No to RH Bills Yes to NFP

JAMES MCTAVISH, FMVD

This essay focuses on the urgency to promote natural family planning (NFP) here in the Philippines. Currently debate rages about the so-called RH (reproductive health) bills. The Church says no to the RH bill but at the same time must also do more to promote NFP. Unfortunately much ignorance surrounds NFP. Most couples know more about contraception than they do about NFP. This means in their reproductive health choices an informed decision of conscience cannot be made. Many in the Church are also ignorant about modern methods of NFP and if asked could only name the rhythm or calendar method as a method of NFP. This technique, introduced in the 1930s, is actually no longer advocated by the Catholic Church. It has been superseded by other methods of NFP which are more efficient and easier to use. To form the conscience of the faithful more needs to be done to promote information about NFP. Priests, religious and nuns also need to be more knowledgeable about modern methods of NFP. The Church must continue to say no to the RH bill but must shout a louder yes to NFP.

Keywords: Natural Family Planning (NFP), reproductive health bill, ignorance, family planning, promotion of NFP

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t present there is a raging debate about the so-called Reproductive health (RH) bills. The Church correctly says no to the RH bill but she must not forget to announce a louder yes to natural family planning (NFP). There are many methods of modern NFP available today but the reality is that most Catholics including many priests and some doctors are rather ignorant about them.
IGNORANCE OF NFP I was recently asked to give a lecture on NFP in one of the top Catholic universities in Manila. I was warned beforehand that the students, after much consideration, were all in favour of contraception and against NFP. I began by stating that one cannot make good choices without the correct information. All the students agreed with this presupposition. I then asked them what was their decision of conscience regarding family planning and the majority of the class was indeed strongly in favour of contraception. I then did a survey and asked two very revealing questions. The first was how many types of contraception do you know? They were able to list most of the available methods including the pill, injections, condoms, IUD (intra uterine device) or coil, male sterilization, tubal ligation, diaphragm, withdrawal and contraceptive hormone patches. I then asked them to tell me how many methods of modern family planning they knew. They could only mention one the rhythm or calendar method. This technique, introduced in the 1930s is actually no longer advocated by the Catholic Church. It has been superseded by other methods of NFP which are more efficient and easier to use. The students were not well informed about NFP and thus could in no way make an informed decision of conscience yet they had already decided in favour of contraception and against NFP. Many couples also cannot make an informed decision of conscience regarding whether to use NFP or not because they are not informed either. Many priests and religious cannot discuss NFP because they do not know about it also. In Tagaytay recently I met a pregnant mother who told me she was expecting her tenth child. Her family was extremely poor so I asked if she

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planned to have more children after this one. She told me that she did not know. There were no natural family planning (NFP) methods offered in her Barangay but only contraception which she did not want to take for health reasons. Her case highlights a sad reality here in the Philippines that contraception is more readily available than NFP such that only 0.4% of married women in the Philippines are using NFP to regulate births whereas more than 33% use contraception. WHAT ARE THE METHODS OF MODERN NFP? There are 6 generally accepted techniques: 1. 2. 3. 4. 5. 6. Basal body temperature (BBT) Billings method (BOM) Symptothermal method (STM) Standard days method (SDM) Twodays method (TDM) Lactational amenorrheoa method (LAM)

The basic principle underlying NFP is that God has instilled a biological rhythm into the female body whereby for some moments in the monthly cycle she is fertile and at other times she is not. The secret of NFP is to determine when the woman is fertile or not and thus most of the methods are also known as Fertility Awareness Based methods. How can a woman know when she is fertile or not? There are certain signs in the body of a woman which can help her know which stage of her cycle she is at: 1. Temperature rises prior to ovulation. Basis of basal body temperature method (BBT) 2. Cervical mucus consistency becomes thinner during fertile period. The Billings ovulation method (BOM) and the Twodays method (TDM) rely on observations of cervical mucus quality. 3. Combining temperature and mucus observation gives the symptothermal method (STM). 4. Standard days method (SDM) calculates statistically when the woman is fertile (days 8-19) and if pregnancy is to be avoided sexual relations are avoided during these days
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HOW EFFECTIVE ARE THESE METHODS OF NFP? Well it depends on whether the technique is correctly used or not but with correct use the efficiency can be as high as 95% (Standard days method) or even more than 97% with the Billings ovulation method. WHAT ARE THE ADVANTAGES OF USING NFP?1 1. Normal intercourse is preserved. Couples can plan the size of their families and space births the natural way. They do not resort to artificial means. 2. NFP is morally acceptable to people of all religions and cultures. It does not separate the love-giving and life-giving dimensions of the marriage act. The unitive and procreative ends of marriage are kept whole. 3. There are no inherent health risks in NFP methods. No pills, drugs, injections, devices or operations are used. A healthy body does not need this kind of medical treatment. 4. Modern NFP methods are effective and reliable. They are based on scientific studies and are time-tested. Simplified methods are easy to learn. Some NFP methods may be combined to reinforce each other. 5. There is no cost involved once the method has been learned. Couples are empowered not to rely on health centers, donor agencies, or drugstores. NFP is pro-poor, and not for profit of outside companies. 6. NFP becomes sustainable from generation to generation. Mothers can readily pass on the practice of NFP to their daughters. 7. NFP involves a joint decision by the couple. Neither partner feels being used by the other. It is an ideal way of exercising shared parenthood. A contraceptive mentality is avoided.
1 With thanks to Bishop Antonio J. Ledesma, Archbishop of Cagayan de Oro City for these ten advantages

