Natural family planning, or NFP, provides "a skill set" to help Catholic and Christian couples "live out their beliefs that Christ is involved" in marriage and family life, a national expert told OSV News.
Representing several natural, morally acceptable methods to monitor a woman's fertility cycle, NFP emphasizes "the role of sex in marriage, and the cooperation of husband and wife in procreation," said Theresa Notare, assistant director of the NFP program in the U.S. Conference of Catholic Bishops' Secretariat of Laity, Marriage, Family Life and Youth.
Notare's office spearheads the U.S. Catholic bishops' National NFP Awareness Week (July 23-29 this year), an annual observance whose dates commemorate the release of "Humanae Vitae," the 1968 encyclical in which St. Paul VI articulated Catholic teaching on artificial contraception, human sexuality, marital love and parenthood. The week includes the July 26 feast of Sts. Joachim and Anne, the parents of Mary. The theme for this year's National NFP Awareness week is "Marriage: One Flesh, Given and Received."
"We still believe a primary good of marriage is having children," Notare said. "God uses the marital relationship to bring new life into the world. And he uses the couple, in their union as one flesh, to uniquely represent his love in the world."
That message still eludes many, including Catholics. A 2016 Pew Research survey found that even among Catholics who attended Mass weekly, only 13% said artificial contraception is morally wrong, with 45% describing it as morally acceptable and another 42% saying it was not a moral issue.
"Believe it or not, it's been 55 years since the promulgation of 'Humanae Vitae,' and I'm not sure there's a more misunderstood church document," said Bishop Robert E. Barron of Winona-Rochester, Minnesota, chairman of the USCCB Committee on Laity, Marriage, Family Life and Youth, in a video message for the observance. "The church is not making a great 'thou shalt not' statement in its teaching on human sexuality, marital love and responsible parenting … (but) proclaiming the beauty and importance of the marital embrace, whereby spouses express their love for one another and become sharers in God's creative action."
Notare, whose doctoral research has examined the history of contraception and the church's response, admits that "we're good in that we have consistent teaching, but we have (previously) been on the heavy side of the negative, and that has created a caricature to this day where people think the Catholic Church hates sex."
Rather, she said, "the Catholic Church wants you to have the best sex possible, and that is God's sex."
NFP methods — which trace their roots to ancient times and were first formally developed during the mid-20th century — have evolved significantly over the past several decades, said Notare.
"It's not our mother's calendar rhythm," she said.
All NFP methods, which unlike artificial contraceptives can be used to either achieve or avoid pregnancy, focus on biomarkers indicating when the female body is most or least likely to conceive.
The three key NFP approaches are the cervical mucus (or ovulation) method, which tracks when cervical mucus is most conducive to conception; symptom-thermal methods, which look to basal body temperature as well as cervical mucus and other biomarkers; and the symptom-hormonal method, which adds another biomarker: the detection of reproductive hormones in the urine.
In each of those categories, specific models and methodologies have emerged with their own certified practitioners, as well as mobile apps and devices for tracking the fertility cycle. Among the popular NFP approaches are the Creighton Model FertilityCare System, a cervical mucus method developed at the St. Paul VI Institute in Omaha, Nebraska; the Cincinnati-based Couple to Couple League International's sympto-thermal training; and the symptom-hormonal Marquette Model offered by Marquette University's Institute for Natural Family Planning.
NFP practitioner Mikayla Dalton of Fig Leaf Fertility in Boston is certified in the Boston Cross Check method, which relies on all three major fertility markers (cervical mucus, basal body temperature and hormones).
Dalton told OSV News that she has recently noticed more non-Catholics eyeing NFP as "a healthy and reasonable option."
"I see increasing awareness … and increased market activity for devices and apps," she said. "They're not aiming for the small Catholic audience, but a wider group of women."
NFP also works to encourage better overall health care for women, she and Notare said.
While NFP practitioners are generally not medical doctors, "we are trained to look at charts for possible red flags," said Dalton. "We don't do any diagnosing, but we can say, 'Look, your chart is showing an unusual amount of spotting, or an unusually short luteal phase, which can indicate any number of conditions.' Some women don't even realize there's something wrong until they come to me, and I'm looking at their charts and point out, 'This is outside of the normal range of experience.'"
Because it requires the full participation of both spouses, NFP deepens marital bonds, demanding "a real awareness of your commitment to why you're doing what you're doing," Notare said.
Yet she and Dalton said that much work needs to be done in bringing NFP to a more diverse audience.
"It's still a boutique ministry hitting white America, where at least one spouse is college educated," said Notare, whose observation has been confirmed by research.
Dalton said Spanish-speaking NFP colleagues have told her that among Boston's Spanish-speaking population, "a lot of women are just more culturally prone to getting long-term birth control, something often recommended by doctors who work with people in depressed financial situations."
Doctors "will recommend women have their tubes tied or have an IUD if they think they don't want to get pregnant again," said Dalton.
Both she and Notare stressed the need for cultural sensitivity and personal encounter in offering NFP to a greater range of communities.
"You have to know how to create a pastoral strategy for NFP," said Notare. "Lead with church teaching, and fairly represent that teaching and NFP methods. People want what's good; we just need to help them understand."
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