In my previous article, Hormonal Contraceptives-The female poison, I have highlighted the various side effects of the hormonal contraceptives. It is evident that its harm outweighs its value. So what next for women of child bearing age – Married women?
The contemporary world has reduced the term family planning to mean the spacing of births. It has also convinced most if not all of us that the only way to space births is to objectify oneself by using the several modes of contraceptives namely, the barrier methods, Intra-uterine devices and hormonal pills. However, there are scientifically proven methods that respect the dignity of the human person, are free of charge and have no side effects. For the purpose of this article we shall call it Natural Methods of spacing or achieving births or Natural Family Planning (NFP).
- NFP is not counting your menstrual calendar days;
- NFP is not withdrawal before ejaculation during the conjugal act;
- NFP is not the use of barrier methods during fertile days of a woman’s fertility cycle.
So what is NFP?
According to usccb.org, Natural Family Planning is an umbrella term for certain methods used to achieve and avoid pregnancies. These methods are based on observation of the naturally occurring signs and symptoms of the fertile and infertile phases of a woman’s menstrual cycle. NFP reflects the dignity of the human person within the context of marriage and family life, promotes openness to life, and recognizes the value of the child. By respecting the love-giving (unitive) and life-giving (procreative) natures of the conjugal act in marriage, NFP can enrich the bond between husband and wife. This aspect of NFP also then supports God’s design for married love.
NFP is based on scientific facts about fertility. The methods are developed from research about women’s menstrual cycles and the signs of female fertility. Over a century ago, scientists discovered cyclic changes in cervical mucus and their relation to ovulation. In the 1920s, scientists identified the temperature rise that signals ovulation. But it wasn’t until the 1950s that scientists developed programs to teach others how to observe and interpret these fertility signs. Today, ongoing research continues to refine the methods of NFP. Any married couple can use NFP. A woman need not have “regular” cycles. NFP education helps couples to fully understand and interpret their combined fertility, so that they can discern when to postpone or try to attempt pregnancy. Couples using NFP to avoid pregnancy abstain from intercourse and genital contact during the fertile phase of the woman’s cycle. No drugs, devices, or surgical procedures are used to avoid pregnancy. The key to the successful use of NFP is cooperation and communication between husband and wife, a shared commitment. It is unique among methods of family planning because it enables its users to work with the body rather than against it. Fertility is viewed as a gift and a reality to live, not a problem to be solved.
- A woman ovulates at only one time during her cycle, and an ovum can survive for only 12–24 hours;
- Spermatozoa live only one to three days in the presence of fertile mucus, with survival up to five days being rare;
- Cervical mucus enabling healthy sperm cells to navigate the genital tract is necessary for fertility (fertile Mucus);
- A man is fertile from puberty till his death;
- Fertility cycle is a function of a woman’s menstrual cycle.
What are the methods of NFP?
A woman’s fertility cycle (not menstrual) has four phases; Menstruation phase; First phase of infertility(Basic Infertile Pttern-BIP); fertile phase; and the second phase of infertility. While in her fertile years, a woman’s body provides several basic ways to identify the fertile and infertile times of her menstrual cycle. The rise and fall of reproductive hormones is responsible for these signs. Recognizing the pattern of those physical signs forms the basis for all methods of NFP. Each NFP method is focused on one or more signs of female fertility. They can be grouped into three categories;
- Billings Ovulation Method (BOM):-
BOM was developed by Drs John (1918–2007) and Evelyn Billings, validated by eminent international scientists and successfully tried by the World Health Organization. It uses cervical mucus/vaginal discharge consistency in identifying the fertile and infertile phases of the fertility cycle already highlighted above. This method can be used to achieve or postpone pregnancy during regular or irregular cycles throughout all stages of reproductive life, including breastfeeding, and peri-menopause.
The cervical mucus changes in viscosity and consistency with each phase of the fertility cycle. These changes are consistent with the phases of fertility. In NFP education, a woman learns how to identify the normal, healthy, cervical mucus which indicates the days that sexual intercourse is most likely to result in pregnancy (the fertile phase). Keen observation of the cervical mucus can tell when a woman is ovulating. Once the couple can identify when the woman is very fertile, they can choose to abstain from sexual intercourse and genital contact if they are postponing pregnancy or engage in the conjugal act when they want to achieve a pregnancy.
More sophisticated trainers teach on how to observe the character of the cervix. It is based on the fact that the cervix opens only three times in a woman’s life; during menstruation; during ovulation; and at childbirth.
