Natural Family Planning – an assessment

Whether or not a sincere Catholic agrees or disagrees with the papal teaching on contraception there is, I would claim, an obligation to give it full, due weight. In other words he or she must read and examine the teaching with a real intention to conform to the mind of the Magisterium. Only then will those who disagree be ready, as Newman suggested, to defend their decision in front of the Judgment Seat.

The element which I want to look at is Natural Family Planning (NFP), which is specifically acceptable in the papal teaching. The method suffers from a good deal of prejudice because of its history. It was once commonly known as “Vatican roulette”. This has not been applicable for years. NFP is established as a reputable method of fertility regulation with safety rates which compare favourably with other methods. And it is used by many non-Catholics who like its natural character and dislike the hormonal or instrumental interference of other methods.

NFP is based, of course, on the fact that a woman is only fertile at one point in her cycle. Provided that this can be identified, and the full marital embrace avoided over that time, conception will almost never take place.

Initially (I speak of the 1930s rather than classical times when it was first recognised) this could only be calculated by taking the longest and shortest cycles which a woman exhibited. In the case of irregular cycles the period of abstinence could be very long indeed, and, even in the best cases, there was a statistical risk of conception.

By the 1950s, when I was married, it had been observed that the end of the fertile period could be established by the small rise in body temperature which occurred after ovulation. This was a great improvement but not infallible. On one occasion my wife had to get up in the early hours, and switched on the electric blanket on her return. We nicknamed that child “Morphy Richards”. And the first “safe” period in the month still had to be calculated on the probabilities.

By the 1960s it was well understood that certain physical changes, recognisable by a woman trained in the method, could indicate the onset of ovulation. It has been called different names but generically it is known as the sympto-thermic method (a combination of biological symptoms and a rise in body temperature). Various detailed refinements have been introduced but it is the basic method used today.

The ideal users of the method are well-motivated, stable couples, leading a regular life, sensitive to each others’ needs and able to communicate well on sexual matters. That may sound a demanding recipe but in fact the conditions are fulfilled by many Catholic couples, and mixed marriages – especially those where respect for the other’s beliefs is high.

Like any other method of avoiding conception, there are disadvantages. Lactation (during which a woman is usually infertile, and normally particularly anxious to avoid conception) can cause problems, as can the irregularities which may accompany the approach of the menopause. Shift working can interfere with the measurement of the rise in temperature following ovulation, and so can ailments and certain medications. Some women find the methods of detecting symptoms unaesthetic.

Most prominent is the element which requires eschewing the full marital embrace for eight to 10 days each month. Since ovulation is related to the end of the month, women with short cycles can find their infertile days very restricted. This is a subjective, but nevertheless real issue. Sexual temperaments differ. For some couples it is an advantage. They would claim that experiencing the lack increases the value of the gift when it is available. For others, this is a great difficulty. They may find, as indeed is the case with many women, that that old “selfish gene”, intent on replicating itself, ensures that the greatest desire coincides with ovulation. When you want it you can’t have it, when you can have it, you don’t want it.

Such couples sometimes report an unnatural preoccupation with measuring the month which dominates the spontaneous expression of their love. Naturally this can be a particular problem when one of the spouses needs to travel a great deal, or is, for instance, a migrant worker. Others find the self-control required spiritually rewarding.

Failure rates need to be measured against failure of the method and failure of the user. On the first measurement the reported figures are way up with the best methods – in the order of one per cent to two per cent. On the second measurement the failure rate can be as poor as 25 per cent. This indicates that the security of NFP is particularly dependent on the motivation and scrupulous care of the couple.

NFP is a do-it-yourselves method, in one sense of the phrase. But make no mistake, it needs proper training (your parish priest or local Marriage Care should be able to recommend sources). A woman will need at least three months to learn her symptoms with confidence, so it’s folly to wait until the wedding night. And her husband should fully understand what is involved.

Working within the general principles I have described, there are different detailed approaches and it is important to be satisfied that the one chosen is the most suitable for a particular couple. Some personal research may be needed here.

Contributors to the blog can of course make any comments they wish. But some might like to think about two questions. The first is whether or not a systematic programme for avoiding conception is a way of withholding the gift of fertility in the same way that using a barrier contraceptive or maintaining temporary sterility through the pill is often said to be. Second, it would be valuable to hear of people’s experiences – good, bad or mixed – of using NFP.

