This is part of a series addressing 1flesh, an organization that argues against the use of contraception and in favor of one method of fertility awareness. Please start with Part I. This is my last post in this series, and I apologize for the length.

1flesh claims that birth control has not reduced the rate of unintended pregnancies.

I think reliable contraception has made ‘intent’ feasible. It makes it possible to actually plan a pregnancy, and if you can’t plan, ‘intent’ is irrelevant. Even fertility awareness relies on a modern understanding of the reproductive system. (Again, it’s not that people didn’t try to space pregnancies before, we’re just better at it now. Married people now have the option to be intentionally childfree.)

When it comes to pregnancy, ‘intent’ is pretty complicated. From an article published by the Guttmacher Institute:

Pregnancy unintendedness is a complex concept, and has been the subject of recent conceptual and methodological critiques. Pregnancy intentions are increasingly viewed as encompassing affective, cognitive, cultural and contextual dimensions…

Conventional measures of unintended pregnancy are designed to reflect a woman’s intentions before she became pregnant. Unintended pregnancies are pregnancies that are reported to have been either unwanted (i.e., they occurred when no children, or no more children, were desired) or mistimed (i.e., they occurred earlier than desired)…

A concept related to unintended pregnancy is unplanned pregnancy—one that occurred when the woman used a contraceptive method or when she did not desire to become pregnant but did not use a method. Intentions are often measured or reported only for pregnancies ending in live births; pregnancies ending in abortion are generally assumedto have been unintended. All of these definitions assume that pregnancy is a conscious decision…

[I]ntentions to avoid pregnancy often do not translate into contraceptive use: Almost half of pregnancies reported as unintended occur among women who were not using a contraceptive method…

First, planning or intending to become pregnant may be distinct from wanting to be pregnant. Second, the concept of planning a pregnancy may not be meaningful to some women. Third, ambivalence about avoiding pregnancy may be expressed in imperfect contraceptive use…

The idea that pregnancies are clearly either intended or not may not be a universally applicable concept…Commonly used questions assume that women always decide about the desirability of becoming pregnant at the time of sexual intercourse. This is not always the case…

Current surveys often ask women to indicate their male partner’s intentions, but relevant data are not usually collected directly from men, and discordance in intentions between partners is common…

So the question of whether a pregnancy is intended or not isn’t actually that obvious. And it’s different from how happy someone feels to find herself pregnant. And not everyone considers planning for pregnancy to be relevant or desirable. And even if they want to prevent pregnancy, they may not take concrete steps to do so.

Then there’s this fascinating study on contraceptive use among teens with unintended pregnancies, which reveals the following statistics: of the teens surveyed, 31.4% thought they couldn’t get pregnant, 23.6% reported their partner’s didn’t want to use contraception, 22.1% said they didn’t mind if they got pregnant, 13.1% said they had trouble getting contraceptives, 9% said they experienced side effects from contraceptives, and 8% were laboring under the belief that they or their partner were sterile. Why on earth would 8% of 15-19 year old people–a very fertile group–think that they were sterile? Not to mention the 31% that believed they couldn’t get pregnant for other unspecified reasons. Why were 22% so ambivalent about pregnancy, when having a child at a young age is so difficult? (And I recognize that the stigmatization of teen parents and lack of social support makes that a self-fulfilling prophecy.) Why did so many girls bow to pressure from partners not to use contraception, and why did so many others report difficulty obtaining it?

Inadequate education about reproductive and sexual health, presumably. Inadequate resources on how to assert themselves in relationships and protect their health, perhaps.

Now, back to intent, and how it relates to fertility awareness, also called Natural Family Planning (NFP). 1flesh claims that the Creighton method has an effectiveness rate of 96.8-98%. This is from an article by Jennifer Fulwiler in the National Catholic Register (she’s a fan of 1flesh, by the way):

You are never going to convince people that NFP is as effective as contraception. Even if someone did misinterpret a NFP joke as a comment indicating that it’s ineffective, it wouldn’t matter. In terms of winning converts to the anti-contraception position, I think that discussions about the high effectiveness rates of the various natural birth control methods are mostly a waste of time…

 

I began reading blogs by smart Catholic women who introduced me to a whole new way of thinking about family life. Instead of seeing pregnancies as precarious, once- or twice-in-a-lifetime events that require extensive planning and hand-wringing, they seemed to see pregnancy as a natural part of married life. They joked that that some of their children were more expected than others, and made passing comments about sometimes being surprised by seeing two lines on pregnancy tests.

Read more: http://www.ncregister.com/blog/jennifer-fulwiler/bad-at-nfp-and-proud/#ixzz27cks4AHe

It’s not that users of fertility awareness are fantastically good at preventing pregnancy, it’s that they have a completely different mindset. If you believe that pregnancies are gifts from God, they’re all intended. By God. People who use NFP for religious reasons probably wouldn’t consider a pregnancy unintended, because they think about intent differently. They use NFP as a tool to space pregnancies, but they’re prepared to accept multiple pregnancies if and when they happen. (Not everyone who uses fertility awareness is religious, but I suspect Catholics comprise a large portion of those who do.)

