So Just What is Natural Family Planning?

by Kelly Phelan Powell

One of the most enduring religious stereotypes is Catholics and their outsized families. We even poke fun at ourselves a bit – we joke and say that when you see a family with 10 children, you know they must be either Catholic or Mormon, because almost no one else has that many kids anymore. But unlike many stereotypes, this one contains a lot of truth. We can laugh at ourselves – always a healthy practice – but in reality, we know that as Roman Catholics, our attitude toward children and families is a serious matter, one that’s rooted in God’s very design of man and woman, in the authority He bestowed upon Peter and the other Apostles and in the nature of Holy Matrimony itself.

One of the Church’s most definitive and politically controversial pronouncements on the subject of marriage and birth control came in the form of Humanae Vitae (Of Human Life), written by Pope Paul VI and issued on July 25, 1968. At the time, the cultural and moral compass of nearly the entire world was roiling from the effects of the Vietnam War, free love, feminism and, of course, The Pill. Not surprisingly, many criticized and even condemned Humanae Vitae as fervently as others supported it. But reading it today, it’s sometimes difficult to remember that it was published nearly 50 years ago. With phrases like “Everything therefore in the modern means of social communication which arouses men’s baser passions and encourages low moral standards…”, it’s chillingly prescient.

In 2014, artificial forms of birth control are less an issue of dispute and more a matter of course; any adult woman who’s anywhere near childbearing age knows this to be true. In a doctor’s office, one of the first questions the nurse asks when he or she comes in to take a female patient’s vital signs is, “What form of birth control do you use?” By this, of course, they always mean hormonal birth control like pills, injections or IUDs or barrier methods like diaphragms and condoms. If a woman answers that she doesn’t use any of those, then I can report from personal experience that they look at her like she’s crazy, stupid or simply bald-faced lying (“I won’t tell the pope,” one assured me). In our culture, it’s almost unthinkable that an adult – especially if he or she is married! – wouldn’t do everything medically possible to avoid having children unless they’re meticulously planned.

But why does the Church proclaim that using artificial forms of birth control is contrary to God’s will in our lives? It’s because openness to new life is by definition part of the Sacrament of Holy Matrimony. “The matrimonial covenant, by which a man and a woman establish between themselves a partnership of the whole of life, is by its nature ordered toward the good of the spouses and the procreation and education of offspring; this covenant between baptized persons has been raised by Christ the Lord to the dignity of a sacrament…By its very nature the institution of marriage and married love is ordered to the procreation and education of the offspring and it is in them that it finds its crowning glory.” (Catechism of the Catholic Church, Article 7, “The Sacrament of Matrimony,” 1601 and 1652)

“A husband and wife are supposed to do everything they can to help each other get to heaven – we don’t just live for ourselves,” said Fr. Peter Mangum of the Cathedral of St. John Berchmans. So although children are not necessary to the matrimonial covenant (“Spouses to whom God has not granted children can nevertheless have a conjugal life full of meaning, in both human and Christian terms. Their marriage can radiate a fruitfulness of charity, of hospitality, and of sacrifice.” 1654), “the refusal of fertility turns married life away from its ‘supreme gift,’ the child.” (1664).

Though most outside of Catholicism latched onto Humanae Vitae’s reaffirmation that artificial forms of birth control are morally unacceptable, the Magisterium actually recognized that there are a number of valid reasons why a married couple may wish to avoid pregnancy for a time:

If therefore there are well-grounded reasons for spacing births, arising from the physical or psychological condition of husband or wife, or from external circumstances, the Church teaches that married people may then take advantage of the natural cycles immanent in the reproductive system and engage in marital intercourse only during those times that are infertile, thus controlling birth in a way which does not in the least offend the moral principles which We have just explained. (HV 20)

And there is indeed a way, one that’s healthier, more natural, inexpensive or even free and statistically almost as effective as the birth control pill. It’s called Natural Family Planning or NFP, and it uses a woman’s basal body temperature and observations about changes in her body to determine when she is and is not fertile. A well-conducted study performed in Germany and published in 2007 found the Sympto-Thermal Method of NFP to be 98.2 percent effective, compared to hormonal birth control’s claim of 99 percent effectiveness.

