I want to tell you story. In some ways, the story is not new. We've all heard it dozens of times—the story about a family living in abject poverty, a family so poor that they can't feed the children they have yet they keep having more. In other ways, this story I'm about to tell is new. It's new because of the story's ending. In India there are many such families, but some women provided a unique solution. Rather than trying to secure funds for condoms, hormonal contraception, clinics, and medical personnel to run the clinics, the Missionaries of Charity (the religious order founded by Mother Teresa) simply taught the people Natural Family Planning. For those unfamiliar with Natural Family Planning, it is a means by which a woman observes the naturally occurring signs in her body to know when she is fertile and when she is not. If a couple wishes to avoid pregnancy, they abstain from sex during the week she is fertile. If they wish to achieve pregnancy, they take advantage of her fertile time.
The familiar adage says, "Give a man a fish, feed him for a day. Teach a man to fish, feed him for a lifetime." Rather than a solution that requires that the poor have continued access to medical clinics and health care personnel, and the continued source of funding that would be required to ship and distribute condoms and other devices, the sisters simply empowered poor Hindus, Christians, and Muslims with the knowledge of how their bodies work, a knowledge that would serve them their whole reproductive lives.
Mercedes Wilson, founder of Family of the Americas Foundation, writes this about how she first learned a natural method of family planning:
I first learned about the natural signs of fertility in 1968 while living in Melbourne, Australia. Having read an article in the local paper about a new natural method of family planning, I visited the center where the Ovulation Method was being taught. To my amazement, in less than half an hour I learned this simple and safe method that enables a woman to postpone pregnancy without endangering her physical and emotional health with chemical agents or dangerous devices.
We were taught the scientific fact that the only time the man's sperm can survive in the woman's body is when the natural signs of fertility are present. In fact, sperm survival is dependent on the presence of a particular type of cervical mucus obvious to a woman during her fertile phase, which is about 100 hours per cycle.1Since this meeting, Wilson has spent about 50 years teaching NFP to people (including the Missionaries of Charity) throughout the world.
In 1993, the British Medical Journal published a study regarding the effectiveness of NFP in India.2 It is from this study that comes some of our best source of NFP statistics. It is difficult to get statistics regarding the effectiveness of NFP for a couple of reasons. One is that, in the US, not a lot of people practice it, so it is hard to get enough participants in order to have a representative sample. Secondly, it is difficult to get statistics derived solely from people who truly used the NFP method, which relies on abstinence during the fertile period if the couple wishes to postpone pregnancy. Some methods of fertility awareness allow a couple to use a condom or other barrier device during the fertile phase. The problem with this is that the condom has a typical-use effectiveness rate of 85%. Therefore, statistics from people who relied on condom use during the fertile phase will show that such Fertility Awareness methods have an 80-85% effectiveness rate. In India however, where the poor learned NFP and relied on abstinence during the fertile phase, a study of 19,483 poor women had a pregnancy rate of less than 1%.
The benefits they received went beyond the ability to plan their family size, however. Mercedes Wilson tells of how women in India would be dragged away and forcibly sterilized against their will. Women could be spared this violation, however, by carrying a card with them that stated they used NFP. In this instance, not only were the poor empowered with the knowledge of their own bodies, its use also protected them against government abuse.3
NFP has also had great success in China. The effectiveness rate in couples using NFP to avoid pregnancy has remained at about 99%. In this country where the one-child policy is strictly enforced, use of NFP has also lowered the abortion rate in some communities. In a study comparing two similar communities, one in which NFP is widely practiced, and one in which the IUD is widely used, the IUD community had seven times the abortion rate as the NFP community (though they had been statistically similar prior to the introduction of NFP).4 Furthermore, the simple use of the Billing's Ovulation Method allowed 14,524 out of 45,280 (32.1%) previously infertile couples achieve a pregnancy.
Though many people maintain that the poor of the world need sustained Western intervention and complicated, expensive, (and sometimes abusive and ethnocentric) population control programs, the success of Natural Family Planning shows that simple knowledge of the fertility cycle is all that is needed. Once people have this knowledge, they can then be autonomous in deciding if and when to expand their families.
1. Mercedes Arzu Wilson, "Love and Fertility." (Family of the Americas: Dunkirk, MD, 2006) Preface, v.
2. R.E.J. Ryder, "'Natural Family Planning': Effective Birth Control Supported by the Catholic Church," British Medical Journal. 307 (18 September 1993).
3. Mercedes Arzu Wilson, (lecture, Master Teacher Institute for the Ovulation Method, St Norbert College, De Pere, WI, 22-25 Sept 2011).
4. Shao-Zhen Qian, "China Successfully Launching Billings Ovulation Method" World Organisation Ovulation Method Billings. 2002. http://www.woomb.org/bom/trials/chinaLaunching.html