Part 2 THE FAMILY Chapter 8 FERTILITY, CONTRACEPTION AND THE FAMILY Brigid McEwen
Irenaeus said in the 2nd century, "God's greatest glory is man fully alive", and as he, being a pupil of Polycarp who was himself a pupil of John the Evangelist, was only a few steps from the Lord, I like to think he knew what he was talking about. As John Paul II says in Familiaris Consortio,
God created man in his own image and likeness, calling him to existence through love, he called him at the same time for love. God is love and in himself lives a mystery of personal loving communion. Creating the human race in his own image and continually keeping it in being, God inscribed in the humanity of man and woman the vocation, and thus the capacity and responsibility, of love and communion. Love is therefore the fundamental and innate vocation of every human being.1
Made in the image of our Creator we are all made out of love and for love and the more fully we resemble him who is love, who is indeed a dynamic community of love, the more fully we are ourselves, what he wants us to be, and the more fully alive we become. One of the ways in which we resemble our Creator is in the power of procreation, our fertility, our ability to become a parent. Through us, he peoples the world, and through our mortal actions he fills the immortal city. It is an astonishing thought that we share in his creative power. Such a power, the gift of fertility, requires our responsibility in its regard, our respect, indeed our reverence. FERTILITY
Our knowledge of human fertility has increased dramatically in the past decades. It was
only in 1924 that Ogino, in Japan, and then Knaus in Austria, became the first to realise that ovulation, the emergence of the female egg, was linked to the subsequent, not the preceding, menstruation. On this was based the Rhythm Method which served many women very well but, which being only a well-informed guessing game, ('Vatican Roulette') has long been superseded: first of all by the Temperature Method which makes use of the woman's bi-phasic temperature pattern to pinpoint when ovulation has taken place; and secondly by the Ovulation or Billings Method, based on the observation of cervical secretions, which indicates when she is about to ovulate, when she is ovulating and when she has ovulated. The information provided by these two methods is the basis of the combined or sympto-thermal method of Natural Family Planning. There is no question about the efficacy of NFP based on fertility awareness, witness Dr Ryder's article in the British Medical Journal. This is one way of controlling fertility - respecting nature's pattern, and acting accordingly. It requires mastery of the method (good teaching) and mastery of self.2 Incidentally the Calcutta women in this study were taught NFP by Mother Teresa's Sisters of Charity who learn it during their novitiate and teach it as part of their apostolate in caring. This is one way of controlling fertility - respecting nature's pattern, and acting accordingly. It requires mastery of the method and mastery of self.
Contraception has the same purpose, controlling fertility, but a different approach.
Strictly, literally, speaking, 'contraception' (against conception) only refers to barrier methods which act by preventing the encounter of the sperm and the ovum, namely, the cap, the condom, the diaphragm, the femidom, sponges, spermicides etc etc.
Some pills do have a contraceptive element in that they alter the characteristics of the
cervical mucus and prevent the sperm entering the uterus, but their chief mode of operation is in the suppression of ovulation (ie sterilization) and in making the endometrium, the lining of the womb, unreceptive to the fertilised egg (ie abortion). The coil, or IUD of whatever form, and of course the RU 486, and the morning after pill, operate in this latter way; they are abortifacients. Injectable hormones such as Depo-Provera are not strictly speaking contraceptives either, but are sterilizing agents.
It is true that a certain impetus behind the movement for contraception came from a
post-Malthusian standpoint. It was Sir Francis Galton, cousin of Charles Darwin (who had been much influenced by Malthus in his idea of the 'survival of the fittest') who was the pioneer of eugenics - a term he coined in 1883, an idea shared by Marie Stopes in this country and later by Margaret Sanger in the United States. But both they, and many others were genuinely concerned about over-burdened mothers, over populated countries and back-street abortions, and felt sympathy, and worked, towards, the dissemination of contraceptive information and supplies. Over the years the Lambeth Conference had spoken of contraception as "dangerous, demoralising and sinful" but in 1930 a resolution was passed permitting methods other than continence "where moral obligation to limit parenthood is felt".
