NFA – the perfect example of Gradualism

I’ve been meaning to revisit the topic of NFP or, as I would prefer to call it, NFA and Joseph Shaw has provided me with the perfect opportunity, with a blogpost critiquing this rather natty little video, promoting the benefits of NFP, as opposed to conventional contraception.

First off, I think Catholics need to stop referring to NFP (Natural Family Planning) and instead refer to NFA – Natural Fertility Awareness. The semantics here are important: the former term implies a contraceptive mindset, validating the secular mindset that every family needs to be meticulously planned in terms of timing and number of children, whereas Natural Fertility Awareness is more accurate in terms of the (more often than not) Catholic mindset of those who adopt this attitude towards their sex lives.

Unlike the secular rigidity of the term Family Planning, favoured by our state health agencies, the phrase Natural Fertility Awareness conveys something of the fluidity and indeed flexibility, of the process. Moreover one does not need to be sexually active in order to monitor one’s own fertility and I’m a great advocate of young women (and indeed young men) being versed in the basic principles, before they may actually need to practice it.

There is nothing inherently immoral about teaching young women how to be aware of and chart their individual fertility – the process takes a few months to get to grips with and do so accurately. The engagement period tends to be a busy and frenetic time. observations can be missed or mistaken. It isn’t unreasonable for a married couple to wish for a short honeymoon period where they aren’t plunged straight into the trials and tribulations of pregnancy at a time when they may be attempting to consolidate financially, especially if they have not previously been cohabiting or sexually intimate.

Indeed if more young women were to monitor their fertility then arguably potential problems could be identified and treated more swiftly. Even, Sir Robert Winston, the IVF pioneer has argued that too many women are being automatically referred for IVF treatment after a failure to conceive, when cheaper and more effective treatments may be available. (Such as for example, the NaPro Centre in Ireland).

Natural Fertility Awareness is scorned by the vast majority of the medical profession, who do not understand it and believe it to be some sort of outdated rhythm method from 50 years ago as opposed to a rigorously scientific method, based on a woman’s own individual fertility, rather than the standardised version assumed by manufacturers of hormonal contraception. This leads to a passive attitude adopted by woman, who are taught to believe that their natural fertility is an out of control monster which needs to be medically  suppressed in order for them to stay healthy.

Last week my youngest daughter came up with an alarming looking rash, (it turned out to be some sort of pityriasis) which needed swift checking out by a medic. Unable to get a GP appointment within a few days, I took her instead to the walk-in centre in central Brighton so she could be seen swiftly. This particular centre also happened to be an anonymous walk-in sexual health and GUM clinic. I was particularly struck by the larger -than-life size posters advertising their sexual health and contraceptive services. Basically there was nowhere you could look without seeing adverts for sexual health prominently displayed. (Which is understandable when you consider Brighton’s considerable LGBT population and the location of the clinic, next to the railway station. You can pop in for an anonymous HIV test).

I was sat in front of an enormous six foot banner stand, which displayed a photograph of a clean-cut, wholesome-looking, causal but modestly dressed, pretty young blond woman, advertising “reproductive health services.’ The image has stayed with me precisely because as I thought at the time, the model was obviously chosen for her ordinary look. The message was crystal clear, all young women will be having sex and therefore they need to ensure that they do not have an unwanted pregnancy or contract any sexually transmitted diseases.

It was precisely the sort of image that I identified with as a teenager or in my twenties, just a normal-looking young woman, probably a professional of some sort, living a normal adult life, in sexual relationships and needing to make sure that she was healthy. Sexual health being just one more adult responsibility that she had to deal with. Take the pill, use condoms with new partners, get checked from time to time to make sure you haven’t inadvertently picked up anything nasty – no big deal, all part of being an empowered grown up.

I had bought into that entire mindset which is why the poster really struck a chord with me.  I too was that ‘empowered’ young woman who believed that all romantic relationships ought to involve sex and that consensual one-night stands were no problem. Sex was  a fun and exciting thing to do and most people who had an unplanned pregnancy had been a bit stupid. (Until it happened to me). Everywhere young women go, they are subtly indoctrinated into a certain way of thinking about sex and their sex lives. The poster was deliberately designed to feature a bland image of an everyday, normal attractive woman, with whom most woman would identify. No doubt in other areas, the models used would vary according to demographics.

