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is scorned by the vast majority of the medical profession, who do not understand it and believe it to be some sort of outdated rhythm method from 50 years ago as opposed to a rigorously scientific method, based on a woman’s own individual fertility, rather than the standardised version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.

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.