Greatest Lovers

Something I’ve been meaning to comment on for the last week: when I was driving home from Illinois on February 14th, there was a wonderful Valentines Day-themed commentary on NPR’s All Things Considered by a woman named Pat Dunnigan. Her (hilarious) argument is that suburban dads are actually the world’s greatest lovers, because of the various situations in which they must overcome all odds in order to have time alone with their wives:

You think it’s hard to get the attention of a woman in a bar? Puh-leeze. These guys have to convince a woman who has fallen asleep in her clothes reading Thomas the Tank Engine stories that what she really wants right now is some midnight romance under the giant pile of laundry covering the master bed.

You can follow that link to read or listen to the whole thing; it’s quite funny, and filled with examples that a lot of us have probably experienced.

But as the hundreds of miles continued to roll past, on my drive back to Michigan, I couldn’t help thinking about who might qualify as the real “greatest lovers:” moms and dads who must use Natural Family Planning. How about this for a situation that many of us have likely found ourselves in:

You’ve been charting and waiting patiently for three weeks, and you’re at last in the final countdown to the end of fertility for this cycle. Day 21 arrives, and despite your best efforts to run the kids’ wheels off…the youngest insists that “I’m not tie-ohd!” Dad makes sure the older ones fall asleep, while Mom works on reading Thomas the Tank Engine to the youngest. Dad checks back in a bit; It’s 10pm and Mom is getting bleary-eyed, but the five year old is excited and wanting to play. Mom keeps reading, and Dad goes downstairs and loads the dishwasher. Dad then very quietly makes his way up the stairs at 10:30, but the five year old is still going strong. Mom is barely hanging on. Dad, looking for something to keep him busy, folds that mountain of laundry on the master bed.

Finally, at 11:30, Dad finds the five year old asleep — but, yes, Mom is also asleep (and fully clothed). Mom’s eyes flutter open as Dad enters the kid’s room, and she mutters something about how hard she tried to outlast the five year old, and how bone-tired exhausted she is, and that she knows how much Dad has been anticipating this long-awaited day.

Dad can now do one of two things: (1) Try to convince Mom that what she really wants, right now, is some midnight romance with him back in the master bedroom…which will get Mom wide awake and guarantee she’s not going back to sleep until 3am; OR (2) force a smile, give Mom a kiss, and tell her she should get some rest.

I don’t need to tell you which option the “greatest lover” will choose. Or, after he chooses it, how much better a frame of mind, or how much more crazily in love Mom will be with him, on Day 22.

Ingesting Unnatural Stuff

When your kids are allergic to nearly everything on the supermarket shelves, it really does change the way you think about the myriad things we put into our bodies. My diet still isn’t as “natural” as it ought to be (I confess to grabbing McDonald’s hamburgers and Fritos corn chips in a pinch), but since switching to raw milk at breakfast, and lunches of nutrient-dense soups made from our own livestock, my health has improved markedly. I hate to think of all that McDonald’s food I put away as a teenager; I loved the stuff, but can’t help thinking about how it impacted my growing and developing body. I guess I’m just glad that our kids have been enjoying such an incredibly wholesome diet from their earliest ages.

Confirming my suspicions about disparate impact of various things on younger people, last night NPR had an excellent story about the ways in which steroids are particularly damaging to teenagers. As Dr. Michael Miletic explains, compared to a thirty year old professional athlete taking steroids, for teenagers “[T]here is a significant difference, because of the continuing development both physically, developmentally, emotionally, and neurologically in adolescents. Things are still rapidly changing within an adolescent’s brain and body; therefore when you introduce something to that body which is changing in such a rapid way, you’re going to have unpredictable effects on all those systems.”

My first thought: why do schools crack down so hard on student athletes who use performance-enhancing drugs…but remain silent about — and in some cases actually encourage — adolescent girls who employ hormone-based contraceptive pills and patches? I’m not a physician, but it seems logical that nearly everything Dr. Miletic says above can be applied as readily to contraceptive pills as to anabolic steroids. It’s one thing for a thirty-year old woman to take these things; it’s quite another for a fifteen year old girl, whose system is still maturing, to be manipulating her body with synthetic hormones. And if you read the medical literature closely enough, you will find plenty of examples of the side effects that hormone-based contraception can cause. As one physician told me:

We had one girl who had a condition called pseudotumor cerebri. This can arise as a consequence of using OCPs [Oral Contraceptive Pills] to treat painful or irregular menstruation in adolescent and teenaged girls. It’s not a cancerous tumor but they are these little masses that lead to very difficult to manage headaches. Also I remember a 22 year old girl we had who had a stroke. She was a smoker and even though she hadn’t used OCPs in 2 years, the only conclusion they could come to was small clots caused by the years of hormone use.

