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“I have a medical reason to use contraception.”
I hear this objection almost every
time I speak
and there is probably no aspect of the Church’s teaching on the
immorality of contraception that priests and laity alike
misunderstand or object to more often than that which applies in the
case of a couple who has a serious medical reason not to become
pregnant.
It is true that drugs and
procedures that, as a side effect of treating a disease, make a
couple unable to conceive are morally permissible because the
purpose of such drugs and procedures is to control the damage done
to the body by the disease – not to suppress the normal, healthy,
God-given fertility of the couple.
Pope Paul VI stated it this way: “.
. . the Church does not consider at all illicit the use of those
therapeutic means necessary to cure bodily diseases, even if a
foreseeable impediment to procreation should result there from -
provided such impediment is not directly intended for any motive
whatsoever” (Humanae Vitae, 15).
A relatively
straightforward example of the use of “therapeutic means” which
prove an impediment to procreation would be the treatment of a woman
with cancer of the uterus. In such a case it is definitely morally
acceptable for a surgeon to treat the cancer by removing the woman’s
uterus even though she will be sterile after this operation. The
purpose of the surgery is to rid the woman’s body of disease and the
fact that she will no longer be able to conceive is an unintended
side-effect.
Sterility that
results from treating a disease is, however, morally distinct from
the use of contraception or sterilization when pregnancy itself
would be dangerous or even life threatening for a woman or any child
she conceives. Women for whom pregnancy would be a serious health
risk are usually told – by their doctors, relatives, friends and,
sadly, even their priests - that because they have a ‘medical
reason’ not to become pregnant it is acceptable for them to use
contraception or be surgically sterilized. But this is not true.
A woman whose
health or life would be jeopardized by pregnancy certainly has very
grave reasons to avoid conceiving, but, as always, both the end (in
this case avoiding pregnancy) and the means by which the end is
achieved must be morally good and the Church is absolutely clear
that drugs, devices and procedures whose sole purpose is to make a
couple unable to conceive are never morally acceptable:
“. . .the direct interruption of
the generative process already begun and, above all, all direct
abortion, even for therapeutic reasons, are to be absolutely
excluded as lawful means of regulating the number of children . . .
Similarly excluded is any action which either before, at the moment
of, or after sexual intercourse, is specifically intended to prevent
procreation—whether as an end or as a means” (Humanae Vitae, 14).
“The regulation of births
represents one of the aspects of responsible fatherhood and
motherhood. Legitimate intentions on the part of the spouses do not
justify recourse to morally unacceptable means (for example, direct
sterilization or contraception)” (Catechism of the Catholic Church,
2399).
“Contraception is
to be judged so profoundly unlawful as to be never, for any reason,
justified. To think or to say the contrary is equal to maintaining
that in human life, situations may arise in which it is lawful not
to recognize God as God” (Pope John Paul II, L’Osservatore Romano,
October 10, 1983, 7).
A simple way to
determine whether a proposed treatment that impacts a woman’s
fertility is morally acceptable or not is to consider whether the
same treatment would be necessary for a single or celibate woman. If
the answer is no, then the proposed drug or procedure is immoral.
Understandably
this is can be difficult to accept because few of us are convinced
that sometimes we must trust God with our very lives. Remember,
though, that Christ has told us that “whoever would save his life
will lose it, and whoever loses his life for my sake will find it”
(Matt. 16:25) and that every one of us is called to the heroic
virtue of sainthood. Refusing sterilization or contraception when a
couple has a truly life-or-death reason to avoid pregnancy is
unquestionably an act of heroic virtue in this day and age and so it
should be no surprise that the temptation to do what the world tells
us is ‘reasonable’ can be very strong in this situation.
If we look
honestly at such a couple’s situation, however, we begin to see that
like every immoral act, the ‘reasonableness’ of contraception is
based on a lie.
There are only two ways for a
couple to be completely certain that they will not conceive:
One is total abstinence
(celibacy) until the woman has definitively reached menopause. The
other is castration - the complete removal of either the woman’s
ovaries or the man’s testes.