Which is why it is so important that women are introduced into another way of thinking about their fertility, namely monitoring their own individual cycles instead of being duped into a passive acceptance of long-term hormonal suppression as being the norm.

This is why I don’t have so much of a problem as Joseph Shaw does, in terms of the secular nature of the video, which is perhaps designed to reach beyond the Catholic faithful.

I’ve personally found NFA to be so enriching for my marriage, despite not always managing to avoid pregnancy, that I want to share it with others because it’s a great thing in and of itself, and as Dr Shaw notes, the fewer people pumping estrogen into atmosphere or suffering from potential side effects, the better. Sceptic readers could do worse than read Sweetening the Pill. In January 2014, Vanity Fair published a 10,000 word expose of the Nuvaring, which has been responsible for thousands of avoidable blood clots and hundreds of deaths, all suppressed by the manufacturers who are now facing lawsuits. Wanting to get women off this stuff is an act of charity and mercy.

Advocating NFA to non-Catholics is the perfect example of graduality – get women onto a more natural and healthier way of avoiding pregnancy and it may well prove a useful first stepping stone in terms of evangelisation. It also might do something to engender better attitudes to sex and the rejection of female instrumentalisation, which has to be in the interests of the common good. I cannot emphasise how much of an uphill battle it is to overturn the entrenched attitudes hammered into children by well-meaning but ultimately ideologically blind professionals, since pre-adolescence.

Every secular priest ought to read this too. Ideally have a copy on hand to lend to couples.

For Catholics struggling with NFA, I strongly recommend Simcha Fisher’s Sinner’s Guide to Natural Family Planning, which is unashamedly written from a Catholic perspective. The book does not tell you how to chart, it does not give the pros and cons of NFA, it does not moralise, or tell you how many children you ought to have, but rather it acts as a spiritual accompaniement purely in terms of the sex and relationship issues related to NFP. If only it had been written two years ago when I was struggling with an unplanned pregnancy, in extremely challenging circumstances. Not only should married couples read it, but anyone involved in any sort of ministry involving engaged and married couples and yes priests, I mean you – it’s not a heavy theological tome, it’ll take a couple of days at most, but most definitely a decent use of your time.

Like Joseph, Simcha identifies the notion of being ‘baby-phobic’ but nonetheless she expclicity rejects the idea of the ‘contraceptive mentality’ that many Catholics using NFA have supposedly adopted. Certainly every Catholic I know who uses NFP, does so with a prayerful mentality and to accept NFA is also to accept that sex could always result in a baby, something that our experience has taught us.

In the aftermath of the Synod, there is a troubling narrative doing the rounds, namely that Catholics who avoid children must have a critical reason for doing so. As I said last year, this is explicitly, not the case, and to get hung up on the ‘grave and serious’ reasons for avoiding conceptions, ignores the actual teaching of Humanae Vitae.

What I said in August 2013, still seems pertinent.

Ultimately if a faithful Catholic couple is using NFP then they are still accepting and participating in God’s plan for creation. NFP/NFA accepts that no method of pregnancy avoidance, bar total abstinence is 100%. It is hugely unlikely that such a couple would then opt for abortion or reject an unplanned pregnancy. Practicing NFP constantly reminds one that this is always a possibility which is why NFP encourages spouses to care for and take responsibility for each other.

We should not berate those who use it in good conscience, procreation is one of the missions of marriage but not the sole mission, there are other ways of building the kingdom, the church does not treat children as a moral good to be pursued at the expense of all other moral goods. Gaudium et Spes 50 suggests that having a large family would be the generous thing to do, but also states that it is up to couples to decide.

But berating those for using NFP to avoid in good conscience, or discouraging discussion of using NFP to plan a family responsibly, is not the way to go, particularly for those encountering these concepts for the first time, which sadly seems to be a not insignificant proportion of the faithful.

To be clear, Joe Shaw did not advocate that everyone should have 10 children, nor did he insist that the reasons for avoiding children ought to be life-threatening, but he was stating that the vocation of marriage must include openness to children. The challenge is how to communicate this beyond the Catholic faithful.

