The last time that I was blogging about NFP was several years ago, and I was angry. I had just suffered a miscarriage as a result of an ill-advised pregnancy. I knew before I got pregnant that I was having reproductive health problems: I was cycling every two to three weeks and having unusually heavy periods each time. Charting fertility was practically impossible because my cycles were extremely irregular and I was living in a perpetual fog because of blood loss. When I sought medical help, the only solution offered was the Pill.
In the meantime, my marriage was suffering considerable strain because there were literally no days when we were sure it was safe to make love. We tried our best to work out what was going on and to find some times when we were reasonably confident that it would be okay, but ultimately I got pregnant. The pregnancy was viable (I heard the fetal heartbeat at my 12 week appointment) but my body couldn’t support it. At fifteen weeks I lost the baby.
This was my third failed attempt at NFP. (I’m currently pregnant with my fourth.)
So I was mad. And being mad, I did what I always do to deal with emotional trauma: I did a lot of research, and had theological and philosophical arguments with everyone I knew. I read Simcha Fischer’s book (which, by the way, I do recommend to anyone who is starting out with NFP). I talked to half a dozen priests. I tried learning yet another kind of NFP. Finally I came to the conclusion that there were no answers to the questions that I had. Most of the priests that I talked to had the decency to admit this. When I laid the situation out honestly, the most common pastoral response was a slowly shaken head, a long breath out, and a wan smile: “That’s a tough one. I don’t know.”
Research didn’t help. I’d assumed my problems with NFP were basically problems with me – that‘s what NFP literature teaches practitioners to believe. If the method fails it’s because you made a mistake in your charting, took a risk when you shouldn’t have, lacked self-control. I asked my NFP instructor what couples are supposed to do if the abstinence is causing severe marital conflict. She said that nobody had ever asked her that question before. I was floored. I knew from friends and from the NFP forums on-line that everybody was asking this question. But I also knew that nobody had a good answer.
I also learned that the NFP success rates that you constantly see published in Catholic sources are severely problematic. The studies that these stats are drawn from only make use of women who are able to effectively chart their cycles, are not postpartem, and have reasonably regular periods. Women for whom NFP would present a challenge are methodologically excluded. In all studies, this represents a significant percentage of the potential sample.
None of the women in these studies have more than 3 children – an important consideration if you take into account the fact that chaotic living conditions, interruptions of routine, stress and irregular sleep are all contributing factors in NFP failure. (2 of my “unexpected blessings” came along because of stressful life changes that threw my cycles off.) When I went for my post-miscarriage check up, the gynaecologist stated outright that if I was going to use birth control, I shouldn’t use the Pill: with 6 children, I would never manage to remember to take it every day. I almost cried with relief. Every time I’d looked and seen the gaps in my NFP chart, I’d thought it was because I was irresponsible, inconsiderate and disorganized. It meant a huge amount to have someone acknowledge that maybe I was just overwhelmed.
The fact that about 1 in 10 women cannot accurately chart does occasionally get mentioned in the literature – but only in the context of saying that “almost everyone” can learn to do this. The strong implication is that women who can’t are either insufficiently intelligent or insufficiently motivated. Again, the problem is with the woman not with NFP. Even when it is acknowledged that NFP might not work for some people, no alternative is offered.
I also discovered that the tests which found super-high rates of effectiveness (equivalent to the Pill) were done using Billings on non-religiously motivated populations, usually in poorer countries. The original Billings manual makes a somewhat coy reference to discovering other forms of intimacy, and the vast majority of people who are not theologically educated Catholics have absolutely no notion that there might be a problem with mutual masturbation or oral sex. Similar studies of religiously motivated groups in North America found much, much lower rates of success. It‘s not really a stretch to realize that a couple who is engaging in other forms of sexual release will not find vaginal abstinence nearly as disruptive as a couple who is trying to white-knuckle it through the fertile period every month. Indeed, one of the most common explanations that North American couples give for NFP failure is “personal reasons.” The intense conflicts that can arise in marriage as a result of sexual frustration are a very powerful motivator for taking risks and cutting corners, particularly in situations where charting is complicated and abstinence is prolongued.
This was starting to explain why almost every couple that I actually knew of personally who was trying to use NFP to avoid was having a baby every 1½ to 2 years. Like me, many said that they were “spacing.” Like me, they would tell themselves and others that the method was working. Like me, they started to cut corners when the pressures and conflicts became unmanageable, and like me they took the responsibility for this on themselves. Like me, they had “decided” to get pregnant – where “deciding” meant that they took small risks in order to preserve their own and their spouses sanity, or to maintain some semblance of harmony in the home.
When you eliminate all of the methodological gerrymandering required to make it look like NFP works as well as the Pill, and you look at the studies of random populations using NFP under normal conditions, the failure rate skyrockets. The statistics that appear in every doctor’s office in the country, the ones that we have all been told are “anti-natalist propaganda” come much closer to fitting the facts. They make sense of my own experiences of trying use NFP, and they explain the fact that so many Catholics who are trying to use these methods are clearly facing unplanned pregnancies at a pretty regular clip.
In practice, NFP does not seem to be very effective as a means of avoiding pregnancy for the average couple. But what about its other touted advantages? Is NFP “marriage building”? Does it help women to celebrate their fertility, and teach men to respect women’s bodies?
Let’s talk about that tomorrow.
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