I find it particularly interesting that when it comes to steroid use by high school athletes, no one is saying “Well, the kids are going to do it anyway. We should let them take the steroids, but under a doctor’s supervision, so they can do it as safely as possible.” No, rather than even tacitly condoning unhealthy behavior, we assume that the kids will respond rationally to the mix of incentives and penalties placed before them. Why, then, do we assume these same kids are such uncontrollable little animals that it’s acceptable to manipulate their still-developing endocrine systems with synthetic hormones…as long as it’s in the name of “safe sex”?

I’m all for zero tolerance toward anabolic steroid use; kids engaging in this kind of dangerous and self-destructive behavior ought to be punished as severely as possible. But in our rush to clean up student athletes, let’s not overlook the significantly more widespread other uses and abuses of synthetic hormones being undertaken by high school kids with still-developing bodies.

Too difficult?

A few weeks back, I blogged about a scientific study which had confirmed the effectiveness of Natural Family Planning.

Now, a piece in Scientific American criticizes that study, saying it is hopelessly unrealistic for couples to abstain for the time during which a woman is fertile each cycle.

Hilda Hutcherson, an ob-gyn and co-director of the New York Center for Women’s Sexual Health at New York-Presbyterian Hospital/Columbia University Medical Center, found that her patients often stop using periodic abstinence methods after only a few months. “It’s difficult to abstain from sex for two out of four weeks,” she says. “That means half the month you can’t have sex. That’s very difficult for young couples.”

I suspect that some NFP-backers will respond by arguing that the average couple has to abstain for less than two weeks each cycle, or that the average couple using NFP has relations as many times per month as other American married couples do. But while these statistics are accurate, I believe that citing them is counterproductive in making the case for NFP.

First off, there are couples using NFP who, due to irregular cycles and extremely serious reasons for avoiding pregnancy, must abstain for significantly more than two weeks. The more times such couples hear the mantras about how easy NFP is, the more likely it is that they will grow discouraged or wonder why they’ve been cursed with so few opportunities to be together. Some might even conclude that all the talk about “less than two weeks” and “just as many times per month as other couples” is simply an elaborate bait-and-switch, and abandon NFP. Perhaps that’s why some of Dr. Hutcherson’s patients stopped using it. (Or, perhaps some of them simply decided it was now time to get pregnant…but that’s an issue for another day.)

But more importantly, to respond in such a way is to accept the critics’ premise—and their framing of the issue as a question of “functionality.” Under this frame, NFP is unacceptable and should not be promoted because the measurable output (avoiding pregnancy during a given cycle) requires far more of an input (abstaining for two weeks) than anyone but the most religiously zealous (who are no doubt putting up with the abstinence only because they fear burning in hell) should be expected to provide.

Instead, I think those in the NFP movement can learn a lesson in argumentation from those who farm with draft animals. Plowing, planting, and harvesting crops with horses is a much slower and labor intensive process than using tractors and combines. The measurable outputs (bushels per acre) per unit of time and effort invested are significantly poorer than what can be achieved with mechanization. And many who use draft horses (particularly the Amish) are motivated by religious concerns. However, there still remain a number of draft horse enthusiasts who are not motivated by religion, and who still use these animals in the fields. One of the leaders in this movement is Mr. Lynn R. Miller, author of several books and editor/publisher of The Small Farmer’s Journal, which is dedicated to promoting farming with draft animals.

Miller never argues that this method of farming is easy, or that it isn’t much more difficult than conventional methods of production. As he says on his website:

It is an evasive and subtle craft but it can be learned. In order to succeed you must seek out good help during the learning process. For the small diversified farm or ranch, horsepower is not just an option, it is a tremendous plus for self-sufficiency.

And:

Can I make a decent living with a small farm? Yes. And the good news is that it ain’t easy. You have to work hard and use your imagination and creativity. That’s the fun and rewarding part. The hard part will be making the decision, the commitment, and taking the plunge.

In other words, it sounds a lot like Natural Family Planning! Sure, some may initially approach it because of religious motivations. And it does take an investment of time to learn the method and understand it. But, the longer we use this method, the more rewarding we find it.

