But Does It Work?

That's one of the questions I'm most frequently asked about Natural Family Planning (NFP).

Now, a scientific journal has published a major study agreeing that the answer is YES.

Researchers have found that a method of natural family planning that uses two indicators to identify the fertile phase in a woman’s menstrual cycle is as effective as the contraceptive pill for avoiding unplanned pregnancies if used correctly, according to a report published online in Europe’s leading reproductive medicine journal Human Reproduction today (21 February).

The symptothermal method (STM) is a form of natural family planning (NFP) that enables couples to identify accurately the time of the woman’s fertile phase by measuring her temperature and observing cervical secretions. In the largest, prospective study of STM, the researchers found that if the couples then either abstained from sex or used a barrier method during the fertile period, the rate of unplanned pregnancies per year was 0.4% and 0.6% respectively. Out of all the 900 women who took part in the study, including those who had unprotected sex during their fertile period, 1.8 per 100 became unintentionally pregnant.

This shouldn't come as a surprise for those who have used NFP faithfully; in our own experience, the method is extremely reliable for identifying fertile and infertile periods of a woman's cycle --- even when the cycles themselves are irregular or disrupted. In years of using NFP, we've never had a "method surprise" pregnancy (the .4% referred to in the study), and we know of only one couple which has. As the full study details, the key to achieving this level of effectiveness is following all the rules and not cutting corners around the edges of the fertile times. But even for those who do not have the most serious reasons for avoiding pregnancy, and can therefore cut some of those corners, the study confirms that the pregnancy rate is still quite low.

But when people ask if NFP "works," I think they're wondering about more than the pregnancy rate. There are usually other, unspoken, concerns embedded in that question. Chief among these is often "What impact will it have on our marriage if we can't have sex any time we want to?" That's a real concern, because particularly for those with the most serious health reasons for postponing pregnancy, NFP can mean long stretches of abstaining. For most couples, the average seems to be between seven and fourteen days; at the extreme, for a small number of couples, it can stretch to 21 days or more.

Can that be difficult? Absolutely. Can it sometimes put a strain on a relationship? Sure. But I keep coming back to the rhetorical question that a childbirth instructor asked us many years ago, in a different context: "Should life's most significant events be free from pain?" For many of us, we don't really learn what we're made of and how much love we have until we voluntarily embrace some kind of sacrifice for our beloved. And when that sacrifice is a shared one, that both spouses cheerfully embrace out of love for each other, and experience together, it can help elevate a husband and wife's relationship to a much higher level.

The key is that the husband and wife have to decide, together, that the other's fertility is not a disease to be medicated away or "barriered" away, but rather a gift and a healthy, integral, organic part of the whole person. Husband and wife must tell each other, I love and want to be united with all of you, the way you are, not just a portion of you. And I want to give you all of myself, the way I am, not just a portion of myself. And if this isn't the right time for a pregnancy, we can wait. I can wait for you.

And then a funny thing happens. While the two of you are waiting, together, you rediscover and renew your relationship. You spend time together in other ways. You talk, every month, about why the two of you are doing this and whether this might be the time to add another person to the community of love which is your family. That's when your relationship begins to reach a depth and level of maturity you couldn't have imagined before. And that's when you can't imagine ever going back.