Wednesday, April 15, 2015

NFP and Me

I have lamented publicly and privately about the lack of conversation regarding NFP (Natural Family Planning, sometimes called Fertility Awareness Method (FAM)).  So, I thought - why not write about it on ye ole' blog?

I've been Catholic less than one decade, and I've been married less than one year.  In all this time as a Catholic, I knew one couple who practiced NFP, and I thought they were crazy at the time.  Everyone else I knew was either sexually active outside of marriage and/or contracepting.  That one family with 8-10 kids in the parish was also crazy in my book, and no other Catholics seemed to take the Church's teaching seriously, including me.  I used the fact that most Catholics I knew didn't follow the Church teaching on sexuality to be a sort of implicit approval of my behavior.  They weren't following it, why did I have to?  Catholics don't really believe that stuff, right?  I could be a good Catholic, believe in trans-substantiation, pray to Mary and the Saints, but still do what I wanted to with my own body, right?  I didn't want to be a prude, one of the annoying religious types.  I saw nothing wrong with gay relationships.  I was indoctrinated on the Sex and the City lifestyle.  My friends and I all watched the show regularly and compared it to our own lives.  I was "enlightened," so I thought, but honestly, I wasn't happy.  I wasn't free.  I was lonely, and I didn't feel as liberated as I was supposed to.  I had a few pregnancy scares, which led me to take the "morning after pill," so, essentially I may have had medical abortions.  How's that for freedom?  Broke all 10 commandments, but great is God's mercy.    

Finally, by the grace of God, I repented and came to my senses.  While I wasn't as promiscuous as I could have been (I was in a few long-term relationships in succession), I threw out the birth control and condoms.  I stopped committing mortal sin.  I had a conversion of heart, or re-conversion.  I realized that, although it was difficult, it was possible to accept the Church's claims on what is right and wrong in this area.  God gives us the grace to do it.  By the same token, for the first time in my life, I remember thinking that it was therefore also possible that the Church could be right on what it asks of my gay friends - abstinence.  I had the wonderful experience of hearing Christopher West speak live at some point about a year after my re-conversion.  It only convinced me further that I was on the right path.  I learned a little bit about Theology of the Body, and with that, I found the intellectual tradition and natural law/philosophical arguments that made so much sense.  It wasn't a matter of Bible verse debates, but a matter of the whole - the whole person, the whole society, the whole intellectual and anthropological tradition.  (Hmm....Catholic comes from the Greek: Kata and Holos - concerning the whole...)  These arguments made much more sense to me than the Sex and the City liberation I was fed in college.  I also went to confession again and again, each time I messed up, each time I remembered something else to confess.  It was not only healing, but it gave me the grace I needed to live this life.  Truly.  

So, fast forward, and here I am, an actual practicing Catholic who not only believes everything the Church teaches, but who is trying to practice it, even in the area of sexuality and Natural Family Planning.  And there is NO ONE I know in the same position.  I live in quite a large metropolis, so I'm sure there are some couples out there who do practice NFP or believe the Church's teachings on sexuality, do you strike up that conversation?  We need couple friends, and I've been praying about it.  But for now, I just read tons of Catholic blogs.  (We have Catholic friends who are not married or who are older, married one in the throes of NFP or family building right now.)

So, that's the short version of my conversion story as it applied to Theology of the Body and sexuality.  (Read a summary of my conversion stories here in Parts I, II, III, and IV.)

As for NFP, we were taught the Sympto-Thermal Method in marriage preparation.  I'm pretty sure that the Catholic church defaults to teaching this method most of the time because it is the least expensive.  I will also say that in our course of about 20 couples, I was the only person who took notes in the class.  Either all these people were experts in female reproductive knowledge, or they totally were only there because they had to be in order to be married in the Church (or so it seemed). Now, it's also entirely possible that I was simply the most vastly ignorant person about my own body in the class.  My parents really didn't explain much to me when I was growing up, except that sex outside marriage was wrong.  I had older sisters, so I did know about "the curse," but I never knew you could also read signs of ovulation.

Here is a crash course in what we learned, in case someone has stumbled upon my blog without knowing what I'm talking about and needs to know how amazing the female reproductive system is.

