The Natural Family Planning Method – What Do You Do When it Becomes Hard to Follow?

The Natural Family Planning Method has its advantages and disadvantages. It has been strongly correlated with successful planning and prevention of pregnancy, as well as the building of healthy relationships. Yet couples can find difficulties using it as in situations like having a partner work abroad, shift work, breastfeeding, or if one of the partners is not committed to using this method. In this interview, Dr Anna Maria Vella addresses these situations and contraception issues for people who wish to live according to the teachings of the Catholic Church.

1. How effective is the Natural Family Planning method?

Dr Anna: “There are a number of methods which promote teaching how the reproductive system of the body works so that a couple can be aware of the chances of pregnancy.“The Natural Family Planning (NFP) method which is a particular method which uses cervical mucus, temperature readings and position of the cervix, is one of them. When followed properly, the Natural Family Planning method has a very high success rate in preventing or planning a pregnancy.  Another advantage of using this method is the positive impact on the relationship of the couple as they enter in a mutual understanding and respect of their body. However, we must acknowledge that the needs of a newly married couple’s are very diverse from those of a young couple who already have children and yet again diverse from those of a couple in their forties. Therefore, the principle of graduality has to be applied when following Natural Family Planning method. The couple gradually grasps the concept of using the Natural Family Planning method and slowly matures slowly into the mentality of applying it. Decisions taken in this regard, depend on particular circumstances and may need to be changed. A good and morally correct decision taken today may not continue to apply tomorrow.

Dr Anna: “Many women who desire to follow the Catholic Church’s teaching feel great frustration and grief, when for various reasons, they cannot follow the ‘rules’ to the letter. Unfortunately, the teachings are often handed down in a very rigid and unpractical way. Men are often put off by such rigidity and at times feel unsafe to follow such methods. The Natural Family Planning method is not a one size fits all method.”

2. What the difference between a contraceptive mentality and responsible parenthood ?

Dr Anna: “Responsible parenthood takes in consideration the couple’s health and the health of the off-spring. It is not about “having two is enough, having one is too little. It depends a lot on what the couple is going through. A couple might feel that at a particular moment it’s not a good time to have a child, but then times and circumstances change. Is it responsible to plan a pregnancy when the mother has severe depression and the family is in financial difficulty? Yet, if a child is conceived, taking responsibility means that the child is still given a chance at life.

A contraceptive mentality is one when two persons want to have sex but at all costs they do not want to have a baby. This is why Pope John Paul 2nd had said that contraceptives can pave the way to abortion. A contraceptive mentality seeks abortive pills and other procedures when contraception does not work. A contraceptive mentality can also damage a relationship because it induces one person to want the other unconditionally expecting him/her to be always available, rather than respecting the needs of the other and his/her body. The concept of using the Natural Family Planning method is different from using contraception. A couple may seek to avoid a pregnancy because they feel that life’s circumstances are too difficult for them to support another life at that moment.  Yet, if a baby is conceived, they are still open to welcome him/her. It is about avoiding a pregnancy rather than against conception (contra-ception).

Dr Anna: “We are encouraged to leave open the possibility for opportunities of loving a new human being. Better decisions are taken by the couple about their sexual relationship when they are taken in God’s presence. Such decisions are difficult to take, if the guidelines of the Church are felt to be posing a constraint rather than life giving.”

3. The Church teaches that contraceptives are “intrinsically evil” but lately Pope Francis said “avoiding pregnancy is not an absolute evil.” What do you think of this?

Dr Anna: “There were cases when the Church accepted the use of contraceptives to nuns as a defence against pregnancy from rape. We cannot say that in these circumstances it is ok and in other difficult situations it isn’t. If it is intrinsically wrong, it is always wrong. But it isn’t the case because here the Church said “ok .

I do not believe that that the use of contraceptives is always wrong. There are circumstances, even within marriage, where for health reasons, it would be better to use contraceptives. When I say contraception, I do not mean the morning-after pill. The morning-after pill can act as an abortifacient in the first days of the embryo’s life. I am referring to regular oral contraception and condoms.

Dr Anna: “Such a case is when the mother goes through a Caesarean section. It is very unsafe to have a child in the first months after birth due to a possible rupture of the uterus which could result in a fatality. In such a case it would be better for the couple to use a contraceptive than to abstain for many months, especially if times are stressful and being close can help the couple to feel more supported. Use of contraception is for a short period of time until the menstrual cycle is back to normal and the mother is not breastfeeding any more.”

4. Would you recommend Natural Family Planning method?

Dr Anna: “I am very much in favour of the Natural Family Planning method and I highly recommend it. When used well, it is highly effective both to prevent and to plan a pregnancy. One has to be committed and chart body temperatures daily. Some couples prefer it if the man takes note of the temperature of the woman so she doesn’t have to explain if she is fertile or not. I have seen lots of couples who use this method who feel good about it and have used it for years. Sometimes the woman feels more respected by her partner/husband, in the sense that he can understand more why she is not available every day. Another advantage is that there are no side-effects when using this method.

Dr Anna: The Natural Family Planning method is different from the calendar method. The latter is not reliable! In the Natural Family Planning method, the woman has to measure her body temperature daily and chart it. The woman also learns to note and chart the quality of her vaginal mucus and the position of the uterus. There are courses available on how to use this method effectively.

However, this method does not and cannot apply at all times or for everybody. These are some examples when it can be difficult to use:

• Couples where you have one partner is a committed Catholic and the other is not or his/her faith is not so important for him/her. Both man and woman need to agree and collaborate to make it work effectively.
• People doing shift work.
• When the couple is experiencing a stressful situation such as financial tension, eg work in a precarious environment.
• Women is forties who are still highly fertile and afraid to get pregnant because of an increased chance of having a disabled child. Their body will soon start going in to menopause and as a doctor I cannot rely on the Natural Family Planning method. I have to take care of the mother’s health, the health of the child, and the couple’s wellbeing.
• When one’s partner works abroad.
• During breastfeeding it is also very hard to use the NFP methos. I have to say that there are couples who manage to use Natural Family Planning method while the mother is breastfeeding an infant, God bless them! It is very hard.

Dr Anna: “A recent example I faced when NFP was not appropriate, was of a couple who had two babies who both died a few days after birth. The couple were told by the doctors that both babies had a genetic condition, and that the possibility of this happening again was high. The mother took the mourning very hard. She could not bear any longer to bury her own children and she suffered from depression for five years. In this case I suggested contraception; reversible methods of course not closing the tubes. One would want to leave the possibility of having children open for such a couple or in the eventuality of a change in circumstances from remarriage. Natural Family Planning method was too complex and risky to use in this situation. Yet, there are circumstances in life when a couple needs to feel closer often. That is why I felt that in this case the contraceptive pill was a good decision.”

5. In the formation of engaged couples, different couples need to be addressed differently…

Dr Anna: “Marriage preparation courses (known as ‘the Cana course’ in Malta) should be updated in a way to acknowledge that most couples today are already living together before marriage. Acknowledging this reality doesn’t mean that we accept this situation. But teachings and courses need to be presented in a new way which also address the realities of these couples. We cannot ignore this fact as if it does not exist. During these courses couples should be challenged and exposed to see the fuller vision of the sexual experience.”

Published: June 2017
Updated: April 2018

Read more:

– Fertility awareness, planning or avoiding a pregnancy naturally
– FEMM – Fertility Education and Medical Management
– Explaining sexual issues to children

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