No form of contraception, even
surgical sterilization, can guarantee that a couple will not
conceive. The chance may be very, very small, but there are real,
live people who have conceived despite having been sterilized. It
does happen. Careful, consistent use of NFP is as effective as
sterilization for avoiding pregnancy, but to believe that anything
short of total abstinence or castration will result in certain
'safety' from pregnancy is to engage in self-deception.
The real decision, therefore,
that couples with the gravest of reasons to avoid pregnancy need to
come to is whether they actually require absolute certainty that
they will not conceive - in which case total abstinence is the only
true option - or whether the small degree of uncertainty that will
remain, no matter what they do, if they continue to be sexually
active is something that they can entrust to God.
“I don’t see any
difference between contraception and NFP.”
This objection
can mean two different things. Sometimes it comes from someone who
doesn’t see what’s wrong with contraception and so doesn’t see why
he or she should bother with the ‘hassle’ of using NFP instead.
Other times, however, the objection is that even NFP is immoral
because it usurps a power that belongs to God alone.
Imagine two
hypothetical couples, each with the same number of children, the
same financial and material resources, the same psychological
stresses and health concerns, each with a serious, selfless reason
not to conceive another child.
One couple uses
NFP to avoid pregnancy. The other uses contraception. Neither
conceives. So what’s the difference? Why is one (the couple using
NFP to avoid pregnancy) cooperating with God’s call to responsible
parenthood and the other (the couple contracepting) engaged in
something gravely immoral?
Well, suppose
that I have a serious and morally good reason to lose weight, but
that there is a gallon of double-super-fudge-chunk -brownie ice
cream . . . with nuts . . . and marshmallows . . . in my freezer and
I have already eaten a full dinner.
I may really want
to eat that ice cream and I may know that the pleasure derived from
the act of eating ice cream is a God-given good and something it is
perfectly reasonable for me to desire, but the consequences of that
act (40 gazillion calories) would not be a good thing for me at this
particular time.
Recognizing that
the consequences of eating a gallon of ice cream are not a part of
God’s plan for me right now I have two choices. I could eat the ice
cream and at the same time attempt to avoid the consequences of the
act by interrupting the natural processes that lead from chewing to
swallowing to digestion to the absorption of the calories that I
ought to avoid and I could theoretically interrupt this process in a
number of ways. I could chew the ice cream, but spit it into the
sink instead of swallowing it. I could swallow the ice cream, but
only after installing a physical barrier in my throat so that it
would not reach my stomach to be digested. I could have myself
hormonally or surgically altered so that I was no longer able to
digest ice cream at all.
Or I could
refrain from eating the ice cream until a time in the future when I
no longer needed to avoid the consequences of doing so.
The result – the
end - is the same in both cases, but clearly the means are not and
the morality of any act is dependent on both the end and the
means. And a difference in the means is the critical difference
between contraception and NFP.
Some of the above
ideas for avoiding the caloric consequences of ice cream eating are
somewhat distasteful. It’s unnatural and a little weird to think
about altering either the act of eating or our bodies so that the
normal process of digestion is impeded. But that a married couple
would ever feel that their bodies or the act designed by God to be
the physical sign of their marriage vows (sexual intercourse) – the
way in which those vows are supposed to ‘take flesh’ – should be
altered so that its consequences of that act could be avoided, is a
great deal more than unnatural or weird. It is tragic.
Christian
marriage is a sacrament and sexual intercourse (the marital act) is
the physical sign of that sacrament in the same way that the body
and blood of Christ under the appearances of bread and wine are the
physical signs of the Eucharist. Consider for a moment how shocking
it would be to see someone receive the Eucharist and then avoid the
consequences of the act by spitting out the host. Contraception
should shock us no less.
By God’s design
there is “an
inseparable
connection . . . which man on his own initiative may not break,
between the unitive significance and the procreative significance
which are both inherent to the marriage act” (Humanae Vitae, 12).
Also by God’s
design, however, procreation is only possible during a relatively
short time each menstrual cycle and during the infertile parts of
each cycle a couple with serious reasons to avoid conceiving is free
to experience the unitive aspect of the marital act – while still
respecting the integrity of their bodies and the act itself –
knowing that their procreative abilities are temporarily dormant.
