NFP and the Single Girl

August 20, 2014 | 20 comments

Victorian birth control propaganda

Did you know there is such a thing as National NFP Awareness Week, recently sponsored by the United States Conference of Catholic Bishops? Neither did I, until the World Wide Web told me so. Fine, you say; so what could a single, Catholic, 40-something woman have to say about Natural Family Planning? Especially when you could instead be reading the work of a Catholic married woman and mother of nine (now ten!), who wrote a book on the subject?

But, really, is there anything a single, middle-aged, Catholic woman could possibly have to say on the subject of Natural Family Planning? Believe it or not, plenty.

Fertility awareness for the single Catholic woman

Single women do have a need to know about fertility awareness, even if they do not have plans to marry in their foreseeable future. For example, before I started keeping track of such things, there could be a rude shock once a month or so. And once I started keeping track, I also started getting interested in what was going on around mid-cycle. Then there are the medical checkups, at which a standard question is "On what day did you start your last period?" Instead of looking at the nurse blank-faced and stuttering, "Uh, dunno, maybe a couple of weeks ago?" I can pull out my smartphone and say, "There's an app for that."

My interest in NFP is not limited to preparing for a monthly visitor. At Catholic Answers, the apologists get lots of questions about NFP, and the women apologists get to answer the questions about "lady days." (Yes, the guys get all the questions specific to male sexuality.) So I've had to learn more than I may ever need to know personally about NFP.

The buzz about birth control

In the weeks since the Supreme Court's Hobby Lobby decision, there has been a surge of discussion about contraception and why women are prescribed drugs commonly used for contraception. One example was a widely circulated BuzzFeed article in which nearly two dozen female employees at BuzzFeed gave their reasons for using birth control. Initially, I chose not to comment on it on my Facebook page, but then two different responses to the article caught my attention for different reasons.

In the first case, I noticed a post in my newsfeed in which someone said, "I want to save this [article] to pass out to the old maids at the nursing home (whose non-kids non-visit them)." The misogyny in the thread spiraled down from there, with one male commenter referring to the women in the BuzzFeed piece as "slags" (presumably a portmanteau created from the words slut and hag).

Because, naturally, the way for good Christians to spread the love of Jesus to women who believe they need contraceptive drugs—or other forms of birth control—for one reason or another is to assume that these women deserve to be scorned in old age as lonely, bitter "slags" who got their just deserts from their life choices. As one of my Facebook friends pointed out, such comments did not account for the fact that not all of the women who shared their reasons for using these drugs said they did so because they wanted to avoid having children altogether. In more than one case, there were legitimate medical reasons for turning to these drugs, such as treating menstrual cramps and adult acne.

Which brings me to the second case. In response to BuzzFeed's post, the website Catholic Sistas decided to ask its contributors to share their reasons "why we don't use birth control." In the original version of the article, which has since been edited to reflect corrections received after publication, the author asserted:

As Catholics, we should know and understand that any form of contraception, even for "medical purposes," between a sexually active couple is never permitted.

At the end of the sentence there was a link to a Catholic Answers' tract on contraception.

My interest was snagged by the reference to Catholic Answers, and I skimmed through the tract that was linked to make certain. As I thought, there was no such statement made that "contraception, even for 'medical purposes'" is "never permitted." On Facebook, I responded:

I don't know where these women got the idea that contraceptive-type drugs used for legitimate medical (i.e., noncontraceptive) purposes cannot be used by a sexually active (married) couple, but it wasn't from Catholic Answers. It was from Catholic Answers that I first learned (and as an apologist myself now have passed on) that the Church does not forbid marital relations between a couple who are using these drugs solely for legitimate, noncontraceptive, therapeutic purposes.

As I said, the post has since been edited. The correction reads:

ETA: We thank each of you for your comments and feedback. This post has been edited to reflect Humanae Vitae's article 15 regarding the use of artificial birth control for medical purposes. We must point out though that while using artificial birth control for true medical concerns (and these are limited in nature) is approved they must never be used with contraception in mind, only to treat the medical need. In the Catholic faith the use of artificial contraception is not allowed to prevent life. We encourage you to research and to read what the Church truly teaches in regard to this matter. This law applies to Catholics and we understand that not everyone who is reading here is Catholic.* We do not wish to force our beliefs on you, however, as a Catholic site who sits fully in line with the magisterium we will always promote the Truth and the ways of the Catholic faith.

Humanae Vitae states: "On the other hand, 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" (HV 15).

