The Pill vs. NFP
- By Jose R. Fernandez, MD
A Catholic Physician's Story
As a family physician, I was trained that the only way to plan families effectively was to use artificial contraceptives, IUD's or sterilization. Although these artificial methods had side effects, I was taught in medical school that they were worth the risk. Moral consequences were not to be considered since our faith life had nothing to do with our bodies, right? I was constantly reminded that one's bag of morals and life ethic should be left at the doorway to medical education. I was there to serve the desires of my patients whether they wanted birth control pills or tubal ligations. My personal feelings, regardless of Church teaching had nothing to do with my practice of medicine.
To be honest, I never knew what the Church really taught on this subject. Even if I had known, I thought it could not impact the way I practiced medicine.
At the beginning of our marriage, my wife and I used oral contraceptives, but after our first child, we switched to the Sympto-Thermal Method of Natural Family Planning. This decision was not really based on faith, but due to our concerns for the side effects of the "pill" and the fact that my wife never took it consistently anyway.
One day at the end of a rotation during family practice residency, one of my best friends asked me a question that shook me to the roots of my being. "Jose???" he asked, "I know you are a good doctor, but are you a Catholic doctor?"
That simple question threw me into a tailspin. I, like so many other Catholics, thought that going to church on Sunday and going to Confession when you did something "really bad," was all that one needed to be a good Catholic. What I found out was that I could not have been further from the truth.
It took me a while to figure it out. I sought the counsel of many. Most could not appreciate the struggle I was in and why I wrestled with these issues, especially at this point in my life. I was made to feel I would be abandoning my patients and that I would be denying them a service I had provided in the past. After all, what would my patients say to me if I told them that I had stopped prescribing contraceptives, could no longer perform vasectomies or tubal ligations, just because of my Church's teaching?
Through it all, my wife gave me the inner strength to know that I was on the right path. As I grew in my Catholic faith I realized God's plan for me, my family and the patients I cared for, had to do with not only what I was doing, but also the way I was doing it. My wife was instrumental in helping me pick up the pieces. In many ways, she showed me I had not entered into a profession called medicine, but rather I had entered into a vocation-a way of life-one that was very personal. She showed me that my faith and values at home should and could impact my practice of medicine.
Since that soul searching, I have become a strong advocate for Natural Family Planning and the Culture of Life. To my surprise (and the surprise of my colleagues) my patients did not feel abandoned. Some were curious as to why I had made this decision, and said they admired me for standing up for my beliefs.
I find myself each day trying to be more faithful to the God who loves and forgives me. Each day, regardless of the 'hat' I wear, I am able to love a little more and forgive a little more. I have learned there are issues, which cannot be compromised. For me, being a Catholic physician is all I know because my faith has pierced my heart and my soul.
I tell you my story not out of pride, but rather as a way to encourage you in your own journey of faith. As a Catholic, a husband, and a physician, I hope to bring to your attention three things:
1. The effects of artificial contraception on the mind, body and soul.
2. The Church's gift of Natural Family Planning and its effectiveness.
3. The reaffirmation of God's plan for you in your married or single life through the understanding of your bodily cycles.
In my renewal of the Catholic Faith, especially with regard to my medical practice, I learned that God indeed has a plan for each of us: A plan transmitted through His Church, taught through its Magisterium, and presented (among other ways) in the form of an encyclical called Humanae Vitae. Written in 1968, this document outlines the Church's teaching on conjugal relationships and responsible parenthood. It taught that, while artificial contraception in any form is morally wrong at all times and for any reason, natural fertility regulation may be used whenever there is a serious need to avoid pregnancy. This reason could be a medical, psychological, social or economic, temporary or permanent one.
Humanae Vitae not only detailed the evil of contraception, but also stressed the serious consequences that would befall society if we fell away from the Church's teaching. As anyone can see, we have fallen away, with estimates of contraceptive use among Catholics and non-Catholics alike as high as 90 percent. The consequences have been devastating in terms of skyrocketing marital infidelity and divorce.
Pope Paul VI's predictions that an increase in contraceptive use would lead to men regarding women as objects of desire and would allow governments to wield technological and economic power in population-reduction programs have been overwhelmingly fulfilled.
The "Pill" vs. NFP
How It Works
The modern-day birth control pill is made up of two types of artificial steroids that mimic the effects of naturally occurring hormones, estrogen and progesterone. These artificial hormones are formulated to act singularly or in combination, and may be taken by mouth, injected or placed beneath one's skin. Their effectiveness relies on three mechanisms.
1. Suppression of ovulation.
2. Impeding migration of sperm, and
3. Inhibiting implantation of the embryo in the uterus
The pill is very effective if used as directed. It can prevent or terminate (more on that later) pregnancy 98-99 percent of the time.
