinguish those who can hold the high demands of continence from those to whom it is not given (Mt. 19:11), taking care above all of the preservation and consolidation of the family.

The Holy Synod of the Russian Orthodox Church in its Decision of December 28, 1998, instructed the clergy serving as spiritual guides that «it is inadmissible to coerce or induce the flock to… refuse conjugal relations in marriage». It also reminded the pastors of the need «to show special chastity and special pastoral prudence in discussing with the flock the questions involved in particular aspects of their family life». (XII. 3)

A couple of points in this document are of particular interest to this discussion. First, the Christian spouses are to define “their [own] attitude to the non-abortive (sic.) contraceptives.” Thus, this document is to be viewed as a guide, rather than a prescription. Second, while the document reiterates that coercion into abstinence is “inadmissible,” it nonetheless “gently” tows the line of coercion by specifically mentioning only one method of contraception–restraining “from sexual relations for a time”– and treating those who cannot abstain as some weaker Christians, those “to whom it is not given” (that is to say, they are lacking that which is not given to them but is, presumably, possessed by others). Interestingly enough, the passage to which the document refers in this case, Matthew 19:11, is actually addressing second marriages and eunuchs, not sex within a lawful marriage. But such is the current state of confusion within the Church on the topic of contraception that virtue is implied to abstinence while the lack of abstinence within a lawful Christian marriage can be treated within the framework of the immorality of divorce.

Leaving aside for the moment the moral valuation of sex within a Christian marriage, let us focus on the distinction between abortifacient and non-abortifacient methods of contraception mentioned but not identified in the Basis of the Social Concept of the Russian Orthodox Church.

Methods of what is commonly referred to as ‘contraception’ can be roughly divided into three categories: abortifacient, non-abortifacient, and possibly-abortifacient. The Orthodox Church takes a strong stance against abortion; and any interceptive^[7] or contragestive^[8] methods may be considered abortifacient (especially the contragestives), depending on one’s definitions of conception, personhood, human life, etc.

Contragestives are methods that lead to the loss of a barely implanted embryo. In technical terms, this is not contraception but chemically-induced abortion, since conception and implantation do occur prior to the loss of the embryo. The RU 486, for example, acts as a contragestive at doses of 200-600 mg.^[9] Methotrexate^[10] and misoprostol are some other examples of contragestives.

Strictly-non-abortifacient and non-interceptive methods are barriers (condoms, caps, etc.), sterilization and abstinence.^[11] Certainly, coitus interruptus (when it actually works) as well as anal and oral sex are also techniques that may prevent conception, but a detailed discussion of their place in a Christian marriage is well-outside the scope of this paper. (To be sure, Orthodox confessionals do point to the use of “creative” sexual positions and techniques by Christian couples—presumably, in order to avoid conception, among other reasons—and a studious reader may find a brief survey of these confessionals in the aforementioned There Is No Sex in the Church (2013).) , Barriers, sterilization, and abstinence are the only true contraceptives, since, when they work, they prevent conception no matter the chosen definition of the term. However, it may be said that sterilization and abstinence are not contraceptive in the same way as barriers, since the very mechanism by which conception may occur is absent (especially in the case of abstinence).

Finally, interceptive methods may pose a bit more of an ethical challenge. These are the techniques that may prevent fertilization, but they may also intercept the embryo and cause it to be expelled before its implantation in the uterus if fertilization happens to occur. These techniques include some hormonal therapy (Ormeloxifene)^[12] and some implants (for example, the IUD when used as emergency contraception).^{[13], [14], [15]} The ethical ambiguity of the use of these methods comes mainly from the utmost difficulty in determining and tracking over long periods of time the exact mechanisms that prevent pregnancy. It may be rare or unlikely but not at all impossible that conception does occur—in the sense that the egg is fertilized by the sperm—but the embryo fails to implant due to the use of medication or device. This ambiguity is further complicated by a lack of consensus on whether a fertilized egg constitutes an embryo or a potential human person, since some of the genetic processes require implantation in the uterus, and the lack of implantation may also be seen as undermining the relational aspect of human personhood. To explore this further, let us take a closer look at the issue of human personhood.

In order to facilitate the discussion, I propose introducing the term ‘a human life’ as any life that has the real potential of naturally developing into a human person. This definition would necessarily include a fertilized egg even before its implantation in the uterus. And if we somewhat arbitrarily define a human life (not a person, a soul, or any other concept, but a basic notion of life) as beginning from conception, then interceptive methods qualify as abortifacient specifically with respect to human life, setting aside a discussion of personhood or ensoulment. The fact that they do not always cause the embryo to be expelled or may do so only occasionally matters little if they do so in principle. Of equally little consequence is the fact that many, if not most, embryos naturally fail to implant and are expelled. The fact that some people naturally die from various causes–from illnesses and accidents to old age—does not give us an ethical excuse to kill off a few of them just to “thin the herd.”

Clearly, there is a vast difference between an unimplanted embryo and an adult human person. The question, therefore, is whether we value human personhood—with its relationships, self-awareness, experiences, memories, feelings, etc.—or human life in general. Because if we place value on human personhood, then babies for some time after birth may be seen as having none. In fact, this is exactly what some ethicists have proposed, arguing that newborns are “morally irrelevant,” and that killing them is not infanticide, but “after-birth abortion.”

A pair of ethicists linked to the University of Melbourne and Oxford University has argued in an article published in the Journal of Medical Ethics that, “both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’.”^[16]

If the moral status of the newborn is the same as that of the embryo and if neither has any moral value by virtue of being a potential person, then the same reasons which justify abortion should also justify the killing of the potential person when it is at the stage of a newborn.^[17]

The position that there is no difference between a fetus and a newborn child in terms of their personhood is not new. In 1972, Michael Tooley of the University of Colorado made this very argument and proposed that killing an infant was permissible.^[18] In 1997, an American psychologist Steven Pinker wrote in the New York Times:

To a biologist, birth is as arbitrary a milestone as any other. Many mammals bear offspring that see and walk as soon as they hit the ground. But the incomplete 9-month-old human fetus must be evicted from the womb before its outsize head gets too big to fit through its mother’s pelvis. …the right to life must come, the moral philosophers say, from morally significant traits that we humans happen to possess. One such trait is having a unique sequence of experiences that defines us as individuals and connects us to other people. Other traits include an ability to reflect upon ourselves as a continuous locus of consciousness, to form and savor plans for the future, to dread death and to express the choice not to die. And there’s the rub: our immature neonates don’t possess these traits any more than mice do. Several moral philosophers have concluded that neonates are not persons, and thus neonaticide should not be classified as murder.^[19]

