National NFP Awareness Week

Faith, Family, & FABMs

By: Madeline Bartram, DO

Director’s Note: Over the years, women and couples of all backgrounds have settled on natural or fertility awareness-based methods (FABMs) as their family-planning method of choice. While some women choose FABMs for the lack of side effects or a desire to avoid artificial hormones, other users value FABMs because they align with their religious beliefs. In this week’s interview, Madeline Bartram, a former FACTS elective participant, interviewed a female relative who desired to use a scientifically sound family-planning method that was consistent with her Catholic faith. For Catholics, this week marks Natural Family Planning (NFP) Week, an annual event held around the anniversary of the papal encyclical Humanae Vitae. In this document, Pope Paul VI highlighted the need to develop reliable natural methods of birth regulation rooted in science. In the decades since then, multiple natural methods of family planning were developed and have shown to be effective both for preventing and achieving pregnancy. At FACTS, our goal is to share the science behind these natural methods, so they may be offered to all women and couples, regardless of faith.

More than 50 years ago, Pope Paul VI released the encyclical Humanae Vitae — translated to “Of Human Life” — on July 25, 1968. The encyclical was written to reaffirm the Catholic Church’s teaching on marriage, contraception, and responsible parenthood. It also confirms the teaching of the Catholic Church on artificial birth control as “intrinsically wrong” because it separates the unitive and procreative aspects of the sexual relationship. I spoke with my sister-in-law Christina,* and we discussed whether or not  fertility awareness-based methods (FABMs) are a form of contraception. Christina now understands that, according to the teaching of Humanae Vitae, they are not. But she had plenty of questions early on.

In her mid-20s, Christina was newly married and seeking an acceptable way to avoid pregnancy. She was in the middle of writing her doctoral thesis to obtain a PhD in Child Psychology at a prestigious university when she learned about the “rhythm method.” She was eager to learn of a way to avoid pregnancy that was consistent with her faith but wondered if this would suffice. As she explored her options, she also asked herself: “Is this relevant to my marriage within the context of the Catholic faith?”

Turning to FABMs

After learning about FABMs, or natural family planning (NFP), Christina dove into the research and began to understand that FABMs and NFP are not the same as the withdrawal method or the calendar/rhythm method that was originally developed in the 1930s. As Christina discovered, modern-day FABMs are instead based on observing and interpreting individual signs and symptoms of fertility. They are not meant to be an alternative form of contraception but instead allow a couple to respect the procreative aim of marriage. This was a relief for Christina.

“FABMs and NFP are not the same as the withdrawal method or the calendar/rhythm method that was originally developed in the 1930s.”

As a couple charts their fertility with an FABM, the couple simply uses the charting to decide when to engage in intercourse in accordance with their family-planning goals. The gift of marriage remains intact, and the couple does not have to close themselves off to the gift of new life. Not only are FABMs in alignment with the Catholic Church’s teaching, but they may also improve couple communication [1] and can be used at every stage of a woman’s life. Although Christina remains highly dedicated to Catholic teachings, she also believes in the power of science and is grateful to have found in FABMs the intersection between faith and scientific evidence.

As we learn in the FACTS elective, FABMs are evidence-based and have been studied and tested using a variety of scientific research methods. As Christina continued exploring the methods, she educated herself about the fertile phase and the external signs reflecting her fertility. She enjoyed learning about the changes in her cervical mucus, shifts in basal body temperature, and the cervical changes prior to ovulation. However, she also recognized the importance of finding a qualified teacher who could show her how to correctly use an FABM.

Christina and her husband, Dave,* excited to start this journey, chose to learn the Creighton Model. She did not want to measure her temperature daily because she was worried about her ability to be consistent, but she felt confident about tracking her cervical mucus changes. After several months of learning to chart, she felt empowered to make more informed choices about family planning. She knew more about her own body than ever before. She had also learned the impact that stress could have on the body and her fertility. As a PhD candidate, she was no stranger to stress. At one point, she even noticed her hair was beginning to thin, an unmistakable physical sign indicating her body was overwhelmed with stress hormones. Inherently, she knew this was bad for her health, marriage, and fertility. As she continued her charting journey, her Creighton Model educator not only made sure she was tracking her cycles correctly but also inquired about life stressors with the potential to impact her mental well-being — and ultimately her fertility.

“After several months of learning to chart, she felt empowered to make more informed choices about family planning. She knew more about her own body than ever before.”

Christina was finally confident that she could trust her body, and she knew how important it was to listen to it. For two more years, she and Dave used the Creighton method to successfully avoid pregnancy. During the process, they consulted their educator with questions and found themselves becoming closer as a couple.Several years later, Christina completed her PhD. Now in her late 20s, she wants to focus on building a family with Dave.

Delighted by the gift that God had given her family, Christina was happy to learn that I was taking the FACTS About Fertility course to educate myself and become a well-rounded obstetrician-gynecologist.

Christina and Dave continue to use the Creighton Model. Now a little more than six months postpartum, Christina’s regular cycles have returned and she has resumed charting to avoid pregnancy for now. She feels blessed to have discovered the Creighton Model and to have conceived and given birth to a beautiful baby boy.

After our conversation, Christina texted me the following words:

“Abstinence does not damage the procreative potential of a sexual act; rather, abstinence is simply an action that has no capacity to lead to procreation.”

She wanted to make sure I understood the point that contraception, such as the oral contraceptive pill, differs from abstaining from sexual intercourse when a woman is fertile as is recommended with NFP. As she explained to me, barrier methods and the pill always carry the intentionality of disrupting the procreative ability of a sexual act. By contrast, deliberately choosing sexual intercourse during infertile periods does not have the intentionality of preventing procreation. For Christina, NFP serves the purpose of marriage and family: to promote the common good, family, and life.

Seeking to understand FABMs from a Catholic perspective inspired me to reflect more deeply on the meaning of sexuality and marriage. My interview with Christina has added a new layer of complexity regarding FABMs. However, it has also allowed me to gain another level of understanding of the value of FABMs for couples — Catholic and otherwise — to effectively achieve or avoid pregnancy.

*Names have been changed to respect the privacy of the interviewee. All information and photos have been shared with permission.

References

[1] Unseld M, Rötzer E, Weigl R, Masel EK, Manhart MD. Use of Natural Family Planning (NFP) and Its Effect on Couple Relationships and Sexual Satisfaction: A Multi-Country Survey of NFP Users from US and Europe. Front Public Health. 2017;5:42. Published 2017 Mar 13. doi:10.3389/fpubh.2017.00042​

ABOUT THE AUTHOR

Madeline Bartram, DO

Madeline Bartram, DO wrote this post while completing the online FACTS elective through Georgetown. At the time, she was a fourth-year medical student at the Texas College of Osteopathic Medicine in Fort Worth, Texas. She graduated from medical school in May 2021 and began an Obstetrics and Gynecology residency. She feels it is important to be a well-rounded physician who understands the benefits of FABMs and is able to educate and offer her patients alternative methods of family planning. She hopes to increase awareness of the FABMs she studied during this elective and share her knowledge with other medical students and professionals throughout her career.