1. Fertility Awareness & Natural Family Planning
Overview of NFP basics – how it works, why it works
Meaning of marriage and sex in light of Church teaching
Living , preaching and supporting NFP

2. NFP is…
Observing one or more of the body’s signs of fertility and… making couple decisions about whether or not achieve a pregnancy – on that basis.

3. Consistent with all religious traditions
A Method of Merit
Medically safe
Highly reliable
Inexpensive
True family planning
A shared method
Consistent with all religious traditions
Medically safe: no negative physical side effects or risks to practicing NFP
Highly reliable: we’ll be going over the effective rates in a minute, but it is as effective as any method of birth control.
Inexpensive: The cost of the class to learn it, and that’s it.
True family planning: NFP can be used both to avoid a pregnancy but also to achieve a pregnancy.
A shared method: NFP puts the responsibility of family planning on the shoulders of both the husband and wife.
Consistent with all religious traditions: No morality issues involved with using NFP, it is never harmful to new life.

4. NFP Can Be Successfully Used...
Regular cycles
Non-typical cycles
Breastfeeding
Peri-menopause
In cases of apparent infertility
For self-knowledge
Regular cycles: If you have a regular day cycle, NFP would be quite easy to learn.
Nontypical: But it doesn’t stop at regular cycles. Because NFP is NOT the calendar method, it can be used for any type of cycle, no matter how long or short. A woman doesn’t know she is within her window of fertility just because she might be 2 weeks after her period. She knows it because her charted symptoms tell her so.
Because of that we can also apply NFP to parts of life where non-typical cycles might be present, such as breastfeeding and menopause.
Infertility: Learning about the woman’s own natural cyles offers a lot of insight into what might be going wrong if a couple has been trying to get pregnant. For example, by charting her temperature pattern, she might learn that she has a thyroid imbalance, and she could get that treated and from there go on to get pregnant.
Self knowledge: Many women find it fascinating that there is so much learn about their own natural fertility cycles.

5. Reasons for using NFP Philosophical/Religious Moral/Ethical Psychology
Biological
This slide offers the many reasons that people may come to use NFP. Every decision made within one aspect of a person will have a ripple effect on the other aspects. This can happen in a negative or positive direction.

6. Female Hormone Pattern
Hormones
Testosterone LH
FSH
Male Hormone Pattern
Female Hormone Pattern
Progesterone
Estrogen
Blood Levels
Blood Levels
This gives an overview of the backbone of NFP.
Male fertility is constant, and here we see steady levels of male hormones over a range of time.
In the female hormone pattern, this range is from one start of your period until the next at the end. It might look chaotic, but it really is a very carefully orchestrated sequence of events, and they all happen in relation to each other.
It’s important to note that this is what NFP is based on. It’s not based on a calendar, but the science of your hormone levels, and the changes in your body that the hormone levels bring about.
Brief overview: In the beginning of your cycle after menstruation, follicle stimulating hormone stimulate development of the follicles in the ovaries. The follicles in turn begin secreting estrogen, and this causes the cervix to undergo changes and to begin secreting a special kind of mucus. As estrogen levels increase, this signals the brain to send leutenizing hormone, and this spike in LH causes ovulation of the egg.
Ovulation in turn causes an increase in progesterone, which is responsible for enriching the lining of the uterus, causing the cervical mucus to dry up, and causing your waking temperature to rise. When a baby isn’t conceived, the levels drop, and everything happens all over again.

7. Ovulation = release of the egg. Occurs only on ONE DAY each cycle.
Role of Cervical Mucus
Ovulation = release of the egg.
Occurs only on ONE DAY each cycle.
EGG lives only hours.
SPERM need MUCUS to survive:
Without fertile mucus, sperm die within hours.
With the best mucus, sperm live 3-5 days.
Why is cervical mucus so important?
Ovulation occurs on only one day of each cycle. Never more than once.
The egg lives a day at best.
Without the kind of mucus that your cervix is secreting at the time of ovulation, sperm don’t live more than a few hours. The fertile mucus provides an environment that protects and nourishes the sperm, and it also forms channels to allow for upward movement of the sperm.
With the best kind of mucus, sperm live 3-5 days. This is why you may ovulate on only one day in a cycle, but you have a “window of fertility” that’s a little longer than that. So it’s possible that you could say, have sex on a Monday, and conceive on Thursday or Friday.
So NFP is all about helping you find this window of fertility, and then letting you decide what you’re going to do about those days based on your family planning intentions.

