Archive for the ‘Your Right to Know’ Category

Natural Family Planning and Relative Effectiveness

Sunday, October 18th, 2020

Your Right to Know: Relative Effectiveness

As mentioned previously in my comments about cervical mucus, the US Bishops established the Human Life Foundation in 1968 to support Humanae Vitae and to promote natural family planning. In the Seventies there was considerable debate about the relative effectiveness of the mucus-only “Ovulation Method” (OM) and the cross-checking “Sympto-Thermal Method” (STM) which uses mucus, temperature and previous cycle history. The Foundation persuaded the National Institutes of Health to run a scientifically sound study in 1976-1978 to compare the use-effectiveness of the OM and STM.

In the formal study, the investigators found an OM imperfect-use rate of 39.7 and an STM imperfect-use rate of 13.7 pregnancies per 100 years of use. In other words, the OM had an imperfect-use “avoiding” effectiveness rate of 60.3% and the STM had an imperfect-use “avoiding” rate of 86.3%. The OM group experienced six perfect-use pregnancies; the STM group experienced zero perfect-use pregnancies. In the words of the final report, “Results of this study show the STM to be superior to the OM of NFP in terms of use-effectiveness.” (Wade et al., “A randomized prospective study of the use-effectiveness of two methods of natural family planning,” Am. J. Obstet. Gynecol. 141:368, 1981, p.375)

Toward the end of the final report, the authors wrote: “It is of interest that after couples were informed in August, 1978, that a statistically significant trend in the pregnancy rate between the OM and STM groups had been found, almost all of the STM volunteers continued in training, and virtually all of the OM volunteers requested to be, and were, thoroughly trained in STM” (376).

In brief, when the relative effectiveness of the mucus-only “Ovulation Method” and the cross-checking “Sympto-Thermal Method” was hotly contested, the US Bishops sponsored a study which found that the STM approach was superior to the OM approach. You have a right to know these things.

Still, some or many dioceses seem to ignore that part of the science of NFP and continue to promote the mucus-only approach as if there is no difference.

Another comparison. In the effectiveness comparisons, not much attention has been paid publicly to the differences in the computation of effectiveness rates, and there is a big difference. The question is this: “How should we count pregnancies that result from not following the rules?”

The terminology has evolved over the years. In current terminology, “perfect-use” pregnancies refer to pregnancies of couples who became pregnant while following the rules. “Imperfect-use” pregnancies refer to pregnancies of couples who became pregnant while not following the rules. That seems rather straightforward, and most people in the NFP movement have accepted that standard.

Most is not all. Dr. Thomas Hilgers, author of the mucus-only “Creighton Model” and “FertilityCareTM” does not accept that standard. He argues that when a couple engages in the marriage act at a time defined as fertile or possibly fertile according to the rules, the spouses are engaging in “pregnancy-achieving behavior.” Well, certainly, but that is true for every method. The rest of the NFP movement counts such pregnancies as “imperfect-use” pregnancies, but Dr. Hilgers does not. The result is that there are relatively few “imperfect-use” pregnancies in his calculations, and that makes his system appear to be much more effective than it would be if he used the standard accepted by the rest of the NFP movement.

How can we tell? In 1985, Joanne Doud, a teacher of the Hilgers system, reported a study in which she claimed a very high imperfect-use rate of 96.2%. Fortunately, she also listed the number of pregnancies that the couples themselves regarded as unplanned. Using those numbers, the imperfect-use effectiveness was only 67% (Joanne Doud, “Use-effectiveness of the Creighton Model of NFP,” International Review of Natural Family Planning, Vol IX, No.1, Spring 1985). You have a right to know these things.

For purposes of comparing apples with apples and for credibility, the rest of the NFP movement accepts the statistical method used by the contraceptive birth control movement. Few in diocesan administration, however, seem to pay attention to the fact that the Hilgers system calculates its user-effectiveness rates in a way that is not accepted or practiced by anybody else in the NFP movement. Dioceses have paid thousands of dollars to have a single teacher trained in the Hilgers version of mucus-only without any comparative indication that his system is any better than the original Billings system or the cross-checking Sympto-Thermal Method.

What about seeking pregnancy? There have been no comparative studies about couples using different NFP systems to achieve pregnancy, and thus there is no evidence that any system of observing and recording the mucus sign is any better for achieving pregnancy than that used in any other system. Fertile mucus is fertile mucus, no matter how observed and recorded. Further, certain types of impaired fertility may be successfully resolved simply by improvements in nutrition and lifestyle.

