Natural Family Planning

Reflection for Engaged and Married Couples

“With the creation of man and woman in his own image and likeness, God crowns and brings to perfection the work of his hands: he calls them to a special sharing in his love and in his power as Creator and Father, through their free and responsible cooperation in transmitting the gift of human life…When, by means of recourse to periods (of fertility) and infertility, the couple respect the inseparable connection between the unitive and procreative meanings of human sexuality, they are acting as ministers of God’s plan and they benefit from their sexuality according to the original dynamism of total self-giving, without manipulation or alteration.”
(Pope John Paul II, On the Family, #28 & 32)

Contact US

Brendan Murphy

Director of Family Life, Marriage Preparation and Adult Faith Formation

(570) 207-2213, Ext. 1133

E-mail

Have we made our decision on a family planning method together?

Is our choice an informed decision?

Have we read and discussed this information together?

Do we know enough about Natural Family Planning not to practice it?

How would attending an NFP class help us make a more informed and mutual decision?

About Family Planning and Natural Family Planning

What is Natural Family Planning?

Natural Family Planning reflects the dignity of the human person within the context of marriage and family life, promotes openness to life, and recognizes the value of a child. By respecting the love-giving and life-giving natures of marriage, NFP can enrich the bond between husband and wife.

Natural Family Planning is:

An umbrella term for certain natural methods used to achieve or postpone pregnancy

Based on scientific research and day-to-day observations of the signs and symptoms of fertility that occurs as part of each menstrual cycle

Effective – its effectiveness rates are comparable to contraceptive methods

Healthy – it’s free of harmful side effects

Holistic – it’s in harmony with couple fertility and it promotes emotional and spiritual growth that strengthens marital intimacy

Applicable to irregular cycles and during postpartum, breastfeeding and menopause

Morally acceptable to the Catholic Church and other major denominations and religions

Virtually cost free.

Modern Natural Family Planning IS NOT the Calendar Rhythm Method.

What are the Signs of Fertility?

A woman’s body provides three basic ways to identify the fertile and infertile times of her cycle. Recognizing the pattern of one or more of those physical signs forms the basis of all methods of NFP. The primary sign of fertility is the mucus released from a woman’s cervix. A woman learns to identify the normal, healthy, cervical mucus which indicates the days that intercourse is most likely to result in pregnancy. The second sign is her basal body temperature. Due to hormonal activity, a woman’s resting temperature changes during her menstrual cycle. Lower temperatures indicate ovulation has not yet occurred. Higher temperatures indicate a rise in progesterone which signals the end of the fertile time. The third sign is a change in the shape or texture of the cervix. Finally, secondary signs such as minor abdominal pain or pressure at the time of ovulation can also be observed.

The Sympto-Thermal Method

The sympto-thermal method is a system using the mucus and temperature signs in a cross-checking way for the highest confidence and reliability in family planning. With this method, a woman needs just a minute to take her temperature when she wakes up each morning. During the day she takes a moment now and then to become aware of her cervical mucus. Her husband records a dot for the temperature on a chart, and at night she records a symbol to describe her mucus. This simple process gives the couple an accurate, day to day picture of her fertility. This particular method of NFP presented by the diocese’s trained instructors, teaches clients to:

Understand the signals of fertile/infertile times sent by a woman’s body during her menstrual cycle

Use these signals to identify the best time to achieve or postpone a pregnancy

Live in harmony with their fertility and with Catholic teaching on responsible parenthood

Strengthen their marital relationship through mutual reproductive responsibility.

Ten Suggestions for Days of Abstinence

DO say “I love you” daily.

DON’T avoid each other.

DON’T forget to say “Good Morning”, “Good Night”, “Hello”, and goodbye kisses.

DO hold hands as you watch TV, drive in the car, fall asleep at night, etc.

DO keep your appearance presentable.

DO avoid alcohol and suggestive books or movies that may lower resistance and affect your choice to abstain on fertile days.

DO reward each other whenever overwhelming feelings of desire are overcome with “rainchecks” or “IOU’s”.

DO small special things for each other (a favorite dessert, a flower, helping with supper or dishes, etc.). Remember, it’s the little things!

DO hold the sexy lingerie and special touches or kisses that are usually overtures to lovemaking until the infertile phase.

DO make plans for the infertile phase…candlelight dinner, music and whatever your hearts desire.

DO share charting responsibilities so both of you are aware of possible fertile days and when infertility begins.

DO make a pact at the beginning of each fertile phase to support each other one day at a time through the period of abstinence.

