The Time Has Come for Pastoral Work in Natural Family Planning

Anthony Zimmerman
The Priest Magazine
July-August 1982
Reproduced with Permission

I wish that doubting priests who read this article could meet people like the midwife in Japan who said to me recently: "Natural family planning should succeed in Japan from now on. Women now have three signs to go by: temperature, mucus, the cervix. They can't miss." Thus spoke this non-Catholic midwife in Japan.

This midwife of mature years said that 170 couples in her area accepted the method. Presumably all are non-Christians. They abstain during the fertile time of the cycle in order to plan families.

Catholics in Japan, on the other hand, sometimes impose curious obstacles and prejudices upon themselves against learning NFP which non-Christians can by-pass without trouble. A Catholic woman, wife of a director of a large hospital, told this story with relish: Their NFP classes are open to Catholics and non-Catholics. Catholics from one parish were saying that the priest was glad they come but those from another said their priest opposed NFP. The women were all atwitter with gossip and the non-Christians thought this to be very interesting. Actually, we have learned from experience to expect more opposition against NFP in Japan from Catholics than from the rest of the population. The story goes on, however, with a happy ending: both priests are now cooperating and NFP is studied seriously in the area.

As Father Denis St. Marie wrote: "Priests are good guys ... but more likely they have been kept uninformed or, worse, misinformed" [about NFP]. And Dr. Elizabeth Wojcik thinks that priests may be too gullible:

Many married couples are already using temperature sign for NFP and they have no reason to mention this in the confessional. But couples who don't know NFP or who don't want to use it, may tell the priest it is impossible and talk a great deal about their difficulties. (1)

Two books were especially prepared for priests and sent to parishes in the USA and abroad: A Reader in Natural Family Planning (1978), and Natural Family Planning, Nature's Way - God's. Way (1980). 1 wish to use materials from these as well as from other sources to answer questions which may linger in the minds of clerics.

1. Is pregnancy possible on every day of the cycle?

You probably have heard what I have heard time and again. "I am one of those women who can become pregnant at any time of the cycle." A certain glibness may accompany the statement, the woman assuming that the celibate will take her word as Gospel. After all a cleric wouldn't argue with someone who knows from experience ....

Nothing could be farther from the truth. A woman can become pregnant only in association with the one single ovulation episode which occurs in a cycle, governed by hormones. The egg dies very soon after ovulation if it is not impregnated; most say within 24 hours. Dr. Shuetsu Suzuki of Keio in Tokyo, who looks at ova many hours with an electron microscope, says that the changes in the egg occur rapidly. In fact, he thinks pregnancy may be possible for only 6 to 8 hours after ovulation.

A woman may insist, however, as one has said to me: "But I am different. I know that I became pregnant just a day before my menstruation." But that doesn't happen. Sometimes there is a bleeding which accompanies ovulation, and women may mistake this for menstruation. By using the temperature sign a woman can know whether the bleeding follows a high phase - true menstruation - or whether it occurs at low temperature, or at the time of the shift - and that may be a very fertile time.

Applicable Interval

The time interval between ovulation and the next menstruation is scheduled by the life-span of the corpus luteum which forms in the follicle after ovulation. The time is quite constant for the same woman, and is applicable to almost all women in the world, namely an interval of 12-16 days. There are rare exceptions to the rule of 12-16 days, records of longer intervals which are constant for this individual. The corpus luteum runs through its cycle of proliferation, formation of blood vessels and secretion. If a pregnancy occurs, and the corpus luteum receives a signal from the newly implanted child, it continues its secretions to support the pregnancy. If there is no pregnancy, it then deteriorates on the schedule of its inbuilt biological clock. Menstruation follows.

Dr. Kyusaku Ogino ascertained all this already in 1923 and published it in the Hokuetsu Medical Journal, Vol. 38, No. 1, Feb. 20,1923. He concluded from his famous chart with data of 65 cases:

The time of ovulation is a period of five days, from the 12th to the 16th days before the expected menstruation. Ovulation occurs with the greatest frequency on the 13th day. The time of ovulation (in relation to the expected menstruation is not changed because of length or shortness of the cycle. (Translated by the writer.)

