Artificial Reproductive Technologies (ART) encompass a sensitive subject area, but are (strangely) one of my favorite things to talk about. It’s a multifaceted topic with many aspects that are often left unconsidered by the average infertile couple – and especially by the average person recommending it. As someone who feels incredibly fulfilled despite living infertility for over seven years, I like to try and bridge that gap by giving some other perspectives. Most people don’t plan on being infertile, so when it hits, it is usually devastating. And the devastation only intensifies as months continue to pass without a positive pregnancy test.
A common reaction to this jarring life circumstance is to eventually turn towards IUI and/or IVF because most are unaware of any worthwhile alternatives, or simply because they desire to have children that share their DNA. It’s not that going the ART route is easy, but many consider it to be their last hope in conceiving a child. Catholics are one surprising branch of many in this boat. The fact that the Catholic Church advises against it as seriously sinful is either ignored, unknown, or believed to be untrue. Many can’t fathom why any Church would reject such “amazing scientific advancements.”
Yet, CCC (Catechism of the Catholic Church) 2377 insists:
According to this statement, IUI and IVF do contradict the principles of human dignity. But here’s the thing that we, Catholics, have to do a better job at communicating to people in this difficult situation:
The feelings of frustration that infertile men and women experience in regards to ART are understandable.
The desire to have a child is very good. It is innate. It is part of God’s plan for marriage. It is part of how God designed woman. It is a desire to respond to God’s very own call to “…be fruitful and multiply” (Genesis 1:28) in one of very many ways, and it is beautiful! When that doesn’t happen naturally, it is extremely confusing to a couple. But science offers a solution, begging the question: what the flip could possibly provoke God to not ordain this?
Clearly there is some misunderstanding?
It is understandable why this Church teaching is initially upsetting, challenging, and/or flat out confusing for so many people who are already experiencing so much pain. On the surface, it appears to be a charitable response to a couples’ inability to bear children. But the fact that a response or solution exists, alone, does not automatically mean that it is just or that it even serves us well.
The end doesn’tjustify the means.
In general, having an unbiased third party to assess the situation from the perspective of all parties involved is extremely effective. It’s even better when that third party truly desires, and knows, what is best for our lives and hearts. The Church doesn’t exist to simply point fingers and ruin our plans just for fun. She was established by Christ Himself to illuminate the most loving choices that are most fulfilling and lead us closer to Himself, even when it feels impossibly hard.
Remember, He didn’t make His own self immune to human suffering. There was a grueling crucifixion and death on the cross that preceded His Resurrection.
He Came to Serve
Understanding this aspect of “Church teaching” is incredibly useful because even when we don’t yet understand why She teaches certain things, we can be sure that Her purpose is to serve, not to hinder, us. Christ has put Himself in service of us, not as dictator over us!
“…just as the Son of Man did not come to be served, but to serve, and to give His life as ransom for many.”(Matthew 20:28)
Nothing is imposed on us. The Church only proposes the most life-giving options. We have the free will to ignore anything we choose to. When we open our hearts to understand why certain “propositions” exist the way they do, these teachings stop feeling so restrictive. Chris and I have never felt “bound” by the Catholic Church’s warning against ART because we not only understand it, but are in complete agreement with it. If it were free and a healthy pregnancy could be guaranteed, we would still decline IUI and IVF for several reasons. This does not minimize the pain of infertility, but acknowledges that It would not serve us as advertised.
*I understand and respect that not everyone feels the way we do. I am simply stating our reasons for not choosing either of these options.
IUI & IVF:
1) Both circumvent God’s perfect design for the co-creation of new life, separating procreation from the sexual act
2) Both circumvent the underlying health issue(s) preventing conception
3) Both can be extremely emotionally invasive (on top of what is already emotionally exhausting)
4) Both can easily make a baby the priority over God and spouse
5) Both can put undue stress on a marriage
6) Both can be physically uncomfortable/painful
7) Neither have guarantees or high success rates
8) Neither improve health, even when a baby is not the result
9) Neither continue to support the women throughout pregnancy
1) Most often creates multiple embryos with a low survival rate. Many of these new lives are frozen or destroyed. Those would be our sons and daughters – no matter how small.
2) It’s very expensive; multiple rounds are often required with no guarantee
Some of these are also reasons why the Catholic Church opposes this practice. She is not opposed to ART in an effort to exert authority, but out of profound respect for each human person and the dignity of the marriage vocation. Still, many beautiful new humans are created this way and each have equal worth and value as humans conceived naturally. However, that doesn’t mean conception occurred under the best of circumstances for the couple.
Making the end the priority makes it easy to lose sight of the effects of the means. God desires more for us! If Chris and I had gone this ART route, we would’ve never met the beloved girl that calls me mommy and Chris daddy – the one God had planned for us all along. I would’ve never been motivated to search for the meaning of my infertility. I would’ve never lived the freedom of all the life-giving gifts I now experience daily. God doesn’t call every infertile couple to adopt, but he does invite all infertile couples to be life-giving! This call can be answered in a plethora of ways.
If life gives you this curveball, there is more than one way to knock it out of the park. Sometimes infertility does end with a baby, and sometimes it just gives us new-life.
When I was a kid, I wanted a kitten very badly. I would often see those four-legged cuties on TV or at a friend’s house and long for a little guy or gal of my own to love and smother with unwanted attention. My parents were not really any kind of animal people, much less kitten people. But nevertheless, I ended up with the most adorable furry surprise on my 10th birthday. To say I was ecstatic might be an understatement – until those unforgettable first and second nights came…
That cat meowed all night long. It walked on top of furniture and knocked things down. It bit and clawed me for fun, using my legs for moving target practice. I lived in fear. And then there came the responsibilities – like, he needed to eat, drink, and have regularly refreshed litter, too? (Insert dramatic eye roll). My pre-teen self had only been aware of the cute and cuddly part of the picture. When reality didn’t meet my expectations, it was no surprise that I was ready to give up and return that bundle of terror.
No, seriously…I actually tried to return the kitten.