*Nota bene: It is not correct to imply that the moral law in general, or even Humanae Vitae in particular, "applies [only] to Catholics." The moral law applies to every human person, and Humanae Vitae is addressed "to all men of good will." What we can say is that Catholics are more culpable for not following the Church's teaching on this matter than are non-Catholics who do not realize the demands of the moral law.

Non-contraceptive use for the Pill for the married Catholic woman

This is only a partial correction, though. Left unaddressed is the question of whether a married woman with a legitimate medical need for the drug(s) commonly prescribed for contraceptive purposes may engage in conjugal relations with her husband. In my experience, this is a point on which many orthodox Catholics are confused. Here is one answer I have given on the subject during my time as a staff apologist for Catholic Answers:

The Church does not require that a married woman who takes medication for a legitimate medical purpose that has the unintended side effects of temporary sterilization and/or possible pregnancy loss must abstain from marital relations while using that medication.

If a person has proportionately grave reason to take a medication for a legitimate medical purpose, then unintended side effects of that medication fall under the principle of double effect. The purpose of taking the medication is to treat a legitimate malady; there is no purpose to cause temporary sterilization or to abort a child. Under such conditions, the temporary sterilization and the possibility—not the certainty—of a pregnancy loss (not an abortion, which implies a deliberate act against the child) are accepted but not willed.

Because marital relations are of such high importance to the health of a marriage, the Church is extremely careful in this age of the breakdown of marriage to avoid placing unnecessary burdens upon the married couple [see this document as one example of the Church's light touch in the pastoral care of married couples]. Those Catholics giving counsel in this area need to be especially careful not to bind consciences more strictly than does the Church, and to substantiate assertions from the Church's documents when they must say that abstinence from marital relations is "required."

This answer did not go unchallenged. It was originally posted in EWTN's Apologetics Q&A forum. In an all-too-common attempt by readers to instigate a fight between experts, someone asked the Pro-Life Q&A forum's moderator, Judie Brown of the American Life League, to comment. Judie Brown disagreed, which is her prerogative, and I responded:

It is the responsibility of the person stating that the Church does "require" a particular course of action to be the one to substantiate that positive assertion from the documents of the Church.

In other words, anyone who wants to bind a married couple's conscience in this matter should be asked to provide substantiation that such a binding of conscience is required by the magisterium of the Church in authoritative Church documents.

Making necessary distinctions

I have often thought that much of the confusion over the noncontraceptive uses of the Pill arises from a misuse of terms. Those using the Pill for noncontraceptive reasons will say that they need to use "birth control" for cramps or adult acne or for some other therapeutic reason. But, if they do not intend to prevent pregnancy, then what they mean is that they take a drug commonly prescribed for contraceptive purposes to treat a legitimate medical problem.

This is not a small distinction. It lies at the root of the political firefight over whether or not insurance coverage for these drugs can be legitimate health care or is instead, always and everywhere, a "lifestyle choice" that should be paid for by the individual. If the drugs treat legitimate medical problems, then the Church does not object to their use (even if there are alternative treatments that could be pursued and may work better). Only when these drugs are used as a means to achieve the end of preventing pregnancy does the Church throw a penalty flag.

What about NFP?

Circling back to our beginning, what then could we take away from educational initiatives such as National NFP Awareness Week? I certainly hope it won't be that there is no such thing as Natural Family Planning (as has been claimed). After all, why should anyone promote awareness of something that doesn't exist? I also hope that it won't be that NFP is a religious bugaboo or that Catholics should be commanded to pray about their marital relations before they are allowed to get married.

Rather, what I hope we might take away from NFP educational programming is that NFP is, if anything, a form of physical discipline. Not discipline in the sense of punishment but in the sense of self-mastery. Those who use it, whether they be Catholic, Protestant, non-Christian, or non-theist—and whether they be married or single—can learn a great deal about reproductive biology and how to become responsible wielders of the superpower of fertility. (Yes, that is an allusion to Spider-Man there.) For theists, such knowledge can increase our awareness that we are "intricately wrought" (Psalm 139:15). For atheists, perhaps such knowledge can raise awareness that we need not "fool Mother Nature" to achieve a legitimate measure of control over human reproduction.

Our words would not be an adequate expression of the thought and solicitude of the Church, mother and teacher of all peoples, if, after having recalled men to the observance and respect of the divine law regarding matrimony, they did not also support mankind in the honest regulation of birth amid the difficult conditions which today afflict families and peoples. The Church, in fact, cannot act differently toward men than did the Redeemer (HV 19).

