Living With Your Fertility:
a presentation for all dioceses and all methods

by Kathleen M. Raviele, MD, FACOG
Vol 15, Nos 1-2
Winter/Spring 2004
Reproduced with Permission

She sat in my consultation room, inquiring about Natural Family Planning classes. The night before, this woman in her early 30s, the mother of two active boys, had convinced her husband she should come off the Pill. Her conscience had begun to bother her after she had participated in a Christ Renews His Parish program. With regret she said, "When we went on our marriage preparation weekend eleven years ago, they mentioned NFP in about five minutes at the end of the weekend. We didn't even give it a thought. Now that I look back on the last eleven years of our marriage I know our relationship in the sexual sphere would have been much better had we not been contracepting. If the whole point of sex is to prevent a pregnancy, I'm not interested."

As an NFP-only obstetrician-gynecologist and as a teacher of NFP, I had heard similar comments over the past twelve years. Couples would search for NFP after finding out what the Pill was really doing to the woman's health or that it was abortifacient. Other couples learned from friends that NFP is an effective and safe way to space children. One spouse might have had a spiritual conversion through a Marian devotion or spiritual exercises and have a great desire to follow Church teaching. Some may have been challenged to change their lives by a priest in the confessional. Those who were married expressed deep regret that they had not heard about NFP in detail when they were prepared for marriage.

The demand for NFP services in the Atlanta Archdiocese over the past twelve years has grown tremendously. Although the Catholic population is still less than 5%, it has doubled in the last ten years to 367,000 registered Catholics, an influx of Spanish-speaking people accounting for half of the increase. In 1991, there were two Sympto-Thermal teaching couples offering four courses per year; today there are 21 certified active teachers of all the methods, teaching in three languages. Additional teachers are in formation. Classes are starting up each month and the individual programs can start couples on short notice.

Many of our priests, especially those who are newly-ordained, preach about NFP from the pulpit. They discuss it with couples preparing for marriage and in the confessional. In Reconciliation, the penitent is taken through spiritual exercises based on a detailed examination of conscience. This has brought about many conversions because often adults are still working with what they were taught in second grade and no longer know the nature of an individual sin. The grace from making an informed general confession to the priest opens their eyes to the truth about contraception. A program called Familia, a study circle for young mothers, is led by knowledgeable Catholic women who guide women through papal encyclicals. In this program, which also can include the husbands, the encyclical Humanae vitae is covered early. In one group, there was a very dramatic response. Despite initial opposition to the teaching, after a priest explained the Church's teachings on marriage, sexual intercourse within marriage, and the role of children, the women understood and accepted the Church's teaching. One woman went on to train as an NFP teacher, another started implanting the eight embryos she had in frozen storage from the in vitro fertilization she had not realized was wrong.

In response to work by the Archdiocesan Office of Family Concerns, headed by Mary Ellen Hughes, and the NFP Office, directed by Lynn Crutchfield, as well as couples heading up Engaged Encounter, in October 1998 Archbishop John F. Donoghue mandated that all Catholic marriage preparation weekends would have a 45 minute program on NFP presented by an NFP teacher. The Archdiocese has always welcomed teachers from all NFP methods, so the challenge was how to come up with a presentation that would cover basic information, but not just about one particular program. Using slides obtained from two NFP programs, a presentation was developed. But it quickly became clear that to savvy, technically oriented young couples, a less than top-notch slide presentation would not persuade them that NFP was modern, scientific or effective.

In early 2003, I explained our problem to Professor Richard J. Fehring (Marquette University) - we needed a professional presentation on Natural Family Planning. A presentation that could be used for RCIA programs, marriage preparation programs, medical groups, weekend parish mission presentations, or secular groups. In response, Dr. Fehring developed a generic PowerPoint presentation on NFP, which we began to use with various groups. Most presentations were at Engaged Encounter weekends or Three To Get Married weekends. The majority of listeners had never considered NFP and were there to fulfill the requirements for marriage in the Catholic Church. Modifications were made based on comments of the audiences, but particularly helpful were those of the marriage encounter facilitators, most of whom used NFP. The generic NFP PowerPoint presentation titled "Living With Your Fertility Through Natural Family Planning" was also presented at the 2003, annual meeting and national conference of the Catholic Medical Association in Philadelphia.

"Living With Your Fertility Through Natural Family Planning" has several sections, including the theology of the body, anatomy and physiology, history of the development of contraception and NFP, some basic examples of charting, modern advances in NFP, the spiritual and psychological aspects of using NFP, effectiveness compared with various contraceptives, and couple satisfaction based on recently published research. The presentation comes with a script that can be studied and given from memory or read. Because it is PowerPoint, the order of the slides can be moved around or only some parts can be given. Depending on the speaker, the program of fifty-one slides takes 45 minutes to an hour to present. Because there is a script, the talk can be given by anyone who supports NFP.

For marriage preparation we learned it was good to get all the misconceptions out right away and involve the audience by asking them what they thought of NFP and what they wanted in their marriage. The presentation then treats God's plan for marriage and the purpose of sexual intercourse. A background on the developments of the various methods of NFP over the course of the twentieth century is then paralleled with the origins of the birth control movement and the acceptance of contraception at the 1930 Lambeth Conference.

Following this, a general review of basic reproductive anatomy and physiology and natural biological markers is provided, without going into how to make observations or giving instructions on how to achieve or avoid pregnancy. The presentation is not meant to teach a method of NFP, but to get the listener interested in finding out more or to sign up for a class.This section is followed by the conditions for effectiveness and comparison with contraceptives methods.

The presentation concludes with an explanation of holistic sexuality, the spiritual, physical, intellectual, social, psychological, and emotional aspects of being human, the gift of children and how decisions about parenthood should be made. The artwork that accompanies the slides is colorful and captures the interest of the audience. One purchaser already stated, "It's very well done, and the note pages are complete and helpful. I'm already putting it to good use I've been asked to present to the St. Luke Society (medical students, residents, doctors, nurses, etc.) at our parish on February 2nd about the science of NFP. Your slides of the method history, hormonal levels, mucus and ClearPlan pictures probably will save me several hours prep time. It's so much easier having slides already done and done so well."

When we realize that fewer than 5% of Catholic couples are practicing NFP and that the rates of sterilization, abortion, and contraception are the same among Catholics as the general population, practices the Catechism of the Catholic Church describe as "intrinsically evil," a lot of work needs to be done. In his letter to the Romans (10:14,15) St. Paul says, "And how can they hear without someone to preach? And how can people preach unless they are sent? As it is written, How beautiful are the feet of those who bring the good news!"

We believe this presentation will help to get the good news about love and marriage and natural family planning to the people.