Everything You Ever Wanted to Know About Natural Family Planning

I recently came across Dustin Riechmann’s terrific and informative blog Engaged Marriage. I really liked what I saw. I noticed that Dustin seemed to know a lot about natural family planning (henceforth referred to in this blog post as NFP), a subject I’ve been interested in lately. I’ve come to the awareness that lots of people don’t seem to know much about NFP (myself included), so I thought it would be awesome if Dustin would write a guest post for me, and teach me and my readers a little something about it. He graciously agreed, although I wonder if he regretted it a little bit afterwards because I asked him a buttload of questions. He was really nice and answered them anyways. Below is the Q&A that resulted from our collaboration. Enjoy!

Can you briefly outline what NFP is, and how it works?

In simple terms, Natural Family Planning (NFP) is fertility awareness.  By recognizing the signs that indicate when a woman is and is not fertile during her monthly cycle, you can reliably avoid or achieve pregnancy by abstaining from sex or “going for it” during the fertile times.

For more information, please see my post entitled What is Natural Family Planning?

What is the difference between NFP and the Rhythm Method? Because isn’t that what all our parents used when they had, like, three unplanned pregnancies? [Also: is it the same thing as the Billings Method?]

Modern NFP and the Rhythm Method (a.k.a the Calendar Method) are very different approaches to family planning.  You are correct that the Rhythm Method was used by a lot of folks in the 1970’s and 1980’s as a “natural” means of avoiding (or achieving) pregnancy.  We often joke when we are giving our marriage preparation presentations that many of those in the room were conceived using this method.

NFP is different.  It’s based on exhaustive modern medical research and it uses several signs to determine whether or not a woman is in the fertile phase of her cycle.  The Rhythm Method used only a calendar as a tool to determine when a woman was fertile, and it assumed that all women had a 28-day cycle.  I think that’s enough info to know that this method lacked reliability!

Modern NFP doesn’t rely on a calendar at all.  A couple tracks a woman’s basal body temperature (her temperature immediately upon awakening in the morning) and the state of her mucus “down there” to track her cycle.  Depending on the method, some also incorporate cervical status and/or the use of a fertility monitor such as the Clearblue Easy monitor.  This tracking is highly reliable and pretty much independent of cycle length or variability.

Oh, and the Billings Method (named after the doctor who developed it) is one of several forms of modern NFP.

Doesn’t NFP still have a really paltry success rate? I mean, don’t accident babies happen left and right when couples try to use this method?

Not at all.  When practiced properly, NFP is 98-99% effective, which is similar to artificial contraception like condoms or The Pill.  The difference is that NFP requires communication between the couple, and it sometimes requires self-control when you want to have sex but are also fertile and desire to avoid pregnancy.  If NFP results in “accident babies,” I’d suspect it is from couples who choose to “break the rules” and take their chances.

When you have sex during your fertile time, you are obviously increasing the chances that you’ll get pregnant that month.  The same would be true with not using a condom “this one time,” forgetting to take your birth control pill or having sex when your pill may not be effective (like when you’re on antibiotics).  If you practice NFP properly, you should achieve the published effectiveness rates of 98-99%.  If you get pregnant doing this, I think God had different plans for your family!

Doesn’t NFP take all the fun out of sex, making it all medical?

No way.  I can see where this would be a concern when you talk about charting temperatures and determining when a woman is and is not fertile.  But in reality, the practice of NFP brings an entirely new level of intimacy to a relationship, and it results in a closeness that simply cannot be achieved with contraception.  I can personally attest to the fact that Sex ROCKS when you are using NFP, and it provides an experience unlike that which can be experienced otherwise.

I think this is conveyed pretty well in my post “How Does Natural Family Planning Benefit Marriage?” and also this NFP Informational Video.

Why should couples consider using NFP rather than just going on the Pill if they want to avoid pregnancy?

The moral and spiritual reasons are well discussed and they’re usually the focus of most NFP articles, so I think an internet search will uncover most of that information.  I would highly suggest that everyone read the writings and hear the talks by Christopher West on these issues.  He really does a great job of relating some heavily theological stuff in practical terms.

In short, the Catholic Church condemns artificial contraception, and so did every other Christian denomination until the 1930’s (many until the 1960’s).  There are many reasons for this, but the basis is that contraception prevents the full exchange of marital love in the act of sex.  When we chose to contracept, we choose to exclude God from the act of love-making.  In fact, we purposely dis-invite him from a process that He created as the ultimate demonstration of love.

Theology aside, all forms of chemical birth control (Pills) can be abortifacients, which means they can cause early abortions when they force the uterus to shed its lining whether or not conception has occurred.  If you believe life begins at conception, this becomes a big deal.

I care about these issues deeply, but the main reason we practice and promote NFP is because of the benefits it offers to marriage.  I’d suggest folks read this post to find out about that, but in short those who practice NFP have a divorce rate under 5% vs. 50% for the general population.

Many other, non-Catholic people practice NFP for the other benefits it provides, including health (it uses no hormones, has no harmful side effects, uses no unnecessary pills) and the environment (no artificial hormones in the environment and no condoms in landfills, to start with).  I actually wrote a post addressing these issues called “Green Sex, Anyone?”

Why did you choose NFP over the Pill?

Our story is long and interesting, and I’ll be writing about it in a post soon.  Basically, we used contraceptives for the first couple years of our marriage.  We weren’t really comfortable with it from a health or moral perspective but felt like we had no alternatives.  We even sought counsel from our priest and got no help.