Our new feline “friend” came from a family friend, so it wasn’t out of the question. But thankfully, a little angel in the form of my brother’s buddy, Paul, visited our house during that frightful week. He understood these little animals and explained to me that this is what kittens do. He was young, immature, and in a new place. Cats are designed to explore and hunt, and need time to adapt to their new surroundings. He probably got scared frequently. Paul taught me how to handle my new little critter and encouraged me to be patient as we both learned how to live with each other. This changed everything. It didn’t mean caring for this new creature would be much easier, but now I was prepared to move forward for better or for worse and from a more realistic point of view. And me and that little guy became the best of friends for the next 14 years.
Did I really just liken NFP to a cat? Well, a lot of people hate both, but what I am hoping to draw a comparison to is the effect our expectations can have on outcomes and sustainability. For a long time, “NFP” has been sold by Catholics as: “an easy, effective, and inexpensive solution to preventing pregnancy.”
But doesn’t that sound familiar?
It is no wonder that many refer to “NFP” as “Catholic birth control.” Although it was with good intentions, I am one of many Catholics guilty of pedaling it this way. I thought that if I painted a picture that resembled what our culture pushes, then it might appear more appetizing. The hard work it takes to acquire so much new information and form new habits, in addition to the potential length of abstinence, became a dirty little secret.
But the cross is not supposed to be appetizing at first glance. It is His agony that grabs our attention and reminds us that the Resurrection proceeds suffering out of tremendous and completely selfless love for another. That’s romantic! It probably won’t automatically trigger excitement, but the crosses that NFP, or fertility awareness, often delivers to couples could be viewed as part of its appeal, especially when we understand that “…we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit…” (Romans 5:3-5).
So let’s describe it in terms that many women wish it had been explained to them in the first place – for exactly how hard it tends to be, in learning and in practice. When it is sold as “easy,” it is sold as a counterfeit version of NFP. When the couple goes to take that info to the bank after years of experience, not all, but many of them will be very disappointed as they discover that it was worth nothing.
I took a little non-scientific poll to find out how NFP was sold to 26 different women, most of which were likely Catholic. Many gave multiple answers, but the most common responses were:
As “Church-friendly” birth control, or a way to prevent pregnancy
Another response I received frequently came in some form of “it’ll be good for your marriage,” which is, indeed, true. But to leave it at that is only the tip of the iceberg. It is not a magical pill (pun intended) that will automatically transform us into good communicators with a selfless disposition and a teamwork attitude. It takes work and patience.
NFP/fertility awareness is often, straight up, very hard. It takes time and effort, just like most things in life that are meaningful. It is hard because marriage is hard; because love is hard! Abstinence is hard because God has made sex extremely intimate and enjoyable. Trust is hard because we often don’t understand God’s purpose in giving or withholding a baby when it’s not what we planned for. But marriage, love, abstinence, self-control, and trust are all also very good. They are all vehicles of incomprehensible joy – like the Resurrection. Unless it is the kind of self-, control has little to do with the way God invites us to live out our Christianity. That doesn’t change once we enter the bedroom.
When we step back and take an honest look at how family planning is communicated to us and how it plays out in real life, we can conclude that:
Contraception is praised for being relatively easy, is actually practiced easily, but often turns out to be unfavorable.
NFP/Fertility Awareness is often praised for being relatively easy, is actually practiced with more difficulty, but turns out to be favorable.
Keep in mind that this is a generalization. Obviously not every situation is the same, but this characterization pretty much sums it up, in my opinion.
So, culture, you can keep your “easy” birth control. But know that easy is not always better. Fertility awareness is not mindless, easy, or just avoiding pregnancy. It is nothing like contraception. It is a way of life. It is avoiding, achieving, health, work, discernment, trust, answers, confusion, joy, pain, time-consuming, natural, empowering, and the list goes on. It’s a lifestyle that is challenging, but even more so rewarding, and is well worth investing oneself into. That is information you can take to the bank and actually receive a valuable return on.
Family and planning are two pretty innocent words on their own, but when you put them together, sparks tend to fly – and not necessarily the good kind. People tend to be pretty opinionated about this topic that affects all of our lives in one way or another at some point. Neither young adults nor middle-aged couples are immune to the discussion. Some teenagers grapple with it whether they realize it or not. It even affects priests, who should become familiar enough with the subject to have intelligent, thought-provoking, and inspiring conversations with the people who look to them for guidance. Marriage prep mentors, pastors, and parents are all in the same boat. When we consider the topic of family planning, there are two different camps of people who emerge – those who have chosen to practice (or discuss) self-control and those who have chosen not to. For those who are educating and inspiring conversations, we have one more choice to make – how will we communicate the truths of each option so that the information remains of value to the user?
It’s not unusual for a teen girl to become sexually active in our culture. If she does, she either becomes familiar with barrier methods or visits her doctor who prescribes birth control without question. If a young woman presents with any symptom ranging from acne to severe pain at her average physician’s office, the prescription will not be different. Many women will continue on that path into adulthood until they are ready to have children and then resume artificial contraception in some form when they are “done.”
It’s not much of a surprise that this is the preferred option for many who are avoiding pregnancy. At first glance, the most difficult part about popping a daily pill is remembering to do it. It also tends to be inexpensive. If the patch or implanted device is chosen, even less effort is required. And just like that, those synthetic hormones are touted to suppress fertility for the purpose of sex without pregnancy. Barriers can be messy, but can also be readily available. Sterilization is a bit more invasive, but serves as a mindless option with the same expected outcome.
It is the mindlessness of contraception that makes it so attractive, at least at first. We have been generally conditioned to view birth control as the gold standard for avoiding pregnancy due to its relative ease of use. That is why it is called birth control – its purpose is to give women (and men) at least some perception of control over their fertility. But at what cost? Some women may nod, but others will cringe while reading certain parts of that third paragraph because of how those wanna-be hormones have wrecked their lives due to unwanted and sometimes severe side effects that were not explained to them by their doctor or educator. It was sold as an “easy fix,” but it has not proven to be so simple for them. At second glance, this so-called easy option may not be worth all that it is claimed to be. And side effects are not limited to the physical. Yet, it is still very popular.
According to the Guttmacher Institute*:
-more than 99% of women aged 15-44 who have had sex have used at least one contraceptive method
-60% of women of child-bearing age are presently using a contraceptive method
If you’re Catholic, you may or may not perceive these stats as a problem.
