Marketing Natural Family Planning: promoting persons over industry - by Rebecca Oas, Ph.D.

August 14, 2012 (Zenit.org) – The United States Conference of Catholic Bishops designated the last full week of July as national Natural Family Planning Awareness Week, with a focus on introducing people to the concept of NFP in general, debunking the common misconceptions that have been attached to it, and attempting to convince couples to use NFP in place of artificial means of contraception. This goal carries inherent challenges, as the target audience has already been at the receiving end of previous awareness campaigns: firstly, that unregulated childbearing is heartless and negligent, and secondly, that avoiding such irresponsible behavior demands the use of physical and chemical restraints on one’s reproductive faculties.

The sale of these contraceptive measures is a multi-billion dollar business worldwide, and that money also goes toward spreading awareness, from slick professional TV ads to calendars and notepads in doctors’ examination rooms that bear the logos of the latest contraceptive pill or device. In contrast, NFP does not have the backing of a huge industry or lobbying group, and its use does not promise increased income to doctors or pharmaceutical companies — or anyone else, for that matter. Additionally, in a society where changes in health care organization mean that doctors must see more patients in less time, training couples in the use of NFP becomes impractical in that it requires multiple training sessions and a level of commitment on the part of teachers and learners alike that extends well beyond the time it takes to write a prescription.

If the use of NFP fails to generate billions of dollars that may be spent on advertising, the flip side of this is the fact that it is free to the user, with no need of monthly co-pays, insurance coverage, or taxpayer assistance. However, studies that have assessed the demographics of NFP users in the United States have found the women who use modern NFP methods are most often white, Catholic, stably partnered, and college educated (1) — a population which, even in times of recession, is not at the lowest end of the economic spectrum. While NFP has been associated with low divorce rates (2), good communication in marriages, and increased awareness of one’s own fertility cycle, it is important to note that the causal relationships between these things go both ways. Communication, fidelity, and collaborative self-denial are pre-requisites for NFP, even as improvement in those areas may well be a fruit of its use.

So how, then, does one go about educating the public about natural family planning in a world where divorce is rampant, single-parent households are common, advertisements for contraceptives permeate the airwaves even as their byproducts permeate the environment, and the birth of children is either demanded or prohibited, but never simply accepted?

To begin, we can tout the benefits of NFP using some of the standards typically bandied about by the promoters of contraception, phrases like “efficacy,” “failure rates,” and “side-effects.”

This approach works not only because this is the language of much of our culture, but also because NFP has been shown to compete very effectively on those fronts when compared with artificial contraception (3). But to leave the conversation there, in a place where the conception of a person with an immortal soul can be labeled a “failure,” would be to fail, indeed, as the letter P in NFP stands for “planning,” not “prevention.” While advocates for NFP education point out that it can also be used to help couples achieve pregnancy, as a balance for its more commonly referenced use in preventing pregnancy, it bears pointing out that this goal has been successfully accomplished for millennia by simply increasing the frequency of attempts, and that any underlying fertility problems cannot be fully diagnosed nor treated through the use of NFP alone.

As we attempt to educate the world, beginning with ourselves, about the use of NFP, it helps to be mindful that Western culture is already a chief exporter not only of contraception, but of the perceived need for it. Even as Melinda Gates pledges billions of dollars to increasing contraceptive “access” worldwide, experts are pointing out that the demand for such products does not currently exist, often due in part to religious or cultural norms (4). Ecological breastfeeding, which results in a period of postpartum infertility, is a natural method of spacing births, but the export and marketing of commercial infant formulas from industrialized nations to less developed areas not only undermines the benefits of this natural practice, but results in increased infant mortality due to formulas being prepared with contaminated water. Furthermore, comparatively wealthy and well-educated societies which, ironically, would be able to support larger families than they typically have, routinely issue documents labeling cultures that encourage large families as retrograde and reckless.

NFP stands in contrast to much of what Western culture offers the world: it elevates commitment over cost, individuals over industry, and stewardship over stranglehold with regard to one’s fertility. Furthermore, it emphasizes the interdependence of couples rather than the absolute autonomy of women, persistence in self-control over quick fixes, and collaboration over individualism. To practice NFP correctly means more than reducing the number of one’s children; it involves strengthening one’s ability to love, and to desire to extend that love through the gift of self and receptiveness to the gifts God gives, even if it means re-examining our priorities.

