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Birth Control And NFP: What's The Difference?

By Frank Pavone, National Director of Priests for Life

Tom and Jane have three children, and have determined that they cannot adequately provide for any more at the present time. They know that artificial means of birth control are morally wrong, and their priest recommended that they use NFP (Natural Family Planning). Yet they do not understand why NFP is OK if birth control is wrong. Don't they amount to the same thing?

Actually, they don't. NFP is very different form other methods of birth control. Here we will give some other reasons -- but first, a word about what NFP is not.

NFP does NOT refer to the so-called "calendar rhythm method," which was based on calendar calculations of a "normal" cycle. NFP, instead, based on direct observations of various signs that occur in a woman's body (changes in the cervix, cervical mucus, and temperature) which tell her when ovulation occurs. These observations are relatively easy to make, take only a few minutes, and work even for irregular cycles. NFP is internationally known and practical and is extremely effective. The medical principles on which NFP rests are being used by more and more doctors for a wide range of purposes.

Morally speaking, then, what is it that makes NFP acceptable while artificial birth control is wrong?

1 ) NFP does not separate sex from responsibility. The act of intercourse has a twofold meaning: sharing of love and giving of life. Married persons who perform this act must accept both sides of the coin. While not every marital act will result in a child, it must nevertheless be open to the possibility of life. The act will be "open" to life as long as the spouses do nothing to "close" it. Here's the difference between artificial birth control and NFP. In the first case, one does something (takes a pill, uses a condom, etc.) to deliberately "close" the life-giving power of sexual intercourse. In NFP, however, no such step is taken. The spouses do not act against their fertility. They do not reject the link between the two meanings of sex (love and life). They simply follow the natural patterns of the body's fertility and infertility -- patterns placed there by God Himself. In the fertile days of a woman's cycle, if there are serious reasons to avoid pregnancy, the couple respectfully steps back from the act of intercourse. In using birth control devices, however, they attack the meaning of the act -- they do the action of intercourse and then undo part of it. In NFP, instead, they simply choose at times not to do the action in the first place.

2) NFP is not just a "method" based on physiology. Rather, NFP is based on VIRTUE. It is based on sexual self-control, which is necessary for a healthy marriage. There are times in any marriage when spouses have to put aside their desire for sex because of sickness, fatigue, travel, or other reasons. In a healthy marriage, love is shown in many ways, and not all these ways of showing love are physical. In fact, to refrain from sex when necessary is itself an act of love. Why? Because in effect the spouses then say to each other, "I did not marry you just for sexual pleasure. I married you because I love you. You are a person, not an object. When I have sex with you, it is because I freely choose to show you my love, not because I need to satisfy an urge." Using NFP requires abstinence from intercourse during the fertile days if a pregnancy has to be avoided. This actually can strengthen the couple's sexual life. When the spouses know that they can abstain for good reasons, they also come to trust each other more, and avoid the risk of treating each other primarily as objects of sexual pleasure rather than persons. Artificial birth control, on the other hand, gives free reign to the temptation to make pleasure the dominant element, rather than virtue. It encourages couples to think that sexual self-control is not necessary. It can encourage them to become slaves to pleasure.

3) NFP puts the responsibility for family planning squarely on the shoulders of both partners, because it requires communication and cooperation. Both spouses need to know when the fertile days of the woman's cycle have arrived, and then decide together what to do (depending on whether they are trying to avoid or achieve pregnancy). To think that such communication and cooperation make the sexual act less pleasurable (because less spontaneous) is simply not true. To know with certainty what stage of the cycle one is in can increase the pleasure and spontaneity of the act, since the spouses can ignore worries about contraceptive failure or side-effects of the pill. Artificial birth control, besides introducing these worries, also puts the "contraceptive burden" on the shoulders of ONE, not both, spouses. It makes it possible for a spouse to cut off the fertility of the act, even without the consent of the other spouse. It can introduce division into the marriage.