According to a 2012 Gallup poll**, 82% of Catholics perceive birth control to be morally okay.
The Catholic Church has long held to her teaching that there are two primary purposes of sex: unity and procreation. Contraception intentionally subtracts one of them (procreation) while not appreciating the full context of the other (unity). And with roughly 1.2 billion Catholics in the world, one may begin to wonder why and how the disconnect exists between understanding the purposes of sex and keeping them intact.
To the average birth control user, part of the unity aspect of sex is obvious. God has been quite generous out of love for us and the indissolubility of marriage to infuse such physical pleasure into the act that co-creates new life with him, continuing mankind. Orgasm triggers oxytocin and endorphins which enhance the bond between two people. But why is the procreative aspect equally as important?
If the purpose of each act of intercourse is to unify the couple and to be open to new life, what does that say about sex when it is intentionally rendered sterile? When the act intends to exclude new life, it makes use of our partner by elevating pleasure as the primary purpose of sex – and that doesn’t convey selfless love or even romance. Sex for pleasure alone communicates selfishness and makes use of another person as an object. Some will shrug that off by describing it as a vehicle for feeling close and intimate. But there are a plethora of ways that we can and should grow in intimacy outside of sexual intercourse.
In fact, for couples who rely on sex as recreation, those physical (outside the context of sex), emotional, spiritual, and communicative aspects of intimacy that are so important to healthy relationships are often underdeveloped, if present at all. And if intimacy means drawing two people as closely together as possible in every way, we can’t do that by excluding our fertility. The more closely we examine this option for family planning, the less appealing it becomes – despite its ease of use.
So, most will agree that a purpose of sex is unitive. It is the procreative part of the scenario that may provoke disagreement about the purpose of sex from the birth control crowd. But I would argue that it is hard to deny this purpose of sex when you consider the reason contraception was created in the first place – so that sex can happen without resulting in pregnancy. It should be no surprise to the average adult that sex makes babies.
If your face muscles have already tensed up because it sounds like I’m suggesting that couples should have as many babies as physically possible, allow me to swiftly address that concern. And if, on the other end of the spectrum, you are pleased because it sounds like that is what I’m suggesting, allow me to address that as well. Although one of the purposes of sex is, in fact, to procreate, it does not mean that God has intended for every woman to have as many babies as possible and “succomb” to pregnancy at His whim. You will often hear me remind my readers that women are not fertile every day like men are. God has designed us, therefore the couple, to naturally fluctuate between periods of fertility and infertility. And let’s not forget that new life is grown from our lives as individuals and as married couples in countless other ways besides making babies – take it from this infertile woman who has found a myriad of ways to bear fruit into this world.
So, God has intended for couples to be able to have sex without getting pregnant, and still be open to life, regardless of how long the window of infertility lasts.
Thus, we have the Catholic Church’s long-held method for spacing children, “Natural Family Planning.” With NFP, or what I think is more appropriately deemed “fertility awareness,” a couple selects one of several different methods to learn how to read the woman’s body and determine the fertile window within each cycle. Then she and her spouse can make decisions (informed by open discernment with God) about which days to have sex and which to abstain, depending on their intentions. This is called selective intercourse. No faux hormones required; just some good old-fashioned self-control for durations of time that vary and can last for weeks…except it’s not actually old-fashioned at all. Contrary to what we often hear characters joking about on TV and in movies, self-control is not an ancient practice which hasn’t stood the test of time.
The other big difference between this method and birth control – sugar coating not included – is that practicing it can be really. frikin. hard. But, at least it pays out in the end…
For NFP week 2020, I teamed up with two extraordinary women to deliver a 6-part series articulating fertility awareness/NFP as it compares to birth control, providentialism, and artificial reproductive technologies in light of Church teaching and our personal experiences. This gave us a unique approach, considering that we come from three very different backgrounds – hyperfertile, subfertile, and infertile.
I think I have saved the most unusual and unexpected aspects of “NFP” worth improving for last. So many view it on a shallow level, but you will see that fertility awareness is multi-faceted and dynamic when you begin to unpack it. If we approach it as such, I think we can have quite the impact on families and culture.
One of the most disappointing things I have witnessed as a Creighton Practitioner is the surprising lack of interest that so many good Catholic men seem to have in the fertility of the woman they love, which should be recognized as their combined fertility. When I have witnessed a man who is sincere in the attention he gives to the whole process (from discernment to accepting crosses to involvement in method), there is a palpable difference in their relationship. What exactly that looks like for each individual couple will be unique and determined by them alone. It takes two people to co-create new life with God, and this should be reflected well before and well after each act of intercourse.
To improve this type of engagement, men need to begin being encouraged by other men before they are married. Early education is important for men, too! We all benefit from being educated on the fertility process and challenged early on to reverence reproduction as a combined responsibility and combined appreciation for God’s impeccable design for the transmission of new life. It will look differently than for girls, but also change over time as more information becomes relevant. I would be interested to see how this early education might affect the rate of teenage promiscuity in addition to marital intimacy.
9. Access to Information
Another common request by women is for information on fertility awareness to be more easily accessible. They want to hear about that and the whole picture of birth control from the pulpit and in marriage prep. They want church teaching on contraception and openness in discernment of growing families to be explained clearly. They want early access to FABMs promoted for the health of younger generations. A list of resources to help people find research, websites that differentiate between methods (find two options in #6), a list of local and long-distance instructors, “NFP-friendly” doctors (doctors who won’t give women a hard time for declining birth control), and doctors who provide restorative reproductive medicine (fertilitycare.org and mycatholicdoctor.com).
Offer group introductory sessions from multiple different methods and invite instructors or speakers to give talks that go into more detail than church leaders can provide. When attending a group intro session, the couples will most likely be expected to pay a fee – not the Church parish. If the Church is simply hosting a general talk, they should compensate speakers fairly for their time which includes the speaking itself and hours of hard work in preparation for such.
Improving access means at least attempting to make posters, handouts, social media, and websites appear inviting in order to attract people to the important information. Whether we’re ready for it or not, communication is becoming modernized and that doesn’t have to be a bad thing. There are many ways that the Church cannot and should not conform, but marketing style isn’t one of them. I bet there are many parishioners with experience who are willing to help. Some churches and Catholic organizations are doing an awesome job at this. Some others find it hard to make changes. If we want fertility awareness to thrive as the asset to our families, faith, and community it is, we have to be willing to invest in it all around.
