When a human egg is fertilized, the result is never a newborn platypus. I didn’t need four years of medical school, three years of pediatric residency, three years of neonatal fellowship, and close to two decades of medical practice to tell me that. In fact, high-school biology textbooks explain that all fertilized human eggs (zygotes), after approximately nine months, become newborn human babies — unless something occurs to interrupt normal development.
This progression from fertilized egg to newborn is neither “alternative science” nor a “rejection of long-standing medical knowledge.” Yet in her paper “Alternative Science and Human Reproduction,” published this month in the New England Journal of Medicine, R. Alta Charo uses those labels to discredit anyone who acknowledges the biological truth about human development.
Charo attempts in her piece to discredit Donald Trump’s pro-life executive-branch appointees. To this end, Charo, who is not a doctor, paints as ludicrous the claim that contraceptives can act as abortifacients by disrupting the natural process of pregnancy and ending a human life.
In reality, the progression of events from sexual intercourse to the creation of new human life is well established.
The process goes something like this: About six days after fertilization of the egg, and multiple cell divisions later, the zygote has become a cluster of cells (now called a morula). It has traversed the mother’s fallopian tube and made its way into her uterus, where the process of implantation will then occur over the next four to five days. The various stages of development will continue to unfold until birth. Uterine implantation provides the ideal environmental mix for human development. If either a drug or a device disrupts implantation, the originating events that began approximately six days earlier are stopped, and the pregnancy is prevented from progressing.
So it follows that devices or medications that impede implantation effectively end — or abort — a pregnancy. This reality contradicts Charo’s argument that contraceptives’ abortifacient action is just a “politically potent assertion by [Trump] appointees.” The potency of the assertion derives from the fact that it is true. As Charo admits, one of the ways contraceptives work is to disrupt implantation.
The government and many physicians, however, define pregnancy as beginning only after implantation. As a physician myself, I prefer not to ignore the physical changes that occur between the moment fertilization occurs and implantation in the mother’s womb. According to my embryology textbook, Before We Are Born: Essentials of Embryology and Birth Defects, the zygote “represents the beginning of a human being.”
From the moment of fertilization, the new human has unique DNA that serves as the cellular blueprint for the duration of his or her entire life. This medical fact does not depend on implantation.
From the moment of fertilization, the new human has unique DNA that serves as the cellular blueprint for the duration of his or her entire life. This medical fact does not depend on implantation: It depends entirely on the uniting of the parents’ DNA. Nor does this fact depend on an elected official’s opinion or a lawyer’s or even a doctor’s opinion about when life begins.
Admittedly, zygotes don’t look like humans. However, at the time of my grandmother’s death, she didn’t look much like her childhood pictures, and if we could have seen her as an embryo, she would have looked even less like the woman she developed into. But her DNA was intact at fertilization and remained intact throughout her life. My ability to recognize her at various stages of her life did not determine whether or not she was alive. The same is true for prenatal life and postnatal life.
There are multiple medical and legal papers arguing about when we should recognize life — the moment we should acknowledge as the beginning of a life — and what rights an individual does or does not have at different stages of life. Unfortunately, the arguments on these questions often reflect the ideological agenda of the arguer instead of the medical reality, which is that a unique life is created at fertilization. The distortion of this physiological truth, Charo’s article notwithstanding, is what makes human reproduction in our era “the victim of alternative science.”