The recent Supreme Court decision on the Responsible Parenthood and Reproductive Health Act of 2012 has charted a middle ground. On one hand, the Court ruled that the law was “not unconstitutional.” On the other hand, it struck down provisions that would have infringed on freedom of conscience. How then should the law be implemented, while respecting the freedom of choice of couples?
Catholic Church leaders in their anti-RH stand stressed the prolife and moral issue, while pro-RH advocates focused on the socioeconomic circumstances of poverty-stricken families, maternal health, and the lack of information on family planning methods. Nonetheless, the pros and antis share some common ground: that natural family planning (NFP), particularly if preferred by the majority of couples, should be included in the implementation of the RH Law.
In a survey of TV viewers regarding their choice of family planning methods a few days after the passage of the RH Law, seven of ten viewers chose NFP. Based on our own pastoral experience in the Archdiocese of Cagayan de Oro, with nearly 10,000 NFP couple-acceptors over the past seven years, many couples would prefer NFP—provided they are given adequate information on the modern NFP methods available today.
Some recommendations thus come to mind:
• The government should include NFP in its RH program. This will give couples a genuine freedom of choice. Equal time and resources should be allotted for NFP promotion as for contraceptives. At present, government workers are designated as FP providers—i.e., they simply provide pills, condoms, or other contraceptive services. Very little or no information on NFP is given, presumably because this requires more time and training.
• In any government orientation on family planning, the first topic should be fertility awareness. This entails an understanding of human sexuality and nature’s way of regulating births through the human body’s fertility cycle. After the module on fertility awareness, couples may then be able to decide whether to go natural or adopt contraceptives. Indeed, NFP methods are also called fertility-awareness-based methods. According to our family life workers, many women taking part in our NFP seminars are not even aware that they have a natural cycle of fertile and infertile periods.
• The government should provide information on all modern, scientifically-tested NFP methods, including the simplified ones. These include the earlier-known Basal Body Temperature, Billings Cervical Mucus, Sympto-thermal, and Lactational Amenorrhea methods. But the list should also include the recently-developed Standard Days Method (SDM) and Two-Day Method. From our pastoral experience, the simplified SDM has drawn the most number of users, and has accelerated the widespread adoption of NFP. These methods should not be mixed with “back-up contraceptives.” An all-NFP approach will enable couples to choose their method according to their circumstances.
• NFP promotion requires values formation. For NFP couples who wish to avoid pregnancy for the time being, abstinence during the fertile period has to be accompanied with the proper motivation—e.g., mutual respect, interpersonal communication, avoidance of health risks, religious teachings, etc. Especially-trained NFP workers are needed who can counsel couples along these lines. NFP, after all, is not merely a matter of methods but, more so, a way of life.
• In its concern for maternal health, the government should provide adequate information on the health risks of various kinds of contraceptives. Its RH program targets lower-income households, but it is precisely among these poorer sectors that a significant number of women suffer nutritional deficiency and are more susceptible to health risks arising from the indiscriminate use of contraceptive pills, IUDs, injections, etc. This is borne out by the testimony of participants in our NFP seminars. Many of them readily shifted to NFP because of their adverse experiences in the use of contraceptives—e.g., dizziness, infections, heart palpitations, etc. Should certain kinds of contraceptives require a doctor’s prescription or a warning label? Abortifacients as stated in the law should also be banned.
• The government can set up a separate track for NFP promotion and provide support for faith-based organizations in promoting the values and methods of NFP. The RH program should be sensitive to the religious and cultural traditions of Christian, Muslim, and indigenous communities. In addition to Catholic parishes in Cagayan de Oro, our pilot areas among Muslim, indigenous and Protestant communities have elicited a convergent appreciation for NFP methods. On the other hand, local government agencies have acknowledged an inadequate knowledge of NFP and have requested the services of our archdiocesan trainers for seminars, the use of our training manuals, and the provision of SDM vertical beads.
Along these lines, it is advisable for the government to carry out its family planning program on two parallel tracks—one for artificial contraceptives and the other for NFP promotion. The NFP program can have its own implementers, including faith-based organizations. Government funding in this regard can be allocated to Church organizations in the same way that the government extends indirect support to private schools through its Educational Service Contracting for students and parents.
Promoting NFP, which is propoor, prohealth, and prolife, can be a win-win approach for government agencies as they acknowledge the freedom of choice of couples as well as the grassroots reach of faith-based organizations.
Antonio J. Ledesma, SJ, is the archbishop of Cagayan de Oro.