This is such a divisive topic.  I’ve tried for years to write about it and haven’t found the courage or the focus.  Here’s my claim:  I don’t like artificial birth control.  I think it is spiritually, physically, and socially harmful.  However, I don’t want to write a diatribe against it or try to persuade people with confrontational arguments.  I’d just like to explain myself well enough that those who commented on my last post can understand my “bass-ackward” and “troubling” point of view.

Definitions  

By artificial birth control, I mean hormonal treatments such as pills, injections, and implants; physical barriers such as the diaphragm and condom; withdrawal; chemical spermicides; irritants and abortifacients like the IUD and morning-after pill; surgical sterilization; and abortion.

There are three main options to the use of artificial birth control.

The first is celibacy, either temporary or permanent.  It is one hundred percent effective.  It may have some long-term health impacts – women who have never given birth, for example, seem to be at slightly higher risk for certain types of cancer, and several male sailors I’ve known described a painful condition called “blue balls,” which I will leave to the imagination of the reader.  Opinion is divided over the psychological impacts of celibacy.  Some claim it leads to madness, while others praise the focus and opportunities of the celibate life.  Permanent celibacy is always going to be a minority practice, though, so we’ll move on to the next.

The second is the – well, let’s call it the bunny option.  Some religious groups have made unrestrained breeding a holy activity.  There have even been people – I hope in the past, but nuttiness springs eternal – who disapproved of breast feeding because it delayed the mother’s ability to conceive again.  These groups hope to outbreed their ideological competition.  May I say, as firmly as possible without hitting Caps Lock, that these bunny breeders do not represent most people who have objections to artificial birth control.  God has asked us to restrain all of our primal appetites for our own good and the good of others, and our appetite to procreate is no exception.  Children are not weapons in an ideological war.

The third option is natural family planning (NFP).  The term is often greeted with scorn because of the failure of “the rhythm method.”  This was a primitive attempt to understand a woman’s natural cycles so as to avoid sex during fertile times if the couple didn’t want children.  It relied on counting days, but there is too much variation in cycles for that to be accurate.  So far as I know, no one still uses the rhythm method exclusively any more than bleeding, cupping, or phrenology.  (Okay, yes, sometimes modern medicine still bleeds patients, but my larger point stands.)  Modern natural family planning is an entirely different thing.

Effectiveness

I won’t go into detail about how NFP works, but you can read more if you follow the links below.  Tracking fertility by using a variety of symptoms, NFP can achieve effectiveness rates between 99% (as claimed by advocacy groups) and 75% (as claimed by the US government).   Be aware that the government fact sheet lumps together all types of natural family planning, including the rhythm method.  The first document’s numbers only reflect the most effective combination of techniques and exclude the rhythm method, so these two rates are not as far apart as they seem.  The government document does state that tracking a variety of symptoms leads to higher effectiveness rates.  No method except abstinence prevents 100% of pregnancies or live births, but my experience over the course of the more than two decades I used NFP was that I never conceived when I wasn’t trying to conceive.

People who have gotten this far in the research about NFP point out that it is only effective when properly used.  Well, that’s true of all methods of birth control.  (Unless you are willing to discuss forcible sterilization and abortion – and those only work when leaders can find all the women.  Let’s not even go there.)  For NFP to work, both partners have to respect each other, know each other, be committed to each other, show self-restraint toward each other – in other words, be loving and responsible.  I could make the point that no one should be having sex with someone who isn’t responsible and loving; however, I can see the reality of dysfunctional and casual relationships all around me.  But when large numbers of people in a society have sex with people who aren’t loving and responsible, that society has bigger problems than just birth control – whether we’re talking about the rape of child brides in Yemen or the crazy rates of teenage pregnancy I see in my job.  There are caring people who try to reduce the effects of the societal problems by pushing artificial birth control.  When I consider my teenage community-college students who are struggling to get anywhere while caring for a toddler, I can understand why.  I have to say, however, that most of my students have access to birth control and choose not to use it for complex personal and social reasons.  Should America then forcibly require implants or other long-term methods of preventing pregnancy?  Should the government make contraception a requirement for receiving social benefits, as some have claimed?  These are not benign claims.  There are other aspects of artificial birth control we need to consider.

Health

Artificial birth control has been implicated in many health problems.  It’s a tangled issue, so I’m not sure who to believe when I read studies and statistics, but artificial birth control has at minimum caused allergic reactions, high blood pressure, infection, urinary tract problems, hormone imbalances, infertility, and possibly cancer.  These problems overwhelmingly affect women, not men.

NFP uses no hormones, spermicides, surgery, or latex; it does not break the skin or insert anything into the body beyond the occasional thermometer.  Once couples get the original training, they don’t need to make regular visits to a health care provider.  Not only does NFP do no harm, it also promotes health.  Couples who use NFP are quicker to notice changes in the woman’s cycle that can indicate health problems.  They tend to be more in touch with their health and understand it better.

NFP, unlike condoms, does not protect against sexually transmitted diseases, and that can be considered a point against it.  However, STDs are one of those bigger problems I mentioned above and need to be addressed more holistically than just handing out condoms.  If NFP promotes loving and responsible sex, it will necessarily reduce the chances of STDs.