Postscript for the sake of transparency

I am extremely happy to go on record as saying that following the birth of our fifth (God willing, living) child in March, I am no longer open to pregnancy.

I should not need to justify this to the Catholic faithful and it speaks volumes that I immediately feel defensive about this decision. Couples ought to be trusted to prayerfully discern what is right for them in their particular circumstances without having to defend themselves to random shouty online strangers.

For those wishing to ‘judge’ my Catholicity, the reasons are as follows:

  1. As I age, pregnancy is exacting an increasing toll on my body physically. This is in turn having an impact on the rest of the family as I am constantly exhausted and unable to function at full capacity. Due to the transient nature of our living circumstances over the past few years, there are no family or friends close by to help pick up the slack. While pregnancy is only a temporary stage, this recent piece from First Things notes that Catholics should not shy away from accepting and validating its difficulties. I am one of those women for whom pregnancy is a form of the Passion.
  2. I am facing my fourth cesarian section. While I know of women who have had as many as seven, 4 is considered the upper limit for this to be performed safely by most surgeons. During the birth of our youngest daughter there were some difficulties in terms of scar tissue and a large amount of adhesions; this next procedure is expected to be complicated and may well result in some damage to surrounding organs or emergency hysterectomy. A recent ante-natal appointment resulted not in discussion of the wellbeing of my unborn baby, but my being exhorted to accept sterilisation while I was on the table. An option which I have declined.

So no doubt in being very clear that we wish to avoid pregnancy – we fall into the scandalous contraceptive mindset. Perhaps the difference is that it’s not that we reject the idea of further children, but of further pregnancies?

However if the Catholic Church really wishes to throw off her image of misogynistic judgementalism, perhaps advocates of the vocation of marriage, ought to embrace the positive instead of loudly critiquing what they believe to be the motivations of the imaginary minority. I don’t need some shouty man imagining that he can persuade the world to tell me how I need to put my health and family at risk if I wish to save my soul or trying to engage me in online discussion about how married couples need to be open to life 100% of the time. Actually this is one issue where the feminists have a point, there is something particularly grating about a man who does not ever experience the physical tribulations of pregnancy and childbirth telling women how they ought to feel about the subject, no matter how logical, rational or theologically correct he may be.

Using NFA requires trust and a whole new way of thinking. Let’s encourage people to do that without telling them exactly what their decisions should be or implying that they ought to have fifty children until their uterus drops out.

13 thoughts on “NFA – the perfect example of Gradualism

  1. Any chance we might see you at the 2014 UK NFP Conference ( in a couple of weeks time?

    A good chance to discuss some of your points with NFP/NFA practitioners, perhaps!

  2. Good Post. My dear friend, having five caesarian births is five heroic acts of virtue. The Church would not have objected to you stopping at one. Thank you for your commitment to life. And I am one of those Catholics who think we should carefully discern whether it is time to conceive or not. We can fall into selfish habits. My husband and I used NFA to both conceive and postpone pregnancy. I supported the family during the first six years of our marriage. Unfortunately, we miscarried two of our planned pregnancies, and were unable to conceive again after number three. We have two children in heaven and a 26 year old son. He was the one in the middle. God bless you. Susan Fox

  3. While I understand the beauty of NFA I can’t help but remain skeptical of its effectiveness. I do hope the church funds more research into figuring out the EXACT times when a woman is fertile/infertile instead of a ballpark figure. I know of many faithful catholic women whose bodies cannot undergo another pregnancy, but still need intimacy with their spouse to keep their marriage strong. Then there’s the fact that raising big families in this century is increasingly difficult, both monetarily and spiritually speaking. Hopefully the Church can devise a way to address these issues without making the women seem as though they’re being lustful sinners vs loving wives and mothers.

  4. Great Post! In the past I was wholly in agreement on this, but I’ve come to modify my position.
    I think it’s certainly true that learning about one’s physiology tends to bring about significant changes in the way women approach their sexuality. Certainly, observation of cycles, points to certain logic about the whole thing, and disillusionment about the way this is distorted and belittled by hormonal contraception.
    I’m sceptical about it serving as a perfect example of gradualism though. There’s rising popularity for secular methods of fertility awareness, but I don’t think their practice leads inexorably to a catholic understanding of sexuality for those who engage in them, in fact, I actually think it would be necessary to already have a strong commitment to catholic sexual morality in order to provide the motivation to abstain during the fertile period rather than use barrier methods or other illict forms of recreational activity, and lots of people on the TCoYF message boards combine commitment to non-contraceptive sex with pro-abortion views.