So then, if it is so effective, why would I as a physician not prescribe it? Because I believe, as a Catholic Physician, I am called to address not just the patient's body, but the personal unity of body, mind and soul.
The effects of artificial contraception can be devastating, depending on a woman's genetic make-up, weight, length of time and type of contraceptive taken. Modern-day contraceptives have potent cardiovascular effects. A woman's chances of suffering a heart attack, a stroke, or blood clots are increased significantly, even at the lowered dosages in use today as opposed to higher dosages given when the pill first came on the market over 40 years ago.
Contraceptives also have a potent carcinogenic effect. They raise a woman's chances of suffering cervical cancer, liver tumors and breast cancer. Contraceptives are linked to increased incidence of migraine headaches, vaginal infections, gallbladder disease, changes in vision and a host of other clinical problems, including death.
Perhaps most sadly, all modern artificial contraceptives can cause early (chemical) abortions. They do this by making the lining of the womb hostile to the implantation and growth of the embryo. Thus, if ovulation occurs despite the contraceptive's first mechanism (and this happens all too frequently), and the egg is fertilized, becoming a new human being, the contraceptive's third mechanism acts to deny the embryo the home and nutrition it should receive in its mother's womb. Therefore, an early abortion can occur during any given cycle and the woman would never know it because the embryo dies and is expelled from the body.
Also, due to a contraceptive's potency, the side effects will likely last much longer than their time in use, and may cause some women to be permanently infertile.
The use of artificial contraception can lead to depression, even after one shot (in the case of Depo-Provera), worsen premenstrual syndrome, and suppress a woman's sexual drive.
The Catholic Church still teaches that deliberate sterilization (temporary or permanent) is a gravely immoral form of birth control. Man and woman were made to be co-creators with God in the making of new human life. Therefore, when one uses contraception it is wrong, not only because it violates the procreative meaning of the sexual act, but also because it violates the unitive act as well. The sexual act is meant by God to be 'total self-giving' and when marriage partners withhold their fertility from their spouses, they are not totally giving themselves. The Catholic Church's challenge to us throughout the centuries has been not to separate the lovemaking and life creating aspects of the sexual act within marriage.
A Healthy Alternative
Natural Family Planning or NFP (of which there are several models, such as the Billings Ovulation Method, the Sympto-Thermal Method or the Creighton Model) is a truly modern and effective way to plan one's family, understand the miraculous function of the human body, and better participate in God's plan for married couples and their fertility.
These methods are all based on the fact that a woman will undergo cyclical changes in her fertility evidenced by certain bodily changes. These changes include differences in cervical mucus, body temperature and others. These signs of fertility and infertility are easy to observe and interpret. The couple can then use these signs of fertile and infertile days to either achieve or avoid a pregnancy.
These methods are highly effective. When learned and used correctly and conscientiously, Natural Family Planning is effective in avoiding pregnancy 99.5* percent of the time. Research has documented its effectiveness in achieving a pregnancy in the first cycle of use at 76 percent.
Why isn't every married couple learning and using NFP? Good question. Perhaps it is because too many people simply don't know the truth about it. NFP is not a repackaged version of the old calendar-based "rhythm method" - a misconception even doctors have today. Unfortunately, medical training in this area, in most cases, is often nonexistent or inadequate.
In addition to the medical benefits of using NFP, other benefits include the enhancement of the married couple's sexuality, and placing responsibility for fertility on the man and the woman equally. This leads to a more loving cooperation in matters of sexuality and family planning. By learning NFP, the married couple comes to a deeper understanding of the physical aspect of sexuality and how it relates to the spiritual, mental and emotional aspects of life as well.
Finally, Natural Family Planning is a versatile method that can be used in all stages of reproductive life. The observations a woman makes as a user of NFP can be extremely helpful when seeking the assistance of a physician, should a reproductive problem arise, in the transition from one stage of life to another. These observations can help the physician diagnose and treat such problems as PMS, ovarian cysts, recurrent miscarriages and infertility. Natural Family Planning is easy to learn, inexpensive, and quickly becomes second nature to the married couples who use it. But most importantly, NFP brings together the physical, spiritual and emotional aspects of a couple's fertility to enrich marriages by following God's teachings and plan for their married lives
* J. Reprod. Med. 1998; 43:495-502
Dr. Jose Fernandez is a family practice physician in Kissimmee, Florida. (407) 847-9090
For more information on Natural Family Planning, contact:
Billings Ovulation Method Assn-USA
The Couple To Couple League (STM)
Family of the Americas Foundation
Northwest Family Services (STM)
Pope Paul VI Institute
One More Soul