We eventually stumbled upon NFP when we were researching ways to get pregnant (we are planners).  We tried the methods on our own and conceived our son the first full month after we quit the Pill and tracked everything.

We have used NFP for both moral and marriage-benefit reasons ever since, which has been about 6 years now.  We had one other (planned) daughter during this time.

The lack of awareness about NFP and its awesomeness are the reasons we love talking about it, and it was one of the motivations behind starting Engaged Marriage.  I should note, though, that NFP is only one part of what we discuss at Engaged Marriage since it is focused on all areas of marriage (marriage preparation, finances, communication, children, romance, etc.).  In a sense, though, all of these issues can be related back to the practice of Natural Family Planning.

Be honest: how long does the average couple have to abstain every month in order to avoid pregnancy?

This will vary depending on the cycle length, the individual woman’s fertility signs (how obvious they are) and just how stringent you want to be about avoiding pregnancy.  As an example, I’d say if you have a 28-day cycle and have dire reasons for avoiding pregnancy, you are probably looking at 10-12 days that you’d avoid sex during the possibly fertile time.  This is obviously just an estimate, and you can reduce this number quite a bit if you have obvious fertility signs and/or are okay with a bit higher “risk” of pregnancy.

Do you have any advice or words of reassurance for couples who want to try NFP but are really afraid of getting pregnant? (e.g. because they’re in school, or have medical conditions that make pregnancy dangerous)

First of all, this is probably a good time to put in a disclaimer to let everyone know my wife and I are not certified as a teaching couple for NFP.  We had training to practice it, and we’ve had great success, but we have not been trained to teach others the specifics.

That said, I would simply point out that when practiced appropriately, NFP has the same “success” rate as artificial contraception.  The only 100% effective means of avoiding pregnancy is abstinence at all times.  I think a lot of couples need to ask themselves whether their reasons are as dire as they might assume at first thought.

The most intimidating time for those who choose NFP is probably the transition away from artificial birth control and the first month or two of using the natural method.  For advice there, I’d recommend the fantastic advice offered by Batrice Adcock (20-something RN and NFP instructor) in the comments area of this post.

What about for women who have really irregular cycles – can NFP accommodate that?

Totally.  My wife has very irregular cycles that can be anywhere from 28 days to 50+ days in length.  We have had two children in the six years that we have used NFP, and both were planned and conceived in the first few months of trying.  Like I explained above, modern NFP methods do not depend on a calendar, and they accommodate irregular cycle lengths easily.

What do you do to help you to abstain during those fertile interludes every month? Do you have any effective techniques for getting through those times? [Is that a really personal question?]

Do I sound like I am afraid to talk about personal issues?   Well, my wife and I follow the teachings of the Catholic Church, which tell us that oral sex has its place only as part of foreplay and shouldn’t be the “culminating event” so to speak.  So, we don’t do that during our fertile times.  We simply abstain from sex.

Abstaining comes down to willpower and a focus on our love for each other.  Sex is awesome, but it’s not the basis of our relationship (that would be called lust).  We can abstain for a few days if we really don’t want to get pregnant.  Incidentally, my wife loves having this time to just hug, kiss, embrace and be romantic with “no strings attached” and no expectations of sex at the end of the night.  It also creates an awesome “honeymoon effect” when you get past the fertile days and are ready to be intimate again…good times!

Why do you think NFP is so little talked about these days? To be honest, I’ve never seriously considered it as an option before. Everyone assumes we will use the Pill. I invite your conjectures as to why this is the case.

For one thing, when NFP is discussed it is unfortunately spoken about as if it’s a “Catholic thing.”  In reality, there are a lot of groups out there using NFP for a variety of reasons (health proponents, environmentalists, naturalists, even feminists), and morality is only one.  Regardless, anything that is considered too Catholic is sometimes dismissed as not applicable to the mainstream.

Unfortunately, many OB-GYN doctors also don’t give any credence to NFP.  Frankly, it requires too much individual attention, and there is no money in NFP.  There is big money in the sales of contraceptives (watch the commercials during any primetime show or sports event if you need confirmation of this).  It is easier and more lucrative to simply push pills and tell people to “suit up” with a condom.

Fortunately, the trend is pointing toward growth in NFP.  And people like me are helping to spread the word about this counter-cultural means of planning our families and enhancing our relationships!

Where can I learn more about NFP? Like, from doctors and nurses and stuff?

Like I mentioned above, you may be hard pressed to learn much about NFP from your OB-GYN, but it doesn’t hurt to ask.  There are a lot of great resources online, and I’d suggest that folks check out the websites of the Couples to Couples League and the Marquette University Institute for NFP.  They should be able to find a local training course, and that is how you should really learn the ins and outs of NFP and put it into practice.

For more non-teaching-specific info, I’d ask people to check out a great site called NFPWorksBlog.com for more information.  Also, I’d love to hear from everyone by email through the contact page at Engaged Marriage, on Twitter (@EngagedMarriage) or on our fan page on Facebook.

Thanks, Dustin!

I hope that was an informative for you guys as it was for me! Let me know if you have any additional comments or questions. I would love to hear from you (and so would Dustin!) Next week(ish) I hope to post my response to this interview on his fine blog.

Tagged as: birth control, Christian culture, conception, fertility, marriage, natural family planning, Sex and Fertility Awareness, sex education, the Pill