  5. Monique. NFA has been studied scientifically. The NaPro Center that Caroline mentioned is just one scientific group. There is no doubt it is more effective than condoms or artificial contraception, which is actually a form of micro abortion nowadays. Many forms of chemical contraception allow you you to conceive, but make the womb inhospitable to human life so you miscarry (abort). Really, the only reason anyone would feel insecure about using it is if they couldn’t trust their spouse to communicate and abstain. And that is a separate problem in the marriage.

    NFA invites the spouses to equality and communication. When they tested the early forms of birth control, two women died. They kept testing. They did test a male form of contraception and a man lost his libido. They immediately stopped testing. Artificial contraception puts the burden of birth control on only one partner, with health consequences for the woman or the man (vasectomy). Yes, artificial contraception (with the burden of contraception on only one partner) does make it very convenient NOT to discuss the matter with your spouse. But I don’t regard that as a good marriage. God bless you. Susan Fox

  6. Several points. One the Evangelicals in the States has been into NFP since the early 1980s and they have not become Catholics. In fact, I was originally trained in NFP by Evangelicals, way back in 1980, when there were no Catholics in the area doing this. These people are still Evangelicals

    Second, being a Catholic has nothing to do with NFP. NFP is not “Catholic” but natural. It is contraception by omission and is intrinsically immoral, which is why I never did it and came to realize that teaching had to be connected to other things as it is right only correct in critical situations-in the canonical terminology, one must have grave reason, to prevent an evil occurring. Once I figured this out, I stopped teaching NFP.

    Third, a woman who is doing NFP should not be talking about this. Sorry, but this is not for public consumption. Why are you sharing such private things on line? The sexual act is sacred and should only be discussed in private, or retreat like meetings.

    We are like God in the sharing of the creative act.

    1. Marie. Several Points.

      1) The Evangelicals may not have converted to Catholicism, I suspect however that this is more due to several of their core beliefs being inimical to Catholicism and that NFP happens to be a shared area of concern.

      2) No-one has claimed that being a Catholic has anything to do with NFP. You appear to have missed the point about why NFA is a preferable term to NFP, precisely to avoid NFA being used as contraception by omission. It is true however that Catholics tend to be more spiritually disposed to correct use of NFA.

      3) I stand by my initial point that getting women off hormonal contraception is an act of mercy. I’ll quote Deacon Augustine from the comments on Joe Shaw’s blog in any event.

      “NFP/NFA is simply a tool and like any other tool it can be used for good or evil purposes. God knows every last intention in our hearts and ultimately it is only His judgment which will count.

      But if people start by doing the right thing for wrong reasons, isn’t it more likely, that by the help of God’s grace, they will grow to do the right thing for the right reasons, than if they have committed themselves to doing the wrong thing at the outset?”

      4)NFP is sanctioned by Humanae Vitae 16 – lawful recourse to infertile periods. It is not therefore contraception by omission. You would appear to be at odds with Catholic teaching and the magisterium if you are claiming that it is not Catholic and furthermore run the risk of seriously misleading women. In a situation such as mine for example, it is absolutely not gravely immoral to avoid future pregnancies. One could easily argue that my becoming pregnant again is not an evil, as your point would suggest, nonetheless it would prove extremely harmful. However I suspect that if you don’t accept the teaching of Blessed Paul VI, there is little point debating this further with you.

      5) Simcha Fisher has written an entire book about using NFP from the perspective of one who uses it both to achieve and avoid pregnancy. I trust you have contacted her in order to inform her of how misguided she is in her writing of this book?

      6) To be clear, I am not sharing anything about our sexual life online rather being clear that I have grave and serious reasons to avoid pregnancy with the aim that other women may understand that the Catholic church does not compel women to put their health or indeed their lives at risk.

      If you have drawn certain inferences that is down to you alone and indeed, I suggest that perhaps you acquaint yourself with Ed Peters blog in terms of suggestions he makes about married deacons and priests and their obligations to chastity.