Now, people want different things from life, and I’m not saying that fertility awareness is an invalid method of family planning. But I wholeheartedly reject the belief that it’s the only moral approach to birth control, or that it leads to superior marriages (lack of divorce is not equal to happiness), or that couples who use fertility awareness are quantifiably more communicative than couples who use other methods of birth control (a notion I frankly find rather offensive and self-righteous). And not everyone wants kids.

Excerpts from negative experiences using Church-sanctioned NFP, from the website Women in Theology (series by Katie Grimes and contributors, specific links below):

I experienced a severe bout of postpartum depression after the baby was born and in this context — with an infant, depression, and very isolated having just finished school and having no friends anywhere close to the same place in life — that we resumed NFP. It was a disaster: my fertility signals were all over the place and between the baby and the NFP we didn’t touch for months, which didn’t help with the depression or our relationship.

Then we did – once – and I got pregnant again…

We had a newborn and an 19 mo old and I was better but still struggling with depression. Again, we attempted NFP and had the same issues with the fertility signals and I got pregnant again. I miscarried very early on and I would have never thought that could be so welcome…

So, I listen to these celibate, childless men… unequivocally and without a trace of compassion condemn my choice [not to have more children] and I struggle with being very angry at them. I think their recent history indicates that there has been far too much concern with protecting magisterial authority at the expense of discerning the truth, which might require talking to a few women. (from ‘MJ’)

 

My job was really stressful and my signs were difficult to read.  My husband and I were virgins on our wedding night, and the long periods of abstinence were adding additional stress on our marriage.  With these circumstances in mind, it’s no surprise that I became pregnant within the first year of marriage, right after enrolling in graduate school…

Sometimes I wonder if the Church’s teaching on sexuality places a greater burden on the poor than it does on those with means. The refrain I hear with NFP is to “try another method” or “take another class.”  But I seriously have anxiety issues over having to face another pregnancy with no money. How can I know if another method will work better, when the only way of testing this is to wait and see if I
get pregnant?  The stakes are simply too risky when caring for two children under 3, both still breastfeeding.

Sugar-coating NFP is not helpful, and I’ve seen Catholics attacked and hounded on Catholic forums for admitting that NFP has been a rough spot in marriage. People will say that NFP was not the problem; rather “poor communication” was the problem, or “lustful behavior,” or “selfishness,” or anything but NFP.

We decided to practice complete abstinence for a year, in order to study Theology of the Body again, try to re-learn my fertility signs, and decide if we would continue practicing NFP.  For a year we practiced the sleep-in-separate-rooms-so-can-follow-Church-teaching-but-not-have-kids method of family planning.

We were afraid of disobeying Church teaching and going to hell, but strict abstinence put more stress and strain on our already stressed marriage…

For us the pressure of feeling like we had to perform on certain days combined with the frustration of “off-limits” days, and the unplanned pregnancies–-it was all very stressful and very hard on our marriage.  Nearly two years after abandoning NFP, I still feel like I am recovering emotionally from the whole experience. (from ‘K’)

 

I became pregnant when we had been married nearly 11 months…

#1 was six months old when I became pregnant with #2.  After #2, even more depressed and stressed out, I decided it was time for real NFP.  We signed up for Couple-to-Couple classes…my chart was a mess because I always had fertile mucus.

After several meetings, the CCL husband looked at my jagged-tooth chart, looked back up at me and said, “There have been times when my wife and I have had to go 6 months or more without making love due to confusing signs”.

My husband and I left that class, tossed the charts, and were pregnant again within three weeks.  I miscarried.  Six months later, we were pregnant again.  I miscarried…We worked very closely with the Creighton teacher to try to get a handle on my charts, but they were always a mess…

One particularly long cycle, we had abstained for six weeks, and I was certain we were finally safe.  We made love that night, and—surprise!–two weeks later I had a positive pregnancy test.  I cried for two days straight. Several weeks later, I miscarried.  I felt nothing but relief and joy—and guilt and sadness for feeling that way…

I began a lucrative career, regained my health slowly, and continued to use NFP but always with long periods of abstinence and frequent falls into “sin” with my husband…

Our marriage has always been strong, but it has only gotten stronger in the years since my husband’s procedure [vasectomy].  No longer do I feel like a science experiment.  No longer do I feel like I can only have intercourse when it feels the least good for me…

I personally feel that not enough attention has been paid to the female sexual experience.  It seems to me that in the Catholic understanding of sex—penis in the vagina for ejaculation—the female sexual experience is really rather inconsequential.  So what if the woman can’t ever make love when it feels best to her ever again in her entire life.  Suck it up and quite your whining about it.  Be glad you can have sex ever.  And better be ready to pay that debt whenever your husband wants it lest you contribute to his sin. (from ‘GS’)

Fertility awareness works for some couples, but it doesn’t work for everyone, and is sometimes actively harmful. 1flesh presents it as one great method that everyone should use for an awesome marriage and sex life. As the women above note, that’s a very rosy, idealized (shame-inducing) way to address messy, complicated human lives.