NFP Awareness Week: Common Misperceptions

Here’s the thing. I’m having trouble figuring out where to begin with this because on the one hand I came to NFP because I’m Catholic but on the other hand it’s something I feel so incredibly passionate about above and beyond the calling of my faith, and that’s what I want to communicate. So let’s skip the conversation about the morality of hormonal birth control and talk about why NFP (and the women [and men!] who use it) deserves consideration and respect. So maybe let’s start with some misconceptions? Yeah. Let’s start there.

1. NFP doesn’t work.
There’s a statistic that’s been quoted to me that non-hormonal contraceptive methods are less than 75% effective (worse than condoms!). My understanding is that there are several reasons for this:

  • Many studies on the subject don’t provide responders with the opportunity to specify that they use NFP; instead, they’re just given an “other” option.
  • In that vein, the “other” option often includes those who do nothing to either prevent or encourage pregnancy, a state of affairs that generally leads to yup you guessed it pregnancy.
  • Also in that vein, there’s no room for distinction between the various NFP methods OR between NFP and the “rhythm” method (more on that in a moment).

Obvious anti-non-hormonal-contraceptive-methods bias aside, if you go to any of the NFP methods you’ll see that they’re all 99% effective, just like hormonal birth control (and way better than condoms). And beyond statistics, I can offer you hundreds of examples of women (and men!) who have used NFP with that 99% effectiveness not just on a monthly basis, but on a yearly or even decadely basis.

“Oh sure,” people will say airily, “but that’s perfect use, and nobody could possibly use an NFP method perfectly.”

Well, all of those 99% effective statistics rely on perfect use. If you forget to take a pill you lose that 99% effectiveness just as surely as if you decide to have sex when you are clearly ovulating out the wazoo. Furthermore, you’re insulting the intelligence and self-control of a whole heck of a lot of people with that statement, which leads me to…

2. But it’s just the rhythm method and everyone’s mother/aunt/grandmother knows that doesn’t work.
This in particular infuriates me because it’s literally as anti-science as being against evolution or climate change. (I said it!) Equating modern methods of NFP with some vague notion that every woman has a 28-day cycle and ovulates on day 14 is. Just. Wrong.

Not only are you ignoring/denying decades of research, studies, and scientific publications on the subject, you’re (again) insulting the intelligence of all the women (and men!) who’ve evaluated the science and rely on it in their daily lives. You’re also insulting your own intelligence, as you could have discovered your error with just a bit of Googling but have instead chosen to buy into a sort of lazy marketing that wants you to think only crazy fundies would be dumb enough to buy into this line of thinking. Speaking of…

3. Only crazy fundies (because let’s be real how many Catholics actually follow this) bother with this nonsense.
Au contraire! Any woman who has ever been instructed to learn her mucus patterns in order to achieve pregnancy has, in fact, used NFP. (That, by the way, is really all NFP is: learning to read a woman’s fertility signs, and then acting with that knowledge in hand.)

Other people who bother with this nonsense include people who are anti-artificial hormones, people who are allergic to latex, people at risk for heart problems and blood clots, and people who don’t like the way the various Pills make them feel. There are also lots of Catholics (far more than that totally-not-biased-at-all Guttmacher study [and subsequent media reporting on it] would have you believe) and non-crazy people of faith using NFP. There are doctors and teachers and mothers and lawyers and accountants and housekeepers, health nuts and theology geeks; there are recent high school graduates and tenured professors. There are women, obviously, but the majority of them are joined by their partners, men who are willing to work with them and keep the communication lines open about where they’re at–not just physically, but emotionally too.

4. But seriously, people can’t actually abstain/understand their bodies/look it sounds nice and all but it’s impossible to live it out.
I don’t think there’s much of a response to this one other than “well, I and a lot of other people are going to tell you it is possible.” And don’t forget that plenty of people use FAM, which DOES allow for sex during fertile times so long as you use a barrier. (So instead of having sex with a condom ALL THE TIME, you only have to use it a few days out of the month.) So if you are one of those people/couples who has to have sex EVERY SINGLE DAY, there’s still options for you. (Also, props to you?)

