Natural Family Planning

Posted by  | Tuesday, February 24, 2009  at 10:12 PM  
I am really excited that we added this topic in to our schedule! It just seemed like an area that the Lord kept leading us back to through comment threads - so it was time to make it official! I hope you'll enjoy hearing each of our perspectives. Please share yours with us as well.

There are so many issues all wrapped in the one general "family planning" topic scheduled for this week. How many kids? When do we have kids? How long after you're married should you wait to have kids? Birth control or not? Hormones or barrier methods? You get the idea....

The first resource I'd encourage everyone to read is an article at the Desiring God website. (I just recently realized that it was probably not written by John Piper himself - but by another staff member...) The article is titled, Does the Bible permit birth control?

The article above sums up our current view of birth control and where we're at now. Here is our story:

When we first got married, we decided to use a diaphragm. My doctor thought I was crazy when I asked for one, but said it was effective if used properly. At that time, I did not desire to use hormonal birth control. When I say "hormonal birth control," I'm referring to drugs such as the pill (like Ortho tri-cyclen - although there are many), the patch (Ortho Evra), the NuvaRing or Mirena (the other IUDs). "Barrier methods" would refer to non-hormonal methods including diaphragms and condoms.

The diaphragm did not work for us. It ended up being painful to use and I went back to my doctor to find out why. She said that it was likely due to the slight endometriosis I had dealt with since beginning my period. (I still see it as a great option for birth control and would try it again if the need arises!) We decided to use condoms and did so for about a month. At that time, I experienced some pretty severe symptoms with my period. (I actually passed out at school one day!) My doctor recommended using hormones to regulate my period and get my symptoms under control. I started on the patch (OrthoEvra) after much discussion and debate. It certainly regulated my period and almost eliminated my extreme symptoms! For that I was grateful, but as time went on, I realized how much I didn't like what the hormones did to my body. After about 9 months on the patch, we went off it and began to think about starting a family. Four months later, we were pregnant.

Once I went off of the patch and while trying to become pregnant - I discovered this great book:

Taking Charge of Your Fertility is a GREAT resource and I recommend it for every woman. After reading this I learned so much about my cycle and how fertility works. (And sadly, I had already taken an entire college class centered on a woman's cycle and STILL didn't know very much!)

Through the book - we now use Fertility Awareness Method (a little more calculated than the "rhythm method" that refers to a more general idea that ovulation occurs around day 14...which is not the case for all - or most - women.) to prevent pregnancy and also to become pregnant. By knowing exactly when I am fertile and ovulating - we are able to use condoms during that time. And I know this is not always the case for everyone, but because I knew exactly when I ovulated - we were able to become pregnant RIGHT away with my second child.

There is one more thing that I'd like to share. While researching hormonal birth control - I learned that it works in ways many women are unaware of. (The Desiring God article does not mention this nor take it into account when discussing the natural family planning route vs. "artificial" methods)- so I wanted to be sure that I did. I know this is a huge can of worms - but please know that I do not think it is a black and white issue.

Most women - myself included - think that hormonal birth control works by simply preventing ovulation. That is not the entire story. Most work in several ways - one of which being to prevent an egg from being released. Another way that many work is by changing the lining of the uterus to prevent implantation, should an egg be released and fertilized.

The website for OrthoEvra that very clearly states that it:

"helps prevent pregnancy the same way birth control pills do: by preventing ovulation, which means that the ovary does not release an egg to be fertilized; by thickening the cervical mucus, which makes it more difficult for sperm to enter the uterus; and by changing the endometrium to reduce the chance of implantation." (italics and bold added by me :)

The endometrium is the lining of the uterus, in case you were wondering.

You could easily look up other forms of hormonal birth control to see how they work. Most work VERY similarly. I don't think this happens every cycle with every woman on hormonal birth control - but it raised enough question for me. This, along with the fact that I don't like how the hormones made me feel, made me decide against hormonal birth control as a method for preventing pregnancy.

Please share with us your thoughts!


Shannon said...

I also read Taking Charge of Your Fertility early in our marriage, and stopped birth control after only a few months.

The book is so informative, and I quickly learned that we as women are a little misinformed about fertility and ovulation. I am so thankful for this resource, and have passed it along to many friends.

Thanks for the thorough post.

Andrea and Grant said...

I too read that book and found it so helpful and easy to understand. And you are absolutely right, there are things about our cycle that I never, ever heard in a classroom. I credit the book for getting pregnant the first time we tried. I also plan on using the FAM as my birth control in the future.

