Holy Sex!--Part 3.1. Fun with NFP

Chapter 10 is about Natural Family Planning or NFP.  To keep the topic together, I am also going to skip ahead and also cover Chapter 15 in Part 4, entitled "When NFP is Too Hard," which deals with problems and objections involving NFP.

For those that might not be familiar with NFP, the idea is that the woman monitors certain physical signs in her body to determine when she is or is not fertile, and then the couple avoids sex at those times in which she is fertile.  The mechanics of how this is done varies depending on which of several methods are employed.  As NFP supporters are eager to point out at every opportunity, it is not the "rhythm method," in the sense that it does not exclusively rely on counting out the days on the 28 day ovulation cycle.  It does involve attempting to map out that cycle in detail, using those physical symptoms to plot where the woman is in the cycle at a particular point in time.  I think it is fair to think of it as "Rhythm Method 2.0."

Popcak talked in the previous chapter about why artificial birth control is bad (and he reiterates that at the beginning of Chapter 10), but this chapter is primarily about why NFP is swell.  To do this, he addresses a series of objections that are proposed for the purpose of knocking them down.  But the real objections to NFP, at least from the people that I have discussed this topic with, are "it's too complicated and/or unsexy" and "it doesn't work."

On the "too complicated/unsexy" front, time for an anecdote.  Senior year, second semester religion class in high school was "family life."  The highlight of the program was having to carry around a baby doll for a month or so, in an effort to convince people not to have sex (actually, the way that project was structured was really Machiavellian, but that's a story for another post).  But, as part of the program, we learned about NFP.  I remember very clearly having a class in which the male teacher explained to a class that happened to be mostly female about evaluating the properties of cervical mucus in order to determine fertility.  I distinctly remember looking around the room at my female classmates, who had a look of complete bafflement on their faces.  Clearly, these young women had never given serious thought to their cervical mucus discharge, and did not appear to be particularly interested in a deeper exploration.  It was, without a doubt, the most awkward 50 minutes I've ever spent in a classroom.

So, NFP is not what one normally thinks of as sexy.  Still, I think it is unfair to dismiss NFP out of hand on this basis.  Sure, mucus analysis is not sexy, but it is not like you are doing it in the moment--my understanding is that you are supposed to evaluate things in the morning immediately after waking up.  Plus, you can make the case that the reaction of my female classmates was a product of poor education about their own bodies (as well as negative attitudes toward their bodies), and that probably has a great deal of merit.  Popcak argues that the use of NFP allows the woman and her partner to learn about her body, which improves their sex life generally.  You certainly don't need NFP to explore these things, but I can see how NFP could be a springboard for this discovery.  So, I take his point.

The more substantive objection is "it doesn't work."  NFP advocates will vociferously defend the efficacy of NFP, but I think it is important to first define what we mean by "it doesn't work."  The most obvious definition of "it doesn't work" is "it doesn't prevent a pregnancy."  Here we get into a big fight about failure rates.  NFP defenders will point to numbers that say that NFP is 98% effective in preventing pregnancy--basically the same as the pill.  That's true, so long as we are talking about "perfect use"--i.e. the woman is reading and charting the signs correctly, every time.  The more common measurement for effectiveness is "typical use"--how most people use the method.  By that standard, the effectiveness drops into the 70s--far below that of the Pill or methods like the IUD.  And that makes sense, as NFP is far more complicated than a "fire-and-forget" method like an IUD, so there is going to be a greater gulf between "perfect" and "typical" use.  

This gulf between "perfect" and "typical" use highlights what I think is the more relevant definition of "it doesn't work," which is "can I reasonably make it work?"  Could a reasonable couple be able to pull this off?

To get some insight into this, I took a trip into the word of NFP blogs on the internet.  In truth, it has been a real eye-opener for me, and I highly recommend it.  In particular, the "Real Catholic Love and Sex" site is excellent (unfortunately, the site appears to be down, so I'll link to the Wayback Machine).  It is certainly a pro-NFP site, but it does not shy away from the more problematic elements, and appears to be committed to allowing "real talk" in the comments section.  Even Dr. Popcak endorses it.

For example of the "real talk", take a look at an article entitled "NFP: How much abstinence?"  The answer appears to be "that depends on how much you don't want to get pregnant."  A woman is fertile for an approximately six day period in a 28 day cycle.  So, you have to avoid sex during those six days.  But none of the methods promise accuracy sufficient to be able to abstain only on the six days the system suggests the woman is ovulating.  So, they build in a margin of error on either side of the ovulation period.  The longer the margin of error, the less chance of conceiving.  But, of course, also the fewer number of days the couple can have sex.  The real no-go period is between 10 and 14 days, leaving between 14 and 18 "available days."  But, included in those "available" days are the days where the woman is menstruating (that is the "Phase I" that the article speaks of).  If you avoid sex during those days, you could easily be down into the single digits over a 28 day cycle.  That's a lot of not having sex.