And what about
the objection that NFP is just as immoral as contraception because
it does not allow God total control over the number and spacing of a
couple’s children?
Ultimately God
always has total control over every area of our lives, no matter
what we do, simply because He is God and therefore omnipotent. If He
chooses (as He once did) even a virgin can conceive and bear a
child. But God has given each of us free will and thereby the choice
to cooperate with His plan for us or not. Couples who use NFP in a
morally correct manner do so in an attempt to cooperate with God’s
plan for the number and spacing of their children – not restrict His
authority over their families.
As any parent
will tell you there is a great deal more to being a good Christian
parent that just ‘popping ‘em out.’ The Church recognizes that the
education and upbringing of each child is a tremendous
responsibility and that there are limits – physical, material,
psychological and social – to the number of children many couples
can raise well. The Church, therefore, does not have any specific
teaching on the ideal family size. All married couples are called to
be both generous and responsible in their acceptance of children,
but the exact number and spacing of those children is a matter for
each couple to discern privately. Granted, in this day and age, the
temptation to forgo generosity in favor of responsibility is usually
stronger, but it is not somehow better to fail to be responsible in
the use of our procreative powers than to fail to be generous.
Pope Paul VI
clearly explained this need to cooperate with God’s dual call to
generosity and responsibility in Humanae Vitae: “With regard to
physical, economic, psychological and social conditions, responsible
parenthood is exercised by those who prudently and generously decide
to have more children, and by those who, for serious reasons and
with due respect to moral precepts, decide not to have additional
children for either a certain or an indefinite period of time.
Responsible parenthood, as we use
the term here, has one further essential aspect of paramount
importance. It concerns the objective moral order which was
established by God, and of which a right conscience is the true
interpreter. In a word, the exercise of responsible parenthood
requires that husband and wife, keeping a right order of priorities,
recognize their own duties toward God, themselves, their families
and human society.
From this it follows that they
are not free to act as they choose in the service of transmitting
life, as if it were wholly up to them to decide what is the right
course to follow. On the contrary, they are bound to ensure that
what they do corresponds to the will of God the Creator. The very
nature of marriage and its use makes His will clear, while the
constant teaching of the Church spells it out” (10).
Here, too, ice
cream provides a good analogy. The act of eating ice cream in and of
itself is not immoral in the least. Humans are designed to enjoy
sweets, even newborn babies strongly prefer sweet tasting liquids
and human breast milk is remarkably sweet. But there are times when
the good of enjoying dessert ought to be foregone for the sake of a
greater good. If I am severely obese, have high cholesterol and have
been warned repeatedly that I will almost certainly have a heart
attack and be unable to care for my children if I do not modify my
diet, to go ahead and eat as much ice cream as I desire whenever I
desire is to fail to exercise the virtues of both prudence and
temperance and is therefore morally wrong.
Likewise, if a
couple has discerned through prayer, reflection and discussion that
because they have a serious reason to avoid pregnancy it is not
God’s desire for them to conceive again at present, then they are
called to cooperate with God and use morally licit means (NFP) to
avoid conceiving. In doing so they no more usurp God’s authority
over their family than they do when they seek employment to provide
income to meet their material needs rather than waiting for God to
send them manna from heaven or educate their children rather than
waiting for each of them to be divinely inspired.
“My conscience tells me that
it’s
not wrong for me to use
contraception,
and I must follow my conscience.”
The answer here
is that the duty to follow one’s conscience is predicated on having
properly formed one’s conscience by accepting the authoritative
teachings of the Church.
The Catechism of
the Catholic Church tells us that “conscience is a judgment of
reason whereby the human person recognizes the moral quality of a
concrete act he is going to perform, is in the process of performing
or has already completed” (1778) and in Veritatis Splendor Pope John
Paul II informs us that “the judgment of conscience has an
imperative character: man must act in accordance with it” (60).
So a person’s
conscience is not his feelings about something, but rather the
use of his intellect and reason to determine what is the right thing
to do in a particular situation, and once a person has carefully and
objectively considered the situation and determines what he believes
to be right, he is morally obligated to follow that judgment even if
it will be difficult, costly or unpleasant.