Michael & Sarah said...

I didn't read the book, but I did get pregnant with our second child WHILE on the pill. So it neither stopped my ovulation NOR made my body "inhospitable" to a fertilized egg. Just food for thought. :) But it has caused me to consider taking more charge of my body after our second arrives!

Mark'sMeg said...

Just more food for thought -- I am pretty convinced (and have talked to many other women who have very similar stories) that the pill totally messed up my cycle and made it extremely difficult for me to conceive when we wanted to. We had to have medical help to get me to ovulate again a year after going off the pill. I know it doesn't affect everyone that way, but I definitely had completely normal cycles before going on the pill and they were never normal afterwards.

Christina said...

Ok - Sarah - have you posted on your blog that you are pregnant!?!? I had no idea!!!! And I said I didn't think it happened every time - obviously there are times the hormones COMPLETELY fail. :)

Meg - I think being on the patch even for 9 months is what made it take 4 cycles for us to conceive #1. (not that 4 months is a long time...) Whereas #2 took no time at all. My cycles were not regular once coming off the patch initially. But had been regular (just severe in symptoms...) prior to going on it. So I completely agree with you!!

Melynda said...

So, I don't really comment, but have been reading your blog for about a year, and I have a dumb question. . . is spermicide considered a barrier method, and is every form that doesn't contain hormones or track your cycle considered a barrier method?

Christina said...

Thanks for commenting!!! We love hearing from readers we don't know!

I believe spermicide would be considered a barrier method - as it simply prevents the sperm from entering the uterus by killing them. Spermicide is not a hormone - so I wouldn't consider it hormonal. Basically a barrier method is anything that physically blocks or doesn't allow the sperm to enter the uterus.

I hope that makes sense. :)

Melissa Pearce said...

I went on the pill to change my cycle for 4 months before my husband and I got married. (I was due to be on my period on our honeymoon-- so vain I know!) For ethical reasons, we had decided not to use the pill or any hormonal birth control, but it took my body a while to get back to normal. In the meantime, we also used condoms and FAM and I love this book. (I actually got my copy at a yard sale for .$25!! After borrowing a friend's copy for months!) worked great pre-first baby. While nursing, however, your body's signs may be ambiguous and are not reliable. Hence my current pregnancy with #2. I would recommend if you are using FAM while nursing, and are trying not to conceive, that you also use a barrier method for longer than necessary. Weschler suggests waiting four days after a temperature shift, but maybe wait a week. I waited four days and then conceived-- which means the first four that were high were actually false highs... Either I had a fever or some other disturbance occurred. My other signs were not reliable either. After four highs, I had two lows and knew something was off, but it was too late. Four weeks later I found out I was pregnant. My kids will be 15 months apart.

Terra Jones said...

We are huge 'fans' of NFP. I was on the pill for about 4 months when I started developing horrible migraine headaches - causing me to miss work and classes. It was horrible. I dealt with it for 5 more months My husband informed me he'd rather me be pregnant if I was going to be 'that moody'... I stopped taking the pill, bought this book ...and then 3 months later we decided to try for a baby. Thankfully we had no problems...we did have a surprise when #1 was about 6 months old...but it was a fabulous surprise :) Basically the same way Melissa said above...We're being more 'careful' this time, but, still continuing with this method.

The Eckerts said...

Christina, thanks so much for sharing all of that. My husband and I have been deep in prayer and studying about this issue. I love to hear where God is leading other families. We are not totally decided yet, but after research, we are more opposed to the pill than we were before.

Here are some facts your readers might be interested in.

If you don't want to read below, it basically is summed up to say that the definition of 'conception' was changed to make it convenient for the pill to be legal.

Here's a long (sorry) quote from the website:

Up until the mid sixties, the question of the beginning of pregnancy wasn't a subject of serious debate. It was well accepted, based upon sound science, that, that conception occurred at fertilization (that is, the union of sperm and egg).

It was also accepted that anything which prevented implantation in fact caused an abortion, as recognized by the US Government and described in a 1963 public health service leaflet:

"All the measures which impair the viability of the zygote [newly created human] at any time between the instant of fertilization [union of sperm and egg] and the completion of labor constitute, in the strict sense, procedures for inducing abortion" [1]

This acknowledgement posed a problem for the family planning movement which was moving away from "pure" contraceptives and more towards drugs which also caused early abortions by preventing implantation of a newly created human being. The only way to make these drugs legally and morally acceptable to the general public was to change the definition of conception.