The take-away from this article is that Popcak's framing of the abstinence period as "7 to 10 days" is disingenuous (indeed, the article begins with a reader calling out Popcak by name for this claim).  Popcak's basic attitude toward complaints about the abstinence period required by NFP is "suck it up."  A little bit of abstinence is good for you, Popcak insists, and can allow the couple to get closer.  Making that claim when we are talking about one week a month is one thing; suggesting couples "suck it up" for 3/4ths of their married life is a whole other ballgame.

But all of that assumes that things are "behaving normally" with the woman's body.  Often times they don't, especially (as it turns out) post-partum.  In this post, we hear about abstinence period lasting for months after giving birth, because all the signs are out of whack.  Think about it this way--you are a woman who has just given birth, so you have a newborn and you may be suffering from post-partum depression.  On top of all of that, you can't have sex with your husband, for fear of having another pregnancy right on top of the last one.  Very bad times, and the advice to the couple to "suck it up" seems woefully inadequate (in another post which is unfortunately not archived in the Wayback Machine, one woman reported an entire year of abstinence post-partum).  Note also that, contra cliched stereotypes that people, including Popcak, trot out, it is the women complaining about not being able to have sex.  Because women enjoy sex, too.

That same website also introduced me to a concept I have never heard of before--the Fertility Awareness Method (FAM).  Basically, FAM is NFP without the abstinence part--you track the cycles and all of that, but during the fertile periods the couple either has sex with a condom or has oral sex or whatever.  Not surprisingly, this is a much easier sell to many than NFP.  One of the authors of the "Real Catholic Love and Sex" site explained it as follows:

 As for NFP, I do recommend it, but only for couples who are well aware of what they are getting into. NFP can be very rewarding, but it can also be very frustrating, which can be very dangerous if the couple is not prepared to handle it.

Couples need to be committed to it, not out of fear of hellfire, or in an effort to earn “heaven points”, or to prove that they are a “good Catholic”, but because they have a very specific, dare I say—very Catholic view of sexuality. They need to believe that nothing will truly satisfy other than sexual intercourse as nature intended and that they would rather abstain than settle for less. Because if couples believe, as most couples do, that sexual enjoyment between a couple is good in itself and any link to procreation is unimportant or undesirable, then choosing NFP over FAM really doesn’t make much sense.

This is why I get frustrated with people overselling NFP or scaring people into it. Because NFP is not always easy, and NFP has it’s own dangers and pitfalls.  

(Emphasis in Original).  That's not exactly a full-throated endorsement of the awesomeness of NFP.  Basically, she is saying that unless you are convinced that using a condom during the fertile periods is absolutely unacceptable, you should probably just do that.  And this is from a strong NFP advocate.  There is a whole world of folks who are using NFP that are less complimentary.  Try this:  do a Google search for "NFP sucks."  You will not find lots of anti-Catholic voices making fun of the idea of NFP.  You will find Catholics who are practicing NFP talking about how much it sucks.


Here's the bottom line.  The problem here is not the charts or the mucus.  The problem here is that couples want a method of pregnancy regulation that allows them to have a happy, healthy sex life.  If NFP allows couples to have that, then great.  But it is clear that NFP cannot guarantee that.  If NFP requires the couple to choose between lengthy, even months long stretches of abstinence on one hand, and basically rolling the dice on the other hand, then NFP is not "working" for that couple.  And for those couples, Catholicism and Dr. Popcak have no answer other than to basically tell them they are SOL.

But the real problem is that folks like Dr. Popcak are not even telling them that.  Instead, Popcak provides lots of happy talk about how swell NFP is, while hiding the ball regarding the potential bad scenarios that might be lurking for a couple.  That's not fair.  And then he dismisses complaints about abstinence periods by telling people to keep it in their pants.  That's just a dick move--he has to know that these extended abstinence scenarios are out there.

If Popcak, and the Church, is really serious about wanting couples to have a great sex life, it needs to offer those couples for whom NFP does not result in a discrete ten day abstinence period something other than a dismissive "Tough Shit" message.  Because, if you want to have the toe-curling sex, you must first have an opportunity to have sex at all.  Without that, all of the rest of this is entirely theoretical.

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