Two Out of Three Ain’t Bad

A recent comment from a secular fertility awareness advocate discussed the difference between secular Fertility Awareness (FAM), where the couples can do what they please during the fertile period, including using barrier methods and alternatives to intercourse, vs. Natural Family Planning (NFP), where abstinence and taking a chance on pregnancy are the only options.

Her post implied that FAM was superior because couples had more options. I can’t say I disagree with her. For most couples, FAM is the better option.

Nevertheless, I still believe that only NFP is fully living the complete truth about our sexuality.

Why I like Fertility Awareness

I am big fan of fertility awareness. Women are infertile most of the time, so why not learn her body to take advantage of natural infertility? Why bombard her body with hormones every day when pregnancy can only occur for a limited time out of every cycle?

natural-family-planning

Philosophically, fertility is NOT a disease. Giving healthy (fertile) women medicine to create an unhealthy condition (infertility) is a really bad idea. Anthropologically, a society that promotes this behavior is saying that there is something pathologically wrong with women’s bodies as they are made. Is it any wonder why so many women in our society have body image disorders?

Fertility awareness works through self-knowledge and self-control. Knowledge is power and self-control is a virtue. Switching to a fertility awareness based method has improved our sex lives and the rest of our marriage.

Fertility awareness is common sense family planning.

Why I like Natural Family Planning

As for Natural Family Planning, which involves complete abstinence during the fertile period, there are some things I really like about it.

natural-family-planning-poster-2012-470x364

I agree with the philosophy behind natural family planning. No, it’s not because I am afraid of going to hell for using a condom or think that the best sex advice comes from a celibate man.

I agree with this philosophy because it speaks about the nature of sex. Sex is designed to be unitive and procreative. It is designed for making love and making babies. Not every sex act leads to conception, in fact, frequently conception is impossible. The problem is with actively removing the procreative element from sex. Because when you remove the procreative element, you change sex, meaning that also lose much of the unitive element as well.

In cases of natural infertility, such as during pregnancy and postpartum, after menopause, and during the infertile part of the cycle, sex is as it is: Nothing is removed from sex and nothing is changed.

Barrier methods are just that: Barriers. We have found that they are psychologically contradictory, trying to come together as one while wondering if the barrier between you will fail. Furthermore, our experience is that nothing else, however mutually enjoyable, is quite the same as intercourse. Nothing is as intimate and nothing brings you together in quite the same way. We have found that these “other forms of sex” are “sexual junk food” compared to the “feast” of intercourse.

On the positive side, remaining abstinent challenges you to be creative at showing your love in your marriage outside the bedroom. Plus, couples have to decide every month whether they will pursue new life or abstain, which is an important conversation to have.

NFP also makes you be “All In” with the method. If you know that your sex life is entirely dependent on being good at the method, it pushes you to be a lot better at the method. It gives you a reason to find those extra days (and days you may have not considered before) as well as fix minor health issues that can extend the period of abstinence.

Both FAM and NFP respect a woman’s body and her health and allow the couple to have “all natural” sex for most of the cycle, but NFP also incorporates the discipline of marital chastity as part of the method. NFP is far more of a lifestyle choice than FAM.

Why I hate Natural Family Planning

Yeah, I get all of that.

But that doesn’t mean that this is easy.

So, here is yet another “Why I hate Natural Family Planning” post. Here are the reasons why:

Natural Family Planning isn’t fair

Some people find natural family planning to be a wonderful experience, even with the abstinence. But often times this is due to factors beyond the couples’ control. Some women have “textbook cycles” with regular periods and clear and obvious signs of fertility. Some women have short periods of fertility and relatively long periods of infertility. Some women have light menstrual periods, which reduces the abstinence there.

Some couples have less serious reasons to avoid pregnancy, which means both less abstinence (more comfortable with risk) and less stress.

frustrated-couple-in-bed-fuse-e1299005809913

Unfortunately, not all couples have things so easy.

Some women have unfavorable cycles. Some women have symptoms that appear to be long periods of possible fertility. Long, heavy menstrual periods may create a second time of abstinence. Sometimes these two times of abstinence may merge together to form one long block. Short cycles may leave few days available for sexual intimacy.