Even earlier, in an 1893 case from Kanev uezd (Ukraine), Roman and Akilina O-v, the parishioners of Priest Ioann Gorbachevskii, had clearly committed a crime: they had strangled their newborn infant.  The civil court, however, unequivocally acquitted them in view of their extreme poverty.^[20] This is not surprising.  Russian lawyers and doctors at the turn of the twentieth century regularly advanced the argument that infanticide was the abortion of the poor, and therefore should not be treated any more harshly than wealthy women who had private doctors perform abortions. But what is interesting is the reaction of the peasant couple:  because they had been acquitted in a secular court, they asked Father Ioann, their local priest, to allow them to partake of the sacraments of confession and communion.^[21] Even more interesting, the Orthodox Church shared the civil court’s assessment that infanticide and abortion were functionally equivalent, but not with an eye to tempering the canonical penalties for either.  From Father Ioann’s point of view, by killing their newborn the O-v couple had committed a grave crime which called for a church penance even if it did not prompt a civil sentence.  He asked the Kiev Consistory if he could admit “the criminals” to the sacraments.

Because of the inherent ambiguity in terminology, one possible position to take may be to argue for the protection of human life, rather than the legal rights of human persons. From this position, a human life begins at conception defined as the fertilization of an egg by a sperm, since what is conceived is expressly a human life, rather than that of a rabbit or a snail.^[22] If we accept this position, then interception is also a form of abortion, regardless of such naturally-occurring phenomena as wastage or miscarriage; just as naturally occurring fatal accidents, terminal illnesses, and deaths from old age do not in any way excuse euthanasing unwanted people who may be a burden to their families or society.

A strong argument may be made that interception prevents a number of what we usually think of as abortions-proper. This may indeed be the case, as abortions in the U.S. reached their lowest level in 30 years in 2011.^[23] But so did the birth rates, and contraception, interception, and chemical abortion may be the reason. Thus, while on a purely cultural and emotional level hormonal interception is much more palatable than pre-birth or after-birth infanticide, from ethical and theological perspectives it is still an issue in need of exploring further with respect to the status of a human life prior to the embryo’s implantation in the uterus.

So, if contraception is to be defined as methods that prevent conception, then the only methods that are purely and always contraceptive are barriers (male and female condoms), sterilization, abstinence, and, perhaps, hormonal therapy. Implants, however, sometimes act as contraceptives and sometimes may act as interceptives. While interception is not the typical mechanism of action for the IUD, it can, at least occasionally, prevent the implantation of the blastocyst and thus act as in interceptive.^{[24], [25]} Hormonal therapy may be almost exclusively contraceptive. It does not appear to impede implantation, since in a small number of cases a pregnancy does occur during perfect use, that is to say, the blastocyst does implant and develop.^[26] The pastoral implications of recommending hormonal therapy for Christian women, however, may be problematic both due to the side effects which will be mentioned further and the very mechanism of action which changes the way a woman’s body naturally works by preventing ovulation. Finally, hormonal contraceptives carry an environmental impact. Synthetic hormones are flushed down toilets, pass through water treatment plants and end up in rivers where they cause endocrine disruption in fish^[27] and possibly have other impacts on the environment that have not yet been identified. As stewards of God’s creation, we must consider these impacts when discussing the ethics of using hormonal forms of contraception.

Barrier methods have a very high failure rate–from 12% for male condoms to 28% for female condoms. Compare this to a 0.05% failure rate for the hormonal implant.^[28] Due to their high failure rate, it is difficult to see how barrier methods would constitute an acceptable long-term method of contraception, should one be desired by a married couple.

Sterilization^[29] is 100% effective if performed correctly, and may be reversible in some cases. It has no negative impacts on the environment. There are, however, two ethical questions that are often raised:

• Is sterilization a way to lessen the need for temperance in sexual life and is it thus a hindrance to one’s struggle against passions?
• Is voluntary sterilization similar to self-mutilation and is it thus an impediment to ordination in accordance with canon 1 of the Council of Nicaea?

On the first question, it seems to me that if one is faithful to one’s spouse, that is to say, sexual promiscuity is not an existing problem, and the same one is observant of the fasting periods of the Church or similar practice, then this is already a good foundation for practicing self-control; sterilization neither adds to nor detracts from this practice. To propose, for example, that male sterilization leads to extra-marital affairs and promiscuity would be equivalent to proposing that hormonal contraception (“the pill”) would lead a good and virtuous Christian wife to cheat on her husband. If unfaithfulness and extra-marital promiscuity are a real problem between Christian spouses, then the roots of such behavior may lie quite outside any discussion of birth-control methods within a healthy marriage.

On the second question, it seems to me that the spirit of the canon has more to do with sexual desire than mutilation of the human body. The first canon of the Council of Nicaea echoes the relevant canons of the Apostolic Council of A.D. 49 (51). According to canon 21, for example, one who has lost his “virile parts” by force or lacked them from birth “may, if he is worthy, become a bishop.” Thus, mutilation as such is neither a spiritual problem nor an impediment to ordination. Canons 22, 23 and 24, on the other hand, provide strict penalties for anyone who purposefully mutilates himself. The Rudder commentary for canon 22 reads as follows:

Whoever willfully eunuchizes himself when in sound condition, whether he do so with his own hands or has someone else eunuchize him, let him not be made a clergyman, since he himself is a murderer of himself by himself, and is an enemy of God’s creation. For God created him a man complete with genitals, but, by removing these, he converts himself into an odd and outlandish nature; since he is neither a man, because he cannot perform the chief functions of a man and beget a human being like himself, nor, again, is he a woman, because he is incapable of undergoing the duties of women, or, more explicitly speaking, he cannot be made pregnant and give birth to children like women, but after a certain fashion he is a third kind of monster, and is, so to speak, a being intermediate between the male and the female species of mankind…

Clearly, the argumentation in this commentary does not apply to vasectomy or tubal ligation, since in both cases one’s genitals remain intact and one does not become “an odd and outlandish creature.” The question of begetting a human life is also inapplicable in our course of inquiry, since we are specifically discussing sterilization only after a couple has given birth to the desired number of children–not sterilization outside of marriage or with the explicit purpose of avoiding conceiving any children. Furthermore, a woman who can no longer bear children due to her age or a man who suffers from erectile dysfunction are still a woman and a man and not “a third kind of monster” merely because they cannot procreate. In other words, Church canons that deal with self-castration or self-emasculation cannot be seen as applicable to vasectomy or tubal ligation in a direct way. Thus, modern sterilization may still be considered as a sure way to avoid conception and interception and the ethical ambiguity associated with the latter. Sterilization within a committed and faithful marital relationship which has already been blessed with a good number of “fair children”^[30] completely prevents fertilization and fully avoids any loss of human life, and provides a long-term alternative to the use of hormonal therapy or implants. Pastoral implications of approving or, especially, recommending sterilization to an Orthodox Christian couple need to be explored further by relevant experts and authorities of whom I am neither.