      If one takes into account Professor Peter’s suggestions about canon law and continent marriages, one could even suggest that by even mentioning my husband’s forthcoming ordination, I am somehow sharing in the creative act.

      I would like to think however, that my intimate life is not of any interest to anyone else and I am shocked that a post about NFP should prompt a response about my own personal life. May I suggest that this is not a topic that you ought to be alluding to, as indeed I have not.

      Best wishes.

    2. Marie, if women who are doing NFP can’t talk about it, how is anyone else to learn?

      The best teachers of this sort of method are those using it themselves – men and women alike..

  7. You did refer to your own life’s experience by referring to NFA in your marriage.. NFP is only to be used in severe cases, according to the language given by the Church and NFA is not any different. Abstinence is only one more way of not having children, which is not the perfect will of God. HV does not encourage regular use of NFP. If for severe reasons of health or extreme suffering, a couple may abstain for a while. The Church teaching is clear that we are NOT to plan our families.

    As to artificial contraception, it is always intrinsically evil and the Church in England has been most lax about teaching this, after the rebellion of the hierarchy after the promulgation of Humanae Vitae.

    As to the Catholic Church being anti-woman, it is precisely the Church which elevated the status of women throughout history by honoring the Theotokos and honoring all mothers, as well as the single women. The great leaders of the middle ages and earlier, such as St. Etheldreda, owe their status to the Church.

    I do not hear or see men being judgmental at all anywhere. Quite the contrary. It is more likely that men pressure women to use artificial contraception in marriage, which is a horrible thing.

    1. I suggest you read my post on spacing of families and use of NFA from last year.

      Not having intercourse during fertile periods is not a sin in and of itself.

      I happily confess to using NFA given that my fertility returns full pelt 12 weeks post partem despite extended/ecological breastfeeding and do so in good conscience with the backing of my spiritual director.

      We are called to be generous woth our family size and open to life but not to pursue this to the detriment of our own and our existing families’ wellbeing.
      Church teaching IS clear that it is up to a couple to prayerfully discern their family size according to their circumstances.

      As to artificial contraception – nowhere do I condone this and equally nowhere have I claimed the Church is anti-women.

      I have encountered many lay Catholic men however taking a ridiculous and un-Catholic stance on when abstinence is acceptable which according to them is almost never.

      Teaching women how to avoid pregnancy through use of infertile periods is not problematic. If it were Mother Theresa would not have employed it in the slums of Calcutta.

      You give women and couples the information on how to achieve/avoid pregnancy and also the catechesis of the Church. You then allow them to prayerfully discern what is right for them in their own individual circumstances.

      The Church does not give a specific, objective list of legitimate reasons for avoiding/achieving pregnancy but rather guidelines. Look at CC2368. Pope Pius XII in his address to Italian midwives mentioned serious reasons for avoiding pregnancy “medical, eugenic, economic and social…which not rarely arise”.

      The phrase about contraceptive mentality originated with St John Paul II in Familiaris Consortio & Evangelium Vitae to describe a modern mindset which encompasses widespread acceptance of literal contraception and lays the foundation for other heinous offences against the human person like abortion and sterilisation. Nowhere is there any evidence that he was speaking of people who use NFP with the wrong mentality.

      But where people do misuse NFA it is the mindset of that individual couple at fault, there is no specific sin of avoiding pregnancy and that is for good reason. Using NFA selfishly is the sin of selfishness, not the sin of contraception and we should not go inventing new sins that appear nowhere in the Catechism or any church document.

      Church teachings do not replace an encounter with the Creator and this is what what judicious use of NFA encourages.

    2. Also just thinking about this, it is important that women who use NFA to avoid are able to discuss this in order that some general principles can be established as the Church does not set any hard and fast rules and as you say, clergy never talk about this!

    3. Generously providing a personal testimony about living out church teaching, which is what Caroline has done here, is entirely different to sharing details of marital relations, which is what you’ve accused her of.

      HV entreats couples to ‘responsible parenthood’, the precise outworkings of which, will vary considerably between different couples, and between the same couple at different points in their marriage, but as you say, this is a subject to be discerned by spouses themselves, and it’s not appropriate for strangers on the internet to assume they can be an audience to this process!

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