10. Financial Concerns
Financial cost varies between methods and between providers. For some methods, the cost decreases and nearly disappears over time. Insurance is slowly beginning to cover some methods under very specific conditions that most cannot fulfill. HSA and FSA do typically reimburse. It can be a high expense that is difficult to afford and may prevent some from accessing it, but many offer sliding scale payment options and won’t turn a client down for financial reasons.
This does not mean the cost should be lowered. Instructors spend a significant amount of time and money to be highly trained in providing this crucial service that so many count on. Being Church approved does not make it a charity. It is a part-job for many whose hard work deserves to be fairly compensated, as with any other profession. Some views on cost may be a reflection of its perceived unimportance by our culture. We are generally willing to pay for the things we deem worth it. Hopefully this will improve along with proper education of what NFP/fertility awareness actually is.
Regardless, there is a lot Church parishes can do to help improve access. There are two local priests in my area that pay for their engaged couples’ Intro session and materials for one year. Parishioners can donate to a fund used to support potential clients in need or to fully sponsor them. What about allocating a portion of the collection at mass on different days throughout the year? Couples benefit from going to sessions together, but are often unable to do so because of children at home. Babysitting opportunities can be explored as well. With widespread improved education on fertility awareness, people may be more willing to contribute.
11. Becoming Familiar with Social Media
Whether you are using social media or not, your audience is. We are composed of many different generations and many of us are learning about numerous topics daily. Social media has become an excellent vehicle for connecting with each other and strengthening our faith. Recommend accounts to follow that will educate and motivate them in regards to NFP/fertility awareness, single life, and marriage.
There are a large number of couples who desire to get married in the Catholic Church, but are unaware of what it means to live out a marriage that is faithful to God and each other – and many times it is through no fault of their own. My husband and I are a relatively new marriage prep mentor couple and have had one engaged couple who had been living together for years to test the waters because no one ever taught them otherwise, nor had they witnessed authentic Catholic living. They were not opposed to the hard truths communicated with love, but set free by this expression of our faith that was new to them. This beautiful expression of our faith lived out is something I constantly witness on IG.
I am by no means suggesting that social media will solve all of our problems. But for many, it will be their only access to genuine representations of our beliefs. From a young age, we need to see women and men who are living their Catholic faith through the same struggles and triumphs as we are both in person and on the web. Social media is just one of many ways this can be done. You do not have to use or understand any platform to direct others to it. Go to marygbruno.com for a list of some of my favorite resources.
Understanding these concepts equips us to have more empowering conversations and provide more access to important information. From church leaders to marriage prep mentors to the people in the pew, we are all always learning and growing. These eleven points are some of the most important ones that I have identified within the realm of NFP and the explanations I have provided are only scratching the surface for some of them. Stay tuned to my page for more easily digestible ideas and information to improve education and accessibility to fertility awareness.
It’s hard to have a compelling conversation about birth control and IVF when you don’t have a clue where to start – or fear that you may offend someone. That is understandable. Having a handful of facts and practical knowledge on these two difficult topics will come in handy, hopefully improving comfort and confidence in future discussions and homilies. Part 3 spoiler alert: that’s what the people want! This second part of my NFP & the Church series continues here with everything you need to know.
4. Hormonal Birth Control
Remember how I explained that FABMs have advanced so much? We can’t say the same about hormonal birth control. Although the potency has been adjusted some, they still introduce a concentrated dose of synthetic hormones into the woman’s body almost daily! The goal is to stop ovulation in hopes of preventing pregnancy and/or to eliminate unwanted symptoms. It often replaces those with other unwanted symptoms.
It is not extremely common, but when breakthrough ovulation occurs, a woman can still get pregnant. One of the actions of the synthetic hormones is to terminate that pregnancy before the woman knows she is pregnant. This is accomplished by making the uterine lining thin, and therefore uninhabitable by the developing embryo. In these cases it is an abortifacient, which means that it is not licit for a woman to use even for “medical reasons” if she is having intercourse.
The perfect use effectiveness rating of hormonal birth control is about on par with the popular FABMs. However, it is rather striking that the typical use effectiveness rating of hormonal birth control tends to be significantly lower than most of the popular FABMs.
You’ll hear from many women that they can’t get off of their birth control because it is controlling their symptoms to some extent. This is understandable and should be addressed with compassion, but it does provoke further dialogue to help paint a full picture of the drug. That action of suppressing ovulation basically shuts the system down in an effort to suppress any symptoms it is causing due to some “system dysfunction.” It does not treat the underlying problem. When off of the synthetic hormones, symptoms will resume and can be worse. Some FABMs, like Creighton with NaProTechnology, are still preferred to birth control because it addresses the underlying problem(s).
Simply stating that the Catholic Church opposes artificial reproductive technologies (ART), or simply explaining that it is wrong because it destroys embryos or removes the unitive from the procreative does an injustice to both the Church and the couple. All of these statements are true, important, and should definitely be said. But they do not satisfy the longings of the heart of the infertile in isolation, thereby paving the way to IUI and/or IVF for many. There are also many who ART is not an option for, but still very much desire to be more included in the Church. Christ desires more for the 1 in 8 infertile couples whose desire for new life is very good. An even more loving and effective approach is to draw them into community by assuring them that they are equally capable of bearing fruit as their fertile counterparts and by providing them with IVF education and most importantly, a suitable alternative.
An infertile couple needs to feel the embrace of their Church despite their apparent inability to conceive a child. Many feel viewed as inferior to other Catholic women who bear children and it can be very isolating. All men and women are called to spiritual parenthood by using their unique and priceless gifts from God who does not consider biological children as superior to the fruits born of the infertile. Discovering this within oneself is rewarding and healing and this is a message that could be better communicated, because the teachings already exist within Church life and scripture itself.
If the ultimate goal of a couple is to grow in love of God and to improve health over having a baby at all costs, then they will almost always find fulfillment regardless of the circumstances. Many couples don’t understand that infertility is not a disease, but a symptom of an underlying issue that is often unaddressed. Artificial Reproductive Technology (ART) attempts to circumvent this symptom to force pregnancy, which makes it frequently unsuccessful or falling short of full term.