Some women have ambiguous and difficult interpret signs of fertility. They may need to try multiple methods before finding one that explains how they work. This involves more classes, more time, more cost, more study, not to mention increased abstinence (or increased risk of pregnancy). Some women have health problems that are causing their cycle disorders. While the fertility charting is an excellent tool for diagnosis and many women have been able to find effective treatment as a result, sometimes it can take some time to resolve these issues. And sometimes the couple may not have the resources to pursue treatment.

Some couples may have very serious reasons to avoid a pregnancy, leading them to use the method in a more conservative way, just to be sure.

NFP advocates often talk about the beauty of a woman’s body. But when charts show not beauty, but dysfunction, it can be very difficult to accept. NFP advocates often talk about the beauty of our sexuality. But when periods of abstinence are long, “safe days” few and far between, and you crave even any bit of sexual intimacy with each other, no matter how imperfect, such talk feels like a cruel joke.

Then there are problems caused by our lifestyles. It is hard to live by the cycle of the woman’s body when you kept apart by work-related travel or similar issues. A couple that would struggle to get time alone without worrying about fertility has to struggle that much harder.

What I hate about NFP is that two couples of equal virtue and equally strong marriages may have radically different experiences with NFP based on factors beyond their control. This isn’t fair and I hate that this isn’t fair.

Natural Family Planning requires the commitment of both partners

There is no way around it, NFP requires the commitment of both partners. NFP pioneer Dr. Evelyn Billings has stated that without cooperation of both partners, NFP is impossible. Popes John Paul II and Benedict XVI have stated, quite clearly, that the virtue of marital chastity that is key to practicing NFP is a joint effort.

But if you’re spouse isn’t on board, you aren’t going anywhere.

What do you mean you're fertile?

Of course, FAM also requires the cooperation of both partners, but the commitment is considerably lower. If he doesn’t want to abstain, he can use a condom. If she wants an orgasm during ovulation, that doesn’t require intercourse.

Some people take the view can the spouse that wants to abstain should abstain and tell the uncooperative spouse to (literally) go f— themselves. But this is no way to have a marriage. It only leads to division and resentment with the uncooperative spouse using their sexuality outside of the marriage.

But sadly, there isn’t really any good solution. Something has got to give.

What I hate about NFP is that no matter how much one spouse believes in it, an uncooperative spouse can prevent them from trying it.

Natural Family Planning requires relational maturity.

In the post Three Things I Secretly Hate About NFP, Rae Jericho writes that NFP requires self-control and maturity and the couples who could benefit the most from NFP often were short on both. This is a fantastic post, go read it.

NFP requires relational maturity. It requires couples to develop their intimacy beyond sex. Because sex is a great way to “patch up” a relationship. It’s a quick fix. Yes, couples can overly depend on it, but sometimes couples just need the closeness, the release, and the happy hormones to get them through a rough spot. NFP requires that couples either find another way to get through the rough spot or accept that having sex may lead to making a baby. Children are wonderful, but they are generally not the solution to marital problems. Developing the relational tools to get through rough spots without sex is very liberating and empowering, but it’s also very difficult and it does take time.

couple-in-bed-embarrassed

It doesn’t help that NFP is hardest when couples are young with high fertility and raging hormones.

NFP also requires couples to be good at sex. Counter-intuitively, high libido couples may have an easier time of NFP than low libido couples. High libido couples can “make the most” of the infertile period, making the period of abstinence a “welcome break” instead of a deprivation (unless, of course, there are extended periods of abstinence). Low libido couples have a surprisingly more difficult time. Anecdotally, many women say they are most interested in sex during ovulation. A common complain among women who “hate NFP” is that they could only have sex when they weren’t interested.

Couples absolutely can learn to enjoy sex during the infertile period, but for inexperienced couples this may take time and effort. Men have to take an extra effort to learn how to please their wives. They have to learn how to get her interested when her hormones could care less. It means taking his time to get her body in the mood for sex on the night when he is READY. TO. GO. NOW. For inexperienced couples, practicing NFP can make the sexual learning curve that much steeper.

Natural Family Planning requires spiritual maturity.

Nearly all the couples who choose NFP over FAM do it for religious or spiritual reasons. Unfortunately, without a well-developed and mature spirituality, NFP is a great way to make you and your spouse “lose your religion“.

The couple needs to have the spiritual maturity to be able to stick with the method, despite the difficulties. It is the spiritual maturity not to blame NFP for the problems in marriage, but life circumstances, cycle disorders, work schedules, or our own flawed human nature for the frustration. It requires accepting that sometimes you can’t always get what you really want, no matter how badly you want it.