The benefits of Natural Family Planning cannot be separated from the benefits of family itself, since it is highly unlikely to be practiced outside of a stable, committed relationship of people who respect themselves and each other. However, despite the fact that many of the people who currently choose NFP over artificial contraception are practicing Catholics, it is important to spread the word about NFP throughout our own communities and the world at large. For just as contraception is the Trojan horse by which hostility toward new life is spread, NFP can be a Trojan horse that introduces the culture of life in places where other, more overt approaches might not gain entry.

Rebecca Oas, Ph.D., is a Fellow of HLI America, an educational initiative of Human Life International. Dr. Oas is a postdoctoral fellow in genetics and molecular biology at Emory University. She writes for HLI’s Truth and Charity Forum.

1)Stanford JB, Smith KR. Characteristics of women associated with continuing instruction in the Creighton Model Fertility Care System. Contraception. 2000 Feb;61(2):121-9.
2)http://www.physiciansforlife.org/content/view/193/36/
3)Pallone SR, Bergus GR. Fertility awareness-based methods: another option for family planning. Journal of the American Board of Family Medicine. 2009;22:147-57.
4)http://www.c-fam.org/fridayfax/volume-15/experts-call-%E2%80%9Cunmet-need%E2%80%9D-for-family-planning-baseless.html 

‘Dehumanizing’ and ‘insulting’: Kenya Bishops slam Melinda Gates’ contraception plan for Africa - by Peter Baklinski

NAIROBI, Kenya, July 31, 2012 (LifeSiteNews.com) - The Catholic Bishops of Kenya have collectively slammed a pro-contraception article that appeared in the country’s Africa Review earlier this month as “dangerous” saying that it could “lead to destruction of the human society and by extension the human race.”

“We cannot allow our country to be part of an international agenda, driven by foreign funds and by so doing, losing our independence and our African values of the family and society,” wrote John Cardinal Njue, chairman of the Kenya Episcopal Conference of Bishops in a letter titled Let us Uphold Human Dignity. 

The article that the Bishops wrote against, titled “Kenya joins global birth control push”,  mentioned that Kenya is among the countries that have “signed up to a new $4.2 billion (Sh356 billion) drive to promote family planning services”, adding that leaders of more than 20 developing countries made “bold commitments” to address “financing and delivery barriers” that women face who seek contraceptive services and supplies.

The article also mentioned that Planning minister Wycliffe Oparanya attended a summit in the U.K. as part of the World Population Day where the Bill & Melinda Gates Foundation, co-hosts of the event, “underscored the importance of access to contraceptives as both a right and a transformational health and development priority.”

But the country’s Catholic Bishops made it clear that they would have nothing to do with the “artificial family planning programme” by “foreign forces”.

“[T]he use of contraceptives […] is both dehumanizing and goes against the teaching of the church, especially in a country like Kenya where a majority of the people are Christians and God fearing. It already threatens the moral fabric of the society and is an insult to the dignity and integrity of the human person.”

The Catholic Bishops urged all Kenyans and the country’s government leaders that “any development which does not protect the human person is meaningless and in vain.”

The Bishops slammed the program for targeting millions of girls and women in Africa with contraception while “many women are dying daily due to lack of proper medical care, food and housing.”

The Bishops point out that there are other “efficient ways of proactive and Responsible Parenthood through the practice of Natural Family Planning” that do not contradict the “centrality of the human person”.

“This of course demands discipline through abstinence, which is a necessary value in married life. This should not be rubbished as impossible,” they wrote

“Nobody should be forced to abuse his/her dignity through contraceptives”, the Bishops conclude.

Melinda Gates’ recently-launched campaign to distribute contraceptives to African women has come under attack by critics who say that it is based on “an unfounded and second-rate understanding” of the issue.

Italian journalist Giulia Galeotti called (http://www.lifesitenews.com/resources/birth-control-and-disinformation-the-risks-of-philanthropy) the Gates’ plan “off-target” and suggested that the people running it were “confused by bad information and by the stereotypes that persist regarding this topic [of family planning].”