Note: A version of this essay originally appeared on the blog, Peace, Joy, Pancakes (7/23/14). It is republished here with permission.


Michelle Arnold is a staff apologist at Catholic Answers. You can visit her personal blog or contact her online through Facebook.
The Catholic Girl’s Survival Guide for the Single Years
"Steeped in the Church’s teachings on the feminine genius, marriage, and theology of the body, The Catholic Girl’s Survival Guide dishes with both wit and wisdom on some of the most pressing questions single women face: vocation, dating, sex, finances, work, depression, and more."

Comments by Catholic.com Members

#1  Ryan Beggy - Bradenton, Florida

While I agree that HV 15 does not mean you can never use the "pill." I would question the idea that it is okay to be maritally active while using the pill since there are no forms of contraceptives which do not also fall under the category of abortifacients. One of the main forms of "effectiveness" for medicinal birth control is to prevent a fertilized egg from implanting thereby causing an abortion. I do not agree that the double effect clause fits this criteria. Additionally I find it very troubling that you would refer to it as a loss of pregnancy as opposed to an abortion... The ends never justify the means CCC 1753.

August 20, 2014 at 10:14 am PST
#2  Michelle Arnold - El Cajon, California - Catholic Answers Blogger

Ryan, I explained quite thoroughly the assertions I made and have nothing further to add. If you disagree, fine; but it is on you to substantiate that your assertions are in line with Catholic moral law (and not just your own scruples) before presuming to bind anyone else's conscience on these matters.

As for the term "pregnancy loss," just to clear up any confusion, I will restate my use of that term (which I did explain). "Abortion," in our modern usage, implies a deliberate act to end the life of an unborn child. I used the term "pregnancy loss" to indicate those times when there is no deliberate act attacking the child but the pregnancy is lost by other causes.

August 20, 2014 at 11:09 am PST
#3  Ryan Beggy - Bradenton, Florida

In response:
CCC 2258 "Human life is sacred because from its beginning it involves the creative action of God and it remains for ever in a special relationship with the Creator, who is its sole end. God alone is the Lord of life from its beginning until its end: no one can under any circumstance claim for himself the right directly to destroy an innocent human being." CDF, instruction, Donum vitae, intro. 5.
CCC 2270 [under the heading “Abortion”]
“Human life must be respected and protected absolutely from the moment of conception. From the first moment of his existence, a human being must be recognized as having the rights of a person - among which is the inviolable right of every innocent being to life.” CDF, DÚnum vitae I,1.

August 20, 2014 at 11:18 am PST
#4  Michelle Arnold - El Cajon, California - Catholic Answers Blogger

Ryan, nothing I said in this post contradicts the Catechism of the Catholic Church. And the assertion you need to substantiate is this one: "I would question the idea that it is okay to be maritally active while using the pill since there are no forms of contraceptives which do not also fall under the category of abortifacients." Please show me the magisterial document in which the Church forbids a married woman who uses "the Pill" for legitimate medical reasons from engaging in marital relations with her husband.

August 20, 2014 at 11:47 am PST
#5  Todd Aglialoro - El Cajon, California - Catholic Answers Blogger

As a father of a large-ish family, trained NFP teacher, and former diocesan family life minister, I wanted to add two quick comments about the moral question of marital relations while a woman is taking contraceptives for licit therapeutic reasons:

1) Both spouses must reflect on their intentions. The contraceptive double effect can't be willed, even a little. The condition being treated is not a Get Out of Jail Free card allowing a couple carte blanche to contracept. This can be especially tricky when discerning whether to choose a treatment that has a contraceptive effect or an alternative one without it. Unless both spouses have well-formed consciences and recollected intentions, one or both could view the contraceptive effect as a kind of bonus rather than as something unwanted. Which would, of course, create the conditions for sin.

2) Also clouding the question is the theoretical possibility that certain hormonal contraceptives can have an abortifacient effect. It's hard to say where the probability-level would have to be to trigger a moral imperative to abstain from relations in such circumstances, but we can see that it some point it would. If there was an 80 percent chance -- having accounted for variables -- in a given month that having relations while a woman was using hormonal contraceptives would result in a new human life being conceived and then terminated, it would be a no-brainer. Obviously that number is absurdly high. But what if it's 8 percent? .8 percent? .08 percent? .000000000000008 percent? Common sense tells us that at some point the level of risk becomes acceptable -- proportionate to the health good being sought. Though for some people, according to their consciences, *any* such risk of that happening rules out the moral use of potentially-abortifacient contraceptives even for licit therapeutic uses.