4) NFP is not just a means of avoiding pregnancy, as artificial contraception is. Rather, it can also be used to ACHIEVE pregnancy since it pinpoints ovulation. It is a wholly positive approach to the sexual life of the spouses. It is clean, inexpensive, morally acceptable, and reliable.

As with anything good, NFP can be misused, if a couple has the wrong motives. Married couples are called by God to cooperate generously in bringing forth and educating new life. For a couple to decide that "we don't want children at this time", there need to be serious, objective reasons (health, finances, etc.). If the reasons are not objective but selfish, then the couple cannot justify the avoidance of pregnancy just because they are using NFP to do it. In this case they are not practicing "family planning", but "family avoidance"!

There are differences between NFP and artificial birth control, but let these suffice for now. As Pope John Paul II has explained, the difference really rests on a person's answers to some very basic questions like, "What is marriage?" What is sex? What is the human body? What is love?" Artificial contraception distorts the meaning of all these things. It sees the body and its sexual faculties as something to be "used", and it fails to acknowledge God's place in love and marriage. NFP, instead, is a practice of virtue, resting upon self-control, inner freedom, respect, trust, communication, and reverence to God's plan for love and marriage. It enriches both love and marriage. Every couple owes it to themselves to learn more about it!

--Fr. Frank Pavone

Printed with permission from Priests for Life.

Wellness Apps You Can Use To Track Birth Control

Cycle tracking apps are becoming more popular with women who want to use a smartphone to know more about their periods and fertility.

"There are many apps available nowadays to track your cycle," says Shieva Ghofrany, MD, co-founder of women's health site A Tribe Called V. Simple cycle tracking apps tell you when to expect your period. Others, also called fertility apps, family planning apps, or birth control apps, help you understand ovulation and when you're most likely to get pregnant.

If you want to get pregnant, a family planning app can tell you when you're most fertile. If you want to avoid pregnancy, you can use your app to know when to avoid unprotected sex.

Cycle tracking apps store and analyze information like your past periods, sleep patterns, heart rate, basal body temperature, and cervical fluid.

You enter the data into the app, which uses the information to make predictions about when you'll have your period and when you'll ovulate.

If you know when you're ovulating, you can avoid unprotected sex on the days around ovulation.

Unlike other types of birth control, family planning apps don't involve hormones and have no side effects. They're noninvasive and don't require pills or procedures. They're also easier to use than natural family planning methods that use paper calendars and calculations to predict ovulation.

But while they can help you track your cycle, they're not as effective as other birth control methods to avoid getting pregnant. Research suggests some apps may be about 93% effective. To compare, the birth control pill is about 99.7% effective when used correctly.

How well an app works depends on the technology it uses and the data it collects. While some apps use a range of measurements like basal body temperature and cervical fluid to predict ovulation, others are more basic. The more data points, the better.

Your cycles may also be irregular, which limits how accurate the predictions may be. For example, your cycle may be different from the typical range of 26 to 32 days. Things like stress, breastfeeding, and PCOS may also change your cycle.

How reliable an app is also depends on you. You need to use it consistently to get accurate predictions. If taking a lot of measurements, like basal body temperature and cervical mucus, is too much for you to keep up with, it won't be as effective.

"While I think these apps are great at improving women's knowledge about their bodies and cycles," Ghofrany says, "I wouldn't encourage their use unless the woman is highly motivated to use all of the mechanisms."

To find a tracking app that you can count on:

Ask your OB-GYN for recommendations. They may know which apps are most reputable and which apps have worked for their patients.

Do your research. Find out who's behind the app and what their credentials are. "Do they have a PhD? Is it an OB-GYN? Ideally, they specialize in reproductive health," says Sophia Yen, MD, a clinical professor of pediatrics at Stanford Medical School.

Check how many types of data it collects. The more, the better. If an app only looks at dates of your last periods, it won't be as reliable as an app that also collects body temperature and amount of cervical mucus.

Look for an app that's easy to use. If it's easy to enter your info every month, you're more likely to use it correctly and consistently.

