Our Bioethics Observatory – Institue of Life Sciences publishes studies in scientific journals. Last February The Linacre Quarterly published an article untitled The use of NFP when pregnancy is contraindicated? which our readers can find it in the section PUBLICATIONS with a link to the Abstract and the possibility of purchase the entire article.

We excerpt from the article what we can publish inside the compromise we have with the aforementioned journal.

Abstract

family planning methods modern NFP

Modern NFP

family planning methodsThe Sacred Congregation for the Doctrine of the Faith has declared the moral liceity of hysterectomy when certain medical criteria are met but does not exclude other options, “for example, recourse to infertile periods or total abstinence.” Consequently, there may be couples who prefer to use natural family planning (NFP) methods. We shall refer to these in this article. The efficacy of NFP methods is determined by knowing the day of ovulation. To that end, three parameters are used: the presence and consistency of cervical mucus, measurement of the basal body temperature, and the determination of particular hormones in urine. Of the NFP methods used, the so-called symptom-thermal method seems to be the most effective. It has been concluded that the postovulatory or luteal phase of the female menstrual cycle is the safest time to avoid pregnancy if the couple has sexual intercourse during this period. Nevertheless, the use of NFP methods has limitations if the length of the cycles varies, there are fluctuations in the basal temperature, or when there are vaginal infections. Urinary hormone levels can also be altered by the use of antibiotics or psychotropic drugs. In general, however, it can be concluded that NFP methods, if used in the conditions mentioned herein, offer a high degree of reliability, similar to that of artificial contraceptive methods. Accordingly, if pregnancy must be avoided in the medical circumstances to which the Congregation for the Doctrine of the Faith refers, NFP methods can effectively replace hysterectomy, thereby circumventing the medical difficulties of this practice.
Summary: The Sacred Congregation for the Doctrine of the Faith has declared the moral liceity of hysterectomy when certain medical criteria are met but does not exclude other options, “for example, recourse to infertile periods or total abstinence.” Consequently, there may be couples who prefer to use natural family planning methods. We shall refer to these in this article. In general, it can be concluded that NFP methods, if used in the conditions mentioned herein, offer a high degree of reliability, similar to that of artificial contraceptive methods. Accordingly, if pregnancy must be avoided in the medical circumstances to which the Congregation for the Doctrine of the Faith refers, NFP methods can effectively replace hysterectomy, thereby circumventing the medical difficulties of this practice.


Medical literature strongly supports NFP use


The article begins with the aim of this study “On December 10, 2018, the Sacred Congregation for the Doctrine of the Faith (CDF) published a statement approved by Pope Francis on the moral liceity of hysterectomy in specific clinical scenarios (Congregazione per la Dottrina della Fede 2019). The final part of the CDF statement refers to the non-surgical options of “recourse to infertile periods or total abstinence” and briefly outlines the process a couple should follow in their decision-making.”

family planning methods“The purpose of this article is to expand on the use of infertile periods in the form of modern natural family planning (NFP). Modern NFP refers to three fertility awareness-based methods that have been extensively, scientifically validated and are highly effective, namely, the Billings ovulation method, sympto-thermal method and Creighton model system (Fehring 2009). This article will review the evidence underpinning the utilization of modern NFP and assess whether its use is appropriate in circumstances when the woman has a very strong medical reason not to achieve another pregnancy.”

The authors, members of our Observatory, continue with the reasons that could have a couple to avoid hysterectomy and opt to NFP methods. “There are couples who, for medical or moral reasons, prefer to rely on NFP methods to defer pregnancy rather than a hysterectomy (Ryder 1993). These methods can also be used for other reasons, though, such as the ecological advantages of avoiding pharmacological or instrumental methods to regulate human fertility, a preference for nonmedical control of reproduction or even for psychological reasons related to better understanding of the body’s physiology. Despite all this, however, the use of NFP methods continues to be controversial in mainstream medical practice due to an alleged lack of confidence in their efficacy and applicability (Guida et al. 1997).”

The study continues with a detailed analysis of each NFP methods and the conditions that should follow the couples for their efficiency.

We end our review with the conclusion of the study which, in our opinion, helps to understand the nature of the paper.

Conclusion

“This article has examined the medical implications of the Sacred Congregation for the Doctrine of the Faith (CDF) statement on the applicability of hysterectomy versus “recourse to infertile periods” using modern NFP when the avoidance of pregnancy is strongly indicated on medical grounds. We have noted that hysterectomy has significant morbidity and does not guarantee a zero-pregnancy rate. In fact, pregnancy following hysterectomy is always an ectopic pregnancy and, as the diagnosis may be delayed, this can be life-threatening. On the other hand, while modern NFP has some limitations, medical literature strongly supports its use in this clinical context. This is due to the high efficacy of modern NFP, especially when intercourse only occurs postovulation, and because NFP has none of the side effects or morbidity of artificial methods of contraception and hysterectomy.”

Read the entire article in The Linacre Quarterly journal