This is where the American Academy of Obstetrics and Gynecology (ACOG) stepped in. In 1965 the ACOG issued a medical bulletin which "officially" changed the definition of conception from union of sperm and egg to implantation: "Conception is the implantation of a fertilized ovum [egg].”

Suddenly, under this new definition, drugs which were recognized as abortifacients now only prevented pregnancy – and could now be called contraceptives.

I would love to hear what your thoughts are on that...

amy said...

i'm really enjoying the discussions this week! we were in the same boat... used birth control pills about a year until my hubby took the marriage & family class @ sebts. it still took us 4 years to get pregnant with our first (also convinced this was due to the pill). we didn't prevent after that and got pregnant with our second 18 months later. i was still nursing our new baby and we decided to use condoms, but i still got pregnant with our 3rd! so we now have a 3 1/2 year old, 14 month old, and a new baby due in July! whew!

my question (and maybe you'll address this later) is about sterilization. i have had 2 c-sections (because of extreme complications with my first birth that resulted in our little one spending quite some time in the NICU) and will have a 3rd c-section with this one as well. my dr has advised about the increased risk with 4 c-sections and so i now have a few months to decide if i want my tubes tied or not. we definitely want to adopt in the future, so i'm ok with not being pregnant again and feel the risks of a 4th c-section outweigh the benefits. any thoughts on the matter?

Lauren said...

Christina, I'm so glad to read what you and others are saying about this issue, and I'm so glad that you're not taking a passive stance on the "backup methods" of hormonal birth control methods. We are FAM'ers ourselves, and our story is much like others. We started out our married life on birth control due to heavy pressure from many, despite the fact that I was never comfortable with it. It changed me, and changed my body so much, into someone I felt like I didn't know or like very much. When we had been married about 6 months, I started researching NFP again, and my husband and I decided to stop hormonal BC.

We feel like practicing FAM has enriched our intimate relationship, which I'm learning is not an uncommon sentiment among FAM and NFP couples! It also puts me more in tune with my own body, and with each pregnancy (2 living children, 2 losses) I've known within 2 days of conception.

Many people argue that there's no evidence that BC has ever contributed to an abortion due to failed implantation, but for us, just the thought of it, the possibility of it, is not worth it. Not to mention any other host of problems women could experience in the wake of pumping artificial hormones into their bodies for years.

Thanks again for sharing truth about hormonal BC, and thanks to you and others for the links. I wish more people would hear and receive this truth.

juliabcooney said...

What a great topic...I look forward to reading others opinion/views. I to really enjoyed reading "Taking Charge of Your Fertility". My youngest is 5 months and I'm still bf'ing my 22 month old and 5 month old. I can't remember much of what TCOYF said about bf'ing but I need to dust it off and check it out -- it was helpful to read the other comments of those of you who were nursing and got pregnant while still using the NFP.

Has anyone heard of the LadyComp? From what I have gathered (from reading the website and speaking with a representative from the company) is that it works alongside of NFP and FAM by simply keeping things calculated in the handheld device. I would be interested if anyone else has heard of it or has experience using it.

A + J said...

I'm so glad you brought up the issue that hormonal birth control can cause a fertilized egg not to implant. We learned about this from the pastor when we did our premarital counseling and were always thankful for that bit of information. It's certainly not an issue that is spoken about enough and one worth thinking about if you are pro-life.


Becca said...

I have never commented before, but we LOVE NFP/FAM! It worked "perfectly" for us for about 18 months when we felt God was telling us to wait to try to get pregnant. And then, it definitely worked (the first try!) when He gave us peace to try. :) We are now expecting our first little one in June.

I was always interested in FAM, but before we got married we prayed and wrestled with what to do. At that time, we honestly had peace about the pill. After about a year on it, I noticed I was exhausted all the time and while normally a cheerful person, I felt like there was just this dark cloud over me all the time and my heart was heavy. We delved into NFP again and read TCOYF. We will never go back to anything else. We both love knowing how my body is working and working WITH it not against it. By my charts, it took about 6 months for residual hormone effects to subside after stopping the pill. I was always a textbook case before the pill, and that eventually returned. Now I tell anyone who asks about NFP/FAM. :)

marymstraits said...

Just to balance the scales here, I love birth control--not the side effects or needing to take it, but because birth control actually enables my husband and me to conceive since it's a part of the in vitro process.

