Radiant Beams from the Gospel of Life

Chapter Four: Natural Methods of Regulating Fertility

Pope John Paul II had been a pioneer promoter of natural family planning as a priest and then bishop, long before he left Krakow for Rome. He became the leading advocate and organizer of this apostolate in Catholic Poland early in his priestly life.

The teaching of natural methods in Poland dates back to at least 1939, when Dr. med. J. Massalka in Warsaw turned his medical office into an information center about natural methods (see Leon Monko, S.J. in Wenisch pp. 349-361). Other doctors did likewise in the following years. But these doctors fled Warsaw in connection with the 1944 uprising, and scattered into other parts of Poland. They promptly began to teach natural methods in their new locations, and nurses and volunteers joined them in the apostolate. Bishops and pastors saw the value of their work and supported them. By the 1950's a network of parish instruction centers began to develop, and marriage counseling activities started to move from doctors' offices to parishes.

Karol Wojtyla, who had became Auxiliary of Krakow in 1958, convened a national scientific congress on natural family planning at Krakow in 1961, which was attended by 250 specialists, teachers of moral theology, chaplains, doctors, nurses, and other cooperators. In 1967 Cardinal Wojtyla established the Institute for Families in Krakow, with Dr. med. Wanda Poltawska as its director. Since then the Institute has exercised vast influence on the family life apostolate in Poland.

In 1970 the Polish Episcopate made attendance at standardized marriage preparation courses mandatory for all who applied for a wedding in the Church; Cardinal Wojtyla played the leading role in bringing this about. The courses were composed to include four lessons about natural family planning. Applicants for a Church marriage were required to bring with them a certificate showing that they had completed the 16 hour mandatory course. Statistics of the Archdiocese of Krakow indicate that in 1978, the last year before Cardinal Wojtyla moved to Rome to become Pope, indicate that 11,400 engaged persons attended the mandatory instructions at the 96 centers, and 13,400 others took advantage of the counseling services (see Monko in Wenisch, 349 ff.).

Cardinal Wojtyla gave the opening address at a Symposium held on 7 February 1967, the year before the promulgation of Humanae Vitae. He made no secret about his convictions that the Church teaching against contraception is true and irrevocable:

The standpoint of the Church rejects contraception. The Teaching Church takes this position as called by Christ to be the custodian of the doctrines of faith and of moral principles. The teachings of the Magisterium of the Church, which are expressed by Popes and Bishops, are, in this matter, unchangeable (Wenisch, 27; translation by the author).

The systematic approach to this apostolate, which involved 3000 centers mostly at the parishes, and more thousands of teachers, was not without effect. This may have helped to finally pass a strict anti-abortion act, effective from 15 March, 1993. Even before this, with the papal visits and the fall of communism, the abortion number had begun to drop: from 123,534 abortions in 1987, to 105,333 in 1989, 30,878 in 1991, 11,640 in 1992, and 777 in 1993 (Fr. Paul Marx in HLI Special Report No. 120, December 1994).

The future Pope, therefore, was a veteran in the area of promoting natural methods long before the Cardinals elected him to head the Church on October 16, 1978. He was fully aware of movements within the Church agitating for a change in the teaching about contraception. He had attended sessions of the Papal Commission on Birth Control, whose "majority" favored such a change. He knew then, as he knows now, that the doctrine cannot be changed because it is a law existing in God and not made by man. Instead of futile bickering about contraception, he had turned his attention to the promotion of natural family planning. He is very knowledgeable about its methods, and now asks bishops and priests to promote the apostolate of natural family planning in their parishes and dioceses (e.g. Address to NFP Congress, June 8, 1984). In this latest encyclical Evangelium Vitae he asserts that the methods now have a firm scientific foundation. Families are able to "make choices" about the number of offspring, which should always be in harmony with moral values:

From the scientific point of view, these methods (natural methods of regulating fertility) are becoming more and more accurate and make it possible in practice to make choices in harmony with moral values. An honest appraisal of their effectiveness should dispel certain prejudices which are still widely held and should convince married couples as well as health care and social workers of the importance of proper training in this area. The Church is grateful to those who, with personal sacrifice and often unacknowledged dedication, devote themselves to the study and spread of these methods as well as the promotion of education in the moral values which they presuppose (#97).

