Understanding Natural Family Planning

Why religious and non-religious couples are using NFP

Let’s talk about Natural Family Planning. Wait… wait… did you just grab the mouse to click away to another screen? Give me a chance.

When you think of Natural Family Planning (NFP) you might think of barefoot-and-pregnant super-religious types who are out of touch with modern science. The words “conservative” or “creepy” or “weird” might pop into your head. I know. I’ve had those thoughts myself. In fact, until recently, the only thing I knew about NFP was a stupid joke:

Question: “What do you call a couple who practices natural family planning?

Answer: “Parents.”

But a few things happened recently: I got yet another letter from a reader requesting that I address NFP (a subject I’d be avoiding for years since it’s such a politically charged issue) and two non-religious friends of mine who are trying to conceive in their early and mid-30s told me they were using NFP methods to learn about the body’s cycles to maximize their chances of having a baby. Quite frankly, I was stunned. So I began to do some research.

Talking about NFP
As I’ve discussed previously in this column, statistics show that most young-adult Catholics are having sex before marriage and the vast majority use birth control of some sort before and during their marriages (according to a 2005 Harris Interactive poll: Birth control/contraception is supported by 93 percent of all adults, including 90 percent of Catholics). Your knee-jerk reaction to NFP may be that the Church is oblivious to the way “real” Catholics live their lives, and is ignoring the scientific advances of birth control. But I’d like to suggest that NFP has gotten a bad rap among young adults, in part because we don’t understand it (or understand why the Church endorses it).

Two promises going in: (1) This is just information—no evangelizing. It’s information about reproduction that is useful to you regardless of whether or not you are sexually active, using birth control or other contraception, single or married or something in between. (2) It’s gonna get a little graphic, so you might want to finish your lunch first if you’re squeamish about body stuff.

Family planning isn’t something that we talk about on a day-to-day basis. There’s a “yuck” factor involved talking about bodily fluids (and being intimately familiar with those bodily fluids). And the idea of not using birth control or condoms for family planning is often derided as silly and ineffective. But as young-adult Catholics, it’s important that we understand the logic behind what our faith teaches about family planning in married life (regardless of what decisions you are making now).

Ready for the facts?
So what is natural family planning? How does it work—and why would someone use it? Is it just for the super-religious? And why does the Catholic Church encourage couples to practice natural family planning instead of birth control pills or condoms?

There are a lot of myths out there about NFP and a lot of social, political and religious implications of whatever family planning choices you make. And since this is a complex topic, this will be the first column in a series dedicated to the truth, as I understand it, about NFP—and how it relates to you as young-adult Catholics.

Read the basics here and then share your thoughts in a quick survey. I’ll use your responses as the basis for my next column.

Ready? Here we go.

What is NFP?
Natural Family Planning is an umbrella term for methods of observation of a woman’s fertile and infertile periods with an eye toward achieving or avoiding pregnancy. NFP isn’t the “Rhythm Method,” where a couple would have sex based on a schedule, assuming that the woman’s cycle was the same from one month to the next. Modern NFP methods treat each cycle as unique and rely on methods of observation to determine whether a woman is fertile or not at any given day of the month.

prevent and achieve pregnancy. It’s about learning how a woman’s cycle works, and making decisions accordingly. If you are trying to get pregnant, or thinking about trying to get pregnant, keep reading—NFP applies to you, too.

How do you practice NFP?
In brief—and I really do mean brief—here’s the drill: To maximize your chances of preventing or achieving pregnancy, a woman needs to chart both her cervical fluid and her waking body temperatures (called Basal Body Temperature) each day of the month. (Some people would argue that just monitoring one of these—fluid or temperature—is enough, but doing both is even better.)

Two non-religious friends of mine who are trying to conceive in their early and mid-30s told me they were using NFP methods to learn about the body’s cycles to maximize their chances of having a baby. Quite frankly, I was stunned. So I began to do some research.

A woman’s maximum fertility is during the time she ovulates. But women often ovulate on different days each cycle. So one cycle a woman might ovulate on day 13 and then the next cycle she might be stressed out, or traveling, and she might ovulate on day 18. This is totally normal, but you’d never know it if you weren’t charting.

Before ovulation, a woman’s waking temperature is lower than it is after ovulation. Around ovulation, there’s often a spike in temperature. If you’re charting your body temperatures, these trends become clear after a few months.

