Natural family planning

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Natural family planning
Background
B.C. type	natural birth control
First use	Mid-1800s (statistical); 1930s (BBT); 1950s (mucus)
Failure rates (per year)
Perfect use	1-9%
Typical use	3-25%
Usage
Reversibility	Yes
User reminders	Dependent upon strict user adherence to methodology
Clinic review	None
Advantages
Periods	Prediction
Benefits	In accord with Catholic teachings, no side effects, can aid pregnancy achievement
Disadvantages
STD protection	No

This article is about religiously-motivated methods of family planning. For a more general use of the term, see fertility awareness.

Natural Family Planning (NFP) is a set of Catholic-sanctioned methods of family planning, which help women to achieve or avoid pregnancy by identifying times of infertility and potential fertility. NFP excludes the use of artificial birth control methods and orgasmic acts outside of marital intercourse, promoting abstinence during high fertility times for couples trying to avoid pregnancy.

Some methods of NFP track one of the primary fertility signs: Basal body temperature, cervical mucus (e.g. Billings, Creighton, Two-Day Method), and cervical position. If two or more signs are tracked, the method is referred to as Sympto-Thermal. Other methods make statistical estimates as to when a woman is fertile (e.g. Rhythm Method, Standard Days Method). The Lactational Amenorrhea Method helps identify and/or encourage breastfeeding infertility. The Rhythm Method, the most well known method of NFP, has a perfect-use failure rate of 9% per year, while other types of NFP have lower perfect-use failure rates — between 1%-3% per year. The common usage failure rate is up to 25% per year.^[1][2]

Contents 1 Users 2 Rationale 3 Benefits 3.1 Divorce rate correlation 3.2 Claims for improved communication 4 Disadvantages 4.1 Implantation failure and miscarriage 5 See also 6 External links 7 Footnotes

[edit] Users

NFP and total abstinence are the only methods of preventing pregnancy approved by the Roman Catholic Church. Worldwide, many Catholics use NFP in obedience to church teaching. However, the practice of NFP among Catholics in developed countries is low. While Catholics made up 24% of the U.S. population in 2002,^[3] only 1.5% of sexually active Americans avoiding pregnancy were using NFP.^[4]

NFP is also practiced by many Protestant Christians. Some find the Catholic rationale convincing, and others use it for their own reasons.^[5]

[edit] Rationale

Catholic doctrine holds that God created sexual intercourse to be both unitive and procreative.^[6] Deliberately altering fertility or the marital act with the intention of preventing procreation is considered to be sinful. Thus, artificial birth control methods and orgasmic acts outside of full marital intercourse are forbidden, while not having sex at all (abstinence) is considered morally acceptable. ^[7] Note that while deliberate orgasmic acts outside of full marital intercourse are forbidden, the Church does not condemn foreplay outside of the context of a normal marital act; that is, so long as foreplay culminates in penetration and climax within the woman. ^[8]That said, the Catholic Church is understanding of "bad timing" and unintended climax outside of the wife.

However, having sex at an infertile time in a woman's life (such as pregnancy or post-menopause) is also considered acceptable, since the infertile condition is considered to be created by God, rather than as an act by the couple intended to frustrate fertility.^[9]

Thus, it is considered morally acceptable to abstain during the fertile part of the woman's menstrual cycle.^[10] Increasing the postpartum infertile period through particular breastfeeding practices — the Lactational Amenorrhea Method — is also considered a moral way to space a family's children.^[11]

The benefits of spacing children are recognized by the Catholic Church^[12] and use of Natural Family Planning for this reason is encouraged. Humanae Vitae cites "physical, economic, psychological and social conditions" as possibly compelling reasons to avoid pregnancy.^[13] Couples are warned, however, against using NFP for selfish, immoral, or insincere reasons. ^[12] Many Catholic sources extol the benefits children bring to their parents, their siblings, and society in general, and couples are encouraged to have as many children as their circumstances make practical. ^{[14] [15] [16] [17]}

[edit] Benefits

• Fertility awareness forms of NFP can be used to track reproductive health in general, and aid in the diagnosis of gynecological health and/or fertility problems. Particularly with the Sympto-Thermal Method, which is based on a scientific method of self-observation, temperature, external and internal mucus, and cervical observations are all recorded daily on a calendar. Any observation of irregularities may prove helpful, providing a doctor or gynecolotist with important diagnostic information with dates and a personal history of any abnormalities.^[18]

• Since NFP methods do not interfere with natural female hormone cycles, NFP has no proven side effects, such as weight gain^[19] unlike chemical and hormonal contraceptives.