On the other hand, when there is a case of difficult infertility, it is good to know that Hilgers-trained doctors may be able to treat certain defects with surgery or other medical techniques in what he calls NaProTechnology. It is also important to know that there are some couples in which one or both spouses are infertile and whose only morally sound hope for a child is the adoption of a baby who needs their loving care.

John F. Kippley

Natural Family Planning and the Covenant Theology

Sunday, October 11th, 2020

Your Right to Know: Covenant Theology

The most basic framework of God’s relationship with man is the covenant. The first was God’s covenant with Noah and every living creature—“never again shall there be a flood to destroy the earth” (Gen 9:11). The second covenant was with Abram (Gen 15:18) and then renewed when his name was changed to Abraham (Gen 17:9-14). The third covenant was with Moses and was sealed with the blood of the oxen that had been sacrificed as Moses said, “Behold the blood of the covenant which the Lord has made with you in accordance with all these words,” and the people committed themselves to living by the Covenant (Ex 24:8). The final covenant of the Old Covenant was made with David, the promise of God that a son of David would establish an everlasting kingdom (2 Sam 7:12-13). Finally, the work of the Old Covenant was completed and the Lord Jesus, the Son of David, established the New Covenant as He gave himself up for us. “This cup which is poured out for you is the new covenant in my blood” (Luke 22:20).

A covenant is a promise that cannot be broken and it covers everything. A contract stipulates only certain things on which the parties agree and generally will also state the conditions under which the parties agree to void the contract. In the first two covenants, God makes unilateral promises. In the covenant with David, he also promises to punish those descendant kings who violate the covenant, and the sorry record of the king-sons of David is so bad that only two or three of them receive favorable comment by the authors of the Old Testament books. But the promise held.

Marriage is also a covenant. When Jesus was challenged by the Pharisees about marriage and divorce, he surprised his questioners. The Jews of that time took it for granted that a man could divorce his wife and remarry. The dispute among them was whether a man needed a serious reason (e.g., adultery), or “for any cause” (e.g., being a lousy cook) as the question was phrased in Matthew 19:3. Jesus asked them what they had from Moses, and they replied, “Moses allowed a man to write a certificate of divorce and to put her away.” (This proof of divorce at least protected a woman from being treated like a yo-yo.) But Jesus replied, “For your hardness of heart he wrote you this commandment. But from the beginning of creation, ‘God made them male and female.’ ‘For this reason a man shall leave his father and mother and be joined to his wife, and the two shall become one.’ What therefore God has joined together, let not man put asunder” (Mark 10:2-9).

In brief, the men of his time wanted to treat marriage as a contract, but Jesus went back to the very order of creation and taught that marriage is a covenant, something that covers everything and lasts until death separates the spouses.

The rainbow was the sign of the covenant with Noah. Beginning with the covenant with Abraham, the sign of the Old Covenant was circumcision of the men. Beginning with Jesus, the sign of the New Covenant is his own Body and Blood in the Eucharist. Each Mass provides us with the opportunity to renew this covenant with the Lord. As St Paul wrote; “…The Lord Jesus on the night when he was betrayed took bread, and when he had given thanks, he broke it, and said, ‘This is my body which is for you. Do this in remembrance of me.’ In the same way also the cup, after supper, saying, ‘This cup is the new covenant in my blood. Do this, as often as you drink it, in remembrance of me.’ For as often as you eat this bread and drink the cup, you proclaim the Lord’s death until he comes” (1 Cor 11:23-26).

In marriage, the sign of the covenant is the marriage act, the sexual union of male husband and female wife. This is a God-given act that by its very nature is oriented toward the co-creation of children and the bonding of the spouses. The marriage act is intended by God to be a renewal of the marriage covenant.

But the renewal of the covenant is not automatic. St. Paul warns us that we can sin by defrauding the New Covenant. “Whoever, therefore, eats the bread or drinks the cup of the Lord in an unworthy manner will be guilty of profaning the body and blood of the Lord. Let a man examine himself, and so eat of the bread and drink of the cup. For any one who eats and drinks without discerning the body eats and drinks judgment upon himself” (1 Cor 11: 27-29). This is why the Church teaches that if you are conscious of having committed a mortal sin, you need to repent and receive the sacrament of Penance before receiving Holy Communion.