I also want to share something I learned but don't want to come across as prideful though it probably will. Our childless years are years with a divine purpose. Any difficulty a God-seeking woman encounters conceiving has little to do with birth control pills or anything else. God is not sitting on his throne wondering how He is going to combat the hormones in the pill to enable a woman to conceive. He is not waiting for the hormones to leave our bodies before we conceive. My sister went off the pill and was pregnant the next month, and I know it was b/c God was orchestrating a wonderful gift for my sister and me and our relationship--our babies were born the same day.

My point here is to alleviate any concern a woman may have that something she has done or taken is preventing her from conceiving or has caused struggles with fertility. I completely disagree. If you are seeking the Lord, He will open your womb "in the fullness of time." Obviously, do your part--take care of your body, etc. but don't think you are struggling with fertility if you took the pill. I really believe it has *nothing* to do with that--struggles with infertility have a function and purpose and are designed to draw us closer to God.

Ruth Palmer said...

For what it's worth, I just wanted to say I was on the pill for 3 years, and when I went off, got pregnant the very next month as well. So, I have to agree with Mary that the pill doesn't always have a negative effect on people. But, this has been an interesting discussion!

Michael & Sarah said...

Christina - no reveal yet, waiting until next week (ultrasound!!). In denial, basically. :)

Amy - I, too, am looking into permanent methods, and my OB recommended Essure to me - I know two folks (one male, one female) who had steriliation done that actually reversed over time - all on it's own! (Vasectomy AND tubal "grew back together" or didn't take initially...) I'm not big into surgery, especially if our second birth goes as smoothly as our first, which is why Essure appeals to me so much. (Um, maybe that could be a topic in and of iteself?!) I hate pontificating on other sites - but I just wanted to share that with you!!

KC said...

TCOYF is great! I read it cover to cover before we started trying and got pregnant on our second try!! I couldn't have been happier.

Christy said...

I have to agree with a few of the previous commenters here. I don't necessarily think that hormonal BC are a danger. I have a few cousins who started them and became pregnant while taking the pill. Also as far as the vasectomy and tubes tied issue well my inlaws had their first two children and my father in law had a vasectomy and they conceived the third after this. After the third was born my mother in law had a tubal ligation and it was shortly after this that their fourth (my husband) was conceived. So I truly believe that it is definitely in the Lord's hands. No matter what we do we are going to have what He gives us.

I personally struggled for seven years before conceiving my firstborn. I had only conceived only one other time that ended in miscarriage before this. Now three years after conceiving my firstborn I have two wonderful little boys that are twelve months and eleven days apart. It is all in God's hands and while we need to take care of what He gave us we are not going to change His plans for our lives.

Christina said...

hey everyone - this comment is from Anna. She emailed it to us. Keep the thoughts coming...

Hello there! I am a lurker via Family Oliver.. I was excited to see your blog title today. It is so rare for me to hear conversation on this topic outside of my own little circle. I should start by saying I am a Roman Catholic who is one of seven children. I grew up with babies being born all around me. Between my mom and my friend’s mothers someone was always pregnant. I think big families are normal and wonderful. This is not to say, by any means, I think it is the right thing for everyone. Given my history it probably is not surprising that NFP was openly talked and it was a given that I would utilize it once married.

Prior to meeting my husband I decided to begin the journey of understanding my fertility. I have always struggled with irregular cycles and I knew that once I found the right man time would get away from me and I would rather spend time planning a wedding and not studying my cycle. I chose to use the Creighton Model and was captivated by the simplicity of a couple’s fertility. I was empowered with knowledge about my body and loved it. The beauty of the method is that it can work for every one regardless of cycle length and in most cases guide you to determining your own “normal” cycle. This method has been taught in 3rd world countries for years to poor and uneducated people. In these communities they are maintaining their populations with the 98% accuracy of the method.

I have not read Taking Charge of your Fertility but am glad to know there are others out there who are not buying into society’s lie that using a hormonal contraceptive is the norm or that they are harmless to a woman’s fertility. The conservative medical view of trying to conceive after being on a hormonal contraceptive is that it will take 12 months for your body to figure out it again has control of ovulation. 12 months! I know many people do not suffer from this time lapse and I am happy for them. The sad truth is that there are many women who do and some that once feel ready to conceive and come off of their BC method learn they have infertility problems that went undiagnosed for years.

I believe everyone must do what is right for herself and the ultimate judge is God. However, I also believe that using a NFP method for planning a family offers the healthiest, both physically and mentally, option for a couple. Not using a barrier method during ovulation and instead abstaining from intercourse is the most conservative teaching of the Catholic Church and is not easy. Working through this challenge with your spouse is very rewarding. I understand that everyone has a different level of conviction on this topic but I think if you are willing to push the norms on the hormones then you may be open to learning a new way to become closer to your spouse and Creator.

