NFP is Fertility Awareness

“…Not to chart and pay attention to one’s fertility and the biological markers of one’s fertility and health, is to miss out on an enormous amount of very valuable information that cannot be re-conformed at a later time. Thus, for a couple to say ‘we will leave it in God’s hands,” they are saying in effect that they are not interested in becoming cooperators with God in these most important aspects of our lives.”

Excerpt from a Creighton Model Textbook*

Emily: One of the mischaracterizations of NFP is that it is synonymous with avoiding pregnancy in people’s minds, and in most minds, it’s an ineffective means. 

When I went through marriage prep, avoiding pregnancy was certainly foremost in my mind. My husband and I were in that crowd of “We want to wait a year before we start having kids,” and NFP was stressed as being on par with birth control for avoiding pregnancy as if to put our minds at ease. 

This mischaracterization was further highlighted in a conversation I had with a friend who was looking at starting a new method of fertility awareness. Her need to space her next pregnancy had become serious and she didn’t feel comfortable with the method she had used in the past to avoid pregnancy. When I suggested Marquette, she said she had used a fertility monitor to get pregnant, and thought it therefore wasn’t for avoiding pregnancy. 

So let’s just start this whole series off by setting the record straight.

Every method of NFP is nothing more than fertility awareness, and each method is designed to teach a woman how to identify her fertile window. It does not become family planning until the information gathered about a woman’s cycles is used to make decisions about a couple’s sex life. That’s it. Fertility awareness is for avoiding pregnancy, achieving pregnancy, and identifying underlying health issues. As both of you know and as we’ve talked about frequently, the wealth of information that we can gather through charting our cycles about our overall health is incredible, and science has just begun to scratch the surface of that. 

Mary: Emily, so well said! When I was growing up, NFP was always explained to me as “that thing Catholics do to avoid pregnancy. Also, Catholics have a lot of babies.” It was even strangely exciting for me to watch my older sister get engaged and then start her NFP classes like it was her official transition into becoming a Catholic woman. Ha! But what a disservice it was to me, and is to so many other women with underlying health issues, to limit NFP to merely avoiding pregnancy!

An OB/GYN, trained in NaPro Technology, looking over Creighton charts

Now I understand how intimately connected my fertility is to my overall health—not just physical, but mental, emotional, and even spiritual. One of my Creighton Practitioner textbooks** describes the method as “truly networking family planning and health” and I absolutely love that way of describing fertility awareness!

Knowledge of how God has designed my fertility as an equally important part of his whole design unlocks new meaning to my purpose and fulfillment as a woman. I am not just a woman with parts capable of producing new life within my body. That is an incredibly beautiful and fulfilling aspect of woman, but there is more to us than that. And having an awareness of how we are designed from a young age not only allows us to connect with our Creator in a new way, but prepares us for our future. 

With an improved and more accurate cultural understanding of what fertility awareness is, girls will be more likely to get the nutritional and medical help they need before they become women suffering with greater underlying health issues that have progressed. It won’t solve all of our problems, but it will at least help us to understand them and ourselves better, especially within the context of marriage and the combined fertility required to co-create new life with God.

Jen: It’s interesting that both of you were sold the “use NFP to avoid pregnancy” bit because I don’t remember that being the way I saw it…maybe because we wanted to have a baby right away? I actually remember thinking, “Well, we don’t really need NFP if we want to have all the babies.”

But since I knew I likely had reproductive issues, I figured it wouldn’t hurt to just take NFP classes like our priest recommended. And I thank God we did, because we needed the fertility awareness part more than we needed the family planning part. In fact, we likely wouldn’t have our oldest son had I not been “aware” of my fertility during that season we were desperately trying to conceive.

Mary: Jen, that pretty much proves the point that NFP has generally been poorly defined and lived out as an example for us.

Although it will look differently when practiced by each individual woman and/or family, it always carries those three incredible benefits. It’s empowering to use the intelligence God has given us combined with his intelligent design to navigate our health and fertility so boldly! When using either no method at all or birth control, it arguably leaves a couple with only one benefit.

Emily: I find it offensive and maybe somewhat hilarious that hormonal birth control (HBC) is even classified as a method of family planning because it only gives one option, which is to avoid a pregnancy as though babies are a disease. Even worse, HBC shuts down an entire system of your body just so that you do not have a child. Meanwhile, its side effects are horrific, and it does nothing more than cover up the issues it’s supposedly treating. 

Fertility awareness is not a competitor with birth control. It’s an entirely different, healthier option for women to not just plan their families but work with and understand their bodies. It doesn’t guarantee us the outcome that we want, but it helps us understand what is happening in our bodies. 

Mary: Your comments about birth control made me laugh out loud because it is so true. How does birth control even get away with describing itself as “family planning?” It is like a dog wearing a sign around its neck that says “I am a cat.” I’m not buying it! And I appreciate your recommendation to frame it more appropriately as fertility awareness because it is also more encompassing than “natural birth control” as it is so informative about our health.

Emily: Absolutely, Mary. In the conversations we’ve had, you’ve mentioned the fact that fertility awareness should be taught as soon as a girl hits puberty. You shared with me that girls who learn fertility awareness at that age actually develop such an ingrained appreciation for the beauty and the wonder of their bodies, that it actually lowers rates of premarital sex. It really highlights how fertility awareness ultimately teaches stewardship over one’s whole being. 

One of the pushbacks on teaching young girls fertility awareness is that their cycles are irregular and therefore impossible to chart. But the opposite is true. We know that the very fact that a woman’s cycle is irregular, especially at the beginning of puberty, makes her the perfect candidate to use charting and fertility awareness to help identify the underlying issues that may be causing irregular cycles and related symptoms. 