Not only is NFP highly effective at spacing births, it’s also a godsend for women who have experienced infertility. One of the most demoralizing and heart-wrenching problems a couple can face, it’s one where even many priests struggle to provide comfort and guidance. Fr. Peter admits he can scarcely imagine facing such an obstacle. But he pointed out that traditional fertility treatments often run counter to the Church’s teachings regarding the sanctity of human life and the dignity of the person. Dr. David Parker, an OB/GYN at Saint Joseph Regional Medical Center in Mishawaka, IN, explained further, “[Intrauterine insemination and IVF] do not involve acts of intercourse and violate the unitive aspect of marital intercourse. Additionally, in vitro fertilization also presents a moral quandary of producing multiple embryos that stay in suspended frozen animation, violating the dignity and personhood of the embryo.” Put simply, said Fr. Peter, “We’re playing God; there’s a picking and choosing. The sanctity of human life – we don’t tamper with that.”

Fortunately, there’s a morally acceptable alternative that’s also highly effective. Dr. Parker specializes in NaProTECHNOLOGY (short for Natural Procreative Technology, also called NaPro), the medical application of the Creighton Model System of gynecologic charting developed by Dr. Thomas W. Hilgers and others at the Pope Paul VI Institute in Omaha, NE. Dr. Parker said that as a young gynecologist, Hilgers was inspired by Humanae Vitae to develop an effective, fertility-awareness-based method of family planning that couples could use to either achieve or avoid pregnancy. “He began to notice distinct patterns in the charts of patients who had, for example, infertility or recurrent miscarriage,” Dr. Parker said. “He began to investigate their cycles using targeted hormonal blood tests and ultrasound evaluation as well as diagnostic surgeries to look for the underlying causes of these issues. From there, he developed medical and surgical treatments to normalize the cycle, thus treating the underlying causes of the infertility.”

But does it work? It certainly does, said Dr. Parker. “NaPro is comparable in effectiveness to Assisted Reproductive Technology (traditional fertility treatments) and also does not use morally objectionable techniques. In general, the cumulative live birth rate in couples that suffer from infertility or recurrent miscarriage is about 60 percent. The cumulative live birth rate for an attempt at IVF is about 40 percent, with multiple attempts at IVF reaching about 60 percent cumulative live birth rate. There is also a much lower rate of multiple gestation pregnancies (twins and triplets) and pre-term birth with NaPro compared to IVF. This is important because multiple gestation pregnancies are at higher risk for complications and premature delivery. Premature delivery is the number-one cause of neonatal morbidity and mortality. Therefore, we should be highly motivated to use techniques that reduce these risks to newborns.”

Like all morally- and religiously-motivated courses of action, NFP and NaPro are easily misunderstood. And unfortunately, they’re also unknown to many Catholic laypeople and not entirely understood by some priests. Fr. Peter said priests learn of NFP in seminary as part of their study of the Sacrament of Holy Matrimony and the Church’s expectations for married couples, but still, some are unaware of its many benefits and the wide range of conditions it can treat. Dr. Parker said NaPro can be utilized for multiple gynecologic issues, including abnormal bleeding, polycystic ovarian syndrome, premenstrual tension syndrome, recurrent ovarian cysts and pelvic pain. That’s why education is so important. “If everyone had a good understanding of what NFP is, they would be more likely to try it,” said Fr. Peter.
Among those working to educate the faithful about NFP are two of the people who inspired Dr. Parker to find a way to practice obstetrics and gynecology without compromising his faith – his parents, Dr. William and Mary Frances Parker. “Having grown up in a large, happy Catholic family, I had experienced first hand how life-giving love can have a transformative effect. I am grateful to my parents for giving me the gift of my seven siblings and imparting the faith to me,” he said.