If some women think - perhaps with mixed pride - that they can ovulate in response to sexual stimulation, they are again 100 percent wrong. Ovulation follows a long series of hormonal events which stimulate follicular development and culminate in the one single event of ovulation per cycle. Immediately after ovulation the cut-off mechanism sets in and unless another egg or two escapes from the ovary within hours, there will be no more ovulation during the month.

The process before ovulation may be longer or shorter, may be stalled for days, may be affected by dispositions and physical or psychological factors; but once the event occurs, it will take weeks before it re-occurs in a next cycle.

Multiple Ovulations

When Monsignor Joseph T. Mangan posed the question about the possibility of more than one ovulation during the cycle, Dr.

Rudolf Vollman, noted authority on the menstrual cycle, gave a decisive answer:

There is no evidence that intercourse, or medication, even medication to induce ovulation, results in more than one ovulation process. The latter may induce multiple ovulations, taking place simultaneously within hours. Such simultaneous, multiple ovulations must not be confused with a hypothetic, erratic ovulation which should occur at different times within the same menstrual cycle. (2)

Dr. Ronald Prem agreed with Dr. Vollman at the above intervention, and added that double ovulations resulting in fraternal twins occur during the same ovulation event, and the two [or three or more] eggs will probably be released within a period of 24 hours time. (3)

Dr. med. Josef Roetzer has written that there are some indications that a slight acceleration of the process leading to ovulation might in some cases be induced by stimulating the cervix but no one has ever demonstrated the existence of paracyclic ovulation stimulated by some action, or a second or third, ovulation, after the cyclic ovulation was completed. (4)

Since there is only one ovulation episode per cycle, therefore, the art of natural family planning works on the assumption that the days of possible conception are all in one sequence, and that their number is limited. If you hear something different, assure the party that, if they can produce the evidence, they can send the scientific world back to the drawing boards.

2. "The time of a woman's greatest desire is during the fertile time. It is unusually difficult for her to abstain then."

Even if it is more difficult for her to abstain at that time, it is not impossible. And for many there is not much difference in this area. Husband and wife learn how to love each other during this time in other ways than through intercourse. The experience of couples is not always the same: at some times it is more difficult than at others. NFP is made into a pattern of life, like eating meals on schedule, getting up in time for work, stopping at red lights, smiling at difficult customers.

God has seen fit to make desire and cycles a gentle and manageable event among humans. If otherwise, a woman's life, married or unmarried, would be difficult. Surveys do not substantiate the claim that desire always goes with the progress on the cycle. For some, yes, for others, no. As Joseph and Arlette D'Sousa say so well:

The mystery of a woman's sexual desire is that it is more closely bound to conditions of mutual affection than a man's is .... His tenderness to her with physical signs and gestures, which accompany his verbal appreciation of what she has been to him, opens her heart to him and her body like a flower, replete with all the richness of a woman's spirit and her physical being. We would not believe it initially but our experience has time and again proved that the physical desire of a wife, when aroused from spiritual and emotional cases, results in a richness of her inner being, through characteristic reactions, far greater than any peak of the biological mucus symptom can foster .... A woman in love desires her husband always.(5)

3."Natural Family Planning is unreliable. Pills and IUD's are 100 percent reliable."

Quite wrong on both counts. If a couple takes three lessons or so, study together until they know the signs, ask by telephone when they are in doubt, abstain when not sure, they can live a pattern of NFP that is near 100 percent reliable. Very many do. They can use this without fail for the rest of their lives, whereas Pill and IUD users have problems with long usage. Condom users should reckon with a failure occasionally, at least once in five years.

George and Sylvia Loom relate how quickly they learned:

Our seven children were a result of practicing rhythm .... Then we went to the Trenton meeting to see whether we could learn something which would give us a little better track record than this rhythm had done .... And it was a surprise to us that we gained confidence in the method so fast, after only two or three cycles. I think the key to this was that we had something we could see, and that we could both share. (6)

Sister Paulette of Calcutta reports how women were afraid when using various other methods, and became confident when they learned the natural way. She spoke about this when lecturing in Japan with Mother Teresa:

Many of them were using the IUD, many the condom .... They were nervous. They could not enjoy any sexual relationship .... The bane of family life was that sexual relationship was not done freely without fear. If the couple used a condom and the condom leaked, and the woman became pregnant, the man said "this is not my child." Most of the time we can observe in the families who are using the pill and the condom, that there is no happiness. And I was thinking about these poor people: they are already deprived of food, deprived of a house, and then they have this problem ....