The avowed aims for advocating contraception were and are
that families woud be happy because planned that every child would be a wanted child that abortions would decrease that sexually transmitted diseases would be greatly reduced
It only needs the (sad) recital of the present figures to show that none of these aims has been realised. (See Appendix) BODY LANGUAGE
I think we have forgotten how important we are. Made in God's image of love and life,
we also, like him, should be the embodiment of truth. Not only our words but our actions should say what we mean. Cuddling a baby, hugging our children and our friends, shaking hands, are all forms of body-language saying - "I love/protect/trust you". The act of intercourse says the same and much more. It is a profound and powerful and sacred statement: "I love you, only you, totally, exclusively till death. I accept you in your totality. I give myself to you in my totality. I trust you totally. You are the person I would accept as the parent of my child". Again to quote from Familiaris Consortio:
As an incarnate spirit, that is a soul which expresses itself in a body, and a body informed by an immortal spirit, man is called to love in his unified totality. Love includes the body and the body is made a sharer in spiritual love. Consequently, sexuality, by means of which man and woman give themselves to one another through the acts which are proper and exclusive to spouses, is by no means some thing purely biological but concerns the innermost being of the human person as such. It is realized in a truly human way only if it is an integral part of the love by which a man and a woman commit themselves totally to one another till death. The total physical self-giving would be a lie if it were not the sign and fruit of a total personal self-giving, in which the whole person, including the temporal dimension,
is present: if the person were to withhold something, or reserve the possibility of deciding otherwise in the future, by this very fact he or she would not be giving totally. The totality required by conjugal love also corresponds to the demands of responsible fertility. This fertility is directed to the generation of a human being and so by its nature it surpasses the purely biological order and involves a whole series of personal values.3
In the ordinary way of things intercourse is devised for the fertilization of the female by the male and in the animal kingdom exclusively so. But in human beings it contains the unitive as well as the procreative element. Not only life but love are involved - "leaving father and mother, the man must cleave to his wife and become one flesh".4 And they are still one flesh if by reason of her age or the time of the cycle the woman is not in fact fertile. The couple accept one another as they are.
But if procreation is separated artificially from intercourse by contraception, something
very different is being said: "I accept you, but not your fertility. I give myself to you, but not totally." It may look the same (with barrier methods perhaps it does not feel the same) but the body is not saying what it means, or rather, is not meaning what it says. It is speaking an untruth. The unitive element is under threat. The couple are not at one.
Of course countless good people, loving couples put up with this state of affairs from
the highest, most responsible motives and accept contraception with profound relief and thankfulness as perhaps a cross they have to bear, and one can only commend their seriousness of purpose and their self-denying ordinance. For many though it is a licence for self-indulgence. After initial caveats and limiting provisos (rather like those surrounding the Abortion Act) contraception has now been almost totally accepted in this country as a 'good thing'. It might be worth recalling what Gandhi said in this regard: "It has been left for our generation to glorify vice by calling it virtue".5 Have we in fact been sowing thorns and thistles and expecting to get figs and grapes? SOME EFFECTS OF CONTRACEPTION
By separating coitus from procreation, that is intercourse from the possibility of
pregnancy, to many minds the field is wide open. It's fun, it's expected, there are few risks. Without elaborating the point it is not hard to see how this attitude leads to adultery and then to divorce, to promiscuity and sexually transmitted diseases and (especially when contraceptives were made available to the young unmarried and then to teenagers without parental consent) - to teenage pregnancies with abortion as the back-up when contraception fails.
It is the pleasure principle when people are used, not loved, when they are seen as
things, not individuals, and from this stems the destructive force of contraception: it attacks the value of the human being and militates against feelings of self-worth. Without the possible procreative element, the person is not accepted in his/her totality which means that there is a break-down in the unitive element. The couple are not at one. They are keeping something back. They are not in total communion with one another. They are isolated individuals.
Curiously, sadly, this isolation, this loneliness, is now mirrored by the next generation,
so that families are divided horizontally as well as vertically. It is not just the fact that couples have fewer children, that the microwave and the television (especially the one in the child's bedroom) do away with the family meal and with conversation, the whole attitude towards confidentiality in regard to adolescents' contraception, cuts the young off from their parents, that is if they are not already cut off by a broken home. No communion, no communication; the family fragments. It is not only the family that fragments: the cracks run through society, of which the family is the basis building block. (Incidentally just as there can be intercourse without procreation, so now also we can have procreation without intercourse. Witness not just
test-tube babies and surrogate mothers but the syringe in the ice-box ready for the fertile time: using the man but not loving him or being united with him: having a child as a right or as the experience of mother-hood not as a gift, a gift of love.)
There is a significant effect on the individual which can be brought about by
contraception - even or perhaps especially when urged on the young as the 'responsible' mode of action: "Do whatever you like, feel free to express yourself - just don't get (her) pregnant". Unless we are Michelangelo or Scott or Shakespeare it might be said that the most important and valuable thing we will ever do in our lives is to bring another human being into the world. Sexual intercourse is an action of great import and power with immortal implications. If those implications are constantly thwarted and there are no consequences to our actions in this important area (and should there be, abortion will deal with them) our actions are devalued and trivialized, we ourselves are diminished, and our masculinity and femininity lose their relevance. It does not matter what we do in the sense of 'what's the point? nothing's worth it'; and it does not matter what we do in the sense of there being no right and wrong. The first is the path to depression and suicide (which is on the increase particularly among young men) and the second, the path to violence which is compounded especially by the accepted idea of abortion. (It is lawful, ie 'good' to destroy helpless unborn children, therefore it is all right to bash your granny. The human mind, even if unschooled, can be pretty logical).
