Abstract

PIP: Methods of family planning involving periodic abstinence are being promoted aggressively by Catholic and other church groups in the U.S. and worldwide, under the name "natural family planning." The major methods are the calendar rhythm, basal body temperature, cervical mucus, and a combination known as the sympto-thermal methods. These methods require avoiding coitus from 7-17 days of the cycle, not including menses. Effectiveness figures quoted range from 93-99% by church sources, to 80.4% by WHO studies of selected women, to 65-89% by family planning experts. Reasons for high failure rates are irregular ovulation, human error, poor instruction, and insufficient cooperation by spouse. Although proponents claim that periodic abstinence is risk-free, they usually fail to consider the alternative risks of pregnancy and childbirth in case of method failure. Furthermore, the major complication rate of pills, IUDs, legal abortions and sterilization amount to only 0.3% of users, and artificial methods protect variously against sexually transmitted diseases, AIDS, cervical, ovarian and endometrial cancer. Other drawbacks of natural family planning are reluctance with handling one's body, cultural attitudes toward open discussion about sexuality and women's autonomy, need for mature communication between spouses, insufficient literacy to use charts, and the cost of extensive training. In the U.S., training is estimated to cost from 2.5 to 3.2 times the costs of barrier methods or pills, not including the time the woman must devote to daily measurements. The article concludes with a review of the recent history of the Roman Catholic doctrine on family planning, of attitudes and practice of U.S. catholics, and of the U.S. government's role in spreading natural family planning and hindering the implementation of other contraceptive methods within and outside of the country.