• Use of NFP to avoid pregnancy requires abstinence during fertile times. However, during infertile times NFP does not interfere with the spontaneity of intercourse, as barrier methods sometimes do.^[20]

• NFP can be free or very low-cost.^[19] Some methods encourage the use of a thermometer and/or photocopied charts, or purchase of CycleBeads. Some couples choose to use special computer software or other paraphernalia.

• NFP is morally acceptable to many religious denominations, specifically the Catholic Church, whose teachings prohibit the use of artificial contraception.^[19]

• The fertility knowledge gained from NFP methods can be used both to avoid pregnancy and to help achieve pregnancy.^[19]

[edit] Divorce rate correlation

Proponents of NFP say it increases marital satisfaction and helps lower divorce rates. Anecdotal evidence and small studies are put forth in support of this view.^[21] One study involving 505 women using NFP found a correlation between lower divorce rates and the use of NFP.^[22]

[edit] Claims for improved communication

Fertility awareness forms of NFP (which require daily charting of fertility signs) can result in couples communicating more about their bodies and sexuality; this is said to improve communication skills throughout the entire marriage. The honeymoon theory holds that the scheduled abstinence encourages couples to express love in non-genital ways, and to have a greater appreciation for intercourse when it does happen.^[23] To date there has been no study exploring this theory.

[edit] Disadvantages

• Some methods of NFP require up to six months of research and observation in order to collect baseline data, so these methods cannot be immediately implemented by a new user. ^[24]

• Some fertility awareness forms of NFP require observation or touching of cervical mucus, an activity with which some women are not comfortable. Some practitioners prefer to use the term "cervical fluid" to refer to cervical mucus, in an attempt to make the subject more palatable to these women. Some drugs, such as decongestants, can change cervical mucus. Women may not be able to rely on these forms of NFP while taking these drugs.^[25]

• Some fertility awareness forms require tracking of basal body temperatures. Because irregular sleep can interfere with the accuracy of basal body temperatures, shift workers and those with very young children, for example, might not be able to rely on those methods.^[25]

• The fertility awareness and statistical forms of NFP require periodic abstinence, known as continence, most commonly 8-10 days of each menstrual cycle. It is common for the woman's sexual desire to be highest on those fertile days, and low in other parts of the cycle. ^[26] That the couple must abstain from sex during the woman's periods of peak sexual desire may be deeply frustrating for both partners, and lead to feelings of isolation.^[27]

• Couples seeking the lowest risk of pregnancy (less than 1% per year) may be required to abstain for more than half of each menstrual cycle.

• The NFP methods that encourage breastfeeding infertility can only be used until the woman's first post-partum menstruation. Even the most strict form results in average return of menses at 14 months post-partum,^[28][29] and menstruation can return as early as 6 weeks post-partum.^[30]

• Some schools of NFP teach that orgasmic acts outside of intercourse, such as oral sex and masturbation, are incompatible with the correct practice of NFP. Some couples are not comfortable with this restriction. Periodic abstinence also limits spontaneous sex.^[31]

• NFP does not protect against sexually transmitted disease.^[31]

[edit] Implantation failure and miscarriage

It has been suggested that unprotected intercourse in the infertile periods of the menstrual cycle may still result in conceptions, but create embryos incapable of implanting.^[32] It has also been suggested that pregnancies resulting from method failures of NFP are at increased risk of miscarriage and birth defects due to aged gametes at the time of conception.^[33] The most recent research, however, suggests timing of conception has no effect on miscarriage rates,^[34] low birth weight, or preterm delivery.^[35]

[edit] See also

• Theology of the Body

[edit] External links

• Serena Canada
• The Couple to Couple League
• Billings Ovulation Method
• Natural Family Planning Center
• Creighton Model System
• Family of The Americas
• One More Soul
• The NFP Files
• The GIFT Foundation
• Cardinal Varkey's Letter on Family Planning Trends Among Catholics: Varkey Cardinal Vithayathil, Kerala, India
• openembrace.com - An update from Sam & Bethany Torode, authors of Open Embrace, which details how they have changed many of their views since authoring their book.

[edit] Footnotes