For close to 20 years, the Parkers, who are members of St. Joseph Parish in Shreveport, have taught couples, both Catholic and non-Catholic alike, the Sympto-Thermal Method of NFP, in which they are certified through the Couple to Couple League ( Mary Frances’s philosophy regarding NFP echoes part of Humanae Vitae: “…husband and wife are ready to abstain from intercourse during the fertile period as often as for reasonable motives the birth of another child is not desirable. And when the infertile period recurs, they use their married intimacy to express their mutual love and safeguard their fidelity toward one another. In doing this they certainly give proof of a true and authentic love.”

“Why are we abstaining? Why are we putting off having children? If you desire each other and are denying yourself, you want to have a good reason for it,” Mary Frances said. “Our fertility is part of who we are. To ignore the fertile aspect of yourself is inherently disrespectful.” In other words, the decision to space births, regardless of the reason, in order to be holy, must carry with it some personal sacrifice, a self-denial. In contrast, when a person uses birth control pills, for instance, there is no self-denial necessary – in that circumstance, the couple can engage in sexual relations any time, and in doing so, they not only ignore their own and each other’s fertility, they no longer have to consider the reasons why they don’t want to have a child at this time. NFP, on the other hand, “helps you to grow in reality, because our actions have consequences – the things you do mean something,” she said.

So it’s easy to see how NFP fosters communication between couples. “It requires that they communicate,” Mary Frances pointed out. The couple must continually communicate about the wife’s cycle, when they can and should enjoy sex and their reasons for either avoiding or trying to achieve pregnancy. And this creates a connection that makes for healthy marriages, something Fr. Peter notices in the couples in his parish who practice NFP. “Their communication level skyrockets – it’s so much higher,” he said. Mary Frances agrees. “The woman and the couple are cooperating with her natural cycles. It brings a level of communication that’s not there if you’re ignoring an entire aspect of your humanity.”

Lauren Merrick, who, along with her husband, David, participates in St. Joseph Parish’s engaged couples ministry, agrees that the advantages of using NFP from a relationship standpoint are numerous. She said it makes the husband part of the process, getting him involved with charting and asking important questions. “It requires you to reevaluate monthly where you stand as to whether or not you are trying to achieve or avoid pregnancy. Having this monthly dialogue secures that you and your husband can honestly and openly discuss where you are when it comes to family planning. ‘Are we ready for a child? Financially, physically, emotionally?’” Many are initially skeptical when they learn that another benefit is increased intimacy. “Some call it the ‘honeymoon effect,’” she said, “because it remains new and exciting when periods of abstinence are practiced.” Another positive aspect of NFP is that it strengthens a couple’s relationship with God. “[You’re] trusting that God has a plan for you and your family,” she said.

But the moral implications of artificial birth control methods aren’t the only reason non-Catholics are increasingly becoming interested in learning and using NFP. “Apart from the moral issue, it’s healthy for the body,” said Mary Frances. Dr. Parker explained, “Contraceptives are composed of various chemicals, such as artificial hormones and even metals. Current research studies have shown that the use of contraceptives are linked to breast cancer, cervical cancer, stroke, blood clots and even multiple sclerosis. Also, most hormonal contraceptives are considered pregnancy category X, meaning that they have been shown to cause serious fetal abnormalities in pregnancy. When there is a method failure with hormonal contraceptives and the woman does not realize she is pregnant and continues taking the contraceptive, she is exposing her offspring to a toxic chemical.”

“Natural Family Planning is just that – natural,” Dr. Parker continued. “It doesn’t utilize contraceptives or procedures that can place the mother and baby’s health at risk. Additionally, NFP charting is a great way to monitor overall health.” Merrick agreed and added, “It’s healthy, safe, inexpensive and easy once you have learned the method.”

Fr. Peter said he wishes more NFP couples would get to know each other and support one another, a sentiment resounding almost exactly from Humanae Vitae close to half a century later:

Among the fruits that ripen if the law of God be resolutely obeyed, the most precious is certainly this, that married couples themselves will often desire to communicate their own experience to others. Thus it comes about that in the fullness of the lay vocation will be included a novel and outstanding form of the apostolate by which, like ministering to like, married couples themselves by the leadership they offer will become apostles to other married couples. And surely among all the forms of the Christian apostolate it is hard to think of one more opportune for the present time. (HV 26) •

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