1. Diane

    I started to respond to the post yesterday, because it bothered me, and then didn’t. I’m not arguing either way on whether or not artifical contraception or NFP is good or bad. The post yesterday and today are very thought provoking, and I heartily agree about marriage. However, I could not see any difference in the intent for using the methods, the message it sends to your spouse as described in the post, etc. Both “manipulate” to prevent pregnancy. I also perceived the argument today to be the same. The “act” of NFP is explicitly for contraceptive purposes, and the perceived take-home message for me was that NFP is better because the “church said so.” This concerns me as a parent of teenagers – no matter how much we may pride ourselves in “teaching” our children over the years – in the teen years teenagers quickly dismiss arguments that appear to end in “because the church said so.”

    • Hi Diane; thanks for commenting. Let’s see if we can illuminate some things.

      NFP is not “explicitly for contraceptive purposes,” as you wrote, although it may be legitimately used to avoid/postpone pregnancy for serious reasons. Rather, NFP is really just the practice of monitoring signs of fertility. NFP works with a woman’s natural (God-given) cycle rather than subverting it. Many couples use NFP explicitly to maximize the chances of achieving pregnancy. Others use NFP to help diagnose health issues that may affect a woman’s fertility. This is why NFP is morally neutral. How a couple uses it is completely dependent upon their intent.

      Artificial contraception is morally negative because its sole purpose is to avoid pregnancy, which is the natural consequence of sexual intercourse. It inserts a barrier, either chemically or physically, between husband and wife, which prevents intercourse from being fully self-giving.

      Regarding intent, both NFP and contraception may be used avoid/postpone pregnancy. The fundamental difference is that the practice of NFP for this purpose requires communication, coordination, and sacrifice, which draws husband and wife together. The couple must observe regular periods of abstinence, which prompts them to continuously discern their intent. NFP cannot be used callously for this purpose and still be effective. The same is not true of artificial contraception.

      Finally, “because the Church says so” is a poor context for presenting anything the Church teaches, especially to a teenager. We do better when we seek to understand the rationale behind what the Church teaches and present that instead.

  2. Diane

    Hi Lisa,

    Although this series has been focused on use of NFP to avoid/postpone pregnancy, the reminder about use of NFP to plan pregancy does speak more to a “moral neutral.” As a discussion point, the artificial oral contraceptive doesn’t have the “sole” purpose of avoiding pregnancy. As you noted, it is often taken for medicinal reasons such as easing menopausal symptoms. So it is slightly more “moral neutral”? I agree about seeking to understand the rationale, which is why I read the article in the first place, as am past childbearing, and I interested for future discussions with my kids. It will be interesting to see how this discussion continues to unfold in the Church.

    • Diane, when the birth control pill is a taken for a valid medical condition, it would more properly be considered a medication that has a secondary, presumably unintended contraceptive effect. If conception is not possible (i.e., the patient is not sexually active or is not fertile), the contraceptive effect is not realized and need not be considered.

      It is worth noting, however, that such medications come with certain health risks. The following are categorized by the World Health Organization as Group 1 carcinogens:

      • • estrogen-only menopausal therapy;
      • • estrogen-progestogen menopausal therapy;
      • • estrogen-progestogen contraceptives.
  3. Birth Control Pills for medical reasons:

    While you are correct that the Church does allow married women to use birth control pills for medical reasons, saying that they must abstain from relations is stricter than what is required by the Church.

    Pope Pius XII answered this question while the Pill was still in development in 1958:

    Is [birth control pill as medicine] allowed to the married woman who, despite this temporary sterility, wishes to have relations with her husband?

    The intention of the person determines the answer.

    If the woman takes the medicament, not with the idea of preventing conception, but solely on the advice of her doctor as a necessary remedy for a disorder of the uterus or organism, she is causing an indirect sterilization, which is allowed according to the principle governing acts with a double effect.

    http://www.pamphlets.org.au/australia/acts1454.html (Unfortunately, the full original is not available in English)

    As for the possible post-conception effects of the Pill, this would be a miscarriage (because it is not intended), not an abortion. Under the principle of double-effect, the possibility of a miscarriage must be weighed against alternative treatment or no treatment. In the case of a woman with an ovulatory disorder so severe to require the Pill as hormonal therapy, she is far LESS likely to miscarry on the Pill than off of it for the simply reason that she is less likely to ovulate, leading to fewer opportunities for conception.

    Still, birth control pills are strong medicine and many women will find that NFP leads them to better treatment and better health. A woman who truly needs the Pill as medicine needs prayers, not judgment.

    • Thanks for the helpful resource and commentary. A few thoughts:

      First, regarding the permissibility of sexual relations while experiencing the secondary effect of sterility, it is worth noting that the pope’s response is far from an unequivocal affirmative. Rather, he cited the following conditions for taking such a medication:

      • • “as a necessary remedy”
      • • “solely on the advice of her doctor”
      • • “not with the idea of preventing conception”

      Let’s unpack that. Basically, a qualified medical opinion (preferably a consensus) must assert that it is necessary to treat the condition and only a medication inducing temporary sterility will suffice. That’s a high threshold before intention is even considered. However, if those two conditions can be met, the patient’s intentions still must be pure. Meeting all three of these conditions consists of no small amount homework and prayerful discernment.

      Second, the potential for loss of life in utero due to the medication’s abortifacient properties, however small, must be considered. Call it whatever you like, but the process is what it is. The only certain mode of prevention is abstinence. Taking all these factors into account, I would not be comfortable advising someone to engage in sexual relations in such a case.

      Third, I wholeheartedly agree that “A woman who truly needs the Pill as medicine needs prayers, not judgment.” Well said.

      • As to your first point:

        I would say the question is whether a non-sexually active woman in the same situation (like a nun) would undergo the same treatment: If so, then it is proper. If not, then the woman should seek the best treatment.

        Once again, I would agree that this consists of no small amount of homework and prayerful discernment. This is NOT a loophole.

        As to your second:

        Would you also advise complete abstinence for a woman who has a problem with repeated miscarriage?

        Would you also advise complete abstinence for a treatment other than birth control pills that can increase the risk of miscarriage?

        The reason I ask is because MANY seemingly innocuous medications (such as ibuprofen) and even “pro-life” alternative treatments for these disorders can also increase the risk of miscarriage—often even more than the Pill. It seems like you are holding such hormone therapy to a higher standard because it happens to also be marketed as birth control.

        • In any such case, I would recommend an initial period of spiritual counsel, prayer, study, and abstinence, during which the couple could discern together whether or not to eventually resume sexual relations.

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