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8. NFP engenders sexual discipline for the spouses through periodic abstinence. The practice of NFP manifests a conscious familiarity with the natural rhythm of the human body, mutual caring between the spouses, and the development of self-control that is carried over in the upbringing of the children. 9. Couples who use NFP seldom or never resort to abortion. They manifest an innate respect for human life. They welcome every child as a gift from God even in the eventuality of an unexpected pregnancy. 10. Couples who use NFP seldom or never end up in separation or divorce. NFP enhances communication between spouses and promotes a wholesome family life. TAKE CARE NOT TO USE NFP WITH A CONTRACEPTIVE MENTALITY Of course NFP needs to be correctly used and the married couple need to have good or just reasons to space their births for example. It is possible to misuse NFP, to use it with a so-called contraceptive mentality such as utilizing NFP to avoid the birth of a child but only for selfish reasons. But when correctly used NFP is a way of spacing births that the Church wholeheartedly approves of. It is important to educate couples about NFP so they can responsibly plan their families and the number of children they desire. PLANNING THEIR FAMILY USING NATURAL FAMILY PLANNING NFP can be used by the couple to plan their family. It is important to realize that a family should be planned. The couple have a serious task in deciding just how many children to responsibly bring into the world. Many incorrectly think that the Catholic Church is teaching us to breed like bunny rabbits and would even wrongly invoke Genesis 1, 28 in this regard - Go forth and multiply. Pope John Paul II stated that unfortunately, Catholic thought is often misunderstood on this point [about responsible parenthood], as if the Church supported an ideology of fertility at all costs, urging married couples to procreate indiscriminately and without

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thought for the future. But one need only study the pronouncements of the Magisterium to know that this is not so(17 July 1994).2 HOW MANY CHILDREN SHOULD A COUPLE HAVE? So how many children should a couple have? This is a decision to be taken by the couple and not to be dictated by the State. The Second Vatican council in a document called Gaudium et Spes (GS) gives the couple some helpful advice: Let them thoughtfully take into account both their own welfare and that of their children, those already born and those which the future may bring. For this accounting they need to reckon with both the material and the spiritual conditions of the times as well as of their state in life. Finally, they should consult the interests of the family group, of temporal society, and of the Church herself. The parents themselves and no one else should ultimately make this judgment in the sight of God.3 An interesting question is to consider if during marriage preparation in the Catholic Church enough emphasis is given on how to plan a family and why. To encourage responsible parenthood expressed either by the deliberate and generous decision to raise a large family, or by the decision, made for serious moral reasons and with due respect for the moral law, to avoid for the time being, or even for and indeterminate period, another birth.4 Pope John Paul II noted that parents must have an extremely responsible attitude. In deciding whether or not to have a child, they must not be motivated by selfishness or carelessness, but by a prudent, conscious generosity that weighs the possibilities and circumstances, and especially gives priority to the welfare of the unborn child (14 Dec. 1990).5 Christian Brugger from the Culture of Life foundation writes:

See http://ccli.org/oldnfp/b2010morality/church teaching.php Gaudium et spes 50 4 Humanae vitae 10. (Henceforth HV) 5 See http://ccli.org/oldnfp/b2010morality/churchteaching.php
2 3