The Sympto-Thermal Method of NFP or FAM looks at symptoms and temperatures to determine fertility. Symptoms mostly include the presence and type of cervical mucus - stretchy mucus (similar to egg whites) indicates that ovulation is coming or near; clumpy mucus (similar to toothpaste) indicates that ovulation has passed.  If one so desires to check, the position of the cervix is another symptom.  A S.H.O.W. cervix (Soft, High, Open, and Wet) indicates ovulation is near.  The temperature readings are done with a basal body thermometer.  It's important that the temperature is taken at the same exact time each day upon first waking up, without even getting out of bed or elevating your heart rate with motion or activity.  This will show that after ovulation, your temperature raises at least 0.4 degrees and stays there.  You're looking for "3 over 6" - 3 days of high temperatures (at least 0.4 degrees higher) over 6 days of lower temperatures.  When your temperature shifts upward, you can bet that ovulation occurred, if it stays there.  Your temperature will then dip the day your next cycle begins, and you start all over reading the signs (or symptoms) and looking for 3 over 6 in your temperatures.

NFP uses the Sympto-Thermal method to teach you that you are "reliably infertile" on the day after 3 days of high temperatures.  (Basically this means the evening of the 4th day after the temperature shift).  Before ovulation occurs, it really depends on the person when you're fertile or infertile.  The egg can be fertilized up to 5 days before it's released, but not after.  You wait 3 days to confirm ovulation (the temperature will stay high).  Also, you wait 3 days because there is a slim chance you release more than one egg, and if you do, it'll always be released within 24 hours of the other egg. So, you're fertile the day you ovulate and the 5 days before.  The problem is that you don't usually know you ovulated until after the fact - you've got the symptoms, which tell you what is coming, but the temperature doesn't confirm ovulation until after it has happened.  For those who ovulate later in the cycle, you'd have some reliably infertile days early on.  For those who ovulate early in the cycle, you'd have few, if any, infertile days early in the cycle.  Menstruation may overlap or directly lead into the "fertility window" (day of ovulation and the 5 days before).  You are also reliably infertile during early days of menstruation, but it also depends on the person - if you ovulate on day 10, menstruation and the fertility window will overlap.  Plus, some people don't like to mix menstruation and the intimate marital act.  It's a matter of comfort and choice between you and your husband.

So, I learned so much doing the Sympto-Thermal method.  After trying to do it for several months, I realized that you can observe signs of fertility that I had never really understood or paid much attention to.  The body is really amazing.  However, ST method didn't work too well for us because my temperatures were off the charts low.  Like, the charts we were given to track my cycle didn't even go low enough to catch my waking temperature (which was usually 94 something).  Because of this, I started taking tons of multi-vitamins to raise my temperature, which did help.  However, I also had a hard time figuring out the 3 over 6 rule.  I take allergy medicine every single day, which dries up mucus of all kinds in my body, so the fertility signs were harder for me to read.  Since so much is at stake with NFP, I opted to look at other methods to see if something might be easier for me to discern.

Enter, the Marquette Method.  After learning and trying the Sympto-Thermal method for a few months, I read online and taught myself the Marquette Method of NFP, which utilizes the Clearblue Fertility Monitor (CFM).  This method is more expensive up front - the monitor is about $150.  It's also more expensive as an ongoing cost - you have to purchase the test sticks every few months ($30-$50 for a box of 30).  So, you set the CFM to day 1 on on the first day of your cycle.  You turn it on every day, to check in.  Eventually, around day 6-10, it will ask you to use one of the urine test sticks for about 10 days per month.  You pee on a stick (or pee in a cup and put the stick in the cup for 15 seconds).  Then, you put the stick in the CFM, which is testing for an increase in estrogen and lutenizing hormone to see if ovulation is coming.  You'll get readings of either low, high, or peak to indicate your fertility level.  Once the CFM finds a peak reading, you can stop taking tests because it will automatically say you're still at a peak level the next day.  At the beginning of your next cycle, you set the CFM back to day 1 and begin it all again.  It starts to learn your body and ask for a urine test about 6 days before the average first day of your peak.  It takes 6 months (or 6 cycles) to get an average.  