8. Signs Fertile mucus: observed by sensation and tissue
Basal body temperature: taken in the morning when you wake up
Offer brief description of the actions involved with observing mucus and temperature on any given day.
Total time to observe the signs: 2-5 minutes a day.

9. Progesterone Type Mucus
Cervical Mucus
Infertile Time
Fertile Time
Progesterone Type Mucus
Estrogen Type Mucus

10. Process of Conception Fallopian Tube Conception Uterus Cervix
Yellow Body
Mucus
(helps sperm to live)
Vagina

11. Impact of Progesterone
4. Enriches Uterine Lining
1. Prevents Ovulation
Yellow Body Progesterone
3. Mucus Plug
2. Temperature Rises
& Stays High

12. Tissue Symbols Tissue-Dry: Ø Sticky Mucus: M Egg-White Mucus: EW-M
Traits: P, O, ¼, ½, ¾.
Egg-White Mucus: EW-M
Traits: 1, OT, T, G.

13. Sample Chart PK
This chart shows the changing pattern of a cycle. There is no mucus present, then a changing mucus pattern, and finally the mucus dries up. (Point out the changing mucus pattern.) The drying up of the mucus is accompanied by a rise in the temperature pattern, which stays elevated until the time of the next menstrual period. (Point out the changing temperature pattern.)
The couple applies specific rules to identify the beginning and end of fertility, and then if they are avoiding a pregnancy, they abstain during the fertile time of the cycle. Ir the couple wants to achieve, they utilize the days of greatest fertility to facilitate their becoming pregnant.
NFP really is this simple. As one couple said recently, “It just makes so much sense. 6 3 1 2 5 4

14. Tissue Observation EW M Ø

15. Implantation Process

16. Achieving Pregnancy

17. Identifying Pregnancy

18. Temperature Pattern

19. Identify Peak Day PK

20. Identify High & Low Temps6 5 4 3 2 1

22. Post-Ovulatory Phase Constant
Last day of Menstrual Cycle
2 weeks
Ovulation
23 Days
28 Days
32 Days
Before Ovulation
After Ovulation
When does ovulation occur?

23. Range of Ovulation

24. Surprise Pregnancy?

25. Two Major Concerns
How well does it work?
Is periodic abstinence possible?

26. Definitions
METHOD EFFECTIVENESS = rules are correctly understood and followed.
USE EFFECTIVENESS = actual use including misunderstanding and carelessness.

27. Natural Family Planning
Method Effectiveness = %
Use Effectiveness = %
It’s important to stress here that no method of family planning is 100 percent effective. NFP compares very favorably with other methods when couples are committed to using it.

28. These Effectiveness Figures Depend Upon…
A course of instruction with follow-up.
Consistent and correct charting.
Knowing and following the rules; especially complete abstinence from genital contact during the method-defined fertile time.

29. Effectiveness of NFP
“Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had an (unintended) pregnancy rate approaching zero. Natural family planning is cheap, efficient, without side effects, and may be particularly acceptable to and efficacious among people in areas of poverty.”
Dr. R. E. J. Ryder British Medical Journal, Sept. 18, 1993

30. The Periodic Abstinence Question
Intimacy is more than sexual expression.
It’s typically 8 to 12 days per cycle.
The Spontaneity Myth.