August 20, 2014 at 1:24 pm PST
#6  Rebecca Roberts - Phoenix, Arizona

Michelle, I would like to start by applauding your use of NFP, even as single girl. Every woman in every walk of life can benefit greatly by the knowledge of her body that even the most basic NFP methods provide.

It is true that there is no place in the magisterial documents that specifically forbids relations between a married couples using contraception (i. e. the Pill) for strictly medical purposes. However, speaking as someone who teaches marriage prep in the area of sexuality and reproduction, it seems to me that reason dictates the correct course of action would be to abstain until the course of “medication” is through.

I say this for few reasons, the first being the object Ryan is raising. All forms of contraception used for other medical purposes are also abortifacients. This means that a couple who resumes marital relations while on “the Pill” or other forms of contraception is risking aborting a child. Can we really say because it is not expressly forbidden that this is an acceptable risk? To lose a child for the sake of clear skin or less cramps? Perhaps in a grave situation, the answer might be “yes.”

Secondly, there is an inherent danger to the integrity of the marriage when something the Church has labeled as “intrinsically evil” is used, even if it is used for a different purpose. Is a couple’s intention enough to separate contraception from its purpose, from it telos, so that it ceases to be intrinsically evil? It is a slippery slope for married couples to tread the line between medical use and contraception. Think of how many cases of prescription drug abuse have started out as an actual condition (i. e. pain from a injury) needing medication. In addition, since contraception is never a true cure (just ask any NaPro doctor) the time that a women is placed on “the Pill” or other forms is often extended indefinitely. This creates a very really danger for the couple intention to shift from the medical need to the convenience of contraception.

With so many new and successful treatments available for the plethora of problems that doctors like to stick women on “the Pill” for, why run the risks of using contraception instead? Why place such a burden on your marriage when there are better options? It may not be a sin, but it is at least an occasion of sin and it makes sense to avoid it.

August 20, 2014 at 1:52 pm PST
#7  M K - Marceline, Missouri

Dear Michelle, I think you have accurately stated the Church's teaching but I would like to reflect a bit deeper on HV 15. What does the Church mean when She used the work therapeutic? My Webster's dictionary defines therapeutic as "having healing powers". Does the birth control pill have healing powers? I know it is commonly prescribed for a multitude of issues that are associated with the female reproductive system. Does it heal these maladies or primarily mask the symptoms. Having struggled through several female reproductive system issues with my wife and finally finding truly therapeutic treatment, understanding, compassion and concern through NaproTechnology and Pope Paul VI Institute for Women's Health it makes my heart ache to hear of women being "treated" with the birth control pill. It irritates me that artificial hormones that cause many negative side effects ranging from blood clots, depression, head aches, cancer, ect was ever approved to be used in the human body when the human identical hormone, which can be readily available, that the artificial hormone is taking the place of has positive side effects that are the opposite of the artificial hormone when taken during the proper time of the fertility cycle.
As stated above HV 15 states "On the other hand, 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." It mentions impediment to procreation which would apply to the ovulation suppression of birth control pill. But if ovulation occurs conception can happen if sperm are present. At conception procreation has occurred and the consequences of the birth control pill are no longer impeding procreation but causing abortion. Instead of viewing those times it would be prudent to abstain from the marital embrace as a burden but instead approach those times with love, giving them as a gift to the subject of our love, our spouse, with all our being as Christ did for his bride on the cross, those times of sacrifice can become a window into the love and peace of heaven. Thank you.

August 20, 2014 at 3:07 pm PST
#8  Michelle Arnold - El Cajon, California - Catholic Answers Blogger

Todd--

My intent in writing this essay was to alleviate the scruples that many well-intentioned conservative Catholics who try to follow the Church's moral law have about NFP. I sympathize with the concerns you raised, particularly since this was an area in which I needed to become educated myself when I joined Catholic Answers apologetics department, and I assure you that this essay was the product of ten years of giving answers to questions on this topic that are in line with the formation I received from Catholic Answers.

I'll try to briefly address the concerns you raised.

1.) Either an act is willed or it is not willed. To say that an act "can't be willed, even a little" reminds me of the old joke of a woman being "a little pregnant." Just as a woman either is pregnant or she isn't, either a person wills to contracept or he does not.

2.) I think you might have overlooked my point that drugs used for legitimate therapeutic reasons should not be called contraceptives. (Please see the section with the sub-head titled "Making necessary distinctions.") Using these treatments may have a contraceptive side effect but that is qualitatively different from committing the sin of contraception.