Galeotti suggested that Gates must be unaware of the reliability of existing family planning methods that are entirely natural, such as the Billings Ovulation Method, which is not only moral in the mind of the Catholic Church, but is also completely free in that in involves no plastics or costly drugs. 

“Using this method, women can know if they are fertile or not, and based on that, can choose their sexual behavior,” wrote Galeotti, adding that the communist government of Peking promoted the method of regulating births that “cost nothing and didn’t damage the health of the woman, a method considered 98% reliable.”

Expert Notes 'Alarming Data' Connecting Oral Contraception and HIV Transmission

In NCR

An interview with Dr. Timothy Flanigan, an authority on HIV/AIDS prevention and treatment.

by JOAN FRAWLEY DESMOND 

The Bill and Melinda Gates Foundation held a July 11 summit designed to raise an estimated $4 billion to promote contraception in the developing world.

The Gates campaign comes amid new research suggesting that use of hormonal contraception doubles the risk of both transmission and acquisition of HIV in regions like sub-Saharan Africa. Register senior editor Joan Frawley Desmond turned to HIV/AIDS expert Dr. Timothy Flanigan to explain how this research is likely to transform family-planning campaigns.

Flanigan offers insight into understanding how big global health organizations and foundations approach these issues and how they perceive natural family planning. He also answers the burning questions: Why is pregnancy presented as a dangerous medical condition? Are there new opportunities to promote natural family planning?

Flanigan is a professor of medicine and infectious diseases at Brown University Medical School and practices at Miriam and Rhode Island Hospitals in Providence, R.I. He has been caring for patients with HIV/AIDS for 25 years, and his research on HIV prevention and treatment has been funded by the National Institutes of Health and the Centers for Disease Control and Prevention. He is the father of five and is enrolled in the deacon program for the Providence Diocese.

 

You’re an authority on HIV/AIDS who has published hundreds of peer-reviewed studies on HIV/AIDS transmission, participated in global conferences and cared for patients with HIV/AIDS near your home in Rhode Island. What are your concerns about the promotion of contraception in Africa and other parts of the developing world?

New research raises serious concerns about whether hormonal contraception — Depo-Provera and oral contraception pills (OCT) — actually doubles the risk of a woman acquiring HIV if she is exposed. And if an HIV positive woman is on oral contraception, it may double the risk that she can transmit it to her partner.

 

How was the study conducted? 

It was a very large study that involved seven African countries. The researchers looked at couples with one HIV-positive spouse and one HIV-negative spouse.

The study was designed to look at whether suppressing the herpes virus would decrease HIV transmission. They enrolled well over 3,000 couples, mostly from sub-Saharan Africa.

Since hormonal contraceptives, especially Depo-Provera, are widely promoted in sub-Saharan Africa, the study provided an opportunity to see whether oral or injectable contraception would increase or decrease the risk of HIV transmission. What they found was very concerning: The hormonal contraception widely touted and promoted doubles the risk of acquisition and transmission of HIV.

The study was very well done, coordinated by the University of Washington in Seattle. The results are alarming and have significant implications for programs that actively promote the use of hormonal contraception.

The study was presented at the International AIDS Society in Rome last summer and was then published in the October issue of Lancet Infectious Diseases, a premier medical journal.

Since the study was published, the National Institutes of Health (NIH), UNAIDS and the World Health Organization (WHO) have convened panels to review the research about how hormonal contraception increases the risk of heterosexual transmission of HIV.

 

How will the study’s conclusion likely affect large-scale contraception promotion campaigns like the Gates Foundation’s global program?

There is great concern, because hormonal contraception has been seen as the solution for reproductive-health challenges. This alarming data must lead to a reconsideration of the whole reproductive-health agenda, which has relied on the promotion of hormonal contraception.

 

How long will it take for this research to result in a broader reassessment of the present strategy?

The data have been rapidly disseminated, but the change in practice takes a long time. The field is confused, in disarray and uncertain about how to proceed.

 

In the broader family-planning field, there has been an attempt to assert that post-conception drugs designed to prevent pregnancy do not work as abortifacients.