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There is no decision more serious to a Catholic couple than whether or not to participate with God in bringing a new human person into existence. The more serious a decision, the more it is due prayer, discussion and discernment God has a plan for every married couple; that the plan includes how many children they should have; and therefore if a couple is concerned about doing Jesus will, they should try to discover whether Jesus wishes them to have more children. They should have all the children that Jesus wants them to have, no less, and no more. Therefore, whenever they are conscious that they might become pregnant, they should discuss and pray over the question: Does Jesus want us to have another child?6 In deciding family size it may be that the couple decide to have another child but they may also decide not to have children for now or for the indefinite future. One couple I know wanted to do some voluntary work in East Timor. They have no children and wondered whether it is allowed to postpone childbearing until after they come back (1.5 years later)? The issues question here is: Is it morally permissible to space the birth of children? And if so, what method could be used to achieve this? Pope John Paul II said during an audience at Castel Gondolfo in 1994: In deciding whether or not to have a child, [spouses] must not be motivated by selfishness or carelessness, but by a prudent, conscious generosity that weighs the possibilities and circumstances, and especially gives priority to the welfare of the unborn child. Therefore, when there is a reason not to procreate, this choice is permissible and may even be necessary. However, there remains the duty of carrying it out with criteria and methods that respect the total truth of the marital act in its unitive and procreative dimension, as wisely regulated by nature itself
6 E. Christian Brugger, D.Phil., Senior Fellow in Ethics, Just Cause and Natural Family Planning, Culture of Life foundation, June 17, 2010. Accessed on 1 Jan 2011 at http://culture-of-life.org//content/view/644/1/

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in its biological rhythms. One can comply with them and use them to advantage, but they cannot be violated by artificial interference.7 FOR WHAT REASONS MAY A COUPLE DECIDE TO POSTPONE OR SPACE BIRTHS? Responsible parenthood means that the parents take into consideration the following factors or conditions in deciding how many children to have and when to have them:8 1. Physical 2. Economic 3. Psychological 4. Social conditions Physical conditions include their bodily health and capacity to bring up the children. It may be that the couple when young, in their physical prime and in good health, decide that it is prudent to try to have a child. In other situations, there may be maternal health factors (or paternal) which would mean the couple decide to postpone the birth of future children for the meantime. Economic factors may lead a couple to decide that for the moment they cannot responsibly bring another child into the world as they may be suffering from severe hardship. On the contrary, they may feel blessed by economic prosperity and desire to go against a selfish mentality that often overemphasizes pleasure and wellbeing to the detriment of the sacrifice inherent in having a child. Psychological reasons may encourage a couple to have more children perhaps the couple see that having another child would be to the psychological benefit of an existing offspring or conversely a further child may bring excessive anxiety to an already taut and overburdened mother or father. Social factors may mean that the society is not a suitable environment to bring children into the world such as a state of wartime or severe shortage of food, or it may be that the social conditions are blooming and would encourage the bringing forth of new life.
7 8

See http://ccli.org/oldnfp/b2010morality/churchteaching.php HV 10

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Christian Brugger gives the following additional reasons as examples of just causes for spacing births: needs arising from caring for highneeds children, the instability of transitional periods such as spouses in graduate school and the debilitating stress that can arise from having a large family in societies where large families are no longer valued.9 All these factors need to be taken together so that the couple can make an informed decision of conscience on whether to have another child or to delay childbearing for the foreseeable future. CONCLUSION : THE NEED TO PROMOTE NFP IN THE PHILIPPINES! Very few married Catholic women in the Philippines are using NFP to plan their families. Out of 1000 married couples, more than half do not use any method at all and of these up to 85% will get pregnant in one year. Of the remaining half or so, around 330 are using contraception, 165 are using withdrawal (or old methods of NFP), and only 4 or 5 couples out of 1000 would use modern NFP. How can we explain this incredibly low figure? Who is responsible for teaching NFP? In many Catholic medical and nursing schools little time is given to study methods of NFP. Also many priests, religious and nuns sadly do not have adequate formation to explain the modern methods of NFP. It would be interesting to survey the promotion of NFP in the Parishes throughout the Philippines. Who is teaching it in the Parish? What is the structure and outlay of the catechetical program to teach NFP? For sure with only 0.4-0.5% of married women using modern NFP much work needs to be done. It is important to tell the lay faithful not to contracept as it is against Church teaching and many contraceptives do untold damage to the health of women. However it is not enough just to say no to contraception if as Church we are not vigorously promoting NFP. In this regard it is thought provoking to read the words of the Philippine Bishops in their pastoral letter Love is Life of 1990 where they said:
9 E. Christian Brugger, D.Phil., Senior Fellow in Ethics, Just Cause and Natural Family Planning 2, July 1, 2010. Accessed on 1 Jan 2011 at http://culture-of-life.org// content/view/645/1/