3.) It sounds to me that you could be saying that a desire not to have a baby is, in itself, sinful. But the Church does not teach that a married couple must will to have a child, or that it is sinful for them to be relieved—for whatever reason—that they cannot have a child. All that the Church teaches is that the couple must leave every conjugal act open to the possibility of new life and must not deliberately impede that possibility by directly engaging in contraception.

4.) The sin of contraception is to impede the marital act from the procreation of a new human being. It seems to me that you may be conflating the sin of contraception with the desire not to have a baby (or, in your words, "the contraceptive double effect," the effect of contraception being that the couple does not have a baby). There is nothing necessarily immoral about a desire not to have a baby, even for a married couple. That's one reason why couples may use NFP in the first place!

In closing, as I said in the blog post, "Catholics giving counsel in this area need to be especially careful not to bind consciences more strictly than does the Church, and to substantiate assertions from the Church's documents when they must say that abstinence from marital relations is 'required'."

August 20, 2014 at 8:38 pm PST
#9  Tara Leitermann - Little Chute, Wisconsin

I would like to humbly point out an issue I have with simply stating that the Church allows the use of the pill for medical reasons. A woman may think, "Well, I have some cramps and and acne before my period: that is a medical issue, so I can take the pill and not feel bad about it." These kinds of problems are just a natural part of being a woman, not a "medical condition". I can see the Church allows use of the pill, if it is intended to treat an actual serious medical condition ("bodily disease", as the document puts it) and not intended for birth control. This does not mean that one can take the pill to get out of the ordinary inconvenience of the female cycle. And if we are following the Church's teaching that use of contraceptives as birth control is gravely immoral (especially that which can cause pregnancy loss), doesn't it make sense to try to find another method of treatment? One that is better for the woman's body, respects her fertility, and doesn't cause unintended loss of pregnancy? While I believe it is important to relieve unnecessary scruples, one needs to be careful not to provide a loophole that in the end, allows artificial birth control to "treat" any problem.

August 20, 2014 at 10:40 pm PST
#10  Michelle Arnold - El Cajon, California - Catholic Answers Blogger

Tara--

While there is an issue of proportionality that must be considered in the equation for determining if double effect applies, I'd also caution against judging for other people whether their circumstances "warrant" using a drug that has contraceptive side effects. Some women suffer terribly from cramping and even from adult acne (which can cause serious scarring and is not just a few irritating zits), and it is deeply unfair to them to presume that they are just acting out of convenience in using these drugs.

St. Teresa of Avila once advised her nuns, "Be gentle to all, and stern with yourself." So, by all means, be very careful in determining for yourself if you have proportionate reason to use a drug that has the side effect of temporary sterilization. But be careful never to presume to decide for someone else if *she* has proportionate reason. That is between a woman, her husband, her doctor, and her confessor. The most you can do is to urge a woman in this situation to consult with them and with other experts, such as the National Catholic Bioethics Center (www.ncbcenter.org).

August 20, 2014 at 10:57 pm PST
#11  Todd Aglialoro - El Cajon, California - Catholic Answers Blogger

Michelle, replies follow:

"My intent in writing this essay was to alleviate the scruples that many well-intentioned conservative Catholics who try to follow the Church's moral law have about NFP....and I assure you that this essay was the product of ten years of giving answers to questions on this topic that are in line with the formation I received from Catholic Answers."

I said nothing about your intentions or your qualifications, so that's not relevant. And since there are people with qualifications that equal or exceed yours, but who disagree with you, appeals to your own authority don't settle anything.

"Either an act is willed or it is not willed. To say that an act "can't be willed, even a little"..."

Okay. Strictly speaking, when it comes to a human act, this is true. But the personal experiences of childbearing couples will bear out another truth: the will can be divided when it comes to the awesome responsibility of procreation. You can want it and not want it. It's possible to say, "I am open to life," and then be partly regretful when life comes to you. It's possible to say, "I don't desire the contraceptive effect of this medication," but to have some part of you be glad for it.

The antidote for this division is self-knowledge. Which is why I counseled reflection.

"I think you might have overlooked my point that drugs used for legitimate therapeutic reasons should not be called contraceptives. "

An unnecessary qualification for our discussion. A contraceptive pill is what it is, even when it's being used for something else. If I use a shovel not to dig but to kill a snake, or if I use a phone book as a booster seat for a child, no one says, "Don't call it a shovel! Don't call it a phone book! You're using those things for other purposes!"