You have many choices when picking an app to use as birth control. Some are free, others aren't. Some require extra equipment, like a special thermometer to measure your basal body temperature.

Here are a few apps that some doctors recommend to their patients.

Natural Cycles. This fertility app, which uses a basal body thermometer to detect fertility, was recently approved as a contraceptive by the FDA. It was evaluated in a study of 22,000 users and found to be an effective form of birth control. "It claims 98% effectiveness with perfect use," Ghofrany says. But that number falls to 93% for typical (not perfect) use.

Clue. This app tracks your period, PMS, and fertility window, while also tracking options like cramps, skin, hair, and sleep, to help you understand your body better. The creators work with scientists and universities to keep improving upon the science they use. "I trust the founders, the fact it is woman-owned, and that they have a relationship with Stanford OB/GYN professors," Yen says.

Ovia. "I like this app because it's the best of traditional paper charting of my basal body temperature and ovulation signs, and it offers tools to journal other health and wellness factors like mood, sleep, weight, and nutrition," says Jen Mayo, a holistic health coach in Stevensville, MI.

Other apps include Flo, a popular period-tracking app, and Spot On, which offers period tracking and access to educational articles.

Talk to your doctor about which birth control method may be best for you.

As you get used to tracking your cycle through an app, use a nonhormonal backup method like condoms to avoid getting pregnant.

Remember, an app is only as effective as how well you use it. Get a special thermometer to take your basal body temperature. Enter your data regularly and consistently.

How To Choose Your Natural Family Planning (NFP) Method

Natural family planning (NFP) is a natural method that you can use to help you decide when to have sex—either to avoid getting pregnant or to increase your chances of becoming pregnant. Other natural methods include abstinence, withdrawal, outercourse, and continuous chest feeding or breastfeeding/LAM.

In a nutshell, NFP is basically fertility awareness. It consists of different methods that help you gain knowledge about your fertility and teaches you how to read your body's natural signals to help you determine which days of the month you are most likely to get pregnant (or avoid pregnancy).

Natural family planning includes birth control methods that do not require medication, physical devices, or surgery.

How NFP Works

Natural family planning relies on fertility awareness. During your monthly cycle, several changes occur in your body. For NFP to work, you need to become aware of your body's natural functioning, so you can figure out when you are ovulating and are most fertile (likely to get pregnant).

By keeping track of the changes that take place in your body, you can plan when you should and shouldn't have sex—depending on your NFP goal.

Each of the natural family planning methods works a little bit differently.

What Are the Different Natural Family Planning Methods?

The following are some of your NFP options:

Standard days method (calendar method): This method has you track the length of your cycle (usually with CycleBeads) and suggests that you not have sex during your most fertile days of the month.

Basal body temperature method: With this method, you use a special thermometer each morning when you first wake up to measure your baseline temperature. After logging your readings for a few months, your fertility pattern should be more clear. This can help you determine when you should have or not have sex.

Billings method: This method instructs you to inspect and track changes in your cervical mucus. This can be helpful because your cervical mucus changes in reliable ways throughout your menstrual cycle.

Symptothermal method: This method is a combination of the other NFP methods. So, you check your cervical mucus, take your basal body temperature, and track your cycle length.

Remember that sperm can live in your body for up to a week. If you have sex without any birth control up to seven days before and a day or two after you ovulate, you have a greater chance of becoming pregnant.

How Effective Is Natural Family Planning?

In order for natural family planning to be most effective, you (and your partner) should fully understand your chosen NFP method. You both need to support each other, be committed to natural family planning, and sexually abstain (or use contraception) during your most fertile times. You must also be willing to monitor and chart your fertility signs.

The average rate of effectiveness of all the NFP methods:

Typical use: 77 to 88% effective (reflects how the average person with the capacity to get pregnant uses their NFP method: not correctly or consistently each and every time)

Perfect use: 95 to 99.6% effective (when you always use your NFP method correctly and consistently)

This means that of every 100 who use one of the NFP methods, 12 to 23 will become pregnant within the first year (with typical use) and five or fewer will become pregnant with perfect use.