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It is said that when seeking ways of regulating births, only 5 percent of you consult God. In the face of this unfortunate fact, we your pastors have been remiss: how few are there among you whom we have reached. There have been some couples eager to share their expertise and values on birth regulation with others. They did not receive adequate support from their priests. We did not give them due attention, believing this ministry consisted merely of imparting a technique best left to married couples. Only recently have we discovered how deep your yearning is for God to be present in your married lives, but we did not then know how to help you discover Gods presence and activity in your mission of Christian parenting. Afflicted with doubts about alternatives to contraceptive technology, we abandoned you to your confused and lonely consciences with a lame excuse: follow what your conscience tells you. How little we realized that it was our consciences that needed to be formed first. A greater concern would have led us to discover that religious hunger in you.10 Let us pray for the grace to reappraise our approach to NFP and clearly recognize the need to promote much more actively the different methods of NFP. Perhaps it is time for all priests in the Philippines to undergo a refresher course about the various techniques of NFP. Jesus the Good Shepherd was often teaching so presbyters also need to be well informed to teach their flock. Could the scant uptake of NFP among the Catholic faithful in the Philippines be attributed to the poor formation and lack of clear instruction of many priests? How NFP is taught in seminaries can be reviewed so that at least when seminarians leave the seminary they have a good theoretical grounding in the modern techniques of NFP. Nuns working with the poor also need to be well informed about these issues. Often, as members of the Church, we also know more about methods of contraception than the various modern methods of NFP described above. Being well informed about NFP would be a great help for the instruction and guidance of the lay faithful.
10

Catholic Bishops Conference of the Philippines, Love is Life, October 7, 1990.

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The NFP policy in the Diocese and corresponding parishes needs to be realistic and concrete. Just because a priest mentions NFP in his homily does not guarantee that it will directly reach the end-users. NFP is often mentioned to couples in the pre-Cana seminar but before marriage, future newly-weds have little interest in family planning instead they want to have children. Who will follow them up later? Not all parishes have comprehensive policies for NFP training and promotion - national guidelines could be drawn up to orient parish policies regarding NFP. Consideration should be given on how to reach the masses, many of whom may not attend mass or be connected to the parish. Credit should also be given to those dedicated religious and lay who actively seek to educate many about the beauty and benefits of NFP. Many communities also are very active in the promotion of NFP. However at times a type of turf war opens up, where competition ensues between rival promoters of different methods of NFP with one group claiming that their method of NFP is superior to othersand promotingit almost to the total exclusion of other methods. Care needs to be taken to clarify the doctrinal position regarding the use of Standard days method (SDM). Whilst a detailed analysis is beyond the scope of this essay, controversy exists and differences of opinion abound over the use of this method. On the one hand, many have had good practical results with this simple and easy to use method which relies on a bead counting system and abstinence of sexual relations between days 8-19 of the womans cwycle. A consensus statement was issued by 29 Filipino Bishops following a dialogue on January 21, 2009 stating that the Standard Days Method, provided it is not mixed with contraceptives, is a natural family planning consistent with the moral teaching of the Catholic Church. The statement notes that the bishop should inform the priest or lay faithful who think otherwise and should stop him from spreading his error.11 However influential voices remain in the Church and Catholic medical circles who denounce this method as being an unreliable faulty technique introduced by international groups with subversive intentions. Other issues are involved but it would be helpful to have a more
11 Consensus statement appears on page 74 of Natural Family Planning - Values, issues, practices, Chona R. Echavez and Estrella E. Taco-Borja (Editors), A joint project of the Research Institute for Mindanao Culture, Xavier Science foundation and Philippine Center for Population and Development, 2009.

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wholehearted agreement regarding the use of Standard Days Method (SDM) here in the Philippines. What is clear is that a massive NFP promotional drive is needed nationwide, requiring investment, time and energy. If people do not know about NFP they cannot make informed decisions of conscience. Only when we inform our conscience well about the various methods of NFP can we as Church guide the people in the right path. In this way perhaps more married couples would be encouraged to use modern NFP and be able to plan their families in an integral and correct way. As Church we must continue saying no to the RH bills but let us also shout a louder yes to the promotion of NFP. n

Fr. James McTavish is a Scottish missionary priest with the Verbum Dei community based in Pansol, Quezon City (Diocese of Cubao). He worked as a surgeon before hearing the call of the Lord to heal the Body of Christ through evangelization Give me life by your Word (Ps. 119, 105). He teaches Moral Theology and Bioethics at the Loyola School of Theology and also gives courses in the University of Santo Tomas. He completed his Licence in Moral Theology (Alphonsianum, 2008) and Masters in Bioethics (Regina Apostolorum).

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