Former Prez of Am.Congress of Obstetricians on NFP 'A 20% failure rate is unacceptable'

On March 10, PRI, a radio news program that airs on National Public Radio tackled the "debate over 'natural family planning': Does it work?" 

No, said one medical expert. And the show offered a narrative based on his view that NFP was especially ineffective 'in "places where women don’t necessarily have the power to say no to their husbands or partners.”

The show begins with a skeptical look at the position of Archbishop Emeritus Oscar Cruz, former president of the Catholic Bishops' Conference of the Philippines. He opposes artificial birth control, backs natural family planning (NFP), and lives in an "upscale" neighborhood, PRI tells us. You can listen to the show here.

The archbishop's stance is challenged by Dr. James Breeden, a self-identified "practicing Catholic," who previously served as the president of the American Congress of Obstetricians and Gynecologists. PRI does not describe his neighborhood, or provide the name of his Catholic parish. The show also neglects to mention that Breeden is a committed advocate of artificial contraception, and thus may have little experience with NFP.

The show's anchor explains: "The natural method has a 98 percent success rate if used absolutely perfectly, Breeden acknowledges. However, in real life, the success rate falls to 80 percent at best, says Breeden. “A 20 percent failure rate is just unacceptable.” 

Breeden clearly doesn't understand that many couples who practice NFP are more likely to maintain a dialogue about whether it might be time to have another child or begin a family. That's the nature of NFP: it stirs conversation about where things are now, and where they might go in the future. That discussion is deepened when both spousespray for God's guidance on such matters. Given that fact, the issue of 'failure rates' doesn't apply in the same way as it  would in cases where two people, who may or may not have taken marriage vows, are fully committed to preventing the birth of a child.

I checked in with the Center for Disease Control, which said NFP had a 24% failure rate, while the male condom had an 18% failure rate. Read the CDC report here.

Still, I was surprised, by Breeden's comments. 

"Even when a woman is carefully monitoring her menstrual cycle, the natural planning method is less successful, Breeden says, 'in places where women don’t necessarily have the power to say no to their husbands or partners.'”

“It requires education and training and periodic abstinence, and requires a certain amount of power that the woman must have to say we’re not going to have sexual relations this day. In many parts of the world that’s not an option that women have,” Breeden says.

He seems to be saying that men, especially men in developing countries, just aren't up to the challenge posed by NFP.  Men can't learn to communicate and respect their wives, and learn to work with their cycle. 

PRI introduces a Filipino couple that demonstrate this point.

 The couple has 7 children, but the husband says it is up to his wife to deal with birth control issues -- while both of them decide how many children they will have.

Archbishop Cruz admonished the man.

 “You want to claim the right to have consummate relationship with your wife; you exercise the right, but you do not want the obligation,” he says. “You separate right from obligation. No, these two go together!” 

The morale of the story is that artificial contraception remains the only viable option, and the good archbishop has his head in the clouds when he suggests otherwise. 

But as I considered his remarks, I thought, 'There is another way to read this -- artificial contraception allows men to have things their way,' and the good doctor is facilitating that mindset.

Fascinating that public-health leaders can sustain a long and ultimately effective  campaign to end smoking, but they won't foster an approach to family planning that nurtures mutual respect, communication and an opennness to new life.

Is that because nobody but the couple benefits when they use NFP? Meanwhile, the number of fatherless children continues to rise, but we just keep doling out free contraceptives and don't bother to ask if we need to teach the virtue of unconditional love and patience and tenderness. And now we circulate a slew of guidelines to curb sexual assault on campus, and make sure young men understand that they can't take advantage of women who have passed out. 

Now, back to the PRI show....

The anchor seems about ready to wrap things up, but then begins an interview with Olga Khazan, the author of "Return of the Rhythm Method," a 2014 article published in The Atlantic.  I was surprised by Khazan's straightforward reporting of this new trend and found her article online.

"Tired of condoms and the Pill, many women are turning to new apps that help them practice one of the oldest forms of contraception," the article explains.

 Khazan describes why NFP is getting another look.

"Becca began using Daysy in June after stints on the Pill and on Nuvaring, the hormonal vaginal ring. (All of the women in this story asked me to use only their first names.) Both methods caused mood changes that she found unsettling, such as bouts of unexplained crying, and the Pill made her nauseous nearly every morning. She and her boyfriend had been together for a while, so although he was wary of “natural” contraception at first, the Pill’s nasty effects on Becca persuaded him to give it a try.

"Becca has about 10 'green' days a month, and at other times, the couple uses condoms," Khazan reports, as she describes some of the new apps that techies have developed for charting a woman's cycle. 

Okay. So Becca isn't exactly on the same page as Archbishop Cruz or Pope St. John Paul II. But couples that practice NFP know that the process can shift the spouses' thinking about the whole context of their relationship. 

Maybe Becca's life is about to be upended. Maybe we need to find a way to present an holistic vision of life to young women like her.

Meanwhile, if Dr. Breeden really wants to stay up to speed with the latest trends, he should check out some of the more popular apps outlined in Khazan's story before he counsels any more patients to embrace artificial contraception and opt out of NFP. You can read The Atlantic story here.