Believe it or not, sometimes the answer is as simple as identifying and using the couples’ actual fertile window. There’s at least five different FABM for that. When it’s not that simple, NaProTechnology is the medical and surgical extension of the Creighton method of fertility awareness, and promotes health and fertility by addressing the underlying causes. It is 1.5-3 times more effective than IVF and at a fraction of the cost. Everyone should know their options.
6. Expectations/Long-term Use
A well-rounded understanding and appreciation for fertility awareness is important, especially since the enemy chooses to attack families. According to Pope Francis at the 37th National Convocation of the Renewal of the Holy Spirit, “Families are the domestic Church where Jesus grows in the love of a married couple, in the lives of their children,” the Pope said. “This is why the devil attacks the family so much.” Don’t forget about Sr. Lucia dos Santos, one of the three children who witnessed the apparitions of the Blessed Mother at Fatima. Before her death in 2005, she predicted that the final battle between Christ and Satan would be over marriage and the family. Consider the widespread use or approval of contraception, abortion, divorce, and ART by Catholics as exhibits A through D.
In order to set individual women and couples up for long-term successful use of fertility awareness, their expectations need to be set appropriately and they need to connect with the method that fits best. NFP is not Catholic birth control and shouldn’t be likened to such. FABM educates and informs a woman of her health and her fertile window, empowering her/the couple with knowledge to help them make choices about sex depending on their prayerful discernment about bringing children into the world. It is a completely different and far more impressive animal than birth control.
Some like to compare it to birth control in order to make it sound more favorable in the sense of control and limiting days of abstinence. I admit that I described it this way until I spoke to people who actually use it to avoid pregnancy, which is not something I have done due to my infertility. The Christian lifestyle has never been about control, but submission to and in communion with God’s will – whatever that may be.
When avoiding pregnancy, it is rare for a couple to need to abstain less than 9 days within a given cycle and it is often more than that (not including the period flow). Fewer than 9 days could mean a problem with fertility. Fertile days vary from woman to woman, from cycle to cycle, and can also vary between methods. In the long run, couples greatly benefit from being given realistic expectations about how much sex they may be saying “no” to at certain times within marriage. A surprising amount of women have expressed a desire for this in retrospect! Tell them the truth – it will be very hard at times, but it will also provide ample opportunities for growth.
Finally, there is no one method that fits best for every woman/couple. A woman or couple should be encouraged to talk to instructors and friends, or find resources to help find the one that is best for them – if we expect them to stick with it. Luckily, my friend Emily has done a lot of that hard work for us in this FABM comparison via interviews. You can also find a good comparison at managingyourfertility.com. It’s also okay to switch methods.
7. Early Education/Fear of Sexual Promiscuity
The idea that NFP is only for engaged or married Catholics fosters a significant misconception. This is another reason why fertility awareness is a better term to use – inviting women of any reproductive age and circumstance to begin learning about her fertile health. It’s ideal for a young girl to have a basic understanding of her fertility prior to menarche, her first period. She should keep track of each cycle, including when she observes mucus and any other symptom until the depth of a defined method becomes more relevant. If there are clear problems like moderate-severe pain or PMS, she should begin charting with Creighton right away, due to its medical extension. FEMM may be a viable option here as well – I just don’t know enough about it yet because it is more new. I do know that it does not offer surgical benefits, but can still be a good option for other purposes. It is beneficial for couples to be comfortable with their chosen method of fertility awareness before they get engaged. If a woman has been charting as a single woman, this will really help facilitate the transition into use while married.
What about when she gets engaged later in life or never? It is just as important for single women to comprehend that they are included in the full spectrum of purposes of fertility awareness. Countless single women who receive the health and medical benefits of natural methods are grateful for it. Many others are simply unaware that it applies to them.
It’s understandable to initially be apprehensive at the thought of teaching teenage girls when their fertile window is. But they are more likely to be curious about and interested in sex when they don’t fully grasp the purposeful connection between sex and new life. An in-depth understanding of the beautifully intricate way God designed her body to work is more likely to foster respect for the reproductive process. Krause, H. And Kardatske, D. show a dramatic decrease of between 30-62% in sexual activity of teenage girls when using knowledge acquired from the Billings Ovulation Method (“Experiential Learning of Fertility Delays Teens’ Sexual Debut,” American Journal of Obstetrics and Gynecology).
These four topics are some of my favorites to talk about, but there is still a lot more worth bringing to the table for discussion. We will round out this series with an assortment of four different important topics including boys and men, ease of access to information, financial concerns, and the opportunities provided by social media Platforms.
Natural Family Planning of “NFP” is often associated with the Catholic Church, even though, as fertility awareness, it is becoming increasingly more accepted by non-Catholic and secular women as a mechanism of holistic health. Under the limiting banner of “NFP”, many don’t bother to consider it as a valid option for family planning, health maintenance, and as a vehicle for certain treatments. You might even say that many leaders in the Church have not fully uncovered the profound beauty and possibilities lying within the different Fertility Awareness Based Methods (FABM) that many refer to as “NFP” – or the need to drastically improve the quality and delivery of information on the topic.
When you get to know the Catholic faith authentically, you will fall in love. Despite being trashed since her birth on Pentecost and being constantly misunderstood, our Church shines and thrives. She never caves under pressure to conform to the times, which often drives people away because it is hard not only to comprehend, but to live a life of real love in accordance with Truth. But I would argue that this very reality only lends to her absolute beauty.
Our Church, in all of her splendor and in imitation of her Founder, is perfect because she has to be. It is through her that God reveals truth to us, guiding us back to Himself. I believe one of the many ways He is visible to us on earth is through the intelligent design of each human being – and there are few avenues that give us a more unique insight into ourselves than NFP. The fact that it is endorsed by the Catholic Church doesn’t mean it isn’t backed by solid scientific research, but it also doesn’t guarantee that every practicing Catholic understands its value and purpose.