5. Sure, you can try NFP, but you’ll only end up with an enormous family.
This is that moment of OKAY, TO BE FAIR, couples who practice NFP tend to have more than two kids. Tend to have, not necessarily do have. As I am learning day by day, a whole heck of a lot has to go right for a woman to get pregnant. Some women are better at getting that whole heck of a lot together than others. But in any case, there are plenty of NFP users who only have two or three children, or who have large gaps between kids, by choice.

But, as previously mentioned, NFP isn’t the same as “no method of family planning.” People using NFP CAN and DO make intelligent, informed decisions about when to get pregnant–but it’s a conversation they’re having every month, not one they can put off indefinitely. Everyone I’ve talked to will tell you that NFP makes you look really hard at the pros and cons of having kids and that a lot of the time it’s hard to escape the paradigm shift that comes with that. But I’ll tell you, the majority of NFP users with huge families knew exactly what they were doing to get there–and that they’re okay with that.

It’s a choice. And NFP users are very familiar with making choices.

6. But the Pill[s] is the only way to treat bad periods/cramps/endometriosis/poly-cystic ovarian syndrome/etc. etc. etc.
This is a delicate subject. On the one hand, women are suffering in a way that only men who have tried to pass a kidney stone can try to understand. The Pill[s] certainly can and does alleviate many of the symptoms listed above. My general understanding is that your average monophasic pill does this by tricking the body into thinking it’s pregnant so that it won’t ovulate (source of weight gain and mood swings, etc.) or (in the more shall we say sophisticated bi- or triphasic pills) by imposing its own cycle of hormones on top of what the body’s producing to try to mimic what a nice normal non-ovulatory cycle would look like (ignoring that there’s no such thing as a normal non-ovulatory cycle).

The problem with this is that the Pill was not designed to be medicine. The Pill was designed to suppress ovulation/thin the endometrium to prevent implantation if ovulation and fertilization happens anyway. A happy side effect of these designs is that (if you take it continuously) it gets rid of periods and thus cramps, it keeps ovarian cysts from bursting (because no ovulation), and it keeps endometrium from growing and thus maybe migrating beyond the uterus. Less happy side effects of these designs (especially of long-term use of these designs) include risks of damaging fertility, developing blood clots, and breast cancer. Other less happy side effects of these designs is that they only work for as long as you’re on the contraceptive.

Used in the short term, getting on and off the Pill may kickstart the body into better hormone production. For most, though, getting off the Pill (whether because you want to get pregnant or because you’re just fed up with feeling crappy) means a full-blown return of all the problems that existed before starting the Pill…because the Pill does not treat causes, only symptoms.

And this is where I start getting a bit hot under the collar again, because while other options DO exist, oftentimes you have to search out a doctor who knows and understands them, and then you have to find out if your insurance will cover them. NaPro technology, for example, stems from an NFP method and thus exists entirely to treat reproductive issues without the use of birth control. Remove the option, and suddenly actual treatments will arise. But it’s a lot easier to prescribe and take the Pill[s], and frankly, it’s a hell of a lot more profitable for the pharmaceutical industry if women stay on the Pill. They have the most to lose once you start throwing out things like “hey, have you tried taking magnesium for a few days to combat your PMS symptoms?”

And maybe it would be different if the Pill were offered as one among many treatment options, instead of the only option, if women didn’t have to fight and research and argue in order to learn about the other options, let alone getting insurance to pay for them. (All this focus on contraception coverage–which is now practically universal, let’s not forget–and not a word for the women poring over the laws and filling out claims for their Marquette test strips and their NFP classes, mostly on their own.) Maybe it would be different if women who decided to put in that kind of effort to avoid the Pill weren’t immediately dismissed as crazy fundies. Maybe it would be different if girls were taught about their cycles–all about them, not just “you get your period and then somewhere in there you ovulate and then your period comes again.” You know, actual comprehensive sex health education.

I mean, in some of these instances, taking the Pill to “treat” hormonal imbalances would be like me taking a cocktail of thyroid and adrenal hormones to treat my hypothyroidism. Sure, I’d be getting some amount of thyroid hormone–maybe even the amount I needed!–but I’d also be getting a lot of extra hormones that I may or may not need or even be able to process properly. I’d be popping a crap-shoot instead of focusing on a treatment designed to target my specific imbalances–and in the case of birth control, that crap-shoot is designed to disrupt even normally-functioning biological processes. And why do I need to disrupt those processes?