History of Natural Family Planning

History of Natural Family Planning

There is no doubt that as civilizations have evolved, people have gained vast amounts of knowledge. Unfortunately, along the way we have lost some basic knowledge about ourselves and the workings of our bodies. The understanding of the signs the body gives us in relation to fertility is a prime example. At least three African tribes in the Australian Aborigines have been documented as using natural signs to plan their families. They did not use their temperature signs but were well aware of their cervical mucus. Such information was passed from other to daughter, just as any other vital information was passed on for their survival.

Until the 1920’s, all Christian churches opposed contraception. In 1930, the Anglican Bishops voted to remove the ban at the Lambeth Conference. Although this ban was lifted, it was done so with the understanding that artificial methods should only be used in “extraordinary circumstances”. History shows that this was not the case. Other Christian denominations soon followed suit and many birth control options became available. Pope Pius XI reaffirmed the traditional Catholic position that contraception violated the natural law. Widespread use of contraception did not enhance married life as it was hoped. Divorce rates soared and women became increasingly frustrated with the technology that was supposed to free them from their worries.

In 1929, research into Calendar Rhythm Method was being done in Japan by Dr. Kyusako Ogino and in Austria by Dr. Herman Knaus. This method predicted the time of ovulation in a woman’s cycle based on what had occurred in her previous cycles. Its lack of reliability for many women, unfortunately, gives today’s natural methods a “bad reputation”. Rhythm and NFP are different and should not be confused.

During the 1930’s, research into the effect of a woman’s cycle on her Basal Body Temperature began and is incorporated today in our current methods. Much work as been done in this field by Dr. Joseph Roetzer in Austria .

In 1950, research into the significance of cervical mucus was started by Drs. John and Evelyn Billings in Australia . Their vital work made it possible to identify the onset of fertility by monitoring mucus changes throughout a woman’s cycle. Use of this information to identify times of fertility and infertility is known as the Billings Ovulation Method. The Billings Ovulation Method was introduced to the United States in 1972.

The Sympto-Thermal method uses a combination of Basal Body Temperature and cervical mucus signs to determine times of fertility and infertility.

Who Uses Natural Family Planning?

Who Uses NFP and Why Should We?

All major religions, including the Catholic Church, accept the use of natural family planning when couples have a sufficiently serious reason for spacing babies or family limitation. On the other hand, some Orthodox churches, some parts of Judaism, and an increasing number of Protestants are opposed to sterilization and the use of contraceptive or abortificient drugs and devices. It should be noted that both intrauterine devices and birth control drugs (both the pill and implants) can cause very early abortions.

In NFP both spouses are taught to understand the nature of fertility and work with it, either to plan a pregnancy or to postpone one. Couples who use NFP soon learn that they have a shared responsibility for family planning. Husbands are encouraged to “tune into” their wives’ cycles and both spouses are encouraged to speak openly and frankly about their sexual desires and their ideas on family size.

Is it natural for a married couple to practice sexual self-control? Yes! No one denies that at times this is difficult, but such difficulties to not make periodic abstinence “unnatural”. “Natural” means living up to the demands of our human nature, a nature “created in the image and likeness of God”. All of the Ten Commandments are sometimes difficult to follow, but all of them spell out the challenge of being true to our own nature.

Sexual self-control can help build the marital relationship, and therefore most couples report that NFP has a positive effect on their marriages. They find that period abstinence helps keep their sexual relationship fresh, improves their communication, and gives them a deeper respect for each other. In addition, the practice of NFP helps to develop the same strength of character that is necessary for marital fidelity and lifelong marriage. NFP couples have an extremely low divorce rate. This makes sense because couples who respect the natural moral law, God’s order of creation, can expect to enjoy its benefits.

Couples rarely begin practicing NFP out of a desire to improve their marital relationship. However, if they are going to practice NFP harmoniously, they soon find that they have to communicate more fully and creatively with each other. Couples do not ignore each other at times when they choose to avoid sexual relations; rather they develop non-genital ways of expressing their love and affection, which is the art of marital courtship.

Natural Family Class Schedule 2012

NFP, Infertility, & Other Special Circumstances

NFP is “healthy”. What does that mean?
NFP is health enhancing. Through NFP charting, a woman becomes aware of her normal fertility-menstrual cycle. Some kinds of cycle irregularities can alert her to possible underlying problems, and she can seek early health-care assistance.

Can NFP work with irregular cycles?
Yes. Modern NFP assumes that every woman is irregular at least some of the time. In general, if her fertile time comes earlier or later than usual, she knows about it because the start of her cervical mucus comes earlier or later.

Can I use NFP immediately after I’ve had a baby?
Yes. The fully breastfed infant is one that is fed on demand 24-hours a day. The constant action of sucking suppresses ovulation. By carefully watching for and charting any changes in mucus patterns which could indicate the return of fertility and by charting her mucus pattern, a woman will be able to notice a change signaling the onset of ovulation. A woman who is totally breastfeeding will experience either a basic infertile pattern of dryness or a basic infertile pattern of unchanging mucus—a continuous mucus discharge that does not change from day to day. For some women, this period will last only a few weeks, while others will experience this pattern for an extended time of breastfeeding, even for one to two years.