When I say, "Use contraception for therapeutic purposes," I should hope it would be tacitly understood that I'm not saying, "Commit the act of contraception for therapeutic purposes" (which would be consequentialism, not double effect), but rather "Use a contraceptive pill for a non-contraceptive therapeutic end."

I'm sure some people don't immediately get this distinction, but I do, and I'm guessing everyone in this comment thread does.

" It sounds to me that you could be saying that a desire not to have a baby is, in itself, sinful."

I don't see how you get that idea. Not from anything I wrote. Again, it may be that in your Q&A experience you have had to deal with people who think that, but I'm not one of them.

"It seems to me that you may be conflating the sin of contraception with the desire not to have a baby (or, in your words, "the contraceptive double effect," the effect of contraception being that the couple does not have a baby)."

In my words, the 'the contraceptive double effect'?? I don't understand what you're saying. The "contraceptive double effect" is not the "desire not to have a baby," it's the physical effect of the artificial hormones in birth control pills on a woman's reproductive system. According to the principle of double effect, that effect is permitted as an unwanted second effect of ingesting those same hormones in those same pills for some presumed health benefit.

For double effect to be validly invoked, the second effect can't be willed. Which brings us back to my first point: when it comes to sex and babies, the will can be tricky and fickle. It's certainly possible not to will the contraceptive effect, and so it's possible for women to use contraceptive pills for therapeutic reasons, and still have relations with her husband, without either of them sinning. But it's also quite possible for one or both spouses to endorse the contraceptive effect and not face up to it. So, reflection.

In closing, there are two other good points being made that I haven't seen you adequately address here -- points that you might do well to educate yourself further on, namely: 1) the abortifacient potential of certain kinds of hormonal contraceptives, and 2) the medical question of whether using hormonal contraceptives to treat endometriosis or PCOS or acne or whatever, can actually be, in any given case, the best therapeutic course. I know more than one knowledgeable medical professional who says no. Someone earlier recommended checking out NaPro technology websites -- might be worth a look.

August 21, 2014 at 8:29 am PST
#12  Michelle Arnold - El Cajon, California - Catholic Answers Blogger

Todd--

I mentioned my own qualifications for two reasons. One, you first appealed to your own authority. And, two, the essay is a product of my formation as a Catholic Answers apologist and the substance of my first response to you was given after consultation with my supervisor. In essence, at least insofar as I am repeating what the Church teaches—personal opinion excluded—I'm giving "Catholic Answers' answer."

As for my intentions, that was my way of explaining to you that this essay was intended to ease scruples by readers. Argument in the thread among Catholic Answers' staffers only ratchets the scruples back up for those who have scrupulous consciences. For that reason, if you have further concerns about what I've written after reading this reply, let's talk privately.

Without going into a long discussion of your concerns about double effect—and which can, in any event, be discussed privately—I'll address your last two points.

1.) In the case of these hormone therapies, "abortifacient potential" is an even more remote unwanted side effect than temporary sterilization. If the greater potential can be accepted but not willed, then so can the lesser potential. Also a mitigating factor is that there is always some degree of natural pregnancy loss in the first weeks of pregnancy. Many women have probably lost a pregnancy without ever knowing they were pregnant or having taken any drug that could have caused it. These drugs may increase that potential somewhat, but we have no way of measuring the degree of increase. That is something to be considered in determining proportionate reason.

2.) I do not deny that alternative therapies exist, and that they may work better for many women than "the Pill." All I am saying is that it is not our place to judge for a woman whether her situation is one in which she "should" be using those alternative therapies, or if she is justified in using "the Pill." In my opinion, the only medical expert whose opinion is relevant in a woman's decision is the medical expert she consults (although I would also urge her to consult with her confessor and the NCBC, so as to satisfy any concerns she may have that she is getting accurate information). Other medical experts can give a general opinion based on their experience with many women, but they cannot presume to diagnose and treat an individual woman who has not entrusted herself to their care.

In closing, I reiterate that it is important that Catholic apologists take care not to bind consciences any more strictly than does the Church. We can give personal opinion, if asked or if it is carefully flagged to be personal opinion, but that opinion should be expressed in ways that do not create unnecessary burdens (such as "Think of all the babies you might be aborting!").