There is a whole separate issue going on in this field: An effort is being made to say that post-conception contraception does not work as an abortifacient. The reason for this aggressive effort is to normalize it.

This is on the cutting edge of the HHS [Health and Human Services] mandate controversy. People are sympathetic to the Catholic Church’s position that it should be able to deny coverage for abortifacients in its employee health plan. When you poll Americans on this issue, you get very different responses if you explain that abortifacients are covered.

 

Many who oppose artificial contraception on moral or health grounds wonder why global public-health organizations and foundations focus so heavily on contraception promotion and provide fewer resources for other health needs. Is this a fair assessment?

There is an underlying philosophy that the root of almost all problems is too many people and that the way to solve these problems is through population control. That philosophy promotes contraception as the centerpiece of its effort.

Authentic development should not rely on contraception, but on economic, social and community development. When that takes place, families plan their children, and population decreases at a level consistent with improved development.

The other problem with this approach is that women and families want children. Recently, I read an article that reported that women on contraception were still getting pregnant, and they needed to be taught to take their birth-control pills. But one reason they don’t take their birth-control pills is because they desire children.

 

Why are experts in the field so unwilling to consider natural family planning?

Natural family planning (NFP) is wrongly associated with the “rhythm method” promoted many decades ago, an approach that is not effective. NFP has evolved, and today it relies on excellent science and is used by couples to space children and to enhance fertility when a woman wants to be pregnant.

Second, many in the field assume that it can only be used or understood by individuals who have advanced education.

That is not the case. But NFP does require that a woman develops an understanding of her cycle and that a couple together make decisions regarding their sexual relations during the appropriate time in the cycle, as interpreted by the NFP program they use. If the couple is not committed, it doesn’t work.

NFP is relatively complicated and isn’t easy to “dispense.” It’s easier to give a shot once a month than to take the time to educate and then discuss a woman’s questions about her cycle.

Finally, public-health organizations want a family-planning approach that can be adopted by women in vulnerable, abusive circumstances, where sexual relationships are harmful or exploitative, such as commercial sex workers and prostitutes. In that context, the spousal consultation that makes NFP a gift for married couples isn’t possible.

 

So because NFP is more of a challenge in non-marital relationships, it is ignored by global health programs. Sounds like they have adopted a one-size-fits-all approach.

Yes, that is true.

But there are programs being tested in resource-limited areas. For example, the World Youth Alliance is working throughout the island of St. Lucia to develop a knowledge-based reproductive-health program.  There, FEMM or “Fertility, Education and Medical Management” is doing very promising work. It’s an example of the promotion of new forms of reproductive health in an atypical setting. It is getting a lot of positive response from the women and teenagers of St. Lucia, along with the Ministry of Health.

 

Are you suggesting that educating people about NFP, along with other promising reproductive-health programs, is still a work in progress?

It’s always a work in progress, because it’s an intimate, complex issue; and that’s true whenever you are doing work that involves human relationships. No reproductive-health program can be applied in all circumstances, but natural family planning is a beautiful gift that should be promoted. And now that we know hormonal contraceptives carry serious risks, a more holistic approach that includes natural family planning may get consideration.

 

Many pro-life activists view the term “reproductive rights” with suspicion because it is often linked to an abortion-rights agenda. 

Reproductive health should be a top priority. And “reproductive rights” should mean that a woman deserves the best health care possible for her, her family and her children.

But reproductive rights have been hijacked. The term now emphasizes the need for “safe abortion.” An “unsafe” abortion takes the life of a child and risks the life of the mother as well. But the answer is not to promote safe abortion, but to understand and support women so that abortion is unthinkable.

 

A new study funded by the Gates Foundation concluded that effective contraception could save the lives of the “358,000 women  ... [who] die each year because of complications related to pregnancy and childbirth.” Clearly, the Gates Foundation is basing its campaign goals on this study. If you had a chance to advise Melinda Gates, what would you tell her?

Pregnancy can be an enormous challenge to women’s health, and they can develop life-threatening problems. In the developing world, you address the risks associated with pregnancy by providing trained health-care providers such as midwives and providing access to Caesarean section for extended labor.

It’s important to understand that the risk of pregnancy doesn’t mean that women don’t want children. Look at China: Look at what challenges women will overcome to have their children.