But the couple also needs to have the spiritual maturity to properly understand what God requires of us. Catholics believe that God does not ask us for more than we are capable of. Because of our flawed human nature, sometimes the best we can do is an imperfect response to God’s commands. Our own efforts to improve ourselves are doomed to failure; it is only through the grace of God and the power of the Holy Spirit that we can change. Or, as St. Augustine said, “God does not command impossibilities, but by commanding admonishes you do what you can and to pray for what you cannot, and aids you that you may be able.”

People get in trouble when they view chastity as a series of rules that are to be obeyed under fear of hellfire. They try to do too much at once. Because they are not capable of what they are trying to do, even if they follow the rules, the problems come out in other areas of their lives. They burn out and give up.

When Humanae Vitae was released in 1968, the Archdiocese of Washington released a pamphlet defending the controversial encyclical. Most of the pamphlet defended the logic of the encyclical and urged couples convinced that “rhythm doesn’t work” to learn “modern rhythm” (i.e. early symptothermal methods of  fertility awareness) which is “extremely effective—more effective than most methods of contraception”.

But an interesting section urged couples who were struggling to try their best. It reminded readers that couples who tried and failed, even failed repeatedly, had not necessarily turned their backs on God. It was a recognition of the difficulties of Catholic teaching on the subject and that even good Catholic couples committed to “rhythm” would occasionally use a contraceptive.

Put another way, the pamphlet recognizes that what amounts to FAM would be the best that many couples could do. But it also leaves room for relational growth and spiritual development.

Basically, I hate NFP because although NFP is a way of gaining maturity, it requires a great deal of maturity to do it successfully and the young married couples who need it often don’t have it.

NFP vs. FAM

I would recommend FAM to nearly anyone. It’s far easier than it used to be. Need help tracking multiple symptoms? There’s an app for that (Android, too). Want something simple? Try Billings. (Online classes available.) Have cycle issues? Creighton Model FertilityCare has a good track record in treating them (Billings, too). Edit: So does Justisse Healthworks for Women. (Thanks, Laura.) Want to just pee on a stick and let the computer do the rest and are willing to pay for the convenience? You would probably like Marquette. Breastfeeding? Marquette is great. So is Billings.

Then the couple can decide how best to use the fertile days. That requires talking about sex, values, family planning, and all those wonderful topics that couples don’t always talk about, but should.

Which leads to happy sexytime.

As for NFP, I do recommend it, but only for couples who are well aware of what they are getting into. NFP can be very rewarding, but it can also be very frustrating, which can be very dangerous if the couple is not prepared to handle it.

Couples need to be committed to it, not out of fear of hellfire, or in an effort to earn “heaven points”, or to prove that they are a “good Catholic”, but because they have a very specific, dare I say—very Catholic view of sexuality. They need to believe that nothing will truly satisfy other than sexual intercourse as nature intended and that they would rather abstain than settle for less. Because if couples believe, as most couples do, that sexual enjoyment between a couple is good in itself and any link to procreation is unimportant or undesirable, then choosing NFP over FAM really doesn’t make much sense.

This is why I get frustrated with people overselling NFP or scaring people into it. Because NFP is not always easy, and NFP has it’s own dangers and pitfalls.

This is also why I prefer the “FAM way” of promoting the methods: It is far more respectful of the couple’s autonomy, personal beliefs, and individual situation. It also focuses exclusively on the science and leaves spiritual advising and moral instruction to those better qualified to do it.

So, do I recommend NFP or FAM? It depends on what you believe, what you value, and what you and your spouse can handle in your marriage. It depends on how much you want to put into it and how committed you are to doing so.

Do you have experience with any of these methods? Did you find that FAM worked better in your marriage, or was the sacrifice required for NFP worth the effort?

Good Intentions

Recently, I was involved in a discussion about whether birth control pills cause abortion.

pill

I am NOT a fan of birth control pills and other hormonal contraception, and it’s not just because the Pope says that “the Pill is a no-no”. K used to take them and they made her weepy and tanked her libido, which was no fun for either of us.  I understand that some women do need them as medicine, however, normal fertility is not a disease. Treating it as one causes all sorts of physical, psychological, relational, and social problems.