The same can be said for abstinence.^[31] Generally speaking, there are two kinds of abstinence:

1) Complete abstinence (the so-called “brother-and-sister model”)

2) Periodic abstinence (fertility awareness)

Periodic abstinence, or fertility awareness, currently has a failure rate of 24%.^[32] Due to this high failure rate, fertility awareness may best be used as a birth-rate management technique, rather than contraception. That is to say, if the couple wishes to have only 3-4 children in 15 years instead of 8 or 10, then this is an acceptable method to “slow down production,” so to speak. Periodic abstinence, however, is not without its shortcomings. Especially for a young couple, turning intimacy into mathematical calculations, compounded by the lengthy fasts of the Church (if they are to be fully observed), may produce tension and temptation, putting stress on a young and developing marriage. The Apostle Paul noted that periods of abstinence must be “by agreement for a season… lest Satan tempt you…” (1 Cor. 7:5). Saint John Chrysostom contends that abstinence without mutual consent (and in the case of fertility awareness, abstinence is always imposed upon the couple by physiological factors, rather than truly consented to for spiritual reasons) may lead to fornication or “though abstaining from fornication [a man will] fret and grow restless and be heated and quarrel and give all kind of trouble to his wife.”^[33]

Many of the same temptations would naturally plague couples that practice complete abstinence, if the latter were to be promoted as some sort of a norm or virtue to which one should aspire, rather than a rare and unique calling. Complete abstinence, or the “brother-and-sister” model, can be characterized by a couple’s decision to completely avoid intimacy. While this technique is 100% effective as contraception, it can hardly be recommended as a norm for most married couples.

Hagiographies of some saints mentions a curious virtue—a husband and wife living like brother and sister.^[34] It is mentioned, for example, that Martyr Conon of Isauria convinced his bride to remain a virgin, and after their wedding the couple lived as brother and sister. Saint John of Kronstadt and his wife also lived as brother and sister from the day they were married.  These cases are extremely rare in the history of the Church, yet they are presented as a high virtue.  But is this really a virtue, and should all Christian couples aspire to it? I think not, but it may make some sense in certain circumstances. Saint Conan’s marriage, for example, was forced; neither he nor his bride-to-be wanted to get married. The situation with Saint John of Kronstadt is less clear. Apparently, he married his wife not because he was attracted to her or wanted to be married at all, but because he wanted to serve in the cathedral where the young woman’s father was the rector. In some way he was marrying a parish, not a woman.  So, he also, like Conon, asked his young wife to remain a virgin.  She seems to have agreed initially—it takes two to tango, and if her husband was not interested, what could she do? But later, this became a source of much sorrow for her. Saint John’s wife is not a canonized saint, whilst he is. So, I dare not say too much more than this about their arrangement and will let a pious reader to draw his or her own conclusions.

These and other very rare instances aside, it seems to make no sense at all to decide to get married only to live as brother and sister. First, if one has a calling to strict asceticism, why get married at all? Why not simply remain unmarried or even enter into a monastery?[35] If creating a “happy family,” as Saint John of Kronstadt put it, is not the goal, why go down that path at all? Unlike ancient Jews, Christians are not under the same socio-religious pressure to be married and have children. Taking upon oneself vows of celibacy, poverty, obedience and devoting one’s life fully to the service of God is an honorable and laudable way of life which can be practiced by anyone called to it. But why force this upon another human being by binding together in holy matrimony? And what if both groom and bride want to remain celibate?—they may be a good match indeed, but it still may be an approach to the sacrament that seems to reject an essential part of that sacrament. Just imagine that two people decide to prepare a feast, a banquet, and they do so, and set a table, and they say to each other, “Let us sit here, and look at all this food, and not touch any of it.” And so they just sit there, not eating, and the food gets stale and old, and then the hungry people die, and both they and their food rot and turn to dust… This would be an odd story to say the least. The story would be even more strange if not altogether cruel if one person invited another for a banquet, prepared a festal meal, but when the dear guest came, the host insisted they just sit there staring at the laden table and not touch any of the food. To be sure, Orthodoxy has plenty of room for asceticism—both in marriage and in the unmarried state—but the Church has never insisted that her children stop eating all food from the day they are baptized and starve themselves to death. There are times for fasting, but there are also times when fasting is prohibited by the canons of the Church. I believe that it is the same with sex: there are times and circumstances when one must abstain, but at other times abstinence undermines the whole idea of marriage. There is a reason why hagiographers use the phrase “lived like brother and sister”—if one withholds the most intimate and vulnerable from another, if some things are not shared in full, then the two are not the icon of Christ and His Church, they do not partake of the sacrament of the two becoming one flesh, but are merely a brother and a sister. Saint John’s diaries reveal this very aspect of his relationship with his “sister”:

Father John’s diaries … show that he had little sense of himself as a partner in any kind of marriage or personal relation save that which he had with God; his conception of the religious life was essentially solitary. … He sought first to turn his relations with his wife into a detached moral lesson or admonition to all married men…[36]

The practice of living without physical intimacy seems to be a reflection of a theme which is repeated often enough in Orthodoxy with respect to monastics, especially the holy ones, whose lives, it is said, are equal to those of angels (равноангельное житие). What is usually meant by this term is the rejection of the flesh in favor of the spirit. This can best be understood, perhaps, within the context of the dualism which the Greek Fathers may have taken from Platonism, with its rejection of the material in favor of the ideal. Saint Gregory of Nyssa, for example, “held that sexuality did not exist in Paradise and that the restoration of this angelic life is the goal of theosis.” Likewise, Saint John Chrysostom wrote that “the consummation of … intercourse occurred after the fall; up till that time they [Adam and Eve] were living like angels in Paradise…” Similar thoughts abound in the writings of holy monastics.