Mary: And along with the knowledge of fertility awareness comes the understanding that it could take up to 7-10 years for a girl’s cycle to become normal, removing the perceived necessity to “regulate” her cycles with HBC and unnecessarily pumping her with synthetic hormones. A little knowledge goes a long way!

Emily, I’m so glad you brought up that study about young girls learning fertility awareness! Dr. Hanna Klaus, an OB/GYN, conducted a study that showed a dramatic decrease of between 30-62% in sexual activity of teenage girls when using knowledge acquired from the Billings Ovulation Method! (Klaus, H., 1996. The Teen STAR Program.)! It may initially feel counterintuitive to think that teens won’t “take advantage” of being outside of their fertile window if they are aware of it. But NFP/fertility awareness actually places a healthy emphasis on the connection between sex and new life, which is the farthest thing from teenagers’ minds as they explore their sexuality. Knowledge of how her body works informs her that it all has a purpose and this understanding empowers her to make well-informed, intentional decisions. Pregnancy is not something that just happens to women—it is an incredible event that our bodies prepare for each cycle!

Mary speaking to high school girls about fertility awareness

Jen: I was definitely one of those high school girls who went to my first gynecological appointment with reproductive issues—I was actually 17 years old and still had not had a period—and what do you think I was given? Birth control. Even though I wasn’t using it as actual birth control (I was a virgin when I married), I knew after one year of being on the pill that there was no point in me being on it. I wasn’t having sex until I got married, and I knew I wanted to have kids, so why I would I keep taking it now? And that was before I knew all the harm birth control could do! Thankfully, I followed the prompting of the Holy Spirit to see a new doctor and request a different approach. I only wish NaPro Technology was more well known back then, because learning it then (as opposed to years into marriage) likely would have saved Logan and me a lot of heartache during those early years when dealing with pregnancy loss and infertility.

Emily: There’s just been a huge disservice done to women by telling them that the only option that they have to treat a plethora of fertility and hormonal diseases and issues is a birth control pill. We literally have one option when we go to the OB/GYN – shut down your reproductive system. What a disservice feminism has done by limiting our options to treat all manner of fertility issues, and then labeling us as backward thinkers if we don’t.

The fact is HBC has not really changed in formula in almost a hundred years. Meanwhile, fertility awareness has advanced leaps and bounds since the 1930s, starting as the rhythm method, to becoming all the modern methods of tracking our biomarkers today. It just makes feminism seem backwards and our OB/GYNs seem backwards that they’re not willing to explore these alternate and holistic health options for women.

Mary: Jen, how did I not know that you were on birth control for those reasons as a teenager? The birth control you were using, by its nature, was actually taking away valuable information from you by suppressing ovulation. Ovulation and its associated hormones are not only incredibly healthy for us, but give us great insight about how our body is functioning. If a teen is on birth control for “health reasons” and/or is unaware of the health benefits of charting, she is being deprived of rich information that can affect her both in the short and long term, as it has for both Jen and myself. 

I also want to add that I don’t recommend using a Fertility Awareness Based Method like Creighton as an alternative to birth control for “health reasons” lightly, even for women of any age who experience severe physical pain. Pain from endometriosis and adenomyosis has sent me to urgent care and the ER multiple times and I have never considered using birth control because basically, I know too much- what it does, and doesn’t do, to my body. 

Jen: We definitely need to emphasize the differences between fertility awareness and birth control, not only when it comes to physical and bodily health but also spiritual health. Using NFP is not “Catholic birth control.” And the people who suggest that NFP is no different than birth control may actually lead people to mortal sin. Because why would people take the trouble to chart and learn their body when they could just take a tiny pill that supposedly does the same thing? That’s such a dangerous notion.The beauty of NFP—or fertility awareness—is that the benefits are multifaceted. 

So many women are fed the lie that birth control is the only way to relieve their pain…but in fact, it’s just masking the symptoms and will likely prolong that pain in the long run. And the spiritual effects may even be worse. When we cut ourselves off from God (through mortal sin, if we are using birth control while sexually active during the fertile periods), we miss out on all the graces that come with living a life that is often full of crosses…which we will get into more later. 

Emily: Jen, what you touched on hit way close to home. 

If NFP is sold as being essentially the same as birth control but licit, when it clearly isn’t, the danger is people will figure out they were lied to and rebel. It nearly happened to me and my husband when we found out about our second surprise baby. I wasn’t going anywhere near HBC, but we definitely talked about using condoms for a while because what we were sold in marriage prep and what we were living were not the same.

When we finally realized that NFP is nothing more than fertility awareness, that babies can come or not and that we can identify our fertile window incorrectly, things made sense and we could accept it. While we didn’t plan our kids, I can go back to those charts and point to the day they were made.

Learning how our bodies work does not lead to a desire to control them. When you understand on an intimate level just how fearfully and wonderfully you are made, you develop not only an appreciation for how God made you, but also a deep desire to cooperate with his magnificent design, not act against it.

*Hilgers, Thomas W., Diane Daly, Susan K. Hilgers, and Ann M. Prebil. “The Sacramental Moment of Human Procreation.” Essay. In The Creighton Model Fertilitycare System: a Standardized Case Management Approach to Teaching, 2nd ed., 230–30. Omaha, Neb., Nebraska: Pope Paul VI Institute Press, 2002.

**Thomas W. Hilgers et al., “Ch. 26: Naprotechnology and the Creighton Model System,” in The Creighton Model Fertilitycare System: a Standardized Case Management Approach to Teaching, vol. 2 (Omaha, Nebraska: Pope Paul VI Institute Press, 2002), pp. 235-235.