Love, Naturally

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7/1/2013

 

An interview with Dr. Theresa Notare about the history, science and benefits of natural family planning

by Alton J. Pelowski


The poster and education campaign for this year’s Natural Family Planning Awareness Week, which will be observed in Catholic dioceses throughout the United States July 21-27, features the theme, “Pro-Woman, Pro-Man, Pro-Child – Natural Family Planning.”)

In his 1981 apostolic exhortation On the Christian Family in the Modern World (Familiaris Consortio), Pope John Paul II applauded the scientific research being done regarding fertility awareness and modern natural family planning. At the same time, he called for “a broader, more decisive and more systematic effort to make the natural methods of regulating fertility known, respected and applied” (35). Soon after, the U.S. bishops launched the Diocesan Development Program for Natural Family Planning with financial sponsorship from the Knights of Columbus. The Order continues to support the U.S. Conference of Catholic Bishops’ Natural Family Planning Program to this day.

Alton Pelowski, editor of Columbia, recently interviewed Theresa Notare, Ph.D., the program’s longtime assistant director, in anticipation of this year’s Natural Family Planning Awareness Week (July 21-27). The annual observance coincides with the anniversary of the publication of Pope Paul VI’s 1968 encyclical Humanae Vitae (July 25) and the feast of Sts. Joachim and Anne (July 26). To find out more about NFP training in your area and other resources, visit www.usccb.org/nfp.

Columbia: What are the reasons that people learn natural family planning?

Theresa Notare: Many couples come to NFP in order to healthfully and morally space births in their marriage. In recent years — and I think this may be tied to so many couples marrying at an older age or postponing pregnancy to a later age — we also have a lot of people coming to the dioceses to learn NFP in order to get pregnant.

Sometimes, in NFP education, a couple may discover that they have fertility problems. Infertility is, of course, a very sad and difficult problem. It presents a life-changing challenge to husband and wife as they try to understand what God wants of them. The NFP teaching community can be very supportive and can refer the couple to a physician who specializes in ethical infertility treatment.

Columbia: How have scientific developments helped modern NFP move beyond the “rhythm method”?

Theresa Notare: Scientific advancements are hugely significant in the development of modern NFP. We have the current methods because good scientists have worked to understand the signs of a woman’s fertility and the role that hormones play in the menstrual cycle. All NFP methods today are reliant on an enormous amount of research that stretches back to the 1940s.

The Calendar Rhythm Method was a method based on science; however, it’s the science of an algorithm, of looking at data and trying to come up with a formula that fits all women. The problem with this approach is that not all women are the same. In fact, what impacts a woman’s hormones and menstrual cycle can vary even within a particular woman. That’s why Calendar Rhythm basically failed for the majority of women.

The natural methods engage the couple in such a way that they learn about their combined fertility and the woman’s signs of fertility in particular. NFP teaches how to interpret those signs by understanding in “real time” what the body is doing in a woman’s reproductive life.

Columbia: What kind of research is being done today?

Theresa Notare: There’s a lot of creative scientific research going on right now, globally and in the United States. There are scientists who are looking at how NFP information can become more simple and precise with regard to pinpointing the event of ovulation and what they call the “the window of fertility.”

Fertility monitors and ovulation detector kits are being refined, and some NFP methods are employing them. Researchers are also studying the return of ovulation after breastfeeding and what this means for NFP. And there are scientists who are looking at how the methodology itself can be made easier to use.

Columbia: What are some of the most common methods being used today, and what are the differences between them?

Theresa Notare: The NFP methods can be grouped into three categories: those that teach one sign of fertility; those that teach multiple signs; and those that distill the information down to a scientific formula. Within each category, there are additional nuances.

The general methods that focus on one sign of fertility are those that track and observe cervical mucus. In common parlance these are often called Ovulation Methods. These include the Billings Ovulation Method, the Creighton Model FertilityCare™ System and the Family of the Americas approach.

Most multiple index approaches are referred to as the Sympto-Thermal Method. In addition to the primary sign used by Ovulation Methods, they track the basal body temperature and other secondary signs. In this group there is the Couple to Couple League, Northwest Family Services’ SymptoPro Fertility and other variations that are taught in different dioceses. Some NFP methods also include monitoring hormonal changes. These are referred to as Sympto-Hormonal Methods, and the Marquette Model is a leader among this group.