Whether one chooses to accept the argument that at least some Greek Fathers were influenced by some ideas of dualism in their approach to the relationship between the spirit and the flesh[37] or not is of little importance to our discussion here. An alternative view could be based on the fact that celibacy and especially chastity of thought and action constitutes a constant struggle against one’s natural physiological and psychological desires and inclinations. Thus, remarks that sexual relations are sinful and a result of the original sin may be less dogmatic and more self-therapeutic for men who are attempting to maintain a commitment to celibacy. Likewise, advice from an elder to a novice monk to never look at women is understandably pastoral and aimed at preventing a certain kind of day- and night-dreams, rather than constitutes a dogmatic exposition on Matthew 5:28. Indeed, a young monk would do well to guard his senses against even the sight of women, lest his imagination be impressed and tempted, and his delicate self-control balance be upset. Likewise, in order to pastorally support his choice of a monastic vocation and strengthen his resolve to keep himself chaste for the rest of his life, it may be wise to impress upon him the idea that sex, even in marriage, is a result of our corrupted state and should be rejected in favor of an angel-like state. How much of such admonitions should be understood as dogmatic, rather than pastoral, is entirely unclear. It is with these factors in mind that we must interpret the monastic Fathers’ descriptions of what life was like in Paradise and their admonition concerning intimacy.

There is very little that we know for sure of life in Paradise; and that which we do learn from the Scripture may be best understood in ways other than literal. We may postulate, for example, that humans before the fall were not subject to any passions, and, sustained by the breath of God, they had no physical needs, such as hunger or the need for rest or sleep. But must we necessarily assume that they were fundamentally different beings? In other words, must we assume that they had no digestive system, since they did not need to eat, and that the digestive system somehow “evolved” in response to the fall? Similarly, must we assume that they had no genitals at all, since they did not have any desire to use them in Paradise?^[38] Of course, it is our Christian belief that the nature we have now is broken and corrupted by sin, and that it was unbroken, uncorrupted and perfect when God first created man. But must we assume that Adam and Eve were to procreate in Paradise in a way that is fundamentally different from ours—such as telepathy or some other such means? It seems to me that it is easier to accept that humans were not to procreate at all, and that all the tens of billions of humans that have been born after the fall are the result of the fall and were never meant to be, than to accept that human nature as we know it now is an entirely different creation and in no way whatsoever resembles God’s original handiwork. The view of many monastic Fathers, however, appears to follow the old Greek saying “soma sema,” and the idea that “the soul is suffering the punishment of sin, and that the body is an enclosure or prison in which the soul is incarcerated”[39] seems to be a presupposition in many monastic writings on human sexuality.

Dualism—whether dogmatic or incidental—with its belief that the body is separate from the soul and to be discarded when the soul is finally freed and “flies away in the mornin’,” does not necessarily adequately reflect biblical anthropology. It seems to offer an adequate enough framework when the body is narrowly understood to mean the very corruption or sin that afflicts us. But as soon as we use it to mean our afflicted nature, as opposed to the affliction itself, we run into problems that cannot be reconciled unless we reject overt dualism for the biblical notion of wholesomeness. To illustrate this, think of a common cold with a runny nose. It would be proper to say that the illness is not part of human nature, and that it is to be rejected, and that there was no illness in Paradise, and there will not be illness in heaven. But it would be strange to extend this logic to argue that there were no noses in Paradise, and that there will not be noses in the kingdom of God. In my opinion, it would be much more reasonable to assume that there will still be noses, but that they will not be runny—that is to say, our nature will be whole, not afflicted by illness or corruption.

Not to dare comment on the aspirations of some to be angel-like—may it not be!—it is my understanding that humans were never meant to be angels in the literal sense—neither before the fall nor after the general resurrection. We were made different from angels from the very beginning. If we assume that angels have a simple nature which lacks a material body and exists only in some spiritual form (an assumption that was challenged in the Middle Ages, but it is not our task here to figure out how many angels can dance on the head of a pin—a symbolic mathematical point), then we have to also realize that humans are fundamentally different from angels—not in a matter of scale or degree, but in our very essence. When creating the first human, God did not make a ghost or a spirit which then somehow became imprisoned in a tomb of physical matter as a punishment for sin. Rather, He made a body out of matter—adamah. We are probably to understand this not as flesh—meat, bones, fat, hair, etc.—but as the totality of human nature in all its complexity. In other words, God created not a corpse but a man. He then breathed into the nostrils of the man the breath of life. This, of course, proves that God created man with a nose! On a more serious note, we see that God created the totality or wholesomeness of human nature into which He breathed His spirit, and His continuous breath is what gives us existence: “When you hide your face, they are dismayed; when you take away their breath, they die and return to their dust. When you send forth your spirit, they are created; and you renew the face of the ground” (Ps. 104:29-30).

Further support for the material nature of man comes from the foundational Christian beliefs in the incarnation of Christ and the resurrection of the body. To save man, Christ became incarnate, not inspirited. We can think of it in terms of Christ’s taking into Himself various parts separately—such as a physical body, a rational mind, a will, etc.—or we can think of the incarnation as Christ’s taking into Himself the entirety or wholeness of human nature. And what was resurrected was not the soul, or the flesh, or the mind, or the will, but rather the wholeness and wholesomeness of human nature in Christ. An “Orthodox doctrine of marriage must be built not on the angelic life of Paradise, but on the importance of the Incarnation for Christian life.” We understand that matter as we know it now is ill, and that Christ’s resurrected body was not the same as our corrupt bodies. But there is certainly no reason to assume that He had no body at all and instead was a spirit or a ghost. In fact, Christ seemed to have made a special point of showing to the apostles that He was neither a shadow nor a ghost, but that His body was real:

Then he said to Thomas, “Put your finger here and see my hands. Reach out your hand and put it in my side. Do not doubt but believe.” – John 20:27

They were startled and terrified, and thought that they were seeing a ghost. He said to them, “Why are you frightened, and why do doubts arise in your hearts? Look at my hands and my feet; see that it is I myself. Touch me and see; for a ghost does not have flesh and bones as you see that I have.”    And when he had said this, he showed them his hands and his feet. While in their joy they were disbelieving and still wondering, he said to them, “Have you anything here to eat?” They gave him a piece of broiled fish, and he took it and ate in their presence. – Luke 24:37-43

The Scripture does not give us any reason to suspect that Christ in His resurrected state ate in some way which was unrecognizable by His disciples. Presumably, He ate in the same manner as we do—by placing morsels of food into His mouth before chewing and swallowing. To be sure, He did not need to eat; His resurrected body no longer needed the nourishment of the flesh of fish. But His resurrected nature—the whole and wholesome human nature—through the act of eating, can be recognized precisely as human nature as we know it and in which we share, not as some alien life form.