Considering my history as a cradle Catholic, my women’s health struggles, my experience as a Creighton Practitioner, and conversations with many Catholic women and couples, I have put together a list of 11 key concepts that I believe will help us improve NFP education and accessibility. These points are separated into three distinct posts to make it easier to digest. Let’s kick it off with a chat about the term itself, understanding the extent of potential health benefits, and setting the record straight about effectiveness.
The term “Natural Family Planning” limits the full scope of possibilities for all of the methods by its very definition. Each natural method (referring to the 5 most popular- Billings, Creighton, FEMM, Marquette, Symptothermal) informs the woman of the state of her health to varying depths, depending on the method. This is in addition to the benefit of family planning by defining windows of fertility and infertility within each cycle. Those health benefits provide a major incentive to users regardless of faith practice.
Fertility awareness is a much more encompassing and accurate description. It also doesn’t hurt that it does not carry the same stereotypes as NFP, which gives us the opportunity to re-open conversations on the subject with people of all faiths and beliefs, including fellow Catholics. I have already seen some priests change the verbiage and it has been incredibly encouraging!
Defining “Health Benefits”
In addition to learning how to naturally achieve and avoid pregnancy, at minimum, a woman will learn how her fertility system functions, the importance of a healthy luteal phase (essential to achieving and maintaining pregnancy), be able to predict when each period should start, good hygiene, and the effects of stress. At most, she will learn its connection to overall health, how to identify brown and unusual bleeding, and how to identify and manage PMS symptoms. She will learn if she is at risk for certain diseases, infertility, some miscarriages, hormonal abnormalities, and some cancers. She will even learn when to supplement hormones (if necessary), and much more. And she can accomplish all this with no side effects.
Ovulation is not only a sign of health, but the action itself promotes health. See Lara Briden’s “The Secret Powers of Ovulation” to begin to wrap your head around the importance of a functioning fertility system. This is in contrast to the action of any form of hormonal birth control. So, the decision to avoid that alone is healthy, and the benefits only improve from there with use of fertility awareness.
These popular FABMs have come a very long way from the guesswork used with the Calendar Rhythm Method, which is no longer practiced by serious FABM users. Thankfully, the CDC has recently updated the effectiveness statistics for FABMs (although the high end of the failure rate is still too high), but anyone who visits the U.S. Dept. of Health and Human Services or the Planned Parenthood website will find information that is incomplete and false. FACTS, Natural Womanhood, and ByItsFruit.org provide up to date research, information, and/or statistics on modern natural methods.
Regardless of method, natural or synthetic, it is important to consider both perfect and typical use effectiveness rates. Perfect use describes use of a method exactly according to instructions. Typical use considers human error. For a quick comparison of all popular methods, including birth control, scroll down on this page.
For the sake of opening up more conversations, it will be helpful to understand a few other nitty gritty details. Pregnancy can occur from genital contact even without penetration. There is a high concentration of sperm in seminal fluid. If sperm find their way to the opening of the vagina during a fertile time when mucus is present, pregnancy can occur. This explains why withdrawal is objectively not an effective way to avoid pregnancy.
From listening to Catholic podcasts to talking with couples who use withdrawal as a method, it’s alarming how few people are aware of these details. I hope accurate statistics, information, and the full scope of health benefits will become common knowledge so women and couples can be better served by them. These first three points are pretty straightforward, but only the tip of the iceberg. In the next part of the series, I’ll give you a run down on birth control, setting appropriate expectations for sex and NFP, promoting early access & use for singles, and a new take on the Artificial Reproductive Technology (ART) discussion.
When it comes to preventing pregnancy – there will always be something to give up, regardless of which method you choose.
The popular options are hormonal birth control/implanted device, barrier methods, or a fertility awareness based method.
NONE are 100% effective.
Hormonal birth control
-Although there is a routine that must be remembered and adhered to, you gain the ease of a relatively mindless daily procedure.
-Intercourse can occur at any time – even if goal is to avoid pregnancy.
-It decreases the risk of some forms of cancer.
-It is often covered by insurance; easily accessible.
-Sometimes you gain symptom relief (when applicable).
-You may gain other unwanted symptoms and put yourself at risk for severe side effects like blood clots, stroke, and some forms of cancer.
-You may lose libido.
-You lose valuable health information that our bodies provide via a functioning system and the ability to treat any underlying cause (when applicable) because the action of the synthetic hormones is to shut down the fertility system.
-There is a risk of causing permanent infertility.
-It only gives the user one benefit (out of 3), which is avoiding pregnancy; it carries no knowledge useful for achieving pregnancy or health.
-If and when the user changes her intention in use of the method, it requires time and planning; advised to wait 3-6 months after ceasing the pill to increase chances of achieving a healthy pregnancy.
-Cost is ongoing.
-It can terminate a pregnancy without a woman knowing she’s pregnant.
-Same as above, but add the possibility of migration of device through organs inside the pelvic cavity.
-Remove the daily procedures of taking a pill, but add the more invasive process of implantation and removal. There is a “shelf life” and at some point, they need to be replaced.
-There are no synthetic hormones introduced into the woman’s body and no severe side effects.
-A woman can change her mind regarding intention in use whenever she chooses.
-Intercourse can occur at any time – even if goal is to avoid pregnancy.
-Possible to use in conjunction with a fertility awareness method (FAM).
-No relief from symptoms (when applicable).
-It requires “suiting up” for sex; requires barrier to be present.
-Can effect pleasure/be uncomfortable/requires clean up and/or disposal.
-It requires some knowledge of “suiting up” correctly to be effective.
-Chemical reactions are possible when using condoms.
-Intercourse occurs during times that are considered infertile anyway if fertility awareness method is not understood (barrier is wasted).
-It is a less effective means of avoiding pregnancy.
-If used in combination with a mucus-only method, it can cause additional discharge that will effect accuracy of observations.
-It only gives the user one benefit (out of 3), which is avoiding pregnancy; it alone carries no benefit of knowledge useful for achieving pregnancy or health.
-Cost is ongoing.
Fertility Awareness Based Method
-All methods are safe with no risks or unwanted side effects.
-Intercourse can occur at any time. (Pregnancy is likely to occur if a day of fertility is chosen for couples with normal fertility).
-Awards the individual with knowledge of self and an array of health benefits, including possibilities of treatment depending on the needs of the woman/couple.