Kyusaku Ogino, Founder of Scientific Natural Family Planning

When Doctor Kyusaku Ogino of Niigata, Japan, began his prospective study in May 1919, women had little to go by to ascertain the fertile days of their cycles. Popular opinion, even medical text books, in Europe and the Americas, were of little help at that time. (In Tanzania of Africa, however, and perhaps in other areas, folklore informed married couples that the periodic and temporary secretion of fertile type mucus in the genitalia, indicates the time when they can conceive.)

Researchers in Germany during the first two decades of the present century, however, were excitedly proposing new theories about a fixed and limited time of fertility which should occur only once during the cycle. Unfortunately they disagreed about its timing. Ruge II concluded that ovulation occurs on days 14-7 of the cycle; Fraenkel, on days 16-14 (of regular 28 day cycles); Schroeder, on day 18.9 in average. So the spread was from the 7th to the 19 days and beyond, almost the entire cycle. Little would their combined findings help couples who sought either to conceive or to avoid conception by natural ways.

Dr. Ogino decided to do research of his own at Niigata University Hospital, where he was on duty to perform gynecological operations. He sensed something amiss in the German research work. A German missionary priest, Fr. Hubert Reinirkens, SVD, helped him with his German studies. He found that the researchers calculated the fertile time by counting forward from the first day of menstruation. Maybe that was a mistake, he reasoned. He eventually counted backward from the first day of the following menstruation, to learn when the fertile time had occurred in the cycle which had just been completed.

He selected 65 cases during his three year study of May, 1919 - November, 1922. He included only those women who claimed very regular or almost regular cycles. He did not mind whether the cycles were long or short, so long as they were quite regular. One of them had 45 day cycles, another 40 days; 27 had 30 day cycles, 11 had 28 days, 3 had 23 days, others were somewhere between. Dr. Ogino marked it all down.

The first thing he examined after incising the abdominal wall was the condition of the ovaries on both sides. Before disturbing them by traction, he inspected whether the one or the other ovary had follicles whose ovum had not been ovulated and drawn into the ampule and fallopian tube; and if so, what were the condition of these follicles. If already ovulated, he observed the condition of the corpus luteum which developed in the ruptured tissue. He was aware that traction during the operation might alter the initial condition; ripening follicles might burst, and corpora lutea might become engorged with blood. Such changes, he knew, would falsify his data if he did not rely on an initial observation.

When he performed an indicated hysterectomy, he usually also excised the appendage on the side which contained the corpus luteum. Later he would conduct a histological examination under the microscope of the corpus luteum and of the endometrium of the uterus when this was possible. By November 1922 he had recorded the data of 65 cases, and could now look for trends.

The corpus luteum, he ascertained, worked like a stop watch; its functioning ticked off at the ovulation signal and stopped automatically in 16-12 days if no pregnancy occurred. Menstruation would follow thereafter. He could give a systematic study to 24 corpora lutea in various stages of development. Very shortly after the ripened follicles had released their ovum (ovulation), the now erupted follicles changed into a corpus luteum. Its vascularization commenced immediately, and within four days, or at most four days and five hours after ovulation (his calculated observation), all the corpora lutea had developed fully. The data indicated that menstruation follows ovulation by 16-12 days in this sampling of 65 women. Well, almost. There were two exceptions.

And that is what Ogino published, very quietly, in a paper in the Hokuetsu Medical Journal on 20 February 1923. The time of ovulation can be calculated counting backwards from the expected on-coming menstruation, he wrote. It has been a mistake to count forwards from the beginning of menstruation. For the first time he mentioned 16-12 days before the next expected menstruation as the fixed period when ovulation occurs. Whether cycles are long or short, this fixed time of 16-12 days remains constant.

It is a long paper, with 92 pages of text, plus 5 pages with photographic reproductions. This time Academia in Japan took notice. Within a year the Japan Gynecological Society awarded a prize to Dr. Ogino for this historic paper which was to end forever the dispute about the fertile time of a woman's cycle.