What makes the marriage act morally different from the same physical act between two people who are not married? It’s the same anatomical act, but there is a world of difference. Sacred Scripture and Tradition describe as seriously immoral all those sexual acts that do not occur within marriage. In other words, in God’s plan, sexual intercourse is intended to be exclusively a marriage act, and within marriage those acts ought to be at least implicitly an authentic renewal of the marriage covenant, that is, at least not contradicting it in any way.

It sometimes helps to remember just what a man and woman do when they “commit marriage.” They promise to love each other, and that entails caring love, not just romantic love. They promise to be faithful to each other. They vow to love and be faithful for better and for worse, knowing full well that there will be difficult times as well as the best of times. And they vow to keep this commitment until death do they part.

Wow! How can those who recognize their own weaknesses and sins write such a blank check to the other person before God? Millions do so every year because they believe that this is God’s plan for love and sexuality and that He will provide all the graces they need to persevere through whatever marital difficulties they will encounter.

The marriage act can also be defrauded, and in more ways than one. There is such a thing as marital rape, and that is certainly not a renewal of the marriage covenant. If you keep in mind that the marriage act ought to be a renewal of the commitment, the caring love, and the for-better-and-for worse of the marriage covenant, then it is not difficult to see that contraception is not a renewal of the marriage covenant. Marital contraception says, “I take you for better but positively not for the imagined worse of possible pregnancy.” It contradicts the “for better and for worse” of the marriage covenant. It pretends to be what it isn’t. It is dishonest and therefore immoral.

The concept is simple: Sexual intercourse is intended by God to be at least implicitly a renewal of the marriage covenant. What I have tried to do in this article is to place that concept in the context of the Commandments, the biblical covenant, and marriage itself.

For more on the analogy between the Eucharistic and marital communions, see http://www.nfpandmore.org/Holy%20Communion%20-%20Eucharistic%20and%20Marital.pdf .

John F. Kippley

Chaste Natural Family Planning

Sunday, October 4th, 2020

Your Right to Know: Chaste Natural Family Planning

The organized natural family planning movement started in the mid-1960s in reaction to the rejection of traditional moral teaching about birth control. Catholic teaching against contraception can be traced back to the New Testament and even has its roots in the Book of Genesis. The teaching against marital contraception was universal among all Christian churches until 1930. In August of that year, the Church of England was the first organized Christian body to break from that teaching and to allow marital contraception in some cases. Pope Pius XI quickly reaffirmed, on December 31 of that year, that contraception is the grave matter of mortal sin (Casti Connubii, n.56). The big majority of Catholics formed their consciences accordingly during the Thirties through the Fifties.

The advent of the birth control pill in 1960 raised new questions, and many Catholics erroneously assumed that the Church would change its teaching. In 1968, Pope Paul VI issued the encyclical Humanae Vitae which reaffirmed the traditional teaching to a Church and a world that had become increasingly contraceptive. A priest at Catholic University of America led a movement for dissent, and many priests were telling their parishioners that they no longer had to form their consciences according to the actual teaching of the Church. Most bishops in the West treated the issue as a “hot potato” to use the words of New York’s Cardinal Timothy Dolan. Many or most Catholics, to say nothing of non-Catholics who respected the Church for its moral teaching, were confused.

The dissent movement provided a great stimulus to the NFP movement, largely led by the laity. Sheila and I became involved in 1968. That summer she researched and wrote her first book, Breastfeeding and Natural Child Spacing, and I wrote Covenant, Christ and Contraception which was the predecessor of the current Sex and the Marriage Covenant.Publications by dissenters soon made it clear that the acceptance of marital contraception also involved the acceptance of the entire sexual revolution with its situation ethics that cannot say “no” to any imaginable sexual activity between consenting persons of legal age, and even includes the acceptance of bestiality.

People have a need and a right to know specific moral teaching and to see that teaching in the context of Christian discipleship. Why bother to state something that seems so obvious? Within the NFP movement, some have said that modern NFP systems are so good as a method of birth control that we don’t need to say anything about morality. They seem to think that to teach Catholic morality is to bring in a crutch, as if the method couldn’t stand on its own. I think that approach is seriously flawed.

Moral teaching has at least two obvious functions. One is to tell us what to do and what not to do. The second function is to explain why something is good or evil, why we ought to do some things and not do other things. The context for moral teaching is a holy combination of Bible and Tradition.