Ultimately, however, it hardly makes a difference whether Adam and Eve could enjoy the intimacy of their union before the fall, or whether people will be able to hug or kiss each other in the life to come. We can imagine that our resurrected state will be unrecognizably different from our current state. Perhaps, there will be no tears in the kingdom of God, but in our current state we can produce tears, and Christ Himself cried. Perhaps we will not have any need for food, and we may not even have a digestive system, but here and now we do, and Christ Himself ate, and He chose to give us His Body and Blood through the act of eating. Perhaps we will communicate through some means other than by creating airwaves with our vocal cords and mouths to be heard by eardrums, and perhaps we will no longer have mouths (since they will not be needed for either eating or speaking) or ears; but during Christ’s earthly ministry He spoke words to people in a human language, and those who had ears to hear heard His words. Perhaps our resurrected flesh will never become tired, but here we require rest, and Christ rested and slept. Perhaps in the kingdom of heaven no one will marry or be given in marriage, but here we do, and it is our belief that Christ blesses every marriage just as He blessed the marriage in Cana of Galilee. He did not turn their wine into water and tell them to live as brother and sister, but rather He turned their water into wine and blessed their marriage.

Complete abstinence from spousal intimacy may have made sense in the lives of Martyr Conon and Saint John of Kronstadt: both did not want to be married, but both were forced into marriage in various ways, and so both decided to remain celibate and serve the Church rather than take care of children and family. But these are exceptions and not the rule, not the canon, not the standard to which all must aspire. In the wedding prayers, the Church does not pray, “May you never touch one another, may you sleep in separate beds in separate rooms, may you live as brother and sister or a schema-monk and a schema-nun!” On the contrary, the Church prays, “May you see your children’s children. Peace upon Israel!” Thus, in stark contrast to the ascetic Fathers who assert that sex in marriage is sinful—just “not too sinful”[40]—the Church blesses sex (for this is the only means by which one may see one’s children’s children) as part of a sacrament, right in the middle of the sanctuary, before holy icons, the holy altar, and by the hand of holy priesthood.

So, perhaps sex should be excused only for the specific and limited purpose of procreation? That is to say, if conception of a child is not the immediate and exclusive purpose of a specific sexual encounter between a husband and wife, then they must abstain? There are three main problems with this thinking. First, this once again presents sex as a sin, which becomes slightly less of a sin if a child is conceived (or, at least, is intended to be conceived). If this is the case, then no man in his right mind should ever have sex. Sure, a man may want to have a child, but the very act of conceiving one will surely put his soul in danger of eternal damnation! A “lesser” sin is still a sin nonetheless—as punishment, one just might get fried on medium heat instead of high heat. Even if we reject the simplistic images of getting fried and simply admit the obvious, we do not have any idea how there can be a “lesser” sin or what it means for us, then we should still not risk it. The earthly joy of raising a baby, who—no one knows—may grow up to be a big disappointment to his or her parents, or even worse, is surely not worth the risk of losing the eternal joy of life with the Lord. If sex is inherently sinful, and only less so if a child is conceived, then no one should have sex or children at all (and thus, all Christians would die out within the next one hundred years).

Second, why would conceiving a child offer any mitigation to the supposed sin of having sex? Is it because raising a child is so difficult and often full of pain that the parents are paying for their sin by having to deal with its fruit? This could be the only possible explanation, since we are under no obligation to have children in the first place. Sure, our government may want more workers and consumers, and even the Church may want more tithers, but there is certainly no salvific benefit to having children (at least, not for men). People who have children can be saved just as those who do not have them. In fact, monastics are convinced that it is easier to be saved without children, and that is why they do not have them. (For if they thought that the path to salvation was easier with children, they would surely follow that path instead!) And so, if having children is neither a spiritual virtue, nor a spiritual necessity but merely an economic benefit to the government or some other similar consideration, the Church should stop blessing marriages, since the married state puts people in danger of committing the sin of having sex (which is only partly excused if a child is conceived), and instead promote the salvific qualities of a solitary state (it is safer that way). In this twisted logic, the common refrain that children are a blessing from God means that they are a blessing because that particular time when their parents had sex can be partially excused, while all the other times cannot. Obviously, this way of thinking is bizarre at best and insane at worst. As William Zion so aptly noted:

It is … wrong to regard eros as primarily nature’s way of achieving reproduction of the species. This would make openness to procreation the criterion for right or wrong use of the sexual organs. A morality devised by celibates on the basis of biological teleology simply will not do. Such a simplistic approach ignores the lived experience of love. Those who know love also know that the structures imposed on them in the name of biological teleology (as natural law) are false to their experience.

Moreover, the kind of morbid attitude toward human sexuality espoused by celibates, while understandable from a pastoral and psychological perspectives, is not supported by the Scripture. The Apostle Peter, for example, is not condemned by Jesus for having a mother-in-law (that is to say, Peter was married and had absolutely no reason whatsoever that we can think of to not have had sex with his wife), and is not considered to be less of a saint than the Apostle Paul. It is true that Paul wrote to the Corinthians, “It is well for a man not to touch a woman,” and it appears that he himself followed this advice. Despite the seeming clarity of this passage, we may do well to consider some issues surrounding it that are less than clear. First, Paul was “circumcised on the eighth day, a member of the people of Israel, of the tribe of Benjamin, a Hebrew born of Hebrews; as to the law, a Pharisee.” Ancient Jews are not known for valuing virginity. In fact, it was their religious duty to produce children, one of whom was to become the Messiah. Paul’s conversion on the road to Damascus happened when he was around thirty years of age. Compare this to the calculations that King “Joiakin married at sixteen, Amon and Josias at fourteen [and] in later day the Rabbis fixed the minimum age for marriage at twelve years for girls and thirteen for boys.” Even though we may assume that the usual age at which young men married was somewhat higher than the minimum legal age, it is nonetheless rather curious that Paul, a religious zealot that he was, had not married by the age of thirty to try to produce offspring for the tribe of Israel. Perhaps, before we can fully understand Paul’s words about marriage, we must consider the context of his personal life and perhaps unique spiritual struggles.^[41]

Second, Christians at the time of Paul’s ministry lived in expectation of an immediate parousia.^[42] Consider the following, for example:

With regard to the question about people who have never married, I have no command from the Lord, but I give my opinion as one shown mercy by the Lord to be trustworthy. Because of the impending crisis I think it best for you to remain as you are. The one bound to a wife should not seek divorce. The one released from a wife should not seek marriage. But if you marry, you have not sinned. And if a virgin marries, she has not sinned. But those who marry will face difficult circumstances, and I am trying to spare you such problems. – 1 Cor. 7:25-28

If one expects Christ to come again within the next few days, many ordinary things no longer make any sense: marriage, children, career, even planting an orchard—all these are too long-term if one does not expect the world as we know it to last that long. We will never know whether Paul’s admonition to the Corinthians would have been moderated in some way had he known that Christ would tarry for at least two thousand years. “Don’t touch women” and “be single” would not have been prudent strategies to encourage if the Church of Corinth were to survive that long.