So we started in Calcutta to teach NFP. [Now, 13 years after starting, 650 new user couples are added every month.] When I asked the women about the difference in their married life during the time when they were using other methods of family planning, and after they changed to natural methods, even the poorest of the poor have a good understanding of the difference. Before we used to be frightened that there might be another child. We didn't know what to use. We used the spiral and we finished with it; we used the pill and are finished with that; and we are frightened. Another child may come! What is going to happen?

But now this was like a new life for them. They could see that not every sexual relationship will bring a child. And when they saw that they could have a relationship during the sterile time, and the menstrual period would come on schedule, they were so happy, they were so free, they said to me: "Sister, now we know everything, we are proud of ourselves. And we keep telling others, and then they come."

During the last two years we have had Dr. Ghosh of the Medical Research Institute doing a study .... He took 500 women and then studied them for two years. There was not one pregnancy. Not one! The result was 100 percent. They all used the sympto-thermic method [temperature and mucus signs.] It was a miracle maybe, but it is true. (7)

The writer spoke with Dr. Ghosh and examined the result of the study about which Sister Paulette had reported. Under the aegis of the Indian Council of Medical Research and Mother Teresa's Missionaries of Charity a careful study was carried out by Dr. Ghosh, Dr. Saha and Dr. Chatterjee to find out the acceptability and reliability of NFP among slum dwellers in Calcutta. Of 700 women approached, 525 accepted. The study lasted two years, between 1978 and 1980. There was a matched control group of 500 who did not use any form of contraception. The 525 practicing NFP used the combined temperature and mucus observation method. Here are the results of the study as Dr. Ghosh reports:

There were no pregnancies in the NFP group but 158 in the control group. However, 28 (5.3 percent) of the study group dropped out during the two-year study due to personal reasons.

It has been my experience that many priests imagine that contraceptives are reliable, safe, fool proof, whereas the natural methods are not reliable. The time has come to lay that myth to rest. Priests are dragging their feet. This can be a real scandal to the faithful for whom the local priest is the usual channel of advice in such matters; the pope is far away, and the faithful are not always certain that they know what the pope really means when he says this and that, until the home priest explains it to them. For them the parish priest is pastor, teacher and prophet, their link with the Church.

The fact that families rally behind the priest when he leads the way to NFP was brought out in a letter written and signed at an NFP Congress in Cali, Colombia in 1977. 1 hope that its words will encourage some of you pastors and priests to help usher in the age of NFP, to do pastoral work in this area.

We know from our experience with families who are practicing the way of life of natural family planning, that family life has improved greatly since the couples have begun to make these sacrifices for each other. Parents are giving more attention to the Christian education of their children and to family prayer. Some pastors find that the people have become more friendly and place more confidence in their priest, realizing that he is concerned with their problems and can talk about things that were once taboo. Quite a number of couples have returned to the use of the Sacraments after having absented themselves for a time. Some couples, who began the practice of natural family planning when living in illegitimate union, have subsequently asked their priest to bless their union. And non-Christians, who had wanted to receive Baptism, but feared to take the step because of conjugal problems, have gained confidence when using natural family planning, and have now come into the Church. We therefore sign this request that special priority be given to the education of the clergy on this question. (Signed):
+Thomas Stewart, Chun Chen, Korea
Fr. A. Zimmerman, Japan
Fr. J. Meanness, India
Fr. D.L. St. Marie, El Salvador
Fr. G. Gibbons, El Salvador
Fr. M. Welters, Haiti
Fr. P. Richards, Uruguay
Fr. P. Rudman, England
Fr. P. Pram, Colombia
Fr. R. Opine, Colombia
Fr. T. Hechuan, Indonesia
Fr. A. Deign an, Hong Kong
Msgr. J. Sei, USA
Fr. A. Lem, Ecuador

Groups No pregnancy during 2 years Pregnancies Total
Study group 525 (-28)* 0 497*
Controls 342 (68.4%) 158 (31.6%) 500

*28 (5.3%) had dropped out.