-There are 3 benefits in one (avoid, achieve, and health).
-The woman can change her mind regarding intention in use whenever she chooses.
-It often facilitates more communication between the couple and encourages them to seek growth in other areas of intimacy
-Cost can be a factor, but for many methods is front-loaded and decreases over time.
-HSA/FSA often reimburse. Insurance companies are beginning to cover services more often, but with specific requirements.
-If the intention is to avoid pregnancy, intercourse should only take place outside of the fertile window.
-There is a learning curve and requires time taken to form and incorporate new habits into daily routine.
-You must acquire a large amount of knowledge (also an upside).
-Time is required to research which method works for individual woman/couple. Sometimes multiple methods must be tried before finding the right one.
-Cost can be a factor; hard to find insurance coverage.
Although it has nothing to do with avoiding pregnancy, there are some who use no method at all. It is worth comparing this as well:
-Intercourse can occur at any time. (Pregnancy is likely to occur if a day of fertility is used for couples with normal fertility).
-No extra time is needed to learn a method
-There is no need to remember daily procedures.
-It is safe with no side effects.
-No knowledge of body is gained.
-It carries no health benefits (which are helpful for health of the woman, but also to help achieve healthy pregnancy that can be maintained).
-If a need arises to have an intention on avoiding or achieving pregnancy, time and resources must be available to do so.
Half the battle of starting a Fertility Awareness Based Method is trying to figure out which one suits the individual woman and couple best- if you are even aware that there are multiple methods to choose from. My friend Emily over at TotalWhine.com has made that process a lot easier.
She interviewed instructors AND users from 5 different methods to help you make the decision that fits you best. Here is a link to my interview as a Creighton Practitioner. At the bottom of this post, there is another link to the Q&A main page.
A resource with specific ideas for growing in intimacy, especially for when sex is not an option
Whether you are trying to avoid or achieve pregnancy, there will be times when you are not having sex. This will often be challenging, as the desire to unite fully with our spouse is a very good thing.
Maybe you’re struggling with infertility or secondary fertility. On this other end of the spectrum, sex can become repetitive and habitual. For some, the emotional pain has eclipsed any sense of enjoyment in this unitive act.
Sometimes we are just bored and/or not feeling connected with our other half.
It is easy to, even unintentionally, separate our “sex lives” into its own little lonely category. But sexual intimacy is not a distinct aspect of marriage. It is an extension of our whole relationship and an expression of our union and depth of intimacy- spiritually, emotionally, communicatively, physically (outside the context of sex), etc. The more intimate we are in all of these other areas, the more fulfilling and unitive our sexual relationship will be; the more fulfilling our periods of abstinence will be.
Sex within marriage is important, but there is so much more to marriage! If we think of sexual contact as contact with the whole person– body, mind, and spirit, we may not be having as much “contact” as we think. Sexual contact with and without genital contact is good for a fully committed marriage relationship. There will be times when every couple avoids genital contact, but we never have to avoid sexual contact. Specific attention given each month (each day!) to focusing on the whole person of our spouse is vital to living out Christ’s plan for NFP/Fertility Awareness and authentic married love.
If you’re not married, many of these tools can still be used to grow closer in your relationship and to help you to discern if this is the person and time that God has called you to marry.
Read the handout “The Many Experiences of Intimacy” below to expand your understanding of intimacy.
Following that resource, there are multiple suggestions on how you can grow in intimacy with your spouse outside of the bedroom. Much of this content was created either directly by or inspired by our marriage prep mentor program, written by Lloyd and Jan Tate and has been incredibly valuable in our own marriage. Each time you complete one of these activities, carve out special quality time and make a mini-date out of it, if possible.
This does not have to be used verbatim. Use this as inspiration to create your own ideas/dates or edit the ones below to grow closer in unique areas of intimacy. You don’t have to leave home or spend money most of the time. Get creative!
Servant and Spouse; Sweetness for the Feetness
Intimacy: Physical- Affirming vs. arousal touch, Servanthood, Spiritual
-Prepare by reading John 13: 1-16 (Jesus washing the feet of the Apostles) together
-Afterwards, one at a time, wash your spouse’s feet (damp cloth)
-Massage your spouse’s feet
-The importance of beginning with Scripture is to focus your mind on a servant attitude towards your spouse and choosing to love for who they are and not for what they give you. Make the foot massage a gift to your spouse and focus on what is best for them, not on what can happen next sexually.
2. The Notebook
Intimacy: Emotional, Communication, Spiritual
-Find, create, or buy a cheap notebook you can both agree on and is able to be opened up to only see one side at a time (like spiral binding).
-Write the following words vertically on the left of both sides (the back side of the first page and the left side of the front of the next page): “Spiritual,” “Physical,” Emotional,” “Communication,” and pick one more word from the list of intimacy words found in the first resource from this document. One side is hers and the other is his to fill out. How can he/she show love for me spiritually? physically?…
-Then, when both are finished, the notebook can be opened up to view both pages, side by side.
-From then on, one person can begin: write a sentiment to the other, close the book and place it on the other’s pillow (or somewhere easy to find). When that person is ready to read it and/or to write a sentiment back, it’s to then be placed on the other person’s pillow. This can go on for years or even the entire marriage- your own personal love book. You can NOT ask for the love book back. You must wait until the other person chooses to write back.
3. Love Language Test
Intimacy: Emotional, Communication
-Even if you have done this before, you can do it again!
-Love is communicated and received in multiple different ways: Physical touch, quality time, words of affirmation, acts of service, and gift-giving. Although we all like to receive love in all of these ways, there are 1 or 2 that we prefer over the others. These make us “feel” the most loved. Many spouses give and receive love in different ways from one another. This test will help you to understand the dominant ways you and your spouse receive love. When we understand how our spouse receives love best, we can aim to show him or her love in those ways, essentially “filling their love tank.” When our love tanks are full, we tend to have fewer conflicts.
-Re-take this test throughout your marriage! Your love languages can change, especially after having children and going through different seasons of life. For more info, read “The 5 Love Languages” by Dr. Gary Chapman.
To take this test: For each number, there are 2 scenarios that are both pleasing. Choose the one you prefer and circle the X which corresponds to it. After you have finished, add up all the X’s circled for A, B, C, D, and E. The letter that belongs with your highest 2 numbers are your top 2 love languages. See the key to determine what each letter means.