Finally, the idea that sex can only be excused and considered “not too sinful” when it is done exclusively and specifically for the purpose of conceiving a child demeans the sacrament of marriage, the sacrament of two becoming one flesh, the icon of Christ and His Church, and reduces it to some childbearing machine, a baby factory, in which sex is merely a means of production. It is like saying that the only purpose of ingesting foodstuffs is to give nourishment to the muscles. While this may sound good enough at first, if that were the case, I ought to never eat any white bread or drink any red wine. While the latter may offer some antioxidants whose benefits are dubious at best, since no matter how much wine a man drinks he dies nonetheless (and often the more he drinks the sooner he dies), white bread certainly offers no tangible health benefits. Even monastics use food and drink to make their hearts merry on feast days, and Christ chooses to impart to us the fullness of His divinity through bread and wine of the Eucharist, apparently without any regard to their nutritional value. Why dare I speak about Communion in this context? Because the union between man and wife—not brother and sister!—is the icon of Christ and His Church. It is a sacrament, not unlike Communion.

Of course, it is not sexual intercourse that constitutes a sacrament. But it is decisively sexual intercourse that makes a relationship between a man and woman a marriage. Mary and Joseph lived in the same house, traveled together, even raised a Child together—and none of that made them married, because they lacked that one essential “ingredient” that changes the relationship from that of brother and sister to one of husband and wife. In fact, the Apostle Paul seems to equate sexual intercourse directly with the sacramental aspects of marriage even when no other characteristics of marriage are present: “Do you not know that whoever is united to a prostitute becomes one body with her? For it is said, ‘The two shall be one flesh.’” Clearly, Paul does not have in mind any aspect of a marriage—love, care, sharing of burdens, raising of children, etc.—except and exclusively sexual intercourse. And in this passage, he chooses to apply the words that are foundational to the institute of marriage precisely to sexual intercourse—even with a prostitute. Finally, at least in Western Christianity, a marriage is not considered complete until it has been consummated (the very word ‘consummated’ means ‘completed’). A marriage which has not been consummated is not considered to be a binding contract and can be annulled even in the Roman Catholic Church. I certainly do not want to introduce some new concept of sacred sexuality or ritual intercourse, but I also do not believe that a husband and wife must feel guilty and ashamed or calculate whether or not a child might potentially be conceived every time they celebrate the fullness of their union. To conclude with the words of Metropolitan Hilarion (Alfeev):

There are two misunderstandings about marriage which should be rejected in Orthodox dogmatic theology. One is that marriage exists for the sole purpose of procreation. What, then, is the meaning of marriage for those couples who have no children? Are they advised to divorce and remarry? Even in the case of those who have children: are they actually supposed to have relations once a year for the sole purpose of ‘procreation’? This has never been a teaching of the Church. … Another misunderstanding about marriage is that it should be regarded as a ‘concession’ to human ‘infirmity’: it is better to be married than to commit adultery (this understanding is based on a wrong interpretation of 1 Cor. 7:2-9). Some early Christian sectarian movements (such as Montanism and Manicheanism) held the view that sexuality in general is something that is unclean and evil, while virginity is the only proper state for Christians. The Orthodox tradition opposed this distortion of Christian asceticism and morality very strongly. In the Orthodox Church, there is no understanding of sexual union as something unclean or unholy.

The argument that sexuality in marriage has only the purpose of breeding degrades a human being, an image of God Himself, to the state of a dog or an even lower animal. This is completely contrary to Christian anthropology. Furthermore, to propose that marriage is blessed exclusively for the purpose of raising children devalues the sacrament and degrades it to the role of ecclesiastically-sanctioned child care. In such a worldview, any union of the spouses–the union of the souls, bodies, spirits, minds–is completely devalued in the absence of reproduction, and the sacrament of marriage completely loses its meaning in cases when reproduction is impossible for any reason. This, however, is not the worldview or the teaching of the Church. The Apostle Paul for example, in his famous exhortation to Christian spouses, talks about love, respect, the sacrament of two becoming one flesh as an icon of Christ and the Church, but not a word about breeding or multiplying (see Eph. 5:21-33). And if we consider this sacrament as fulfilled within Christ Himself (for surely, all sacraments find their fulfillment in Christ), He and humanity did actually become one flesh in His incarnation. Thus, seeing marriage and human sexuality as being exclusively or even primarily a baby factory is in some way a profanation of the sacrament of Christ’s incarnation.

Just as food fasts and feasts have less to do with nutrition for the flesh than they do with spirituality, community, and family; in much the same way, the intimacy of a married couple is not purely a reproductive function, but an instrument as well as an expression of love, bonding, trust, and commitment. And this may be obvious to most. People who engage in sexual behavior, rarely say to each other: “I want to reproduce with you” or “I want to breed you.” It seems to me, they much more frequently say: “I love you.” Harakas, for example, correctly states that sexual union expresses “the mutual love of spouses.”^[43] Even monks who occasionally fall and fornicate–examples of which abound in hagiographies and paterikons–are not consumed by a desire to produce babies, or to pass on their genetic material,^[44] but by very different desires and passions.

If we accept the idea that sexual intercourse between husband and wife does not always have to have the explicit purpose of producing offspring–a position that has not necessarily been proven in this paper, but hopefully outlined with some degree of clarity–then some forms of contraception may be found morally acceptable within the context of an otherwise-healthy family. And it appears that the only method which currently is truly and always contraceptive and does not raise any ethical problems with respect to the possible destruction of human life is sterilization. It is, certainly, premature to bestow official ecclesiastical blessings on sterilization as much more ethical and theological work needs to be done, but it may be good to continue the discussion of whether this is a long-term solution that is ethically preferable to hormonal therapy, for example, and is safer than artificially manipulating a woman’s hormones for years or even decades. In fact, the morality of promoting long-term hormonal therapy as an acceptable method of contraception for a Christian couple may be challenged by the side-effects that range from breakthrough bleeding, to increased risks of venous thromboembolism, breast cancer, and, possibly, depression.