Now, the “technical answer” about whether birth control pills act after conception is that it is theoretically possible, but unlikely and unproven. Combined Oral Contraceptive Pills work in four ways:

  1. Stop ovulation by suppressing ovarian activity.
  2. Stop fertilization by thickening cervical mucus.
  3. Reduce the likelihood of implantation by making the uterine lining inhospitible to the embryo.
  4. Making women depressed while reducing their libido and sexual responsiveness, leaving fewer opportunities for conception. (But for some reason the pharmaceutical companies don’t advertise this one.)

Standing alone, mechanism #3 would be abortifacient, however, there is some question about whether this is ever an issue. Specifically, if #1 and #2 (and #4) fail, will #3 fail with them? Even if the endometrium is impacted, there are other things that could possibly go wrong and prevent fertilization when a woman is taking a dose of artificial hormones that isn’t quite high enough to work as intended.

Whatever exactly happens when the Pill doesn’t quite work, studies show that combined oral contraceptive pills are very effective at stopping ovulation and preventing sperm from entering the uterus so that any other mechanism of action rarely, if ever, comes into play. If these two mechanisms fail, the studies show that there is a significant chance that pregnancy will result.

Language Matters

But there is a possibility that the Pill has an effect on early pregnancy, even though it appears to be a small one. There are two different ways to describe this possibility:

  1. Birth control pills may increase the risk of early miscarriage.
  2. Birth control pills can cause an early abortion.

Blogger Rae Jericho at No Wealth But Life points out that for any other medication, the first description would be used and that use of the second description is “grossly inappropriate” to describe what is happening. It is especially inappropriate to use the second description when birth control pills are used to treat medical conditions. Even the Pope is OK with that. (En Español)

So why do people opposed birth control pills insist that they cause abortions? Why choose the second possibility?

First, I think that many people aren’t completely aware of exactly how the pill works. They may read the package insert, see the third mechanism, assume that all three mechanisms are equal, and don’t bother to look any further. Any medication taken with the purpose of avoiding pregnancy that ends a pregnancy after conception is, by definition, an abortifacient. Pretty simple, right?

Simple, yes, but overly so. To not understand how a drug works is scientific sloppiness. While most people don’t even read the package insert, much less the detailed studies, those who are promoting an unconventional and counter-cultural method of family planning with a (largely undeserved) bad reputation cannot afford to be sloppy about the science.

But I see something a bit more troubling. The second wording, linking birth control pills to abortion is more emotionally charged than simply linking them to early miscarriage.

According to a recent Gallup poll, a majority of Americans consider abortion to be morally wrong, while the overwhelming majority of Americans, including 82% of self-identified Catholics, have no problem with contraception. The moral case against abortion is bumper-sticker simple: Thou Shalt Not Kill. The moral case against contraception and sterilization is a bit more complex, harder to understand, and easier to disagree with.

So instead of taking on the difficult case of explaining the problems of birth control pills to a largely unreceptive audience, (especially when there is so much marketing behind promoting the Pill as a solution to all woman’s problems) some people think it’s OK to take a short-cut by putting an undue emphasis on possible post-conception effects.

I understand that these people mean well. They want to spare couples the negative consequences of hormonal contraception and show them a better way.

But is this not the very “ends justify the means”, manipulative, and dishonest behavior that is contrary to basic Christian morality?

Moral failings have consequences, no matter the good intent. And the consequences for sloppiness, dishonesty, and manipulation is that these erode trust.

Sexuality and family planning are extremely sensitive subjects. Especially family planning methods based on self-knowledge and self-control. When people struggle in these area, they must be able to trust those who are there to help them. If trust has been eroded by dishonesty, they will feel betrayed. And VERY angry.

We’ve been there and we know that feeling.

Furthermore, such emotionally charged language polarizes the discussion. It makes others closed to your ideas, even when beneficial to them and presented by others.

But another consequence of dishonesty is how it impacts the person who engages in the dishonesty. Sin not only harms others, it degrades ourselves. Or as Rae writes:

This abuse of language is dishonest, and it hurts not only those with whom we seek to communicate, but our very selves. When we misuse language and select terms based on what we wish to prove rather than appropriateness for describing a particular situation, we end up shaping our own thinking. Eventually we lose the ability to logically consider facts because we have skewed our minds with twisted words.

Dishonesty erodes our ability to think and our ability to love. Without our minds and our hearts, we lose others . . . and ourselves.