How does NFP work during pre-menopause?
Somewhere between the age of 35-50 woman can expect to see a change in her cycles and they may vary in length from one cycle to the next. However, the knowledge gained from this method will help a woman to understand that these changes are normal for the pre-menstrual phase. To determine her current state of fertility, a mature woman should record as much information as possible on her charts, including “hot flashes”. The pre-menopausal woman may experience an ovulatory cycle; however, careful charting and good observations are necessary to identify the less frequent fertile phases. These practices combine to make NFP a useful and reassuring element of the maturing couple’s sexuality.

How can NFP help a couple struggling with infertility?
There are several reproductive technologies compatible with Catholic teaching. NFP can assist couples in identifying their most fertile days and intercourse should be timed for those days for at least six months before proceeding to medical interventions. When proceeding with infertility treatment, a good rule of thumb is that procedures which assist marital intercourse in reaching its procreative potential are morally acceptable. Procedures which add a “third party” into the act of conception, or which substitute a laboratory procedure for intercourse, are not acceptable. For the answers to other common questions about family planning, turn to Rev. Mathew Habiger.

Responsible Parenthood

NFP vs Contraception

-adapted from Good News about Sex & Marriage by Christopher WestAdmittedly, it is difficult to see the important distinction between periodic abstinence and contraception when the emphasis is placed on “natural” vs. “artificial” methods. There are a lot of things we use that are artificial but not immoral. So why is artificial birth control any different?

Contrary to popular belief, the Church does not oppose artificial birth control because it’s artificial. She opposes it because it’s contraceptive. Contraception is the choice by any means to impede the procreative potential of a given act of intercourse. In other words, the contracepting couple chooses to engage in intercourse, and foreseeing that their act may result in new life, they intentionally and willfully suppress their fertility.

This can be done by employing a large variety of artificial devices and hormones, or by sterilizing surgical procedures. It can also be done without employing anything artificial at all, such as in the practice of withdrawal. So in order to avoid a great deal of confusion contraception is the best word to use when describing what the church specifically opposes. “Artificial” really has nothing to do with it and is better left out of the discussion altogether.

Furthermore, the Church approves of NFP (when there is just reason to postpone pregnancy) not because it’s “natural” as opposed to “artificial”, but because its in no way contraceptive. Never does the couple practicing NFP choose to impede the procreative potential of a given act of intercourse – ever. NFP is not “natural contraception”. It’s not contraception at all.

As philosophy professor Janet Smith points out, we take pills when we are sick. We have surgery to cure maladies and disease. Fertility is not a sickness. Fertility is not a disease. Infertility is the malady that needs to be cured. The only intelligent thing to do when there is honest need to regulate fertility is to come to understand God’s design for fertility and work with it. That’s what NFP is all about.

Effectiveness of Natural Family Planning Methods

University of Heidelberg Study (published February 2007)
99.6% Method Effectiveness

This study involving 900 women, who were observed over a 20 year period (1985-2005), was published in the journal, Human Reproduction, and found that the correct use of the Sympto-Thermal Method (STM) to postpone pregnancy led to a rate of 0.4 pregnancies per 100 women per year. The lowest pregnancy rate was found among women who abstained from sex during their most fertile period identified through STM.

In contrast, women who used STM but (in violation of Church teaching) used a barrier method, such as a condom, during their fertile period (instead of abstaining) had a higher pregnancy rate (.6 pregnancies per 100 women per year).

In addition, the study found that women who had sex (without contraception) during the fertile period had a pregnancy rate of only 7.5 pregnancies per 100 women per year, which researchers noted was a quarter of the rate one would usually expect. They attributed this statistic to the greater awareness couples practicing STM have of their personal fertility cycle.

British Medical Journal Study
99.8% Method Effectiveness

The largest natural family planning study combined effective teaching with high motivation and showed that natural family planning can be extremely effective in the Third World. The study was of 19,843 pre-dominantly poor women in Calcutta, 52% Hindu, 27% Muslim, and 21% Christian. Because of poverty motivation was high both among the users and among the well trained teachers of natural family planning. The failure rate was similar to that with the combined contraceptive pill – 0.2 pregnancy/100 women users yearly.

The World Health Organization Study
99.996% Method Effectiveness

A total of 869 women of proved fertility and widely varying cultural, educational, and economic backgrounds were studied in five centers (Auckland, Bangalore, Dublin, Manila, and San Miguel, El Salvador). Regardless of culture and education, 93% of the women recorded an interpretable ovulatory mucus pattern. Of the El Salvador women, 48.1% were illiterate and yet recognized the mucus symptoms.