It may also be worthwhile to engage in the ethical evaluation of contemporary scientific research in the area of contraception. The Church may choose to make it clear that the development of true contraceptive methods is preferable to the development of interceptive techniques, and that it is important for us to determine whether hormonal therapy and modern implants are always and strictly contraceptive, or whether there is a certain percentage of interception that occurs.

In the context of this discussion, it may be necessary for relevant ecclesiastical institutions and Orthodox theologians and ethicists to consider the following three tasks:

• Develop a coherent position with respect to the concept of a human life and the unimplanted embryo within this concept. This work must specifically consider cases of interception, when fertilization occurs but implantation is prevented.
• Develop a coherent position on voluntary sterilization for a married couple that has had the desired number of children. In conjunction with this work, it would be prudent to consider the appropriate number of children that a Christian couple may have or to acknowledge that giving birth to ten children is no more virtuous than raising three. Certainly, those who wish to have many children should be celebrated and supported, but should they be encouraged to do so in cases, for example, when they must heavily rely on government assistance in order to feed them? On the other hand, those who choose to have only one child may be able to provide for him or her, but should financial considerations be taken to this extreme?
• Develop a coherent position on interceptives and on scientific research on true contraceptives. If true contraception is of value to our faithful, and if interception is morally problematic, it may be good to develop a position which can be presented to both the medical community and to the faithful and the clergy. The current methods of birth control are not new: the IUD was developed more than a century ago and hormonal therapy has been around for more than sixty years. The only relatively recent developments have been in the area of chemically-induced abortion. Perhaps, a clear Orthodox position on the direction in which science should move would be helpful.

Why is this work necessary? Because most Orthodox families in the United States today are not riding in small busses with 10, 15, or more children. And if I were to guess (and this is purely a guess), most couples who do not have 10 or 15 children are not living as brother and sister either. Furthermore, we do not see too many married priests or deacons with 10 or 15 children. This indicates that most of our married clergy and parishioners do in fact use some form of birth control, which makes work at clarifying the position of the Church on birth control very relevant.

One option which I have barely mentioned in this paper on contraception is not using any at all and having as many children as is physiologically possible. In the wedding prayers, the Church certainly encourages couples to have many children. There exists a pious tradition of trusting God to give as many children as He will. This tradition can be expressed by the phrase “the Lord openeth the womb, and the Lord closeth the womb.” In other words, a young couple is encouraged to live a normal sexual life of husband and wife and trust that God has a plan for how many children He would give them. No matter what the couple does, they will have no more children than the Lord gives, and no fewer.

First, the position of “trusting God” seems to lack (or chooses to disregard) a basic understanding of human physiology. It appears that for most young healthy couples, the more sex they have, the more children the Lord “wishes” to give to them, and the less sex they have, the fewer. In other words, the Lord’s will can be easily manipulated simply by changing the frequency of a couple’s sex life. Obviously, this is a strange proposition which makes no good sense to anyone who is seeking to determine the true will of God for their family. The situation becomes even more confusing when we take into account that the Church appears to regard having many children as well as being abstinent in marriage (and thus, having few or no children) as Christian virtues.

Second, the Lord seems to open wombs in the most unfortunate of situations. Humbly noting that His ways are not our ways, and it is not up to us to question His will, it is difficult to understand why the Lord would open the womb of an underage girl who was raped. Or was the rape also part of God’s will? And why would the Lord not close the womb of a victim of incest? And most curiously, why would the Lord choose to allow fertilization completely outside of a womb (IVF), knowing very well that most of the fertilized eggs—approximately 9 out of every 10—would never see the inside of any womb at all?

Another twist on the open/close scenario is something that I witnessed in my own parish. A young couple was unable to conceive for several years. All tests showed that both the husband and wife were healthy. Then the doctors decided to take the husband’s sperm, put it in a syringe-type contraption, and inject it deep into the wife. This worked, and a child was conceived. Now they have a beautiful baby girl. Must we think that the couple was unable to conceive because the Lord closed the wife’s womb? And must we then conclude that the medical procedure was pleasing to the Lord because He clearly opened the womb at that time? Or must we assume that the couple has angered God by stepping outside of His will? And would that be possible? Syringe or not, God could have kept the womb closed if He so willed.

Clearly, we have a choice to either ascribe some very bizarre behavior to God, or to admit that things in human reproduction must be a lot more complicated than the formula “the Lord openeth the womb, and the Lord closeth the womb.”

Furthermore, it is still an open question whether the Church should promote having as many children as humanly possible as a Christian virtue, and thus implying that 1-4 in a lifetime is falling short of that virtue. Just as is the case with contraception, there are ethical consequences of promoting a 10-child minimum as a God-pleasing Orthodox standard and placing implied or explicit ecclesiastical guilt and a label of spiritual weakness or a threat of displeasing God by not following His will on those couples who choose to have fewer. Even the Pontiff of the Roman Church which is completely opposed to any form of birth control except abstinence, now speaks of responsible parenthood and no need to breed “like rabbits in order to be good Catholics.”^[45] The Orthodox Church made no clear official pronouncements on the matter.^[46] However, simply avoiding the issue and not having (or not voicing) a position does not mean that God’s will is somehow automatically done. Most often, if the Church fails to provide guidance, the void is quickly filled with other sources of guidance. If the faithful do not have the position of the Church to consider, they will have other considerations: social, financial, cultural, selfish, etc.

It is imperative that Orthodox theologians grapple with issues which are uncomfortable, difficult, and therefore the least explored. Covering ourselves in fig leaves of false modesty and leaving the faithful to fend for themselves in a rapidly-changing and uncertain world is simply irresponsible. The true task of a modern theologian, it seems to me, is not to summarize ancient ascetic writings on how to be saved in the desert–a path so rare that only a few from among the monastics follow it–but how to be saved in this world, in this country, at this time. This paper does not pretend to provide any answers, but it is my sincere hope that it has managed to raise a few questions. My musings expressed here on electronic paper do not represent opinions of the Church or of her official theologians and should not be treated as such. But years of pastoral work make me believe that whether the Church intrudes upon spousal intimacy of the faithful–something it has clearly done in the past–or chooses to be silent on the matter, the ethical and theological questions surrounding conception and contraception continue to present a challenge for many Orthodox Christians, and thus further discussion of these topics is very much warranted.