2. Basal Body Temperature Method (BBTM)
Basal body temperature is the lowest body temperature attained during rest (usually during sleep). It is generally measured immediately after awakening and before any physical activity has been undertaken. Ovulation causes an increase of one-half to one degree Fahrenheit (one-quarter to one-half degree Celsius) in basal body temperature. The tendency of a woman to have lower temperatures before ovulation, and higher temperatures afterwards, is known as a biphasic pattern. This method is used to pinpoint the ovulation time thus enabling a couple identify when to avoid or engage in the conjugal act depending on whether they are postponing or achieving a pregnancy. Its only weakness is that it identifies post ovulation infertility phase.
3. Symptom-Thermal Methods (STM)
STM typically combines charting of the Basal Body Temperature (BBT) and (Billings Ovulation Method (BOM) of cervical mucus observation with other optional indicators, such as changes in the cervix and secondary fertility signs to identify when a woman is fertile. With this method, a couple can chart the pre ovulation infertility phase and the post ovulation fertility phase, and of course ovulation.
With the development of ovulation prediction kits (or OPKs), the rise of certain reproductive hormones such as estrogen and luteinizing hormone (LH) can be observed. Other optional signs, such as breast tenderness or minor abdominal pain at the time of ovulation, can also be observed by the woman.
How it Differs from contraception
There is an inherent inseparable connection between the unitive and procreative aspects of the conjugal act. The connection between the two aspects of the conjugal act is in fact such, that the destruction of its procreative reference necessarily destroys it’s unitive and personal significance. Why? Because the conjugal act has a significance that goes beyond the expression of affection and pleasure it offers. The conjugal act does not in any way lose its full meaning and value if one knows that a conception is out of the question, as when age, an inevitable operation for the sake of health, or pregnancy exclude it. The knowledge that a conception is not in question does not in any way taint the conjugal act with irreverence. This act in such a marriage, if it is the expression of a deep love anchored in Christ, will rank even higher in its quality and its purity than that in a marriage in which the love is less deep and not formed by Christ even though it leads to a conception. Yet even when, for good and valid reasons (such as the endangering of life or grave economic misery), conception should as far as possible be avoided, the marital act, whose meaning and value is the actualization of an ultimate union, in no way loses its raison d’etre. The intention to avoid conception does not imply irreverence as long as one does not actively interfere in order to frustrate the link existing between the conjugal act and a possible conception. Nor is the use of natural family planning in order to avoid conception in any way irreverent, because the very fact of the possibility of natural family planning, that is to say, the fact that conception is limited to a short period, includes also a God‐given institution. This also has a meaning, and it is definitely reverent to accept the opportunity which God offers to those spouses for whom the avoidance of conception is imperative! That conception is restricted to a short time also implies a word of God. It not only confirms that the bodily union of the spouses has a meaning and value in itself apart from procreation but it also leaves open the possibility of avoiding conception if this is imperative for serious reasons. To make use of natural family planning is not to imply the slightest irreverence or rebellion against God’s institution and the wonderful link between the love union and procreation; it is in no way a subterfuge, as some people tend to believe. On the contrary, it is a grateful acceptance of the possibility granted by God to avoid conception, if this is imperative, without frustrating the expression and fulfilment of spousal love in the bodily union. As soon as we see the abyss which separates the use of natural family planning from artificial contraception, we have answered the rhetorical question: “Why should artificial contraception be a sin if the use of natural family planning is allowed?” And as soon as we see clearly the sinfulness of artificial contraception, we can and must clearly repudiate the suggestion that this is the proper means to avert the threat of overpopulation. No evil in the world, great as it may be, entitles us to use a means for avoiding it which is sinful. To commit a sin in order to avoid an evil would involve adhering to the ignominious principle, “the end justifies the means” (Dr. Vincent Njuguna- St. Matia Mulumba Mission Hospital)
NFP represents a unique approach to responsible parenthood because it calls for shared responsibility by husband and wife; is based on scientific research about the signs of fertility; treats each menstrual cycle as unique (from experience, it is unique); teaches husband and wife to daily observe the signs of fertility; has no harmful side effects; maximizes the possibility of achieving pregnancy when intercourse takes place during the fertile phase of the wife’s menstrual cycle; is effective for postponing pregnancy when intercourse takes place during the infertile phase of the wife’s menstrual cycle and; respects the unitive and procreative nature of conjugal love. In NFP both husband and wife are taught to understand and live God’s design for married love—this will give them countless blessings.