Changes to Look For When Using NFP

Natural family planning methods require you to monitor and track specific changes that occur in your body. This process will help you predict when you are most fertile and likely to conceive.

Cervical mucus: The presence, color, and thickness of your cervical mucus can tell you what changes are happening in your body. After your period ends, you should have "dry days" (with no cervical mucus). You are not likely to get pregnant during this time. More mucus is made (and is often cloudy or whitish in color and sticky) as you are getting close to the time you will ovulate. You should be abstinent at this time or use back-up contraception if you don't want to become pregnant. Right before you ovulate, you should see the most mucus. It is usually clear, slippery, and easily spreads apart on your fingers. This is when you are most fertile. If you have sex at this time, you may want to use an external condom, sponge, or internal condom to avoid getting pregnant.

Basal body temperature: Before you ovulate, your basal body temperature is usually between 96 and 98 degrees. It will rise a little bit (typically less than one degree) when you ovulate. Because the temperature changes are so small, you need to use a special basal body thermometer, which is designed to measure more specific temperatures. If you record your basal temperature every day, after a few months, you will have a better idea of when you will be fertile. In general, you are most likely to become pregnant two to three days before your temperature rises and one day after that. Once your temperature has been higher for at least three days, your chances of getting pregnant are much lower.

Why People Choose Natural Family Planning

Some couples choose NFP for religious reasons or just as a personal preference.

You may choose NFP because you feel more comfortable using a natural birth control method that has no side effects. Some couples may turn to natural family planning because they are allergic to materials used in devices like IUDs, implants, diaphragms, or condoms (though there are latex-free condoms, as well as polyurethane ones).

Some may decide on natural family planning because they cannot use hormonal birth control.

Natural Family Planning Is Not Advised for Some People

Although there are a lot of advantages to using NFP, it may not be the best birth control option for all. There are a couple of reasons for this.

In the beginning, natural family planning takes a lot of time and effort every day. You need to remember to track the days of your menstrual cycle, and chart temperature and/or cervical mucus.

Many people do not have completely regular menstrual cycles/periods. This can make it difficult to accurately pinpoint the definite time that you are fertile each month.

Your menstrual cycle can be affected by many factors. Stress or being tired or sick can cause shifts in your cycle.

Infections or colds that cause low-grade fevers can have an effect on your basal body temperature, so your temperatures that month may not reflect your overall fertility pattern.

Even though natural family planning is effective, this method may not be the best choice if preventing pregnancy is a high priority—either due to health reasons that being pregnant can cause or because you are not ready to have a baby.

Things to Consider if You're Going to Use NFP

Fertility awareness or natural family planning methods require training, commitment, discipline, and determination in order to be most effective. You and your partner need to be able to communicate, trust, and cooperate with each other.

Because NFP does not protect you against sexually transmitted infections, you should also be in a stable, monogamous relationship.

Even though natural family planning methods are typically inexpensive and do not require you to visit with a healthcare provider, you should do your research and possibly receive specialized training if you want this method to be effective.

A certified/qualified professional can properly teach you the NFP method of your choice. They can assist you in your monitoring to make sure that you are doing this the right way, and that you are correctly interpreting your body's signs and fertility pattern.

A Word From Verywell

NFP is a great and empowering natural birth control method that can be used to help you determine when having sex may or may not result in pregnancy.

Know that your first task with natural family planning is to become familiar with your menstrual cycle and to chart your fertility patterns. Be patient because this monitoring can last for several months (and have a back-up contraception plan during this time). Also, keep in mind that if you do not completely or reliably follow the instructions of your chosen NFP method, it can be much less effective.

The truth is, in practice, NFP may not be as reliable as other forms of birth control. That being said, if you are committed to tracking and recording your fertility information, you can enjoy much higher success rates. You might find mobile apps dedicated to helping you chart your fertility useful.

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