The Ten Commandments are the prime example of telling us what to do and what not do. They are also a prime example that God’s commandments are much more of a blessing than a burden. It is true, of course, that at times it is very difficult to say “No” to temptations against the Commandments, and that’s a burden, but a little reflection reveals that each Commandment is much more of a blessing.

Just consider what a culture would be like if its members were not constrained by the Commandments. You don’t have to exercise your imagination; just pay attention to the daily news. In the United States we are living with two or three generations of men and women who have received no moral and religious education in the public schools. As Sheila and I watch the evening local news, we commonly hear a litany of robberies, beatings, shootings, murders, and sexual crimes including rape. I feel almost as sorry for the criminals as for the victims. When would most of these criminals have been taught that these crimes are seriously sinful and are putting them on the path to hell?

Excluding God from public education wasn’t part of the game plan of the Founding Fathers. The first tax-supported legislation for education in Massachusetts was called the Old Deluder Act. Its purpose was to prevent the work of the devil. The Ten Commandments are so necessary for the well-being of society that some skeptics have claimed that they were not revealed by God but are simply the accumulation of human wisdom. Even the commandment dealing with keeping holy the day of worship could be rationalized because experience shows that people do not function well without at least one day of rest per week.

Three of the Ten Commandments prescribe our relationship with God. Seven of them describe our relationship with each other. One of these is concerned with our parents, six deal with everyone else, and they are all stated in the negative—Thou shalt not… Of these, two deal with sexuality. That is, one-third of the Commandments dealing with ordinary relationships are concerned with sex. So it should not be a surprise that the Catholic Church has to keep addressing sexual issues.

Moral teaching is, of course, not confined to the texts of the Ten Commandments. For example, they say nothing directly about fornication, incest, sodomy, contraception, prostitution, usury, and all sorts of social injustices including slavery. These are subsets of the Commandments, so to speak, and are addressed in other places in the Bible and in the Sacred Tradition of the Church. It is important to realize that Jesus did not give us an expanded book but instead gave his Church the Holy Spirit to guide the teaching of the Church. This is called the Magisterium or teaching authority of the Church.

The Onan account. In Chapter 38 of Genesis, we read the story of Onan who is slain by God for his contraceptive sin of withdrawal. The anti-contraception interpretation was provided in the footnotes of Catholic bibles for many years, and probably Protestant bibles as well. After all, Luther called the sin of Onan a form of sodomy, and Calvin called it a form of homicide. The writers of the footnotes in the New American Bible of 1970, writing at a time when they were undoubtedly influenced by the spirit of dissent raging in the Sixties, changed that interpretation and wrote that it was only for his violation of the Law of the Levirate, a sin of selfishness, that Onan was slain. (The Levirate required the brother of a childless widow to give her children who would be considered as children of the dead brother.) However, the text of Deuteronomy 25:5:10 spells out the punishment for the selfish refusal to fulfill the Levirate, and it is only an embarrassment, not a death penalty. Further, in the Onan account there are three people who violated the Levirate—Onan, Judah his father, and Shelah his younger brother—but the only one to receive the death penalty is the one who went through the motions of the covenant act but made it an act of contraception.

I have inserted this short note on the Onan account because dissenters keep bringing up the Levirate-only interpretation or claim that they have no idea for what sin Onan was slain. For a more complete treatment, please see http://www.nfpandmore.org/2006_SIN_OF_ONAN.pdf .

The all-important context of the New Testament is the teaching of the Lord Jesus about the daily cross. “If any man would come after me, let him deny himself and take up his cross daily and follow me. For whoever would save his life will lose it; and whoever loses his life for my sake, he will save it” (Luke 9:23-24). Of course that does not mean that just because something is difficult, it is demanded by the Lord. But when a teaching of the Church is denied primarily because it involves carrying the daily cross, the argument is simply meaningless in terms of Christian discipleship. Yet, that is the theological nonsense that is behind the dissent movement.

I do not mean to imply that many Catholics have been deceived by the dissenters’ “can’t say no to anything” arguments. I suspect that few have read them. No, they have accepted contraception because they have been seduced by the culture and have heard almost nothing from the pulpit or other avenues of adult Catholic education to contradict the culture and to affirm the teaching of Humanae Vitae. And perhaps many of them, seeing public criticism of Catholic teaching on birth control but never hearing it supported from their local priest or bishop, rationalize that such silence means consent to dissent.

Ordinary people have both a need and a right to know what the Catholic Church teaches about love, marriage and sexuality—and why.

John F. Kippley