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Considering Natural Family Planning? A doctor answers 6 big questions


Rob and Julia Campbell | Stocksy United

Grace Emily Stark - published on 02/23/18

NFP goes way beyond religion.

When people think about family planning, they most likely think about it as a deeply personal choice—which isn’t wrong. But there’s another way of looking at family planning, and particularly at Natural Family Planning (NFP): through the lens of social justice.

Dr. Brian J. Burke is a staff physician in family medicine at a hospital on Guam. Together with his wife, Johanna, Dr. Burke has been teaching NFP for eight years. We thought his view on how NFP goes hand in hand with promoting greater justice in healthcare were fascinating and worth sharing.

First off, what is Natural Family Planning?

Dr. Burke: Natural Family Planning is another name for fertility awareness-based methods of family planning. These methods monitor a woman’s external signs of fertility in response to the changing levels in hormones that occurs throughout a woman’s cycle. There are four major signs that can be monitored, including: cervical mucus, basal body temperature, the cervix itself, and the absence or presence of luteinizing hormone in the urine. In monitoring the changes in these various signs, a woman can note the times in her cycle when she is fertile or infertile with a high degree of accuracy. A couple using a modern method of NFP (hint: not the rhythm method!) who is seeking to postpone pregnancy will know what times to abstain from intercourse in order to effectively avoid pregnancy.

Why do you promote NFP?

Dr. Burke: I promote NFP because it allows a woman to get to know her body, and to recognize that there are changes throughout the cycle in response to varying hormone levels; changes she can chart. The woman comes to know what’s normal and abnormal in her cycle, which enables me to address specific issues in the reproductive cycle, whether through targeted hormone therapy or supportcorrecting nutritional deficiencies, and/or treating any underlying medical conditions. Moreover, NFP has no side effects, and has an effectiveness of 99 percent for avoiding pregnancy when used correctly. It can also help couples with subfertility achieve pregnancy by allowing them to take advantage of “timed intercourse” during the woman’s fertile window.

The vast majority of women use some sort of hormonal contraception for family planning, all of which have a number of side-effects and risks. Most of the women using these methods don’t understand how their fertility cycles work, or understand that there is only a small window each month when they can get pregnant. Many are prescribed hormonal contraceptives to treat the symptoms of underlying medical issues and menstrual irregularities, with the idea that contraceptives “fix the problem.” In reality, hormonal contraceptives simply “cover up” the problem, because they function to suppress a woman’s cycle without actually addressing the cause of any underlying issues.


Read more:
Why Millennial women are rejecting the pill

The term “reproductive justice” in modern discourse often means access to birth control, abortion, sterilization, and even artificial reproductive technologies (ARTs). Do you agree with the association of “justice” with these therapies and procedures?

Dr. Burke: I think it’s a misnomer. When we take a step back, and look at the nature of reproduction on the biological level, we see that it requires an intimate act between a man and a woman to create a child naturally. This act is both unitive and procreative, bringing the couple together in both love and pleasure. If we look at this through the lens of true justice, we can’t separate out the biological from the emotional, in the sense that if a man and a woman are going to engage in this voluntary act, they need to be willing to accept the natural consequences of it. Now, that doesn’t mean every act has to result in a child, but it does mean that it would be unjust to use things like abortion or contraception to try to prevent the procreative aspect of this voluntary, intimate act. In short, the term “reproductive justice” has been misused in order to justify acts that are inherently unjust, in the sense that they destroy a human being, and/or disrupt the intimate act between a man and a woman. These technologies and procedures warp the sexual act from being one of true love and self-gift, into one that is a use of the body and the other. And how can we say we are acting justly towards another when we are, in fact, using him or her?

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