The Gates Foundation has been extraordinarily generous, but the idea that the promotion of oral contraception is the No. 1 answer to maternal health needs is misplaced.

Here’s Twenty Bucks: Don’t Have Babies - by Greg Pfundstein and Meghan Grizzle

In Public Discourse

 

Melinda Gates and the Family Planning Summit will waste 4.6 billion dollars on contraception for women in third world countries instead of addressing the educational and healthcare-related challenges pregnant mothers face.

A June 26 press release from Save the Children, an international humanitarian organization, begins ominously: “Pregnancy is the biggest killer of teenage girls worldwide, with one million dying or suffering serious injury, infection or disease due to pregnancy or childbirth every year.”

One million is a big number, and a friend who sent the press release insisted that his jaw dropped when he read that, in his words, “teen pregnancy is responsible for over 1 million deaths a year in the developing world.”

There is a subtle, but important, discrepancy here. The report says one million teenage girls die or suffer serious injury, infection or disease due to pregnancy, the operative word being the conjunction. What our friend read was that one million teenage girls die annually due to pregnancy, full stop. When we read the email, before reading the press release, we were confused. According to the World Health Organization, in 2010, 287,000 women died of pregnancy-related causes. Could Save the Children be so brazen as to claim that the number of teenagers dying in childbirth was nearly three and a half times the total number of pregnancy-related deaths worldwide? We were intrigued.

It turns out that the actual report, Every Woman’s Right: How family planning saves children’s lives, states that only 50,000 women ages 15 to 19 die every year of pregnancy-related causes. Now that’s different. Although this figure is terribly tragic, it represents only 5% of the one million that the press release implies in its first line, “biggest killer…, with one million.” Our friend can be excused for misunderstanding.

The Save the Children report was released as part of an effort to draw attention to the Family Planning Summit organized by Melinda Gates in London this month, which has now concluded with an enormous amount of money—some $4.6 billion—secured to meet the supposedly unmet need for contraception. The blustery rhetoric with which Save the Children and other groups worked to prime the pump for the Summit is a sure sign that we should be wary of the claim of nearly universal consensus that more funding for contraception in the Third World is the answer to the maternal mortality problem.

So do we need more money for family planning? USAID has budgeted fully $547 million for family planning in 2012, and the Gates Foundation spent $437 million in 2009. With EU nations included, we are easily over one billion dollars in family planning funds annually. That’s a lot of money. We need more? Every dollar spent on family planning is a dollar not spent on other urgent needs, like education, basic health care, and infrastructure.

There is no question that it is a travesty when anyone dies of a pregnancy-related cause, and it is particularly tragic when adolescents do. But the vast majority of these maternal deaths are preventable. Let’s look at how $4.6 billion could be used to reduce maternal mortality.

First, the provision of skilled birth attendants is particularly critical to combat maternal mortality. According to UNFPA, providing skilled birth attendants to all women would reduce maternal mortality by 75 percent.  Skilled attendance at birth has been shown to correlate with lower maternal mortality ratios. A survey of 58 countries where 91 percent of maternal deaths occur shows that less than 17 percent of the world’s midwives are available in those countries. The provision of midwives worked in Sweden in the 1800s, and it has worked recently in countries such as Sri Lanka, Malaysia, Thailand, and Egypt. A large scale birth attendant training program would be a straightforward, highly measurable, and long lasting intervention that would significantly decrease the maternal mortality ratio. Gates’s $4.6 billion will not be spent on such a program.

In addition, access to education should be a major concern in efforts to decrease teenage pregnancy and the maternal mortality ratio. More educated women delay and space their pregnancies, which allows them to maintain their health, and education empowers women to determine for themselves how best to control their fertility.

The educational level of women is also highly correlated to the maternal mortality ratio. The education a woman has represents both the opportunities she has had and the opportunities she will have in the future; it also “promotes increasing autonomy, awareness, responsibility and knowledge for self-care, healthy lifestyles and behaviours.” An educated woman therefore will access the appropriate maternal and reproductive health services, including skilled birth attendants, greatly reducing her likelihood of maternal death. This affirms the central role of education in combating maternal mortality. Also, because women’s educational attainment means access to information about appropriate prenatal and postnatal care and childbirth, it follows that the maternal mortality ratio can decrease in areas where women typically do not have a high educational attainment, so long as they are provided with information about best practices related to their pregnancies. Gates’s $4.6 billion will not be spent on primary and secondary education for girls, either.