We know today that the temperature rises slightly at the time of ovulation, a rise which couples can use to locate their fertile time and its end. We also know that the corpus luteum is programmed to secrete the hormone progesterone which stimulates the preparation of the endometrium for the reception and nidation of the newly conceived embryo. If there is no conception the secretion stops and the corpus luteum then deteriorates. Menstruation follows. But if a new life is conceived, the embryo sends a chemical signal to the corpus luteum to continue secretion of progesterone and so to prevent menstruation and to continue nurture of the endometrium. A slight secondary rise in the temperature a week or so after ovulation, if it occurs, gives evidence of the successful fertilization; the temperature then remains elevated instead of dropping as usual a day or so before the expected menstruation; this continued high temperature, together with the missed menstruation, are first and valuable signs of a pregnancy.

The newer methods of natural family planning, by means of which women can rely on the temperature shift, the mucus signs, the condition of the cervix, in addition to the (optional) Ogino calculations, or a combination of these and other indications, are far easier to follow and more exact than the Ogino calendar method alone. New electronic devices make it even easier, but are not absolutely necessary. All the natural methods of finding the fertile time of the cycle, however, have as their central point of departure the work of Dr. Kyusaku Ogino done at Niigata University Hospital in Japan, whose first results were published in 1923. He provided the scientific data which shows that ovulation precedes the next expected menstruation by 16-12 days.

Three Points of Contention About NFP

The Pope begins the section on NFP in the Encyclical The Gospel of Life with a request that education in NFP be made available to married couples, to help them obey God's commandments in actions connected with procreation:

The work of educating in the service of life involves the training of married couples in responsible procreation. In its true meaning, responsible procreation requires couples to be obedient to the Lord's call and to act as faithful interpreters of His plan. This happens when the family is generously open to new lives and when couples maintain an attitude of openness and service to life even if, for serious reasons and in respect for the moral law, they choose to avoid a new birth for the time being or indefinitely. The moral law obliges them in every case to control the impulse of instinct and passion, and to respect the biological laws inscribed in their person. It is precisely this respect which makes legitimate, at the service of responsible procreation, the use of natural methods (#97).

Three problems come to mind immediately when reading the passage: 1: How do we "interpret God's plan about procreation" in our family? 2: What do we understand by a "serious reason" which can legitimatize NFP? 3: Does the obligation to remain always "open to life" forbid couples to hope that their practice of NFP be successful - that it be infertile? We begin with the first, namely are we permitted to "interpret God's plan" by deliberately and with forethought selecting infertile days of the cycle for marital intercourse?

A number of earnest people, especially mothers, feel that it is not right to deliberately choose to avoid children by limiting marital intercourse to fertile days of the cycle only. They feel that the creation of new life is so sacred that humans should "leave hands off," trusting rather in Divine Providence.

The problem was very real to a father of seven children who once argued with me that NFP is a sin against God because it interferes with His plans for each family; that is, unless it is obvious that another conception would manifestly threaten death or serious illness to the mother, or if genetic inheritance indicate serious malformation of offspring. I disagreed. We went together to consult a high Vatican official.

The Vatican official immediately responded quite as follows: God gave us a brain. He wants us to use it! Think reasonably about your family. If you say, "Leave it to God" in a kind of self-induced fatalism, you might end up by blaming God if you can't handle the family situation; for example, because births come too fast and too often. God gave you a brain. He wants you to use it! ... He spoke abruptly and to the point. He had little patience with my friend who had scruples about interfering with God's plan by reasonable use of NFP.

Secondly, what kind of "serious" reason justifies use of NFP? The term of "serious" must be interpreted in the context. On the one hand it can mean the opposite of "trivial" or "lack of truth." On the other hand, it can signify "a reason proportionate" to difficult family circumstances. Finally, it can also, in its proper place, mean "grave;" that is, so momentous, severe, critical, weighty that mortal sin comes into question.

Pope Pius XII, perhaps THE moral theologian of our century, said on the one hand that a couple would need "grave reasons" to avoid children habitually, even entirely, to spend the entire married life without having any children. "If, according to a rational and just judgment, there are no similar grave reasons ... then the determination to avoid habitually the fecundity of the union ... can be derived only from a false appreciation of life and from reasons having nothing to do with proper ethical laws" (Address to Midwives, 29 October 1951). Couples would need a truly grave reason to remain entirely childless by using NFP.