I know I have gone on long enough but want to be thorough and provide a couple of other references. There is a newer method of NFP called the Marquette Method. It was developed out of Marquette University in Wisconsin and has had great success. It utilizes a little technology to analyze hormones in your urine and alert you to your ovulation time. The only downside is that, unlike the sympto-thermal (Basal Body Temp) method or Creighton Model, it requires a regular financial commitment. However, for breastfeeding woman it can provide great assistance in feeling confident about her fertility.

Here is a link to my sister-in-law’s blog Testosterhome. This page should send you to a series of posts by her about NFP, if it does not check out testosterhome(dot)net. There is real discussion about the challenges and benefits of NFP as well as looking at fertility in a different light - a mixed blessing. Also, this link will take you to an article entitled Contraception, Why Not by Janet Smith. This is a great explanation with facts, figures, and examples of why the Catholic Church maintains its NFP-ProLife teaching.

I hope this information is informative and has not seemed pushy. As I said at the beginning, I think it is wonderful that there are more people out there standing up against the hormone push. Choosing to not use hormonal contraceptives gives the appropriate weight to every choice of intercourse. There are no “free” nights. You must make a concerted effort to, in some of your cases, utilize a barrier or choose to abstain. Sex is a gift and should be respected and its consequences acknowledged. When we do this we are taking responsibility for our actions and this is sorely needed in our world.

Christina said...

I think the number of c-sections a doctor is comfortable with varies from woman to woman and doctor to doctor. When I had my second c-section (hoping for a VBAC, but alas she had to come early like her brother!) this was biggest fear that I'd be automatically done at three. My doctor (who is fairly progressive and willing to try things some doctors won't) said that was not the case. However, he told me this BEFORE I delivered my 2nd. After I delivered her, he told my uterine scar was very thin and that we needed to wait a while longer between kids this time and also not labor. So I'm not sure if that fact will change his view on how many c-sections will be safe for me. Anyways....those are my thoughts on that!

As far as tubes tied, etc. I have no idea. Except I was half afraid my doctor did that during my 2nd c/s. For some reason (maybe its normal and he does it during every c/s) he asked me at least 3 times if he was tying my tubes!! Sheesh, what if I got confused and said yes!? Jacob and I were laughing about that just last night.

Tamara said...

I also read Taking Charge of Your Fertility and found it quite personal problem that has, at this point, led me to use hormonal birth control, was HORRIBLE incapacitated, in bed for 2 days, labor like cramping...the husband would have to stay home from work for at least one day each month to care for the kids while I lay in bed curled up trying not to be sick from the discomfort. Sounds ridiculous, I know, but it's my reality (oddly, I never had these problems until after the birth of my kids, either..weird). So, upon speaking with my OBGYN about these problems, she suggested the pill for relief. And it's worked--but I HATE that I'm putting chemicals into my body, I HATE how the pill works...prior to having our first child we'd learned about how hormonal BC works and decided it wasn't right for us, so we quit using it and never intended to use it again. Until these problems came up. So I guess my question is: Does anyone know of any homeopathic/natural remedies for horrible periods that I might try in hopes of bidding the pill farewell forever?

Thanks for a great post!

Christina said...

I am in the same boat you are. Although, my symptoms have been better after the birth of each kid...only now are they starting to get worse again (one year after #2 was born).

The only thing I have to offer - and I'm hoping she'll see this and chime in...Margaret (a POH author sometimes...) told me once that her period cramps almost WENT AWAY when she got refined sugars out of her diet. I am not as disciplined as I think she is about this, but I do see a link between my period symptoms and how I've been eating.

But, if mine continue to get worse, then I'll reconsider hormones for controlling my symptoms - b/c like you, I'm incapacitated. Recently, I've been out with terrible pain and symptoms with OVULATION too. No need to use FAM here...I KNOW when I ovulate. Ugh!

Jessica said...

Thank you so much for posting this, I agree with your stance on hormonal birth control 100%. My best friend Lauren (already commented) has been directing me to this site for months and I FINALLY decided to delve into the deep deep (TIME CONSUMING ;) ) process of seeing what it's all about. I love the closeness of you ladies who write and think this is an amazing Christian resource for women and mothers. Thank you so much for all your hard work on this blog!

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