Our sense of our own worth has declined. We have forgotten how valuable and extra-
ordinary we are. We have forgotten that the Almighty made us because he loved us and wanted us to share in his creative power and creative delight. It is not for nothing that the Song of Songs is used as an image of Christ's love for his church, nor that Christ's love for his church is used to illustrate married love. 6 EFFECTS OF NFP ON THE COUPLE
As a teacher of Natural Family Planning & Fertility Awareness, I find that over and
over again (after the initial question, "Why has no one ever told us about this before?") couples say that though they may have come to learn about family planning they are glad they came because they have learnt so much about marriage - NFP can be a school of love: it requires communication, consideration and self control. It is also the acid-test of a mature relationship. It is not just that there are no side-effects as with the pill (obesity, depression, headaches, loss of libido or possible health risks) nor aesthetic considerations as with condoms and caps etc, and intercourse is complete, normal and natural, this is an enterprise where responsibility is shared, and the lessons of consideration, loving kindness and self control are learned together. The couple have to communicate. They make love as and when they wish. If they want to avoid or postpone a pregnancy then they abstain from intercourse at the woman's fertile time; and this abstinence, far from being an insurmountable obstacle, becomes in fact a space where their relationship is rejuvenated. If on the other hand they would like to conceive a child they can tell the optimum moment and prepare themselves physically, psychologically, spiritually - lovingly - for such a great event, the start of a new life.
Fertility is regarded as a gift not a disease. The woman is not a patient under a doctor
(and incidentally the pill is the only medication specifically designed to make a healthy system not work); she is an autonomous individual empowered by her own self-awareness (which as likely as not she learnt from another woman). She empowers him, her husband, who is fertile all the time, with knowledge of her own (lesser) fertility and they rely on each other for self restraint. "Chastity and discipline are the manly virtues which enable man to make the forces of nature the instrument of his freedom".7
The couple do not cost the state anything for free contraception (nor of course do the
medical profession or the drug companies receive anything from them). They do not contribute to the pollution of the planet: the condoms on the beaches, the oestrogenic compounds in the
water system. They do not suffer the iatrogenic effects of contraception which together with various abortion procedures contribute to much infertility. As has been said, "For the Best Results Follow The Maker's Instructions."
But passing on the Maker's Instructions and teaching NFP to married and engaged
couples, only to adults in fact, is not enough. The knowledge of fertility awareness needs to be imparted much earlier to the young. Some of the current sex education material is so degrading that we should act swiftly to provide accurate decent information. Ignorance is no defence to the young under constant pressure from society, the media and their peers, who mature physically much earlier nowadays and who anyway have the right to understand their own bodies. In the early 80s the Drs Billings initiated a schools programme in Australia8 to teach the pupils about their fertility and they found that the knowledge imparted a sense of self-respect and self-worth which is almost infectious. It is much more effective than 'assertiveness-training' which has rather un-Christian connotations. The girls realize that they have a complicated, delicately balanced, fluctuating fertility which is precious, special, and amazing. The boys realise this too in regard to the girls and in regard to their own constant fertility which in its particular way is no less extraordinary. The Billings find that the sexual behaviour of the pupils is far more respectful and responsible towards each other and the teenage pregnancies have significantly decreased. The different attitudes, the contraceptive and the fertility attitude to youngsters at school could be illustrated by what two doctors said to me. One, a doctor in a large manufacturing Border town said he wished he could put all the VIth form in the local school on the Pill. All sexually active? all medically fit? all mature enough for their fertility not be permanently switched off? no contra-indicated medication? I am sure it was said half in jest, but I felt it was also wholly in earnest and I felt he was regarding the girls as cattle. The other doctor had a practice in a poor part of Glasgow (the practice itself is pretty poor as the doctor does not send women for abortion nor prescribe contraception which means considerable financial loss).9
He got a female NFP teacher to go into the local school and tell the girls about their
fertility. They were deprived, 'hodden doun wee lassies' from tenements (and broken families), not very bright , under privileged. They heard all about their fertility and came out from the school 'walking feet tall'.