Soon thereafter, as though to clarify his meaning, Pius XII taught that the limits of what is allowed and proper in the use of NFP "are very wide": "We affirmed the legitimacy and at the same time, the limits - in truth very wide - of a regulation of offspring, which unlike so-called `birth control' is compatible with the law of God" (Address to Families, 26 November 1951). The regulation of offspring, in his words, is compatible with the law of God when done within the "very wide" limits of what is reasonable. We reason for example that it is always permissible to use NFP to space births properly - say two years apart or more. That alone is a non-trivial reason, serious enough to motivate parents to adhere to periodic abstinence during one or several years. No additional "serious" reason is required.

Furthermore, some couples LOVE children - the more the better - and are happy with many and cope well. Their happiness is usually contagious to the fortunate children. Other parents love their one or two or three, but have even keener interests in the area of service to the community, or art, or intense professional work. They may feel that a large family of children would be frustrating to them, and perhaps their frustration would have a feed back to the detriment of the children. As Pius XII said for them too: the limits of what is legitimate are very wide.

What is to be said about a so-called "overpopulation" problem in reference to family planning? First of all, "Overpopulation is not a valid reason for spreading illicit birth control practices" said Pius XII (To Families, 26 November 1951). The Magisterium excoriates the actions of governments and agencies which promote contraception, a thoroughly mistaken activity which offends God and trivializes human dignity. In #16 the Pope insinuates that governments neglect rational ways of dealing with problems of development by flashing overpopulation as a red herring; that they attempt to cover up their governmental mistakes and mis-policies by using the myth of overpopulation as a smoke screen: "Rather than wishing to face and solve these serious problems with respect for the dignity of individuals and families and for every person's inviolable right to life, they prefer to promote and impose by whatever means a massive program of birth control. Even the economic help which they would be ready to give is unjustly made conditional on the acceptance of an anti-birth policy" (#16).

Does the Magisterium actively promote natural family planning as a suitable policy to curb world or national population growth? Negative. The Magisterium indeed teaches that NFP is licit to ease "overpopulation" pressures if they exist right within the family circle; that is, to balance family population with its own family resources. But overpopulation which is said to exist elsewhere, in a nation or the world, without immediately impinging on this and that family to make life difficult there, is not a valid reason to use NFP. Promotion of NFP to solve a mirage of demographic problems is Don Quixote essaying forth on his donkey swinging a wooden sword to right all the wrongs of a bad world; is casting one's pearls before swine.

In the above passage, the Pope approves that couples be "generously open to new lives" (#97), which is an encouragement to bear and rear children bountifully. That he does so in the very same encyclical in which he mentions demographic concerns (#16) gives us a key to authentic Magisterial teaching. This amounts to a quiet denial that couples should, in our world today, take demographic concerns into consideration when they decide about births in their family. Rather, they should look to the needs of their own family, and cultivate a hearty welcoming attitude toward new lives. More about this later.

The third problem to be addressed is whether the obligation to remain always "open to life" forbids couples to hope that they will be successful in avoiding children for the time being by use of NFP. The answer is NO. Couples ARE allowed to hope, with all their hearts, that they will be successful in avoiding pregnancies when they legitimately confine the marital act to the infertile times only. Some moral theologians and commentators ask parents to walk on a tight rope, to delicately balance their own need to limit births against nature's drive to conceive. They forbid parents to hope that their act will be infertile.

There is no need for such mental ambiguity at all. Parents may indeed wish and hope that intercourse confined to the infertile period be absolutely and unmistakably infertile. The couple remain "open to life" in this case in the general sense that they judge infertility at this time to be in the best service of life, as God planned it, and as their family circumstances indicate. Just as parents save money by not buying extra's so that the budget allows good family living as a whole, so also parents who "save on children" for the benefit of the existing family, are open to the best interests of life in that family. The marital act in such circumstances retains its full orientation toward God and toward life. As Dietrich von Hildebrand explains:

Nor is the use of natural family planning in order to avoid conception (emphasis mine) in any way irreverent, because the very fact of the possibility of natural family planning, that is to say, the fact that conception is limited to a short period, includes also a God-given institution. This also has a meaning, and it is definitely reverent to accept the opportunity which God offers to those spouses for whom the avoidance of conception is imperative (p. 69).

Couples may indeed hope that legitimate intercourse during the infertile time be truly infertile; they thus approve of God's plan; the plan, namely, that we be always open to life in a reasonable manner.

Next Page: Chapter 5: Natural Family Planning Today
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12