So far this
should not be difficult for most people to grasp. Almost everyone,
Catholic or not, understands the moral obligation to do what one
believes to be right (to follow one’s conscience) up to this point.
But to stop here and claim that all that is required of me is to
carefully consider the situation and then do whatever I believe to
be best is an incomplete and badly distorted understanding of
authentic Catholic teaching. Because there is no reference to an
objective standard of right and wrong – because ultimately I alone
decide for myself what is right and what is not – this kind of
‘freedom of conscience’ is nothing more than simple moral relativism
Catholics believe
in objective truth and recognize the Catholic Church as the teacher
of that truth. Simply by identifying myself as a Catholic I claim to
accept the authority of the Church to inform my conscience through
its teachings. Again, the Catechism of the Catholic
Church:
“The law of God entrusted to the Church is taught to the faithful as
the way of life and truth. The faithful therefore have the
right
to be instructed in the
divine saving precepts that purify judgment and, with grace, heal
wounded human reason. They have the
duty
of observing the constitutions
and decrees conveyed by the legitimate authority of the Church”
(2037).
In acknowledging the existence of
objective truth and the Catholic Church as the teacher of that truth
we can see that there are two parts to the obligation to follow
one’s conscience. I must first properly form my conscience by
accepting the official teachings of the Church in matters of faith
and morals (and this unquestionably includes sexual ethics and
family planning) before making a ”judgment of reason” about a
proposed act. The teachings of the Church are to be the starting
point for determining whether a given act is right or wrong and we
are always morally obligated to adhere to these teachings as we work
out their particular application in our lives. Or, put another way,
”Personal conscience and reason should not be set in opposition to
the moral law or the magisterium of the Church” (Catechism of the
Catholic Church, 2039).
Here's another example of how this works:
We know that, “for just reasons, spouses may wish to space the
births of their children,” but we are cautioned that it is every
couple’s “duty to make certain that their desire [to postpone or
avoid pregnancy] is not motivated by selfishness but is in
conformity with the generosity appropriate to responsible
parenthood” (Catechism of the Catholic Church, 2368).
There is, however, no official Catholic
list or formula for determining what constitutes such a just and
unselfish reason. Husbands and wives must prayerfully examine their
particular situation, weigh the two requirements of generosity and
responsibility against each other and arrive at a decision about
their own, unique family circumstances. No one can do this for them
and it is their moral obligation to follow the dictates of their
consciences once they have arrived at a decision.
We also know, however, that “’every
action which, whether in anticipation of the conjugal act, or in its
accomplishment, or in the development of its natural consequences,
proposes, whether as an end or as a means, to render procreation
impossible’ [i.e. contraception and sterilization] is
intrinsically evil” (Catechism of the Catholic Church, 2370) and
here there is no need (or room) for interpretation. That
contraception and sterilization are evil and always immoral applies
to every person in every situation and we are morally obligated to
accept this truth as the starting point for any consideration of
whether or how to space or limit the births of our children
And what of the objection that we free to
disregard Church teaching on some particular matter because the
Church doesn’t always teach infallibly? As any skeptic will point
out, there have been occasions on which officials of the Church –
even popes - have proclaimed untruths and you have probably heard
someone use this as a justification for picking and choosing which
teachings to follow. The fact is, however, that matters of faith or
morals which all bishops gathered throughout the world have, at any
point in history, declared to be held definitively are taught
infallibly1 and the intrinsic, universal evil of
contraception is one of these.2
Finally, it is important to understand
that no one, including an individual priest or bishop, can
release us from the moral obligation to follow the Church’s teaching
on contraception. Freedom of conscience is, in the words of Pope
John Paul II, “never freedom ‘from’ the truth but always and only
freedom ‘in’ the truth” (Veritatis Splendor 64).
“I’ve tried NFP and it didn’t work.”
This is probably the most difficult objection to answer because it
can mean so many different things and because it is usually
extremely emotionally charged, so it is wise to proceed with great
gentleness and sensitivity.