For NFP purposes, the same rules apply after ovulation - basically wait 3 days if you're trying to avoid pregnancy.  Instead of 3 days of high temperatures, it's 3 days after the CFM finds a peak day.  You're reliably infertile on the evening of the 4th day after the first peak reading.

I found with the CFM that sometimes I would jump from a low reading to a peak reading, with no high reading in between.  One month, I didn't get any peak reading whatsoever.  I don't know if the sticks were faulty, or if it just missed it.  (I was not pregnant, and I do believe I ovulated.)  The Marquette Method was and has been good for me because I don't have to worry about random temperatures.  It is nice to trust the science of a urine test, even though it has been wonky or wrong a few times.  However, knowing what I do from the Sympto-Thermal method, I can cross-check/verify the CFM.  Usually I can sense that peak is coming based on cervical mucus observations or temperature observations, even casually.  In the future, I think I will start taking my temperatures in conjunction with the CFM urine tests, just to confirm a 3 over 6 shift if the monitor doesn't pick up a peak day.

I am considering making another big purchase and switching from the Clearblue Fertility Monitor to the OvaCue fertility monitor.  It would be expensive, but there wouldn't be the costs of urine test sticks every few months.  Also, we aren't trying to conceive just yet, but I wonder if the CFM is reliable post-partum or during breast-feeding, so I'm already thinking of something that might be more versatile in that respect.

Concluding thoughts:

1)  Umm, why didn't we learn this stuff in the 7th grade when we learned everything else?  I'm serious! Why are we only teaching girls about "that time of the month" without teaching them what happens in between?! - ovulation is extremely significant, and it can be tracked!!  The more I learned about NFP and Theology of the Body, the more angry I am at the contraception industry and culture - it just medicates away a natural process of our bodies and leaves people dependent on pharmaceuticals and ignorance.  I really never thought I'd be one of "those" people, but it is the only thing that makes sense to me.  It's so cool to me that I learned all of this in my beloved Catholic Church.  I just wish it hadn't taken me so long to come around.

2)  There are two good books out there if you want to dig a little deeper into FAM or nutritional helps.  (I am not paid to endorse either of these, this is simply my opinion.)  They are Taking Charge of Your Fertility by Toni Weschler and Fertility, Cycles, and Nutrition by Marilyn M. Shannon.  TCOF is not written from a religious perspective at all.  It simply explains the body and how to track fertility signs and symptoms.  FCN is written from a Catholic perspective.  It's good for looking up any issues or problems you might have (like low body temperatures) and she gives nutritional advice on a natural way to heal the body.  (The book does not replace medical advice for deeper problems, but just general good health practices and natural approaches to typical problems with our diets and nutrition.)

3)  God knew what he was doing.  I have found that I am most attracted to my husband around the time of ovulation.  Go figure that our bodies are actually designed to come together, and that they give us signals to this effect constantly!

4)  NFP is difficult.  NFP is not a cure-all.  If you are experiencing infertility, NFP can help point that out sooner because you'll be in touch with your body.  If you are extremely fertile or have wonky signs, NFP can be frustrating.  It's also really frustrating to sleep next to someone you love and have promised your life to...if you're trying to avoid pregnancy.  No one wants to abstain from a good thing with the one you love, but sometimes there are reasons for that.  Having said that, NFP is worth it.  I don't want to ever go back to contracepting.  In particular, I had a bout of UTIs right after we first got married.  I don't know if NFP contributes to this - times of abstinence, followed by times of coming together might irritate the body in that way.  I can see how NFP could also be very difficult or frustrating when trying to read post-partum or pre-menopausal signs.  I suppose I will cross that bridge when I get there.  While difficult, NFP is a great way to discipline yourself, to remind yourself that God is the one in charge of your fertility, to respect that the marital embrace is oriented toward reproduction (duh - but that fact is trained out of us in this culture), and NFP helps you learn to fast in a new and different way.

5)  One more time, for good measure - for all the difficulty, NFP is worth it.  I know more about myself.  I am able to live out my Catholic beliefs.  I feel more respected as a woman than I ever did when contracepting.  I feel like we honor and respect the actual marital act itself - the fact that it creates life.  We are open to life, but just not planning on it quite yet.  We are learning to deny ourselves and subject ourselves to God's will in our sexuality.  It is empowering and beautiful.  

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