Cost

Depending on how it’s done, NFP costs little or nothing.  There are virtually no ongoing costs.  That independence is a good feeling in America; it’s essential in poorer countries.  Women who have little or no income can, with brief education for themselves and their husbands, avoid the costs of supplies, travel, and treatment for the secondary effects common to artificial birth control.  I’ve trained couples in a developing country in NFP.  They were desperate for an alternative to hormone injections or abortions, the two methods of birth control offered where we were.  Even to get the injections or abortions, they had to pay to travel to a larger town, find somewhere to stay, and feed themselves during the trip.  In many cases village women did not have the money to do that.

Another plus is that people using NFP are not supporting multinational pharmaceutical companies by buying monthly supplies of pills or condoms – it’s the ultimate local, sustainable technology.  I don’t want to vilify pharmaceutical companies unjustly, but even if their motivations for providing birth control are entirely charitable (which they aren’t), they still cannot know and care about individual women.  Village health educators, mentors, and support groups can.

Women’s Rights

Reproductive choice is accepted around the world now as a basic human right.  Those countries that deny women reproductive choice are unattractive ones – poor, violent, and repressive.  It’s good that we in developed countries care about women’s rights to have children or not to have children as they see fit.  But as far as reproductive rights affect us here in the West, let’s be honest – what we want is the right to have sex whenever we want, with whomever we want, and not get pregnant.  And even that is complicated.  In our current environment of sexual freedom, most women at least occasionally have sex not because they really want to but because they think they have to – to be liberated, to avoid seeming clingy or old-fashioned, to keep the affections of a man who could find sex somewhere else, or just because everyone’s doing it.

Artificial birth control is profoundly anti-woman.  Now that it is widely available, no one, man or woman, sees the need to understand the unique qualities of female physiology.  One could say – and many do – that ignoring feminine uniqueness and having sex as if we could never get pregnant is liberation.  Almost every movie and television show takes for granted that sex on demand is liberating and fulfilling for women.  On the contrary; by ignoring feminine difference we are treating women like commodities or slaves – they are to be available for sex at any time, however costly it is to their bodies and psyches to do so, and any “failure” of women to be just like men, in other words to get pregnant, has to be paid for by the woman.  And by the child, of course.  (Abortion is even costly for men, although not all realize it.)

NFP starts with the conviction that fertility, both male and female, is a natural, healthy thing.  It also accepts that there are times when pregnancy is not a good option.  NFP asks men and women to respect themselves enough to practice abstinence for a few days when they have both agreed to delay pregnancy.  Both pay the cost of restraint.  Both participate in the monthly discussion of whether to allow for pregnancy or not.  In this relationship, women are equal to men and have a voice in how they are treated, given their own unique nature; they are shown true love by being respected for who they are.

Population and Resource Balance

I hope by now I don’t even have to make the case that NFP is not an irresponsible approach to the larger environmental issues.  All of us, when we wonder if our species can sustain our current lifestyle, set moral limits on what we’re willing to do to control our population.  For example, nuclear weapons are a very efficient means of population control, but we aren’t willing to consider nuking the world.   Artificial birth control is not the only option for finding balance.  NFP is as effective as artificial birth control and, unlike nuclear holocaust or artificial birth control, respects individual choice and dignity.  It does no harm to its participants, isn’t financially burdensome, and requires cooperation and not coercion so it can’t be forced by repressive governments.

If you are concerned about a sustainable lifestyle, artificial birth control is a useless band-aid.  It has not in itself prevented the world population from increasing from 4.4 billion in 1980 to 7.1 billion today, despite its legality and availability in most countries during those years.  It has nothing to do with the increasing per capita consumption of the richest citizens of the world.  Offering birth control to people who can’t restrain their appetites, who judge their worth by their fertility, or who force themselves on others doesn’t do anything to address the root problems of our sinful nature.  Our goals should be justice for men and women, rich and poor; temperance in our impulses; unselfish love for those around us; and a respect for a variety of lifestyles, including celibacy.  These are what the Bible calls for.  That’s hopelessly idealistic, you might say – it’ll never work.  Well, no, it won’t work.  None of our own efforts will work to save us or our world.  A better question than “Will it work?” would be “Is it right?”

Morality

Until 1930 all churches believed that artificial birth control was wrong.   The Catholic Church still does.   I don’t want to present their arguments here, but those who are interested can read more about the topic in The Catechism of the Catholic Church (which is available on line here or in St. John Paul II’s The Theology of the Body (which can be read here). While these are Catholic documents, they express a view that was more or less universally Christian until recently.   Just because people did something for a long time doesn’t make it right, of course, but it’s worth looking into their reasons for thinking what they did.

I’ve tried to address the most common criticisms of alternative family planning methods – that they don’t work and that those who espouse them think that women should be kept barefoot and pregnant.  I don’t want to imply that those are the only issues to consider, though.  NFP isn’t just a more benign form of contraception, although it can be used as such.  What sells it to me is that, unlike artificial birth control, its undergirding philosophy supports the revolutionary, even bass-akward, Christian ideals of justice, love, and self-sacrifice.