When properly taught and
correctly and consistently used, NFP is over 99 percent effective
for avoiding pregnancy3, but while NFP is not difficult
to understand it usually does require some formal instruction to
learn and use correctly. Often when someone says that they have
already tried NFP and it didn’t work, the problem was that they
never really learned NFP in the first place. Sometimes they tried
the calendar rhythm method (an older method of NFP – developed
around 1930 - that is only effective if a woman has very regular
cycles, which many women do not) or read a pamphlet or website or
book on NFP and thought they understood it well enough to use it.
Other couples who have experienced an unexpected pregnancy did learn
NFP properly, but later decided that keeping a chart was unnecessary
or that one or more of the rules did not apply to them or did not
apply in the cycle in which they conceived.
When a couple who has experienced
an unplanned pregnancy while using NFP has the chart of the cycle in
which they conceived reviewed by an NFP teacher they will almost
always find that they conceived as a result of misunderstanding or
misapplying some aspect of the rules to avoid pregnancy. So the
first suggestion for couples who believe that NFP doesn’t work for
them is to meet with an NFP teacher and determine whether NFP really
‘didn’t work’ or whether they just didn’t really use NFP.
Statistically NFP is as effective
as any contraceptive and true surprise pregnancies (those that occur
despite consistent, correct application of the rules to avoid
pregnancy) are so rare that they can honestly be considered little
miracles, but they do occur and here we come to the heart of the
difference between NFP and contraception - the question of who is
really in charge of planning our families.
The answer is that it is always
and only God who is
charge and that He has a specific plan for each of our families that
only He knows the whole of. He reveals this plan to us in bits and
pieces as it is time for us to act to cooperate with it, but usually
He doesn't let us know years in advance exactly how many children He
has in mind for us, nor how they will be spaced. What He asks of
each couple is to prayerfully and honestly try to discern His will
for them and then to cooperate with that plan.
A couple who believes that it is not God’s will for them to have
another child at present cooperate with God and do what is right by
using NFP to avoid pregnancy. If a couple conceives despite their
best efforts not to, however, they can then trust that God is
telling them, in no uncertain terms, that His will for them has
changed. It doesn't mean that they necessarily did anything wrong in
their use of NFP or even that they incorrectly discerned God's will
when they determined that they ought to avoid pregnancy. It simply
means that right then God is asking them to accept one more child .
. . right then.
This can be shocking and upsetting because we are used to thinking
that we are the ones in control of our lives. But we aren't
really. Ever. In any area of our lives.
When scientific literature discusses the ‘failure rate’ of a method
of family planning this refers to the number of pregnancies that
occur despite correct use of the method and even in this sense NFP
is no more likely to ‘fail’ than other methods of family planning.
Really, however, there are no ‘failures’ with NFP because even
children whose conception completely surprises their parents (and
their parents’ NFP teachers) are specifically willed by God. A
couple who uses NFP is far more likely to understand this than a
couple who contracepts because the cycle-to-cycle discernment
process that they must go through in order to continue to avoid
pregnancy encourages them to recognize that they are to be
cooperating with God’s plan for their family rather than doing the
planning themselves.
God sees the whole picture and we do not. He loves each of us and
each of our children more than any of us can possibly imagine and we
must learn to trust Him. And this is what
Catholic family planning
really amounts to for all of us – trusting that God is in control,
even as we work to cooperate with His plan for each of us, and that
“in everything God works for good with those who love Him” (Rom.
8:28).
Like much of life it's simple, but it's definitely not easy.
e
Sara Fox Peterson is a certified teacher of the Billings
Ovulation Method of NFP, a regular columnist for CatholicMom.com and
the mother of two.
FOOTNOTES:
1. See
Lumen Gentium,
25.
2. Prior to 1930 all Christian
churches (i.e. all of Protestantism, Orthodoxy, etc.), not just the
Catholic Church, held that contraception was always gravely immoral.
3. See
http://www.woomb.org/bom/trials/index.html and
http://www.ccli.org/nfp/effect1.shtml
For more
information about NFP or to locate a certified NFP teacher contact
one of the following organizations:
The Billings
Ovulation Method Association:
(651) 699-8139
www.boma-usa.org
Couple to
Couple League International: (513) 471-2000
www.ccli.org
FertilityCare
Centers of America:
www.fertilitycare.org
The World
Organisation Ovulation Method Billings: 61 3 9481 1722
www.woomb.org
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