Probably subliminally to participate in systems designed by men who treat pregnancy as something that happens to “other people,” but now I’m heading into the realm of “why NFP is a feminist issue,” which will be Friday’s post. There we’ll also address the “NFP represses women” myth.

If you can think of any other major misconceptions I’ve missed, please leave me a comment and I’ll do my best to address it! Disagreements, discussions, etc. all welcome in the comments; please, just keep it civil! (She says, pretending she has an active comments section.) 🙂

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9 thoughts on “NFP Awareness Week: Common Misperceptions

  1. 7. Jo your list is only six points long why couldn’t you have made it a nice number like 5 or 10 don’t you know anything about clickbait headlines.
    I know, I know, and trust me, it’s driving me crazy (especially sitting here looking at number SEVEN ugh seven so prime so useless during factorization) (7 4 1 8 5 2 9 6 3 0 I mean look you have to check every time even though it’s never going to be in there) (okay, done with the math for now). I’M SO SORRY.

  2. Catharine

    As referenced in my comment on your previous post, my reproductive system has never quite worked right. When I was 18, I went six months without a cycle. My doctor told me I needed to go on the pill to protect my reproductive system, because going indefinitely without a period could damage my uterus. So, in a convoluted way, I went on the pill so I could get pregnant? Anyway, who knows? It was already wonky before that, so I can’t say being on the pill for a few years was the cause of my infertility. I quit taking it when I got engaged because we wanted to have children right away. What I can say, for sure, is that the way my body responded to the pill was absolutely nothing like the way it responded to actually being pregnant.

    I also don’t know why I keep rambling on your comments. I can’t do NFP, because I am still infertile. If I wanted another baby, I’d have to do more fertility treatments, so that kind of takes the N out of NFP. But I do believe that most people would do better to listen to their bodies, for reproductive and other reasons. Our society is much too quick to throw pharmaceuticals at everything these days.

    Mind you, I realize that some people need medication. You can pray for God to cure your diabetes, but keep taking your insulin until He does, right? I just feel that we, as a society, are overmedicated, and agree with you that a lot of times, non-pharmaceutical options aren’t even considered. I’m done now.

    • yeah, I remember you saying once that you were on acutane and that probably messed you up too? The period thing is weird because some of the current medical thought is that, ironically, if you’re on the pill it doesn’t matter if you take the placebos or just keep on taking the hormones because your uterine lining is so thin you’re not having a “true” period anyway. But that hasn’t really been tested as much sooooo good on your doctor for trying to get something going. On the other hand, the problem causing your no periods was your no ovulation, and birth control isn’t going to help with that at all, you know? I think THAT’S one of the big questions I’d like to see addressed more fully, rather than just being told “you need to get on the pill.”

      I think NaPro does its best to keep the N in NFP as much as possible, but they do fertility treatments too–not IVF, but they’re all about doing surgery to remove endo and putting you on Clomid to get you ovulating, etc. etc. etc. But they also advocate diet, exercise, vitamins–more normal things, you know?

      And again for me the thing about insulin is that it’s directly addressing the problem, namely, lack of insulin. Like, a friend of mine has PCOS, and she’s currently on Yasmin to help with the acne, and I was helping her research it, and the drug that helps with the acne is indicated for birth control and acne–but the acne is a side effect for the PCOS. Does the drug actually treat the PCOS? Do we have drugs that are solely intended to treat PCOS (which can be caused by several things we think but don’t know could we look into that more)? I get the feeling the answer is no, and I get the feeling it’s complicated but partially the pharmaceutical industry’s fault.

      But yeah, we can definitely agree that there need to be more options. :-/

      • Catharine

        Do keep in mind that I was 18 twenty-one years ago. I believe my doctor gave me the best advice he could. At the time. But in the 21 years since then, you would think they would have made more progress than they have. . . Also, accutane messes up a lot of things, but I have never seen anything linking it to infertility. Not saying it doesn’t mess with fertility, just that I haven’t seen the article(s). And I got on accutane when I was 24 or 25, so I had documented problems before that, anyhoo.