About Quentin

Portrait © Jacqueline Alma
This entry was posted in Bio-ethics, Catholic Herald columns, Church and Society, Moral judgment. Bookmark the permalink.

12 Responses to Natural Family Planning – an assessment

  1. James H. says:

    Well, it worked for us. I found the self-control it requires salutary. Periodic abstinence creates and enforces a level of sympathy and commitment from me that just wouldn’t be there if my wife was permanently available. And absence makes the heart (not to mention the brain) grow fonder, to the extent that I regard sex as a privilege, not a right.

    On the other hand, daughter no. 2 began when my wife’s cycles were still wildly out of kilter after daughter no. 1, but I hasten to add that we weren’t charting at the time. Our girls are 18 months apart (5 and 3-and-a-half), and play very nicely together.

    It’s been nearly 10 years now since the last time we used any barrier methods, and I’m glad to say we don’t need them.

  2. kouin says:

    I think one has to have a ‘certain way’ to speak of these matters.

  3. Blue says:

    Taking Quentin’s other question, all other things being equal NFP seems, from one point of view, actually more artificial than other methods. (Not that I have any objection to it for those whom it suits.) Take the pill as an obvious example. It gets taken with the rations, just like taking aspirin for the heart or statins for cholestoral. End of story. With NFP your programme for whole month is mapped out, and you have to go through different procedures to make sure it all works. In other words a lot of concentration and effort has to go into avoiding conception.
    Lucius says elsewhere on this blog that the only alternative purpose to non-procreative intercourse is pleasure. I wonder whether his wife agrees with him. I would say that the alternative is the expression and deepening of married love. Pleasure comes with it of course – and, unless you’re a puritan, so much the better. In fact shared pleasure is a big contribution to intimacy.

  4. it seems worth remembering in this discussion that Jesus rarely talks about sexual sin. Yes, there’s the woman about to be stoned for adultery (“Neither do I condemn you, go – and sin no more.” And the prostitute who anoints his feet (“Much has been forgiven her because she has loved much.”) He reserves his fierce castigation for a whole catalogue of other sins, like hypocrisy or enforcing the minutiae instead of the deeper meaning of the law. Sex seems to be very low in his list.

    I just put the question: has the Church, laity and clergy, imitated Jesus’ priorities?

  5. Horace says:

    What I was taught on this subject at school was quite simple.
    [Of course, this was around 1940 and things were perhaps simpler then.]

    1) Marriage is about having and bringing up children.
    2) Intercourse (‘sex’) is the way in which nature causes children to be born.
    3) God made sex very pleasurable otherwise there wouldn’t be any (or at least not many) children.
    4) Attempting to obtain the pleasures of sex by any other means than that of natural intercourse between husband and wife is wrong.
    5) Entering into marriage with the positive intention of never having any children is stupid, besides it means that it is not really a marriage.
    6) Continence or self control ( i.e. when a husband deliberately refrains from intercourse with his wife) is not in itself wrong and for good reasons may be praiseworthy or even required.

  6. I recall being taught very much the same as Horace recounts – though perhaps half a dozen years later. What has changed, at an official level, is a degree of emphasis in certain respects.
    In the 1930s and 40s much controversy went on about the justification for using the safe period on an organised basis. The teaching Church was still strongly influenced by the Augustinian position that the only justification for sexual intercourse was the procreation of children. This however was clarified by Pius XII who taught in 1951 that, for sufficient reason, the safe period could be lawfully used, even over extended periods. In effect this meant that sexual intercourse had another important purpose, that is the expression of love between husband and wife. But at this stage the reproductive purpose was seen as primary and the love purpose as secondary.
    However Vatican II taught that the primary and secondary distinction did not apply and that both should be considered proper ends of marriage. No teaching was given on contraception as such since this decision was explicitly taken out of the Council’s remit. It merely said that avoiding conception could only be achieved by lawful means.
    The papal commission is not relevant here as its constitution was advisory, so the next teaching (motivated to a great extent by the advent of the pill) was HV.
    JP11 strongly defended HV through his concept of the theology of the body. Wiki has an account of the theology of the body, and JPII’s addresses on the subject are at http://www.ewtn.com/library/PAPALDOC/JP2TBIND.HTM

  7. Horace says:

    A personal witness:-
    Our first child was born 9 months after we married.
    My wife had considerable difficulties before, during and after the birth.
    As a consequence we avoided the ‘fertile period’ and had no children for the next 4 years.
    [My moral teaching and belief – well before Vatican II , HV and NFP – is summarised in an earlier entry in this blog. As a young doctor I was tolerably familiar with the physiology of conception – albeit only from an academic point of view. We were much too naive to use any complex methods like the body temperature signs described by Quentin.]
    When my wife felt that she was ready for a second child we had a baby who was delivered by Caesarian Section.
    After this we felt it prudent that we should have no more children.