Adolescent girls and women also need access to basic and maternal health care. When governments focus intensively on maternal and child health, introducing health measures such as low-cost basic health care, including prenatal, postnatal, and obstetric health care, and social protection for the extreme poor, the maternal mortality ratio decreases drastically. 4.6 billion dollars could also help improve the poor medical infrastructures in countries with the highest maternal mortality ratios.

The push for contraception as a solution to maternal mortality is also problematic because many women won’t use it. The claim that 222 million women lack access to contraception is misleading. First, it is not necessarily a matter of access. Many women have access to contraception and choose not to use it. Social scientists and public policy experts identify women as having an unmet need for contraception even when those women have not expressed a desire to use contraception. The idea of unmet need for contraception ignores the reasons for unmet need that women express, such as concern about health and other side effects of artificial contraception, and incompatibility with religious and ethical beliefs. The fact that a woman is not using contraception is not the same as an unmet need for contraception. The more relevant datum would be the number of women who want contraception and cannot get it. That number is much less than 222 million. Another helpful figure would be the number of women who do not want to use contraception and do not have access to other methods of family planning, such as knowledge-based fertility education programs.

But even if we assume that it is true that 222 million women want contraception and can’t get it, do we really need $4.6 billion more in funding for contraception? That’s twenty dollars for each woman. A woman whose education has not been improved; whose access to essential healthcare has not been improved; whose very real and legitimate desire for children has not been met; whose economic opportunities have not been improved a whit. For this woman, Melinda Gates has one message: “Here’s twenty bucks; don’t have babies.”

Even worse, the promise of more aid from the Gates Foundation incentivizes local government officials and family planning authorities to start pushing contraception on women even if they don’t want to use it. This can lead to undue influence or coercion, eerily reminiscent of the population control movement.

There is no question that there are vastly different ideas of the value of human life at work here. The folks at Save the Children and their friends at the Gates Foundation think human persons are better off never existing than being born into poverty and dying before reaching their full potential. There are also very different ideas of how population relates to economic development that are quite germane to this controversy. Let that be. As a practical matter, it seems unlikely that Gates and friends will be able to have substantially greater success than decades of similar effort have had. It is a tragedy that they won’t spend their enormous resources trying to empower women who want to bring children into this world to do so safely and with the support of the medical resources they need.

Those of us who value all human life, from conception to natural death, should regret this terrible misallocation of resources, but we should also work to defend and protect, and indeed empower, those women whom Melinda Gates wishes to subject to her idea that contraception is their single most important unmet need. Let’s not forget that this idea is the same idea that underlies the population control movement, which has promoted contraception for decades in an attempt to reduce the population. The Family Planning Summit, which coincided with World Population Day, may not have used this rhetoric, but the simple fact is that women and men ultimately want to bring children into the world. Not all the contraception on earth will change that. Rather than try to prevent them from doing so, we should work to ensure they can do so safely.

Greg Pfundstein is the Executive Director of the Chiaroscuro Foundation. Meghan Grizzle is the Research and Policy Specialist at the World Youth Alliance.

Catholicism offers love lessons contraception fails to teach - by Melissa Moschella

New York City, N.Y., Mar 18, 2012 / 12:49 pm (CNA).- Proponents of the recent Health and Human Services contraceptive coverage mandate often criticize Catholic teachings. Yet how many have truly considered the reasons behind our opposition to artificial birth control?

Have they explored research linking contraceptive use to higher rates of divorce, unplanned pregnancy, sexually transmitted diseases and abortion?

I’ve come to embrace Catholic sexual teachings not because I was taught them from childhood (I was not) but through my own reflection. As a Harvard undergrad and now a Princeton Ph.D. student, I’ve engaged with defenders of radical feminism and sexual liberalism, yet I find the Catholic position more convincing.

Any informed citizen — especially anyone inclined to dismiss Catholic sexual teachings as obsolete or anti-woman — ought to know some basics about the Catholic perspective.