1 Familiaris Consortio; The Christian Family in the Modern World John Paul II, 1981. Part II 2 The British Medical Journal, Sept. 1993, No. 307, pp. 723-6 3 Familiaris Consortio; Part II.11 4 Cf. Genesis1:27, Genesis 2:23-4; Matthew 19:4-6; Mark 10:6-9; Ephesians 5:25,28-31 5 ‘Must births be limited?’ What Ghandi Thought, Krishnaswamy in Way Forum, 1957,pp. 19
6 Cf. again Ephesians 5 7 Family Planning and Modern Problems, Stanislas De Lestapis SJ, Burns & Oates, 1961 8 Creative Love and Christian Sexuality Programmes run by the Billings Family Life Centre, 27
Alexandra Parade, North Fitzroy 3068, Victoria, Australia
9 For example, NHS: fees and allowances 1995/96. Contraceptive service fees: Ordinary
Contraceptive fee per year £13.70 – IUD fee £45.909
APPENDIX TO CHAPTER 8
The divorce rate is now more than one in three in the UK 1993 Fewer marriages: 299,000 More divorces: 165,000 (highest ever) Couples Divorcing with children up to 16: 95,000 Children up to 16 with parents divorcing: 176,000 (OPCS Scotsman 23 August 1995) __________________________________ 1991 British Medical Journal published survey based on women who had given birth 6 months previously showing proportion of unwanted pregnancies
1984 27% unwanted pregnancies, 70% using contraception
1989 31% unwanted pregnancies, 69% using contraception
___________________________________ According to the NSPCC, cases of physical abuse of children more than doubled between 1977 and 1989. In the same period abortions rose from 102,677 to 170,463 in England and Wales and from 8,174 to 10,997 in Scotland. (NSPCC Publications: Trends in Child Abuse etc etc) ____________________________________ Since April 1968 4 million abortions have been performed in UK. In 1993 168,711 abortions (462 per day) have been performed in England and Wales, 11,069 abortions (30 a day) in Scotland. Only a tiny fraction of one percent of abortions have been performed in emergency for the stated reason of saving the mother's life or preventing grave permanent injury to her physical or mental health, or because of substantial risk of serious physical or mental handicap in the child. (In 1993 three such abortions were performed in England and Wales, one such in Scotland: SPUC June 1995 Update). Over 90% are for 'social' reasons. ___________________________________ Back in 1966, the British Medical Journal considered that accounts of back street abortion was vastly exaggerated. (Legalised Abortion: Report by the Council of the Royal College of Obstetricians and Gynaecologists, BMJ 2 April 1966 1 850-854.) ______________________________________ Live Births outside marriage as % of all births
In 1991, some 373,500 conceptions occurred outside marriage, that is 44% of all conceptions compared with 43% in 1990 - thus continuing the upwards trend. (Population Trends No 73, Autumn 1993) ______________________________________ At the beginning of the century the illegitimate birth rate was 3% and pregnancy rare in girls under 16. 1945-56: under 16 conceptions rose to 200: 0.8 per thousand. End of Sixties: conceptions 6.8 per thousand.
1991: girls aged 13-15, conceptions 9.3 per thousand. (Dr Margaret White, Children & Contraception, Order of Christian Unity) _________________________________________ The BMJ in Feb 1992 Feb BMJ reported 8,000 girls under 16 attending family planning clinics. The abortion rate for teenagers aged 15-19 was 20.9 per thousand women (BMJ 1992 304: 275.1) _________________________________________ Pre 1950, Cervical Cancer was unusual in women under 40. From 1971-3 to 1986-8 percentage increase in women aged 25-34 was 154%. The risk of carcinoma of the cervix doubled in women who began their sexual activity before the age of 17 (Barron, Sexual Activity In Girls Under 16 (British Journal Obs and Gyne, Aug Vol 3 1986) ____________________________________________ Nursing Standard gives incidence of chlamydia infection in UK as between 3 and 4 million cases each year (Nursing Standard Oct 20 Vol 8 No 5 1993)
Healing of Neuropathic Foot Ulcer using a Novel ‘Wound Boot’ (Kerraboot™) Leigh R1, Latif N1, Hollingsworth S2, Barker S2, Hurel SJ1 INITIAL MANAGEMENT OF PATIENT'S HEEL ULCERS Department of Diabetes1 and Surgery2, University College Hospitals, London,IV antibiotics (ceftazidime, flucloxacillin, ciprofloxacin, metronidazole)Wound care (dry dressings changed every 2 days) Abstr
This publication contains an abbreviated version of mywife's medical history as an individual with the full formof the MELAS Syndrome, a mitochondrial disorder. (Some of the symptoms and clinical signs of the MELAS Syndrome discussed inthis publication may be applicable to other mitochondrial disorders.) Karen Ann Jackson 1956-1992 This material was created, (and/or) assembled and edited