        But, back to the issue at hand: NFP awareness. I’m glad you’ve written such accessible blog posts about it, because I do not think the general public has any idea what NFP entails. Good job, and thank you.

  3. Thank you for laying this all out. I’ll defend my public school health class almost to the death (or at least to serious non-disabling injury), but it shaped my perception of NFP to the image in your first few points.

    I did have one friend who probably *could* have explained it to us all in greater detail, but she opted out of that unit.

    On the other hand, have you come across any women who’ve gone on the Pill to alleviate acne or cramps when nothing else would work? I’ve had it expressed to me that way, though don’t know exactly how much else had been tried, and have always thought those cases need to be considered.

    • BUT DID YOUR PUBLIC SCHOOL HEALTH CLASS TEACH YOU ABOUT CERVICAL MUCUS? (Honest question. I’ve never heard of one that does, but I also didn’t take one myself, so you know, PLEASE ENLIGHTEN ME.) :-b if it didn’t we can talk about conspiracy theories about why NFP is conflated with the rhythm method. But seriously, I feel a little ridiculous having to be like “look, we trusted it to work before my husband deployed, and we trusted it to work after he got back and I was not in a health place to have a baby, and it’s worked, guys, BECAUSE IT IS SCIENCE.” (It is also human self-control, but if you can’t control your sexual appetites to that extent you need to take a long hard look at the whys of your sex life.) (Also, if you’re not Catholic, masturbation is on the table, so really, it shouldn’t be that hard.) (But now we’re also getting into “lies the world has told us about how sex is supposed to work” which is a completely different topic.) (Whoops.)

      Ah. Can’t say I blame her. To be fair, I actually did get fairly comprehensive sex ed when I was nine during a Girl Scouts lock-in (it was the local hospital’s version of The Talk, moms were invited to come listen, there was a Q&A afterwards, and it was way better than anything I got in public school).

      Absolutely I have! And mostly I talked about my thoughts on that up in my response to Catharine’s comment–if your acne is that bad or your cramps are that bad, probably you have a hormonal imbalance or SOMETHING causing it–and the Pill is not. primarily. designed. to. treat. that. something. We can talk about the differeing levels of hormones in the various pills, but they all do the same thing, and if you HAVE something like PCOS (which the acne is often a symptom of) then being on the Pill is not going to help you out later on when you want to get pregnant/the Pill does not help you achieve actual natural normal hormonal balance. It goes back to my thyroid example? So to me the problem is less that you went on the Pill because your symptoms were terrible and awful (because I 100% support wanting to get treatment for that kind of thing, because it is AWFUL) and more that for some reason the Pill, which is NOT ACTUALLY DESIGNED TO TREAT THOSE THINGS but happens to in the course of doing what it was designed to do, is presented as the only way of treating those imbalances. But it’s a band-aid that only gets rid of the symptoms and we need to be demanding better treatment and more research and as long as everyone’s just taking the Pill it is…not going to happen.

      …whoops I got into conspiracy theories anyway. 🙂

      • To answer your first question right now, yes, as a matter of fact, it did–though not as part of NFP. The teacher explained that cervical mucus is a natural part of a woman’s cycle and helps the system clean itself out.

        Looking back, I’m surprised that this class was coed, but they stopped splitting us up after the original Talk in elementary school.

        • Yeah, that’s what I’ve seen in things like Teen Cosmo or whatever–“some discharge is natural, it’s just the vagina cleaning itself.” And some women do have near-constant vagina cleaning going on. But how hard is it to add “it’s also a sign of where you are in your cycle, and when you have lots of ooey mucus-y stuff it means you’re ovulating”? And furthermore, I’m not entirely convinced that the ooey-gooey is related to vagina-cleaning-out-at-all–it’s more of the sperm-friendly-pH-so-that-sperm-can-travel-in-a-nice-wet-environment-up-to-the-uterus thing.

          But hey, your class was better than anything I ever got, so probably I should stop complaining. 😛

  4. Pingback: NFP Awareness Week: Why It Matters | precisely what exists

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