31. Availability of Intercourse
Anytime
End of day

33. What does the Church really say?
Sexual Intercourse is a sacred expression of a sacramental reality
Love-giving/Unitive
Life-giving/Procreative
Fertility is a gift of personhood.
Within a Christian marriage, sex is a sacred expression of a sacramental reality. Let’s talk about what that means. First, what is a sacrament? Roughly speaking, sacraments are a physical expression of a God’s grace and love in our lives. Marriage itself is a sacrament, and when 2 people get married, it’s for 2 reasons. To be united in that love, and to have a family together. Why do people have sex? 2 reasons: to be united in love, and to create a family together! The same aspects of sex are the same aspects of marriage: love-giving, and life-giving, sometimes called unitive and procreative. Sex involves the whole person and every time it happens it is meant to reflect the commitment to one’s spouse in permanent, faithful, and unconditional love that is open to new life. To put it another way, every time you are having sex with your spouse, you are renewing your marriage vows. So the Church says that because of that, any attempt to separate one of these aspects of sex and marriage, life-giving or love-giving, is wrong and immoral. It’s saying that it’s so meaningful and beautiful that it needs to be given the respect it deserves every time.
Another thought is that fertility is a gift from God our Creator. Our fertility is a normal healthy functioning aspect of our bodies. When we take a pill to render useless this otherwise healthy system, we have to wonder how we’re treating our bodies. What disease do we have that we’re taking this pill for? What part of our body needs “fixing”? Treating our bodies this way implies that there is some part of our bodies that we’re not comfortable with, as God made them. And the same message is there with a condom. If a guy puts on a condom, he is saying, “I love you….but I need to protect part of myself from you.” Thinking of our sex as this sacred expression of our marriage vows and the language that speaks, we can see how condoms don’t fit into this picture either.
Contraception implies conditional love by rejecting part of the individual. It takes away that total self-giving aspect that sex should be about.
NFP is not against conception or fertility. With NFP, fertility is recognized and treated as a positive aspect of a person.

34. Theology of the Body Human persons are made in God’s image
Our bodies are an outward expression of who we are
We give and receive love through our body
“Law of the Gift” of self
Opposite of loving is using
Marital chastity is fulfilling the “law of the gift”
- George Weigel, Witness to Hope
Men and women are both made in the image and likeness of God, so when they become one flesh, they become a complete image of God, in a perfect giving and receiving of love. There are profound mysteries to be discovered about God, within the marital act.
The Catholic Church doesn’t say that our bodies are bad, it says that our bodies are good, and so it matters what we do with them. We embrace the physicality of our nature because it makes visible the invisible. The Church is known for being a sensual religion. (posture of our bodies in prayer, incense, water, physical nature of sacraments)
Which brings to the second thought to be pulled from this – within this intimate act of perfect giving and receiving of love, we also have the ability to participate in God’s creation by welcoming life, and participating in the act of creating it.
Just as God creates the world, we create life during the moment when we become most like Him.
JPII’s Law of the Gift of Self: “Man only truly discovers himself through a sincere gift of himself.” Jesus showed us this way to fulfillment by his offering on the cross. Our vocation in life, whatever it may be, calls us to discover in what way we can best give ourselves to others. For those called to married life, our primary means to discover our true worth is in service to our spouse and our children, in helping them achieve Heaven. This goal is a complete reversal of society’s view of fulfillment, which is me-centered, and not other-centered.
Opposite of love isn’t hate, it’s to use. Think of the opposite of the “gift of self” – to use another person for my own gain, my own pleasure. How interesting that sex is one of the most common and tempting ways that we use another person as an object, when on the flip side it gives couples the ability to so profoundly give themselves totally to each other, and to discover such profound mysteries about God’s love for us. That is no coincidence. The stakes are higher.
Chaste love is using our bodies the way God intended us to, according to our vocation in life – we are all called to chaste love. Chaste love requires that we not become bound by our whims and urges, but that by having self-control, we have the freedom to give and receive love in an other-centered way.

35. What is the difference? Birth Control NFP Suppresses fertility
Places barriers to deliberately prevent the transmission of life
Sex is no longer totally self-giving
Pregnancy occurs in spite of the couple’s actions
Accepts fertility
Always open to the possibility of life
Sex is total self-giving
Pregnancy occurs because of the couple’s actions
Let’s talk more about the differences between NFP and artificial birth control. The Church has always taught that artificial birth control is objectively wrong. In fact, until 1930, all Christian churches opposed contraception. But what, really, is the difference. The Church doesn’t oppose artificial birth control because it is artificial; medication, hearing aids, glasses, are all artificial but aren’t opposed by the Church. This is because they work to restore healthy functioning in the body. On the other hand, contraception means “against conception”. The goal is the purposeful elimination of the gift of fertility. Contraception implies conditional love by rejecting part of the individual. It takes away that total self-giving aspect that sex should be about.
NFP is not against conception or fertility. With NFP, fertility is recognized and treated as a positive aspect of a person. NFP accepts this gift and works within its parameters. Contraception simply suppresses it. So while the end is the same, avoiding pregnancy, the means aren’t equal.
Give example of “end doesn’t justify means”…ex: two people that make an A on a test…one studied hard, the other cheated. Or two women that want to lose weight. One exercised and improved diet. The other binged and purged. The goal was equal and good, but one way was healthy and the other wasn’t. The way you accomplish something makes a difference.
The end may be the same, but the means are not equal.