And why is that true, even when (and perhaps especially when) the periods of abstinence are long? It’s because NFP practitioners approach the marital relationship holistically, much like the teamster approaches his small farm. A farmer who is only in it for the bushels per acre is a sad and one-dimensional farmer; the farmer who works with his horses through the natural cycles of production and rest can find great satisfaction in that process. The same can be said for spouses: it is sad when unity is only measured by the physical dimension. In fact, for a healthy marriage, many dimensions of unity must be cultivated; artificial contraception allows spouses to ignore these and cut to the physical whenever they like. NFP, precisely because it has the admittedly-difficult periods of abstinence, leads spouses to cultivate all the other dimensions of their relationship and fit them together in their proper places.

I think this line of argument is the most effective response to pieces like the one in Scientific American. NFP is much more than a method of avoiding pregnancy, and we must challenge those who seek to reduce it to such. In terms of ease and maximizing opportunities for physical relations, NFP loses to the Pill as readily as draft horses lose to tractors — regardless of whether the period of abstinence is seven days or fourteen or twenty-one. Rather, we need to step back and re-frame the issue as one of maximizing total marital health and happiness at times when avoiding pregnancy is necessary. In that comparison, NFP wins going away.

But Does It Work?

That’s one of the questions I’m most frequently asked about Natural Family Planning (NFP).

Now, a scientific journal has published a major study agreeing that the answer is YES.

Researchers have found that a method of natural family planning that uses two indicators to identify the fertile phase in a woman’s menstrual cycle is as effective as the contraceptive pill for avoiding unplanned pregnancies if used correctly, according to a report published online in Europe’s leading reproductive medicine journal Human Reproduction today (21 February).

The symptothermal method (STM) is a form of natural family planning (NFP) that enables couples to identify accurately the time of the woman’s fertile phase by measuring her temperature and observing cervical secretions. In the largest, prospective study of STM, the researchers found that if the couples then either abstained from sex or used a barrier method during the fertile period, the rate of unplanned pregnancies per year was 0.4% and 0.6% respectively. Out of all the 900 women who took part in the study, including those who had unprotected sex during their fertile period, 1.8 per 100 became unintentionally pregnant.

This shouldn’t come as a surprise for those who have used NFP faithfully; in our own experience, the method is extremely reliable for identifying fertile and infertile periods of a woman’s cycle — even when the cycles themselves are irregular or disrupted. In years of using NFP, we’ve never had a “method surprise” pregnancy (the .4% referred to in the study), and we know of only one couple which has. As the full study details, the key to achieving this level of effectiveness is following all the rules and not cutting corners around the edges of the fertile times. But even for those who do not have the most serious reasons for avoiding pregnancy, and can therefore cut some of those corners, the study confirms that the pregnancy rate is still quite low.

But when people ask if NFP “works,” I think they’re wondering about more than the pregnancy rate. There are usually other, unspoken, concerns embedded in that question. Chief among these is often “What impact will it have on our marriage if we can’t have sex any time we want to?” That’s a real concern, because particularly for those with the most serious health reasons for postponing pregnancy, NFP can mean long stretches of abstaining. For most couples, the average seems to be between seven and fourteen days; at the extreme, for a small number of couples, it can stretch to 21 days or more.

Can that be difficult? Absolutely. Can it sometimes put a strain on a relationship? Sure. But I keep coming back to the rhetorical question that a childbirth instructor asked us many years ago, in a different context: “Should life’s most significant events be free from pain?” For many of us, we don’t really learn what we’re made of and how much love we have until we voluntarily embrace some kind of sacrifice for our beloved. And when that sacrifice is a shared one, that both spouses cheerfully embrace out of love for each other, and experience together, it can help elevate a husband and wife’s relationship to a much higher level.

The key is that the husband and wife have to decide, together, that the other’s fertility is not a disease to be medicated away or “barriered” away, but rather a gift and a healthy, integral, organic part of the whole person. Husband and wife must tell each other, I love and want to be united with all of you, the way you are, not just a portion of you. And I want to give you all of myself, the way I am, not just a portion of myself. And if this isn’t the right time for a pregnancy, we can wait. I can wait for you.

And then a funny thing happens. While the two of you are waiting, together, you rediscover and renew your relationship. You spend time together in other ways. You talk, every month, about why the two of you are doing this and whether this might be the time to add another person to the community of love which is your family. That’s when your relationship begins to reach a depth and level of maturity you couldn’t have imagined before. And that’s when you can’t imagine ever going back.