First, the concern for women who need birth control pills as a hormone treatment is a nonissue. As Pope Paul VI’s encyclical "Humanae Vitae" states, medications necessary to treat hormonal imbalances are morally unproblematic, even if infertility is a side effect. Mandating insurance coverage for such treatments would be acceptable from a Catholic perspective. Catholicism is not against treating diseases; it is against treating fertility as if it were a disease.

"Humanae Vitae" is also noteworthy for predicting that liberal sexual ideology, and the “contraceptive mentality” it fosters, will lead to the treatment of women as sex objects. Indeed, our post sexual revolution culture is marked by the objectification of women.

The feminization of poverty (60 percent of those in poverty are single mothers) was an equally predictable result of the higher divorce and out-of-wedlock pregnancy rates that came in the wake of sexual “liberation.”

Contraceptive use increases unplanned pregnancies because when you make a risky behavior less risky, people engage in more of it. Two-thirds of unplanned pregnancies occur among women using birth control.

That also means more abortion — the ultimate backup “contraceptive.” Contraceptives fail at least 10 to 15 percent of the time, with 54 percent of women having abortions using contraception the month they became pregnant, according to the Guttmacher Institute. And, it is important to note, some “contraceptives” can themselves cause abortions — for example, “Ella,” which works similarly to the abortion drug RU-486.Catholicism teaches that sex is about committed love. Relationships based on sensual attraction don’t offer what we’re really longing for — love that endures even when age or illness take their toll.

Sex is powerful body language that says, “I give myself to you completely and for the rest of my life.” To say that with your body when you haven’t said it with your heart and mind is like nodding “yes” while thinking “no.”

The prospect of pregnancy is a nagging reminder that sex inherently calls for total, life-long commitment. Contraception undermines that because it involves making a complete gift of your self while intentionally holding back the capacity to procreate, which is essential to that gift.

Catholicism teaches that sexual union is profoundly good, within marriage and with openness to the gift of new life — the only context in which you actually mean what your bodies are saying.

This doesn’t imply having as many children as possible — in fact, natural family planning methods are 99 percent effective when used correctly — though it does imply a huge shift in our cultural understanding of sex.

The “quick fix” sexual culture has been tried and found sorely wanting. Catholicism reminds us that there is another option, and challenges us not to settle for anything less than genuine love.

Moschella is a doctoral candidate in political philosophy at Princeton University, specializing in parental rights in education.

Expressions of Affection Within Marriage

WASHINGTON, D.C., OCT. 19, 2011 (Zenit.org).- Here is a question on ethics answered by the fellows of the Culture of Life Foundation.

Q: I'd like to ask a question about the appropriate place in marriage of sexually arousing behavior.

I'm getting married in November. I am presently taking an antidepressant medication that could be dangerous for an unborn child. My fiancé and I are planning on using NFP [Natural Family Planning] to avoid pregnancy when we get married. Originally we were excited to welcome a child right away into our life. But now that we know that the medication might seriously harm any child we conceive, we are looking into the legitimate options open to us for responsible family planning (perhaps I'll be able to go off the medication later, maybe I can switch medications, or maybe we'll always need to avoid and we will look into adoption).

I am specifically interested in answering the question whether or not we should avoid arousal after we get married while we're abstaining, in the way we have been striving to do during our courtship. I have read conflicting thoughts on this. I (we) would be grateful for any help you can give us. And we would appreciate your prayers!

William E. May and E. Christian Brugger reply:

A: You ask whether there is any obligation after you are married and legitimately practicing periodic continence to avoid "arousal" during the times when you believe you should abstain from engaging in the conjugal act.

For the sake of clarity, we will presume that your belief is rooted in a conscience judgment that you should not pursue pregnancy while you are taking this medication. Pope Paul VI teaches that "serious reasons" can justify such a judgment (Humanae Vitae, Nos. 16, 10); Pius XII uses the term "serious motives" (Address to Italian Midwives, 1951); John Paul II calls them "just reasons" (Theology of the Body, No. 125.3), and Benedict XVI speaks about "grave circumstances" (Papal Message to Humanae Vitae Congress, Oct. 2, 2008). Avoiding severe injury to a gestating child clearly is a serious reason to abstain from intercourse during fertile periods, and so without knowing further details, you do seem justified in using NFP to avoid pregnancy.

