Fertility, science and conscience

Geoff and Lauren Gentile with their children, Luke (left) and Maximilian

For the last year, Lauren Gentile and her husband, Geoff, have taught a class on natural family planning at the Church of St. Vincent Ferrer in New York City, advising couples who are, for the most part, engaged to be married and trying to postpone a pregnancy.

Some of the couples, who range in age from their 20s to about 40, are coming to the class at the encouragement of a Catholic priest, and many are trying to delay having children until they complete their education or are in more solid financial standing.

“Others have had poor experience with the birth control pill, and they are looking for another method” that does not have the contraceptive’s side effects of weight gain and irritability, said Lauren Gentile, of the Bronx, N.Y. “Some people want to be more environmentally conscious, looking for something more natural.”

Studies suggest Catholic couples who use natural family planning, as directed in 1968 by Pope Paul VI’s Humanae Vitae, are in the vast minority. Estimates based on a 2006-2008 study by the National Center for Health Statistics showed that Catholic women were, essentially, just as likely as others to use some form of contraception, according to statistician William Mosher. The nationwide estimate for women who use contraceptives was 61.9 percent overall, compared to 61.6 percent of women who identified themselves as Catholic. Based on the study, Mosher estimated that natural family planning is used by two out of 1,000 Catholic women in the country.

But the three methods of natural family planning -- the Couple to Couple Sympto-Thermal Method, the Creighton FertilityCare System Method and the Billings Ovulation Method -- are taught nationwide by instructors affiliated with a local diocese or fertility center.

In New York City, about 40 instructors lead group or individual lessons in the three methods, according to Karina Morales, natural family planning coordinator at the archdiocese’s Family Life/Respect Life Office. The methods “may be used either to postpone a pregnancy or to achieve a pregnancy,” she said. The archdiocese has not compiled figures on the number of people who attend the classes.

One of the more recent studies on the effectiveness of natural family planning, conducted in Germany and published in 2007 in the journal Human Reproduction, found that the Sympto-Thermal method results in 0.4 pregnancies per 100 women per year. The study, which was based on data collected between 1985 and 2005 from 900 women who met the selection criteria, concluded that the method, if used correctly, is comparable in effectiveness to “modern contraceptive methods like oral contraceptives.”

But in a 2009 article published in the Journal of the American Board of Family Medicine, authors Stephen Pallone and George Bergus concluded that data on the three natural family planning methods, or “fertility awareness-based methods,” is “of insufficient quality to draw any valid conclusions.”

The article cited a 1970s U.S. study on the Billings Ovulation Method, which focuses on cervical changes, and which was found to have a 1 percent pregnancy rate if used correctly. The Creighton Model, or NaproTechnology, described as a standardized modification of the Billings method, was found to have a 99.5 effectiveness rate, according to a study coauthored by Thomas Hilgers, one of the developers of the method and director of the Pope Paul VI Institute for the Study of Human Reproduction in Omaha, Neb.

Though data needed to precisely measure the effectiveness of natural family planning methods are not currently available, Pallone and Bergus wrote that existing evidence suggests the methods can be effective as a means of contraception. However, they went on to say that “physicians’ and other medical personnel’s limited knowledge of and experience with the methods inhibit broader use,” and suggested that it should be offered as “a reasonable choice for family planning.”

In Humanae Vitae, the passage reads, “we are obliged once more to declare that the direct interruption of the generative process already begun and, above all, all direct abortion, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children. ... Similarly excluded is any action which either before, at the moment of, or after sexual intercourse, is specifically intended to prevent procreation -- whether as an end or as a means.”

However, the majority of Catholics do not believe Catholic identity hinges on particular behaviors, such as following church teachings on birth control, according to findings published in American Catholics Today: New Realities of Their Faith and Their Church, a 2007 book based on surveys of three generations of Catholics, conducted from 1987 to 2005 and funded in part by NCR. In the 2005 survey, 75 percent of those polled said one can be a “good Catholic” without obeying the hierarchy’s teaching on birth control, a number that rose from 66 percent in 1987, when the first survey was carried out, to 73 percent in 1993, dipping slightly to 72 percent in 1999. Rather, being a good Catholic “requires creedal belief and receiving sacraments,” concluded the authors.

“A lot of Catholics have figured out that they’re supposed to follow their conscience,” said William V. D’Antonio, one of the book’s authors and a fellow at The Catholic University of America’s Institute for Policy Research and Catholic Studies. “They’ve figured it out; the church is simply wrong.”

Others have found the church’s teaching on birth control relevant to their lives. Lauren Gentile said a series of lectures by Pope John Paul II led her to “the conviction that natural family planning is good for marriage.” She said a large part of this benefit is the increased communication between a husband and wife.

“The basic teaching is that we can come to know God through our bodies,” she said. “By giving all of ourselves to each other physically, including our fertility, it points to the deeper reality, that we want to give all of ourselves to each other.”

She said that the three-month class she and her husband volunteer-teach on the practice of the Couple to Couple League Sympto-Thermal Method involves a lot of science. “When you start to learn the way that God’s designed the body, it’s really marvelous,” she added.

Gentile, a stay-at-home mother of two who is 29, said she and her husband, 30, have practiced natural family planning for the three years they have been married. They have a 21-month-old child and 2-month-old baby, but are not planning too far into the future as far as more children are concerned. “We’ve just decided to take it one child at a time,” she said.

[Alice Popovici is an NCR contributor living in New York.]

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