Finally, Georgetown University’s Institute for Reproductive Health has taken the lead on developing new formulas or algorithms to predict the window of fertility. They have developed the Standard Days Method, which uses a bead system, and the TwoDay Method, which teaches women how to identify the cervical mucus sign in a short amount of time.

Columbia: Why isn’t NFP practiced by more couples?

Theresa Notare: The main reason is that the majority of people don’t know that these natural, healthy and effective methods exist and that they are viable. And Catholics in particular do not consistently understand Church teaching on the immorality of contraception. Church leaders and NFP educators need to continue to get the word out.

A second issue is that when couples do hear about NFP, they wonder if it’s too hard to learn and use. This is why it’s important for NFP educators to help couples understand that NFP is worth the effort, and it’s also why some NFP researchers are trying to simplify the methods.

A third obstacle to NFP acceptance is related to technology. Modern people have a “technology-centered” way of viewing things and finding solutions. This makes NFP look suspicious. At the same time, there is a disconnect between the way many people embrace organic foods, healthful living and exercise, but are nonetheless willing to use chemicals or other technology to suppress the healthy function of human fertility.

Finally, there’s the issue of a culturally false understanding of the human person and sexual freedom.

On a practical level, turning away from the use of contraception and embracing the Church’s teachings on human sexuality, marriage, conjugal love and responsible parenthood will be difficult for some couples. Since periodic sexual abstinence is the NFP means to avoid pregnancy, these couples will have to readjust their ways of relating to each other.

Now, this is not impossible. In NFP education we hear some amazing conversion stories from couples telling us that they thought they knew each other, only to find out that they were basically swimming on the surface. Living God’s plan for them and switching to NFP has allowed their love to deepen.

Columbia: When NFP is used to avoid pregnancy, how is that different than contraception?

Theresa Notare: Some people argue that if you have the mentality of wanting to avoid a pregnancy, it doesn’t matter how you do it. But if I’m hungry, for instance, there is a moral difference between buying or stealing food.

Likewise, there is a big difference between NFP and contraception. Contraception deliberately frustrates the procreative potential of the marital act and is therefore sinful and never morally permissible.

NFP, on the other hand, enables its users to work with the body rather than against it. If a married couple, for just reasons, uses the information they learn from NFP to avoid pregnancy, they are doing nothing to directly impede God’s design for life and love. They are simply refraining from sexual intercourse during the fertile window of the woman’s cycle. In this approach to family planning, fertility is viewed as a gift from God. Ultimately, NFP respects God’s design for married love.

Columbia: What are some of the benefits of using NFP instead of contraception?

Theresa Notare: On a practical level, NFP costs little — usually fees are charged for just the instruction and some materials. It also does not pollute the environment, since the methods are completely organic.

NFP also provides valuable information that can be applied throughout a person’s reproductive life cycle. And, in many instances, NFP can act as an aid for women’s health.

With regard to the spousal relationship, NFP couples will often talk about how their relationship has deepened and grown because of the discipline of the NFP lifestyle. Spouses must be supportive and are asked to be more mindful of their joint desire to try to achieve a pregnancy or not. This type of conversation in the most intimate area of life can strengthen communication.

With regard to children, NFP couples are in a strong position to speak to their kids about the meaning of human sexuality and why chastity is a freeing virtue.

As for women in general, NFP is empowering because despite all of the sex education that exists in schools, most women have a very poor understanding of their fertility.

Although the list of benefits goes on and on, we can finally note that on the deepest level embracing God’s design for married love imparts both peace and joy.

Columbia: Do couples who practice NFP tend to have larger families?

Theresa Notare: This is difficult to answer because we have not done a systematic “head-count.” I do know many NFP couples who have quite large families and others who have only two or three children.

That said, in some of his research, Dr. Richard Fehring of Marquette University has documented the emotional and spiritual growth of couples who use NFP. Even if a couple first learns NFP to avoid pregnancy, in the daily, ongoing practice, they can deepen their appreciation of who they are, as God made them. They will then begin to understand the amazing gift of being stewards of life and what it means to be a mother and father. This helps them open their hearts to God’s call for more children.

The bottom line is that when embracing the NFP lifestyle, a husband and wife will be encouraged to grow in their understanding and love of each other, their family, society and God. This is what makes good marriages great!