By "arousal" we take you to mean sexual arousal that ordinarily leads to genital intercourse. It is the kind of behavior that helps the male have an erection and the female to receive him bodily into herself. This behavior is, of course, good and upright for married couples to intend when they are preparing for intercourse. We presume that you and your fiancé are presently avoiding "arousal" behavior of this kind, and rightly so, since you are not yet married.

It seems to us that a married couple, who judge they should not engage in the conjugal act here and now, also should not deliberately cause the kind of arousal befitting the preparation for intercourse, and so should avoid arousal type of behavior. This does not exclude ordinary expressions of affection. But behavior that deliberately causes genital stimulation is more rightly considered "foreplay." It is likely to put oneself (and one's spouse) into a proximate occasion of the grave sin of masturbatory behavior; or to tempt the couple, in the heat of the moment, to engage in intercourse against their prior moral judgment that they should now abstain. We leave to you the judgments about what types of behavior may elicit this kind of sexual arousal.

We warn against an overly scrupulous interpretation of what we've said. A mark of a healthy relationship is the freedom between spouses to love one another and express appropriate affection during "feast" or "famine." If certain types of arousing behavior should be avoided during times of abstinence, this emphatically does not mean that spouses should be distant toward one another. There are a hundred ways to express love and affection non-sexually that can deepen spousal unity during these times: back scratches, foot rubs, hugs, sharing a glass of red wine, watching a good video, taking a road trip, going out to dinner. The most important thing is not to stop talking to one another. Spouses, especially husbands, should not pout or act irritably during times of abstinence because of the sacrifice entailed. It's not the wife's fault -- "her darn fertility" -- that's making you sacrifice. It's your collective moral judgment that this is the right thing to do. As Christians, that moral conviction takes on a greatly enhanced character in the understanding of God's will. This is what Jesus wills for me -- for us -- right now. Embrace it and let it facilitate a growth in charity, humility and self-control.

My Slogan: “Practice Saved Sex!”

by Fletcher Doyle
I am a journalist and a convert. That sounds like an oxymoron.

Two years after joining the Catholic Church, my wife and I began practicing Natural Family Planning (NFP). I found that the chastity required to get through the periods of abstinence caused profound changes in me. I stopped daydreaming of swimsuit models, wealth and fame. I became grateful for all God had given me, most of all for my wife. My appreciation for her and all that she gives me grew, improving an already good 20-year marriage.

I was curious to find out if other people had been so affected. This is where the journalist and the convert converged. I interviewed NFP couples and read thousands of words on conjugal union and the effects of contraception on the relationship between men and women. So for five years I thought about nothing but sex, except during the hockey playoffs. This was a challenge to chastity, but the result was a book, Natural Family Planning Blessed Our Marriage: 19 True Stories (Servant Books).

Here is what I learned. When women took control of fertility with the pill and the IUD in the mid-1960s to the mid-1970s, men said “cool.” Men's behavior changed, as they no longer felt responsible for their sexual partners. (This can be seen in the disappearance of shotgun marriages.)

There was an accompanying drop in commitment between men and women. Trust between the sexes fell because men no longer acted in expected patterns.

When you add in the increase in women's wages and the decrease in men's wages, you created couples who are neither financially nor sexually interdependent. This is why, social scientists say, the divorce rate doubled in that time frame.

NFP can repair the damage. Men acknowledge responsibility to their wives. Commitment increases because the couples know when pregnancy is likely before they make love. Their trust increases: she trusts he will fulfill his obligations when he assents to sex; he trusts she is making accurate observations of her fertility and is keeping him informed.

He develops a sense of awe in the way God made her, and she develops a sense of gratitude that he is willing to sacrifice his own pleasure for her sake. And both grow in their love and trust in God when they see the plan for sex and marriage that He built into their bodies. I have seen and experienced how using Natural Family Planning can make a difference in marriage. That should come as no surprise because it's God's way to practice responsible parenthood – it’s His design for life and love!



Fletcher Doyle is the author of Natural Family Planning Blessed Our Marriage , (Servant

Books).