36. Abstain vs. Sterilize
“The choice to abstain from a fertile act of intercourse is completely different from the willful choice to sterilize a fertile act of intercourse. NFP simply accepts from God’s hand the natural cycle of infertility that He has built into the nature of woman.” -Archbishop Chaput

37. The difference… Familiaris Consortio, 32 (1981)
“…between contraception and recourse to the rhythm of the cycle: it is a difference which is much wider and deeper than is usually thought, one which involves in the final analysis two irreconcilable concepts of the human person and of human sexuality. “
If these two differences are fully studied to the extent that they deserve, we come to find that they are so different that they can not even be compared.

38. Birth Control Pill Becomes Available (1960)
The U.S. Food and Drug Administration approves the sale of an early version of the birth control pill
People expected:
Fewer unwed pregnancies
Happier marriages
Brief history of contraception in the last 50 years.

39. Pope Paul VI Humanae Vitae, 17 (1968)
“Responsible individuals will quickly see the truth of the Church’s teaching about contraception, if they consider what consequences will follow from the methods of contraception and the reasons given for the use of contraception…”
Justification of behavior leading to marital infidelity
Gradual weakening of the discipline of morals, especially among the young.
Loss of respect for women; use of women by men to serve men’s desires.
Disregard for women’s psychological and physical equilibrium.
Coercive population control policies by governments.

40. In Our Culture Today
Exclusivity and permanence are no longer the norms for sexual relationship
STIs have increased in number of diseases, in infection rates, in decreased treatability
Infertility rates have increased
NY: 39% of pregnancies end in abortion (2000)
Abortifacient potential of contraceptives
Morning after pill

41. US Catholic Bishops A Campaign in Support of Life, 2001
We address this issue because some promote widespread use of contraception as a means to reduce abortions and even criticize the Church for not accepting this approach.
It is noteworthy that as acceptance and use of contraception have increased in our society, so have acceptance and use of abortion…Tragically, our society has fallen into a mentality that views children as a burden and invites many to consider abortion as a “backup” to contraceptive failure. This is most obvious in efforts to promote as “emergency contraception”: drugs that really act as early abortifacients.
Touch on link between contraception and abortion in our culture– contraception has ramifications that go beyond the singular couple and family you may be counseling.

42. The Abortifacient Potential
Any hormonal contraceptive can potentially destroy new life by interfering with implantation
Most women are not informed about the modes of action of their contraception.
Main mode of the pill: prevents ovulation – no harm to life presented.
But we know that the pill does not always prevent ovulation. The pill does not have a 100% effectiveness rate, even with perfect use. Women can and do get pregnant on the pill, which means they ovulate on the pill. So ovulation sometimes happens.
The secondary mode of action of the pill is that is affects the lining of the uterus so that if conception does occur, that newly conceived life has difficulty implanting in the uterus. What would happen is a very early miscarriage that would look like a period, and a woman wouldn’t know what has happened.
This is not to say that this happens often, but the potential is there every time.

43. Authentic Marital Embrace
We are saying that our marital embrace is so valued in its authenticity as a sign of our total gift to each other… that we want no rubber walls between us; no spermicides, no coils or loops, no risky drugs to louse it up.”
“In a time of abstinence, I am able to ‘say’ to my beloved something that could not be said in another way about the quality of our love. I am, in a sense, able to ‘prove’ something that might not be verified in any other way. For the choice of this (NFP) means to her that I love her with a love that goes far beyond an appreciation of some useful service she provides for me, that I love her not for some sexual pleasure she gives to me, but rather with a love for her as she is in herself. In short, this means of family planning can become a time when I am able to live out a truly transcendent love.”
- Clayton Barbeau, marriage/family therapist and author