August 21, 2014 at 9:12 am PST
#13  Todd Aglialoro - El Cajon, California - Catholic Answers Blogger

Michelle, I don't really disagree with either of those two points. You'll note that in my first reply I said that the abortion risk was acceptable if the health good being sought was proportionate to it. But that's not a slam-dunk in every case. We must evaluate three factors: 1) the likelihood of the pill's having an abortifacient effect (as best as we can figure), 2) the weight of the physical good being sought, and 3) the accessibility and viability of alternative treatments that do NOT have the potential to be abortifacient.

A case with a relatively high abortifacient potential, combined with a relatively low health benefit, combined with abundant alternatives would seem to rule out moral use.

Yes, women and couples need to make this decision themselves, but they need to make it in conjunction with sound medical, moral, and pastoral guidance.

It's important to mention alternatives, in fact to shout about them loud and clear and not just leave women and couples to whatever their doctor has to say, because there's so much ignorance about alternatives -- and a vested interest in conventional medicine to support the pharmacological status quo when it comes to birth control. Ask anyone who has been on the NFP front lines for any amount of time, or any mother who goes for a follow-up visit to her OB/GYN starting with her third or fourth child.

To whatever extent our ready acceptance of contraception-as-therapy upholds and legitimizes that status quo, we ought to weight that, too, in making a decision. If not strictly as a matter of morality, than as a matter of strategy in the war against the Culture of Death.

"Catholic apologists take care not to bind consciences any more strictly than does the Church. "

Agreed. Even so, we must also not take a kind of sola scriptura approach to the Church's official moral prescriptions. Humanae Vitae does not unpack every jot and tittle of Church teaching on the subject, and neither does the Catechism. That's the job of bishops, pastors, theologians, teachers... and apologists.

August 21, 2014 at 9:36 am PST
#14  c f - Dev Null NOB, Sfax

I would like to hear your further thoughts on this issue in two respects. Someone made the statement " I would question the idea that it is okay to be maritally active while using the pill "

Given, that people who are martially active have some unknown chance of conceiving while using 'the pill' and given also that the pill in that circumstance may cause the death of an innocent human person.

Could you supply for me a sufficient medical reason that would justify that chance? I'm thinking adult acne and painful cramping don't justify the taking of innocent human life. So what does?

I don't binding the catholic conscience to HV in this circumstance , unless one can first satisfy the morally binding principle of 'tho shall't not commit murder'

I'm trying to be direct and avoid quibbling over terminology. But the statement that abortion only occurs when you intend to kill someone doesn't quite wash with me.

Does murder occur only when you 'intend' to kill someone? What about negligent homicide? maybe it is not 'first degree abortion' but it is still death of another human being. It would seem there is a moral responsibility to avoid such situations.

August 21, 2014 at 10:55 am PST
#15  Mark Jeffords - Ceres, California

Michelle, in response to your commenting #4, why do you need a magisterial document to tell you that it's immoral for a married couple to use a potentially abortafacient contraceptive drug while sexually active? They would be gambling with the lives of their unborn children if they were to conceive while using such a drug. If life begins at conception and these types of drugs are at least potentially abortafacient, do you really need a Pope or Bishop to spell it out for you in a some lengthy document?

If the couple if sexually active, and they know they have the possibility of conceiving, and they know the drug being used could possibly end the newly conceived life, and they go on using it anyway (for medical or any other purpose), how could they not be in mortal sin? You can wait for an official document if you want, I'll go with common sense and avoid mortal sin.

August 21, 2014 at 10:58 am PST
#16  Todd Aglialoro - El Cajon, California - Catholic Answers Blogger

Mark, you addressed that question at Michelle, not me, but I'd like to weigh in if you don't mind.

Whether we could use a potentially abortifacient drug for some other reason is not an absolute either-or question. For we do many things that have potentially harmful, even deadly consequences for ourselves and others, and we do them without sin. Why? Because the chances of those things being harmful are very slim, and the good being sought is at least proportionate.

For example, I could put my toddler in a car seat and take her on a car trip. We could get t-boned by a semi and she could die. Why did I put her in that car when the chances of her dying were greater than zero? Because the chances were very small, and I had some good end in mind for taking her on that trip (going shopping, to church, on a play date, whatever).

Similarly, any kind of medical treatment that could harm oneself or others has to be subjected to a risk-versus-goods analysis. If the health good of a particular medical treatment were sufficiently great, and if the risk of conceiving and aborting a child were sufficiently small, it would be licit.

How great? How small? Well, this is part of the problem I raised in my first reply. We just don't know how often intercourse while using certain kinds of hormonal contraceptives (we say "the Pill" for shorthand, but it's not just the Pill) actually leads to conceptions and then miscarriages. It's practically difficult if not impossible to test clinically. This is why, in recent news, Hobby Lobby could object to certain contraceptives being abortifacient, and the media could say Hobby Lobby is just wrong, without there being a simple factual way to resolve the dispute.