    If all this sounds very simple minded – it was and is. We simply put our trust in God and know that we have been specially blessed.

  8. kouin says:

    I wasn’t married to a catholic . I wasn’t an active catholic myself.
    The general prevention was the pill.
    With me it is the womans body and her choice.
    These days being an aware catholic I say the Hail Mary.

  9. claret says:

    I really do wonder how many married practising Catholics who use artificial birth control (leaving side for a moment if such use qualifies them to be termed ‘practising’) really identify themselves with some of the horrors that are assigned to them.
    Do they really consider that their use of barrier contraception is ‘intrinsically evil’ and hence that they are in grave sin?
    Do they really see themselves as selfish ( here it would seem to be only men who are selfish!) individuals who do not see and feel marital intercourse as an act of love but only of sheer lust.
    Do they really see themselves as architects of divorce, abortion, sexual diseases, etc. as is attributed to them?
    I would think , and sincerely hope, that they do not.
    What really is the difference between some convoluted, partly manufactured (thermometer, training courses, and charts needed,) means of birth control, designed and approved to prevent procreation, to that of using barrier protection for exactly the same effect?
    Not a lot I would suggest. To approve one means of ‘artificial’ monitoring to prevent procreation as being OK but not of another means of ‘artificial’ application is hair splitting.

  10. Lucius says:

    In answer to one of the questions posed, yes, it is possible to use NFP with a contraceptive mentality. The teaching of the Church in Humanae Vitae indicates the need for a serious reason to space or postpone births.

    Those reasons ought to be based on Catholic values. Unfortunately Catholics could imitate the spirit of the times around them and posit such “serious reasons” as a bigger bank account, a house in the country, two cars, a certain state in a career, etc., etc. before consideration of a second or third child. Thankfully the population bomb nonsense of the 60’s has been exploded for being just that: nonsense.

    Moreover there is a notion of “planning” which is dismissive of large families based on a lack of trust in Providence and keeping up with the Jones family. After all Catholics no longer want to appear “ghetto” or odd or religious fanatics. Unfortunately NFP presentations can sometimes supply the science of NFP but not with Catholic values.

  11. cordelia says:

    I too have always been a bit mystified about the Church’s distinction about ‘natural’ methods versus chemical and barrier methods (or what Mrs Blair would call ‘contraceptive equipment’). It would be quite logical for the Church to say all contraception is wrong, as I was taught – every time sex takes place there must be a chance for fertilisation – but a tad unrealistic.

    I’ve always thought the most important thing is to be discreet and discrete about one’s sexual behaviour, and part of that is using contraception, although no method is 100% – the Combined Oral Contraceptive Pill which inhibits ovulation so there is no getting rid of a fertilised egg, abstinence, chasity, whatever the conscience dictates. Same goes for ‘barrier’ methods. I can’t believe many committed couples use NFP – in fact, it is now used more as a method for getting pregnant rather than avoiding it.

    You can read David Lodge’s ‘The British Museum is Falling Down’ to see the funny side – but, again, that’s an educated, intellectual Catholic’s story. NFP cannot be used effectively by those who need it most:the poverty-stricken and uneducated in the less fortunate parts of the world – particularly where the Catholic Church has great power and loyalty and finances health programmes, tying itself in knots about the use of condoms as a prophylaxis against HIV/Aids.

    I admire the way the Catholic Church takes a moral lead in areas where the rest of the world engages in ‘debate’ which is merely obfuscation. The contraceptive argument will continue but I still don’t see why NFP is held to be more ‘moral’ than the other methods I have mentioned.

  12. Malteser says:

    In response to Quentin’s initial question, and Claret and Cordelia’s comments, are you saying that abstaining from sexual relations in order to avoid conception is no different, in principle, from having sexual relations and using artificial means to prevent conception?

    It seems to me that the latter is a deliberate attempt to frustrate God’s will, whereas the former is not actually doing anything at all. How can not having sexual relations be sinful – unless, I suppose, you are persistently withholding the gift of yourself to your spouse for no good reason?

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