^[1] The earliest Egyptian mentions of birth control come from approximately the same time period (Ebers Papyrus 1550 B.C. and Kahun Papyrus 1850 B.C.) and included sticky substances with spermatocidal qualities–see Lipsey, Richard G.; Carlaw, Kenneth; Bekar, Clifford. “Historical Record on the Control of Family Size”. Economic Transformations: General Purpose Technologies and Long-Term Economic Growth. Oxford University Press, 2005, pp. 335–40.

^[2] For a more detailed discussion of historical attitudes toward oral and anal sex within an Orthodox marriage, see Sveshnikov, Sergei. There Is No Sex in the Church!: On the Problematics of Sexuality and Gender in Orthodoxy, 2013.

^[3] Sveshnikov, ibid.

^[4] Breck, John. The Sacred Gift of Life: Orthodox Christianity and Bioethics. Crestwood: SVSP, 1998, 90.

^[5] Synodal Affirmations on Marriage, Family, Sexuality, and the Sanctity of Life. July, 1992.

^[6] https://mospat.ru/en/documents/social-concepts/

^[7] Interceptive methods do not prevent fertilization, but prevent the implantation of a fertilized egg in the uterus.

^[8] Contragestive methods expel an already-implanted embryo, thus causing a chemically-induced abortion.

^[9] Gemzell-Danielsson K, Marions L (2004). “Mechanisms of action of mifepristone and levonorgestrel when used for emergency contraception”. Hum. Reprod. Update 10 (4): 341-8.

^[10] Methotrexate is used predominantly for chemotherapy of cancer.

^[11] Hormonal therapy and modern IUDs are also non-abortifacient and will be discussed separately.

^[12] Low-dose progestogen may also act as in interceptive by the thinning and atrophy of the endometrium (Glasier, Anna (2010). “Contraception”. In Jameson, J. Larry; De Groot, Leslie J.Endocrinology (6th ed.). Philadelphia: Saunders Elsevier. pp. 2417-2427).

^[13] Steven G. Gabbe, ed. Obstetrics : normal and problem pregnancies (6th ed. ed.). Philadelphia: Elsevier/Saunders. p. 528.

^[14] Trussell, James; Schwarz, Eleanor Bimla (2011). “Emergency contraception”. In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 113-145.

^[15] RCOG Faculty of Sexual & Reproductive Healthcare, Clinical Effectiveness Unit (January 2012). Clinical guidance: emergency contraception. London: Royal College of Obstetricians and Gynaecologists.

^[16] J Med Ethics doi:10.1136/medethics-2011-100411, published in JME on March 2, 2012, and online on 29 December 2014: http://jme.bmj.com/content/early/2012/03/01/medethics-2011-100411.full

^[17] ibid.

^[18] Philosophy & Public Affairs 2 (Fall 1972) pp. 37-65 (c) 1972 Princeton University Press

^[19] New York Times. November 2, 1997

^[20] This information was graciously provided by Dr. Nadeszda Kizenko of SUNY Albany.

^[21] See Laura Engelstein, “Abortion and the Civic Order: The Legal and Medical Debates” in Barbara Evans Clements et al. eds., Russia’s Women: Accommodation, Resistance, Transformation. Berkeley:  University of California Press, 1991, 205.

^[22] Interspecies hybrids are outside the scope of this presentation as they are outside of most human reproductive experience.

^[23] Jones RK and Jerman J, “Abortion incidence and service availability in the United States,” 2011, Perspectives on Sexual and Reproductive Health, 2014, 46(1):3-14.

^[24] Oritz ME, Croxatto HB (2007). “Copper-T intrauterine device and levonorgestrel intrauterine system: biological bases of their mechanism of action”. Contraception 75 (6 Suppl): S16–S30.

^[25] Stanford JB, Mikolajczyk RT. “Mechanisms of action of intrauterine devices: update and estimation of postfertilization effects.” Am J Obstet Gynecol 2002; 187: 1699–1708

^[26] Trussell, James (2011). “Contraceptive efficacy”. In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.).Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863.

^[27] Williams RJ, Johnson AC, Smith JJ, Kanda R; Johnson; Smith; Kanda (2003). “Steroid estrogens profiles along river stretches arising from sewage treatment works discharges”. Environ Sci Technol 37 (9): 1744–50.

^[28] The CDC. <http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm&gt;

^[29] Here, I speak only of sterilization within a lawful marriage and only after the couple has had a desired number of children.

^[30] From the Orthodox wedding service.

^[31] Here, I speak only of abstinence within a lawful marriage and only after the couple has had a desired number of children or made a firm decision not to have any and to live as brother and sister.

^[32] The CDC, ibid.

^[33] Hom. 19:3

^[34] Most of this section is from Sveshnikov, Sergei. There Is No Sex in the Church!: On the Problematics of Sexuality and Gender in Orthodoxy (2013)

[35] It must be pointed out that in the past, being paired up with a man may have offered a woman a certain degree of protection, social status, etc., but this is arguably no longer the case, and a modern woman called to celibacy can easily remain unmarried and self-sufficient in the world if she does not wish to be married and does not have a monastic calling.

[36] Kizenko, N. A Prodigal Saint: Father John of Kronstadt and the Russian People (2000)

[37] The very division of human nature into separate components—spirit and flesh—is, perhaps, a good definition of dualism.

^[38] Genesis is quite clear about there having been a male and female originally created by God (1:27, 5:2). It is clear to most what differentiates a male from a female in the most immediate sense. It appears, therefore, that from the very beginning, that which differentiates a male from a female was present in human nature, even before the fall.

[39] Socrates in Plato’s Cratylus.

[40] For context and sources of this and other references, see Sveshnikov There Is No Sex in the Church (2013)

^[41] For further discussion on this topic, see Adams, Jay E. Marriage, Divorce, and Remarriage in the Bible, Zondervan, 1986.

^[42] For further discussion, see Rubio, Julie Hanlon. A Christian Theology of Marriage and Family. Paulist Press, 2003.

^[43] Harakas, Stanley. Living the Faith: The Praxis of Eastern Orthodox Ethics. Minneapolis: Light and Life, 1992, 239.

^[44] Even though, an evolutionary biologist could certainly make that connection.

^[45] McElwee, Joshua. “Francis lambasts international aid, suggests Catholic should limit children.” National Catholic Reporter. 19 January 2015.

^[46] This is not to say that the Pope’s comments are very clear either.

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