Detailed analysis in the WHO study confirmed the effectiveness of mucus symptom observation as a means of family planning. The probability of conception from intercourse outside the period of fertility defined by cervical mucus observation was 0.004. Intercourse on days designated as fertile by cervical mucus observation resulted in conception with increasing frequency the nearer to ovulation that intercourse occurred. Intercourse on the peak day of cervical mucus secretion resulted in a probability of conception of 0.667.

Thus it is clear that women of all cultures and educational backgrounds can learn to recognize when they ovulate and are potentially fertile, and that if intercourse is avoided on potentially fertile days, pregnancies will not occur.

The Los Angeles Study
100% Method Effectiveness

Between 1976 and 1978, the U.S. Department of Health, Education, and Welfare conducted a prospective study to determine the relative user effectiveness of two different systems of Natural Family Planning. Participants were randomly assigned to either the Sympto-Thermal Method (STM) or Ovulation Method (OM) sides of the study. However, they were first screened to eliminate any couples who had a serious health, economic, or social reason to avoid pregnancy. The resulting group of 1257 couples had an average age of 28 and had only one child per family.

In the STM side of the Los Angeles study, couples determined the end of Phase I by using a calculation based on the woman’s previous cycle history (short cycle minus 21 equals the last day of Phase I) and cross-checked that with the continued absence of mucus. They determined the start of Phase III by cross-checking three days of well elevated temperatures with four days of the disappearance of the cervical mucus which characterizes the fertile time.

The couples who followed these simple rules achieved a 100% effectiveness rate in avoiding pregnancy, i.e., zero unplanned pregnancies. (The couples who used the OM rules had 5.67 unplanned pregnancies per 100 woman years of exposure, i.e., about a 94% method effectiveness rate. Better OM results were achieved in a five nation World Health Organization study: a standard Pearl rate of 2.6; i.e. a 97.4% effectiveness rate.)

A 100% effectiveness rate cannot be sustained in a large population and thus claims made for the STM state “99% method effectiveness.”

The Fairfield Study
99% Method Effectiveness

Between 1970 and 1972, 1022 couples participated in a five nation (Canada, Colombia, France, Mauritius, U.S.A.) study called the Fairfield Study after the university of the principal investigator. The calculation used to determine the end of Phase I (short cycle minus 19 or 20) was more liberal than that used in the later Los Angeles Study; a three day temperature-only rule was used to determine the start of Phase III without cross-checking for the disappearance of cervical mucus. The couples who followed these more liberal rules achieved a method effectiveness rate of 99% according to the Pearl formula (9 unplanned pregnancies in 14,416 months of exposure).

The Roetzer Studies
99% and 100% Method Effectiveness

Dr. Roetzer has distinguished between the method effectiveness of Phase I and Phase II according to his rules. In his 1978 study, he reported that coitus during the first six days of the fertility/menstrual cycle yielded one pregnancy in 8,532 cycles, a Pearl rate of less than 0.2 per 100 woman years of exposure, i.e., well within a 99% effectiveness. Using a combination of three days of well elevated temperatures cross-checked by three days of the disappearance of more fertile mucus to determine the start of Phase III, couples experienced zero unplanned pregnancies in 17,000 cycles, i.e. a 100% method effectiveness rate.

The Doring Temperature-Only Study
99% and 100% Method Effectiveness

Dr. Gerhardt K. Doring tested the only pure temperature-only system reported in the literature–using a temperature based calculation for determining the end of Phase I as well as the start of Phase III. With the formula “earliest day (in previous cycles) of thermal shift minus 7 yields the last day of Phase I,” there were 13 unplanned pregnancies among 37,035 cycles, a Pearl rate of 0.42 per 100 woman years, well within the 99% level of effectiveness. Among 307 couples using a three day very strong thermal shift pattern for the start of Phase III and confining intercourse only to Phase III, there were zero unplanned pregnancies in 11,352 cycles, another 100% method effectiveness rate with a limited population.

The Vincent Study
99% Method Effectiveness

Similar results were achieved in a French study published in 1967. Couples in this study had intercourse only in Phase III as determined by a rule similar to that of Dr. Doring., There was one unplanned pregnancy in 17,500 cycles yielding a Pearl rate of 0.07 per 100 woman years of exposure, well within the 99% level of effectiveness.

Conclusion 1. Studies conducted in Canada, Colombia, France, Germany, Mauritius and the United States have demonstrated a 99% method effectiveness for the Sympto-Thermal and Temperature-Only Methods. These studies were conducted under a variety of conditions and demonstrate beyond any reasonable question of a doubt that this extremely high effectiveness can be achieved by ordinary couples who receive adequate instruction and follow the relatively simple rules of these methods.