The various benefits of NFP cannot be exhausted but some include that NFP methods promote a holistic approach to family planning which both respects procreation and has the potential to deepen the intimacy of husband and wife in that it is open to the life giving nature of the marriage act; NFP methods support reproductive health. They are good for the body. The natural methods have none of the harmful side effects caused by contraception, especially chemical contraceptives (e.g., pill, injection, etc.). For the woman, NFP charting can even assist in the diagnosis of underlying medical problems. And, if a couple find they are having trouble conceiving, NFP information can help them pinpoint the most fertile time of the wife’s cycle. NFP methods can be marriage strengthening. NFP relies on couple communication and behaviour change. NFP methods require husband and wife to cooperate with each other in the most intimate area of their lives. During times of periodic sexual abstinence, husband and wife live a renewed courtship as they discover non-sexual ways to express their love for each other. On a practical level, husbands are encouraged to “tune into” their wives’ cycles, and both spouses are encouraged to speak openly and frankly about their sexual desires, hopes for number of children, and prayerful discernment of God’s will for their marriage. When living the NFP lifestyle, husband and wife learn that they have a shared responsibility for safeguarding God’s gifts of human sexuality, marriage and family. They also grow in their understanding of God’s will for their family size. NFP has the potential to make good marriages great. NFP is also free. In Kenya, training of couples is free, and exercising it accrues no costs whatsoever.
A number of NFP providers teach a variety of approaches to NFP. In Kenya, in addition to the Catholic Church, we have Human Life International Kenya among other organizations. It is endowed with doctors-physicians and gynecologists- and volunteer couples who are users of the methods. On-line courses are offered by Couple to Couple League, WOOMB International and most catholic dioceses all over the world.
The big question that comes when this is raised is, does it even work? What are the success rates? Well, from a users point of view, (we-my spouse and I- are users of the BOM) it depends on what you are trying to do. Are you trying to achieve pregnancy? Then yes it is successful, but remember, children come from God and are blessed unto us when God sees it fit to bless us with children. It is always for his glory. Are you trying to postpone pregnancy? Then yes it is. Currently rated at 99%. You just have to remember the fact that sex during fertile days can result to a pregnancy.
What makes it not work? Most of us have grown up in a world that glorifies sex and believes that sex is any time anywhere as long as there is a woman and man. Premarital sex is celebrated and those who choose to abstain till marriage as viewed as abnormal. Transfer the same attitude to a marriage situation and parties in a couple, believe that since they are married they are free to engage in the conjugal act any time but are not willing to embrace the fact that sex is both unitive and procreative, functions that are not mutually exclusive. Couples thus will seek to frustrate/treat the procreative aspect of the woman by letting her be responsible for her fertility and willingly frustrate it by taking the hormonal pills, implants and having intra-uterine devices inserted in her womb. The other major reason is fertility is viewed as a woman problem and should be fixed. Most men, not all, tend to abstain from responsibility of the procreative aspect of sex. Sex thus attains a selfish end as opposed to the unitive end that it was ordained to have. NFP introduces to the couples the value of joint responsibility in this key part of their married life; their sexual life; where each party appreciates and accepts the whole person and does not try whether medically or otherwise try to suppress any body functioning.
The biggest challenge I find is the attitude. How are we going to change this attitude that NFP does not work, bearing in mind even the medical practitioners who interact with families daily do not even want to think of this as an option because it is a concept out of this world. How do we even try to change a concept that is far-fetched because the other options are a multi-billion business enterprises that any other information that contradicts that which they advocate for will kill their business? Are we going to be brave enough to go against the norm? Or will we be complacent and keep failing to teach what is the best option? Are we going to watch as the cases of cervical and breast cancers rise and cower because we are too afraid to face this multi billionaires? Well the choice is mine, especially as a woman to abstain from the chemicals or to keep the poison in our systems. Either way, someday we shall all live the consequences of our decisions. I have always said, sexual matters are very key to the woman, and whatever is contrary to that which we believe in can be avoided by ensuring that the people we choose respect us and value that which we value.
Can we please stand up!
I acknowledge the contribution of Dr. Vincent Njuguna of St Matia Mulumba Mission Hospital and Augustine Richard Kakeeto, Lecturer at Catholic University of Eastern Africa- Kenya.