4. Emotional Needs Christmas List
-Take some quality time to pray and consider your answers for this next challenge. Make a wish list of 5-10 concrete things your spouse can do to fill your love tank. Your spouse’s list may surprise you!
-Post your spouse’s list in a special place, viewed often.
-Try to meet one of these needs in some way regularly. Get creative!
– This Christmas list is also a great resource to access after a fight or when you are feeling like the two of you are in a period of disillusionment (See suggestion #21 for an explanation). “To love” often means initiating an act of the will to do something you don’t feel like doing, for the good of your spouse. The good feelings typically follow acts of love.
5. Couple’s Weekly Examen
Intimacy: Communication, Spiritual
-Each week, set aside a specific time to sit together and prayerfully consider the following questions:
How did we encounter Christ in our life this week?
What gifts from the Lord were we particularly aware of this week? How did we share those gifts with others?
Conclude this part with a prayer of gratitude and praise.
Did we serve one another unselfishly this week?
What steps did we take to nurture the physical, spiritual, and emotional needs of our relationship?
Did anything happen this week that is still unsettled between us? Can we talk about it now and seek reconciliation?
Is there any change we’d like to make in the week ahead to live out our Sacrament more faithfully?
Conclude this part with a time of contrition and recommitment. Ask for the special graces needed in prayers of petition together.
6. Conflict Resolution (used with permission by Lloyd and Jan Tate)
-Begin with a prayer and read each option. Make choices together! Remember to think of the good of your spouse first.
8. Warm Hugs!
-It turns out hugs can improve health, reduce stress, increase happiness, reduce anxiety, and more?! According to a family therapist noted in this article, “We need four hugs a day for survival. We need 8 hugs a day for maintenance. We need 12 hugs a day for growth.”
-Yea, I think “survival” is a little extreme, but it can’t hurt to make like Olaf and give more hugs. Read the article together and challenge yourselves to hug at least 10 times/day! My husband and I are shooting for 14 and haven’t made it yet, but it has been fun trying.
9. Sweet Morning Treat
Intimacy: Communication, Emotional
-Create or buy notecards and keep a stash in a special place.
-Write a note: short and sweet or deep and encouraging, it’s up to you! What is something you love about your spouse? How can you make him or her laugh? What can you thank them for today? What does God want them to know today? You can even just sign your name with a heart. Leave it in a place that your spouse will find first thing in the morning. Try to make it a surprise for them.
-Repeat this often and for no particular reason at all or to encourage your spouse when entering a rough day.
*This one is my favorite to do.
10. One Fine Day Challenge
Intimacy: Emotional, Healing
-Pick a day and resolve to say nothing negative at all to your spouse. Don’t tell your spouse when you start.
11. Mission: Thanksgiving
Intimacy: Spiritual, Gratitude
-Make a list of 100 things you are grateful for. That’s right, I said 100. Take a whole day or weekend to complete this mission, if you want. Stopping at 100 is not mandatory.
12. 2 Cooks in the Kitchen
Intimacy: Communication, Recreational
-Find a recipe you both agree on: baking or cooking. The spouse who does not usually do the cooking completes the recipe but cannot look at it. The other spouse must give good support and direction. Have fun with it!
-Do it again in the future and switch roles.
13. Eye of the Beholder
Intimacy: Creativity, Recreational, Aesthetic
-Grab a camera. You can use your phone.
-Go out in nature and take pictures. Get creative. Try to make even the simplest and ugliest things look beautiful.
-Pick a picture or 2, print it out and frame or keep in a book. Repeat another day. Grow your collection.
14. Chalk Art
Intimacy: Recreational, Community
-Get some chalk and write an uplifting or positive message together in your driveway for each other, neighbors, and/or anyone who walks or drives by.
15. Mission: Fasting
-Fast one day from something you enjoy: TV, snacking, sweets, phone, social media, negativity
-Do this for your spouse for a special intention or just for him or her to grow in holiness
16. Hunny I’m Home
Intimacy: Emotional, Service
-Bring a smile to your hunny’s face by surprising him or her with their favorite treat or meal after the day is over or when he or she comes back from work, “just because.”
-It doesn’t have to be edible. Maybe there is some small gift that they would appreciate and bring a smile to their face.
17. Love & Lyrics
Intimacy: Emotional, Musical
-Find the lyrics to a special song, your spouse’s favorite, or one that expresses how you feel about him or her and hand write the lyrics in letter form.
-You can also choose to write your own song for your spouse
18. Trivia Challenge
Intimacy: Intellectual, Recreational, Service
-Find a trivia game. We use “Trivia Crack,” a free app that can be downloaded on your phone.
-Play the game against your spouse. Loser washes the dishes (or choose your own act of service). Be kind regardless of the outcome!
19. Service Project
Intimacy: Service, Spiritual
-Pick any type of service project to do together.
-Suggestion: Buy some materials and/or food & water in bulk and make paper bags to deliver to homeless or anyone in need. If you live in a city where homeless people gather in a certain area, you don’t even have to get out of your car. You can hand bags out at stop signs and/or stop lights. Be safe!
-Add a personalized touch to each bag. It can be a card from you or something drawn from children. You can also add holy cards. Let them know they are seen, valued, and loved.
-Donate blood together
20. Prayer Card Personal
-Cut out paper in the shape of a prayer card.
-Write your own unique prayer specifically for each other.
21. Mission: Affirming vs. Arousal Touch
Intimacy: Physical, Communication, Emotional
-Pick a day or two to complete this challenge all day long.
-With each physical touch to your spouse, tell them if it is intended to be affirming (confirming love and acknowledgment of your spouse for who they are) or arousing (intended to initiate or develop towards sex).
-It can’t be both! There is an important distinction to be made here. Different types of touch have different intentions. Affirming touch is good to cultivate as just another way to show love to your spouse. It is good to know that we can touch each other without thinking about where it will lead next sexually, married or not.
-Verbally declaring your intentions will help the couple to grow in unity, making sure they intend to communicate what they are actually communicating.
22. Three Phases of a Relationship (used with permission by Lloyd and Jan Tate)