That said, I'm not aware of any pro-lifer who asserts that it happens with any great frequency -- just that it's theoretically possible.

August 21, 2014 at 11:47 am PST
#17  M K - Marceline, Missouri

Todd, I would like to alter your analogy to make it more comparable to the situation being discussed. To use language from natural law, the typical natural end of putting someone in the car is to travel to your destination. The natural end of the marital act is procreation and unity. Taking contraceptives affects the procreative end of the marital act. Likewise I could decide to put used tires tires on my car to save money. If those tires have little tread on them there is some chance that if it rains during my journey the vehicle could hydroplane with potentially devastating results. What culpability would I bear? What if I needed the money to put food on the table? I didn't know it was going to rain when I chose to install the used tires or when we started our journey. If it wouldn't have rained we would have completed our journey safely. Likewise the couple didn't know the she was going to ovulate (unless she was observing the signs taught in NFP). If ovulation didn't occur no baby would have died. If I would have observed the signs of rain drops falling I could have stopped my car, eliminating the risk of hydroplaning. If the couple would observe the signs of ovulation they could do likewise. If I didn't know the car could hydroplane with semi bald tires and you did I pray you would tell me before I put myself and child at risk.

Michelle, I would like to trust the doctor but my experience has been like what Todd mentioned but earlier. After the first child the OB strongly stated that we needed to choose a form of birth control. When we said we would use NFP the OB sarcastically expressed her opinion. After the third child the coercion for either my wife or me to be sterilized was very strong. A mother I was talking to relayed that after a C-section and before the OB closed her up, the doctor said why don't we just cut those tubes while we are in here, your husband doesn't need to know. This environment is not uncommon in OB/gyn offices. How likely is it to get unbiased medical information in an environment like that. Something has been trying to divorce humans from the gift God gave them of participating in creation from the times of Genesis. his efforts seem greater now and he has made much progress in the medical community since the advent of the pill. Having read "Naprotechnology, Unleashing the Power of the Woman's Cycle" asking questions of the nurse and doctor trained in NaproTechnology that treated us, and witnessing the results I have seen more than enough evidence of what is effective treatment. So when I find someone who is ignorant of what those artificial hormones actually do to the womans body and mental state I try to find a way to charitably inform them and help them get "good tires" on their car. Allowing them to be ignorant of better treatment and to continue to suffer would be uncharitable.

August 21, 2014 at 2:08 pm PST
#18  Michelle Arnold - El Cajon, California - Catholic Answers Blogger

Todd--

As I said previously, I don't think further public argument between us in this thread is helpful, and may actually be harmful for readers who suffer from scruples. Let's talk privately.

August 21, 2014 at 4:15 pm PST
#19  Michelle Arnold - El Cajon, California - Catholic Answers Blogger

Mark--

The question is not what *I* need to convince me whether or not to use hormone therapies or to choose alternative treatments. The question is what I can tell *other women* about what the Church teaches. I am an apologist, not a guru. If the Church does not bind someone's conscience, I certainly do not have the authority to do so. All I can do is to explain what the Church actually teaches—not what I would like it to teach, not what seems to me to be a good idea, not what I think others should do.

Do apologists offer personal opinions or educated interpretations of Church documents? Sure. But we always try to flag personal opinion as personal opinion, either by using qualifiers (e.g., "might," "maybe," "could") or by flagging it as personal opinion (e.g., "It seems to me...").

And when it comes to intensely personal pastoral questions such as this, we always recommend that the inquirer discuss the matter one on one with qualified experts (e.g., doctor, medical ethicist, spiritual director, confessor). We always try to remember that the Internet may be the first place people may go with such questions, but it should NEVER be the last place. Our job is to point inquirers on to real-life professionals who can assess them as individuals and not as impersonal abstractions.

August 21, 2014 at 4:26 pm PST
#20  Ged Narvaez - Daraga, Albay

great article michelle, i think you are sufficiently clear to the topic and on objectives in scruples. i think todd does not endorse/intend for us to reach scruples, but rather give righteous way/reflection/guidance also part of the banner of catholic answers. his experience also give us a wonderful insights,"add (clarify) unto it", and do not violate catholic teaching but helps us to be responsibly obedient. again, thank you very much for both of you.:-D

August 21, 2014 at 6:51 pm PST

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