Around ovulation, hormones stimulate the cervical cells and produce mucus that looks like eggwhite or white, stretchy goo (not the scientific term). Women often notice a bit of “white stuff” or “leaking” in their underwear mid cycle; this is the normal and natural cervical fluid. When the cervical fluid is at its peak, a woman is at her most fertile.

So a woman who is trying to avoid pregnancy could chart both her temperature and her cervical fluid and avoid sex when she’s most fertile. A woman who is trying to achieve pregnancy, will chart and monitor in the same way, but when that cervical fluid starts flowing, she’ll clear her schedule, grab her husband and block out some time for romance.

Does it work?
NFP is 99% successful at limited or spacing pregnancies “when used as directed,” as the ads would say. What this means is that if you understand the methods and you follow the guidelines—every day—it works. Out of 100 couples who follow all the guidelines carefully, only1-3 will get pregnant in a year. If you don’t follow all the guidelines, it’s less effective: About 2-15 will get pregnant in a year.

NFP is very effective for couples trying to get pregnant because it helps couples to know when the optimum time is for conception.

Who uses NFP?
According to the United States Conference of Catholic Bishops, less than 4% of Catholic married couples of childbearing age use natural family planning methods. Translation: Most couples use birth control, not NFP.

Most Catholic doctors aren’t insisting on NFP methods either: According to a 2005 national survey, 87.5% of 327 self-described Catholic physicians said they would “prescribe birth control to any adult patients that request them and for whom they are medically appropriate.”

In fact, most doctors don’t know a lot about NFP, says Dr. Theresa Notare, assistant director of the Natural Family Planning Program for the United States Conference of Catholic Bishops. This is especially a problem when couples are faced with possible infertility.  Infertility has become a money-making industry, and most doctors will push a woman straight toward in vitro fertilization rather than taking the time to explain to her how her body works.” This is a shame, she adds, because understanding a woman’s cycle is one of the first things a couple should do if they want to get pregnant.

If you’re having sex before marriage, can you use NFP when you get married?
The majority of young adults—including Catholic young adults—have sex before marriage. If you are a woman using birth control pills or other forms of hormonal contraception, but you want to use NFP when you get married, you can make the switch … with some advanced planning.

To prepare for NFP in marriage, the first thing the couple needs to do is abstain from sex, and stop other forms of birth control. “We know a lot of young people are sexually active before marriage,” says Dr. Notare. “A woman who is a on the birth control pill will need to come off the hormonal contraception and then wait for her body to get back into a normal cycle.” This may take one cycle or up to a year of cycles, depending on the woman. While each different natural family planning method has its specific guidelines, three months of charting and monitoring fluids will usually be enough to teach a couple how the fertility cycle works.

Should men care about this?
NFP is only effective when a couple works together to abstain or plan sex at certain times. Communication between the couple is key, and if you and your spouse can work together to create life and plan your family, it can be a bonding and growing experience. “It’s always best to teach a couple together,” says Dr. Notare. “The guys get really excited. For them to find out how their beloved is constructed, how the science and methodology of a cycle works, it’s a big deal when the men understand it.”

Why does the Catholic Church endorse NFP?
According to the Catholic Church, NFP is a morally acceptable way of spacing and limiting the number of births a married couple has. Just like God paused before each act of new creation in Genesis, it’s OK for married couples to space out the number of kids they have

On a basic level, Dr. Notare says, couples who learn NFP are learning about fertility education. “By practicing NFP, you are honoring your body and understanding that it as linked to the life force. The church’s support for NFP it’s not based on merely being natural but that they respect the value of life.”

Natural Family Planning
Do you have a favorable opinion of natural family planning—or do you think it’s too complicated or ineffective? Thinking of trying NFP now or in the future? Share your thoughts on Natural Family Planning by taking a short survey here. To Answer the Questionnaire, Click Here

The Catholic Church teaches that the holy and the divine and the spiritual are one with the body and nature. To block human fertility—to prevent the creation of life—with hormones or condoms can be seen as separating the body and the spirit. Married Love and the Gift of Life is a great resource to understand the scriptural and practical reasons of the Catholic teachings on NFP.

So, what do you think?
Share your thoughts by emailing me at puresex@bustedhalo.com and by taking the survey on the right side of this page. Have you and your spouse used NFP? Have you taken an NFP seminar and decided not to use that method? Do you think the Church should be open to other methods of birth control? Let your voice be heard!

And stay tuned for a follow-up column incorporating your thoughts — and why my non-Catholic and non-religious friends are turning to NFP methods to try to get pregnant in their 30s.