44. “I can’t use NFP because…” Irregular cycles
Pastoral Concerns
“I can’t use NFP because…”
Irregular cycles
Doctor recommends contraception as medical treatment
Circumstances make use difficult
Irregular cycles – you’re now informed enough to know that irregular cycles are not required!
Contraception as medical treatment – this is tricky because you have to respect doctor-patient relationship. However, there are doctors that do not prescribe the pill ever due to ethical reasons. Most doctors lack knowledge beyond treating any condition with a prescription for the pill. The pill does not treat the problem – it only masks the symptoms, which will return when the woman stops the pill. You can encourage alternatives for treatment, and find doctors willing to work with these alternatives, or just refer to local NFP Provider for more info.
Circumstances make use difficult – “I can’t use NFP because my husband travels and is only home periodically. I also have long cycles and can’t make sense of my pattern. NFP is causing problems in our relationship because we’ve only had sex twice in the last 6 months!” It’s important to understand in this scenario that NFP is just ONE factor in the overall picture. There are many factors to consider: husband’s job that keeps him away (is this job the best fit?); irregular cycles (has she sought treatment?); their priority level to avoid (is avoiding a pregnancy really what God is calling them to right now?)
Some of these factors can’t be changed, but some might be. It’s important to look at this situation and consider ALL factors, and not just blame all problems on NFP.

45. Prayerful Discernment for God’s will Responsible Parenthood
We can’t forget
Open to Life
Prayerful Discernment for God’s will
Responsible Parenthood
- Couple continues to apprise the situation their entire reproductive life, prayerfully
- Factors: physical and emotional health of each person and family members, $, support, social factors (war, famine), etc..
HV (10)
We can’t forget that in our zeal to promote NFP that we don’t just tout it as “Catholic birth control”. Within our outreach, we need to make sure that we include practical application support, and provide couples with the tools to properly discern their family size and the encouragement to continually take the situation to God and seek His will.

46. Think Eternal…Teach the Truth
Afraid of losing people? “Let me turn that around…” -Archbishop Chaput
“Let me turn that around: If priests don't preach the Church's message about contraception, heaven loses people. Don't be afraid. When Jesus preached the truth, He lost people. But, little by little, He gained even more people. Take courage in the Lord.”

47. How can Priests promote NFP?
Maintain prayer life.
Preach NFP from the pulpit.
Educate in confession.
Provide NFP Intro Course to your married and engaged couples.
Introduce NFP to adult converts in the RCIA program
Educate Pro Life Ministry
Within a Christian marriage, sex is a sacred expression of a sacramental reality. Most people marry to express their love, to be untied, and to have a family together. These two aspects of marriage are the meaning of sexual expression: love-giving and life giving, sometimes called unitive and procreative. Wedding rings are the public symbol of the commitment of marriage, and sexual intercourse is the private symbol of the marriage vows. Sex involves the whole person and is meant to reflect the commitment to one’s spouse in permanent, faithful, and unconditional love that is open to new life.
The Catholic church has always taught that artificial family planning is objectively wrong. In fact, until 1930, all Christian churches opposed contraception. Is NFP really any different from the use of contraceptives? The Church doesn’t oppose artificial birth control because it’s artificial; glasses, hearing aids, medications are all artificial but aren’t opposed by the Church. This is because they work to restore or approximate healthy functioning of the body. On the other hand, contraception means “against conception.” The goal is the purposeful elimination of the gift of fertility.
NFP is not against conception or fertility. Fertility is recognized and treated as a positive aspect of personhood. While the end is the same, that is avoiding pregnancy, the means aren’t equal. It’s easy to see this in other areas of life. For example, we would not consider it reasonable to consider stealing as equivalent with working hard to obtain some material goal nor would we consider it equivalent ot cheat rather than study in order to excel in school The way something is accomplished makes a difference.
Contraceptive intercourse implies conditional love by rejecting part of the individual’s personhood, their fertility. For intercourse to be a true gift of self to the other, it must be a free gift; rejecting NFP because of an inability to deal with periodic abstinence implies that intercourse is less than a free gift of self. Being able to say, “no” is necessary in order ot fully say, “yes.” Undoubtedly, NFP challenges a couple to grow. It requires the same virtues that are required for a successful marriage. IF a couple is convinced that they can’t handle NFP, they could reasonably wonder if whether they are truly ready for marriage.

48. NFP Video Diocese of Phoenix NFP Promo Video