Is Catholic rhetoric about NFP telling the full story?

The Catholic tendency to romanticize natural family planning can be harmful to relationships and family life and can even jeopardize women's health.
In the Pews

Five of my nine pregnancies were the result of trying to use NFP (natural family planning) with a man who became drunk and abusive towards me and the children if I couldn’t keep the period of abstinence short enough.

NFP, for those unfamiliar with the term, is a method of birth regulation where a woman monitors and records different fertility signals during her menstrual cycle and avoids sex during times when she is likely to get pregnant. There are several methods of NFP, but none use any kind of drugs, devices, or surgical procedures, and it is the only kind of birth regulation allowed by the Catholic magisterium.

I studied several methods and tried using hormonal test strips to figure out when I was ovulating, but repeated pregnancies contributed to debilitating anemia and irregular cycles that made it practically impossible to chart. Each unplanned pregnancy was a fresh crisis that kept me focused on surviving in the short term, and I had no time or mental energy to think about an exit strategy. Meanwhile, the mental and physical costs of being continuously pregnant and/or breastfeeding for 16 years left me too exhausted to give my older children the care and attention they needed.

It wasn’t until life-threatening birth complications forced me to adopt more effective measures that I was finally able to catch my breath, acknowledge that my marriage was harmful, and get myself and my children out.


During NFP awareness week, Catholic media will inevitably be flooded with articles extolling the virtues of natural family planning. While advocates would like us all to be aware of NFP’s virtues, proponents rarely acknowledge the impossible burdens it can place on those for whom it does not work.

NFP may be a godsend for some couples, but until its limitations are acknowledged, it will continue to harm families and individuals whose sufferings are often trivialized, denied, dismissed, or even romanticized by the church. At a time when the church is prioritizing such synodal values as listening and accompaniment, our religious leaders need to listen to the stories of those who have experienced NFP as damaging, and reevaluate our collective understanding of what healthy, ethical sexual relationships look like.

I spoke with a number of women whose experiences with NFP fell far short of the rosy images that generally appear in pamphlets and talks promoting the church’s teaching.

Rose Marie had multiple NFP failures due to endometriosis, which made her cycles irregular and difficult to track. “I had complicated pregnancies, two of which almost killed me, one seriously risking our first baby,” she says. “Once I had healed physically after the birth of my second baby, I was left in the throes of postpartum depression and postpartum psychosis but was still told by a priest that I couldn’t go on birth control and receive communion—even if being on birth control meant I wouldn’t take my own life or die in another complicated pregnancy.”


Although NFP advocates often claim that their methods will work for any woman, the big studies that show NFP to be highly effective omit women who are breastfeeding, have irregular cycles, or who are, for whatever reason, unable to identify their fertile days. Women who have recently had a baby or who have reproductive health problems are often those most in need of an effective way to avoid pregnancy, but when they choose NFP, they are rarely told about the lack of peer-reviewed research into its efficacy in their situation.

The most common harm, the people I spoke with say, was a break-down of intimacy. Although NFP is often touted as “respecting a woman’s fertility,” many women find that it does so at the cost of respecting their sexuality. One woman, who asked to be called Lillian, says that NFP “transformed sex into a chore in which desire and pleasure for me had nothing to do with it, obliterating the significance of consent and emotional connection.”

Contrary to the popular claim that NFP “divorce-proofs” your marriage, several women identified NFP as a factor contributing to marital breakdown. For some, this was caused by the erosion of intimacy. For others, Catholic sexual teaching provided an opportunity for a coercive partner to weaponize a woman’s fertility against her. Domestic violence advocates have long observed that pregnancy can be used to keep women isolated and dependent on controlling men—a dynamic recently highlighted in the Netflix docuseries Shiny Happy People. A method of family planning that can only be used if both partners are fully committed to avoiding pregnancy is a method that gives women in toxic marriages no control over their own fertility.

One woman I spoke with had a child with an abusive spouse after NFP failed due to sexual coercion. “Pregnancy and then a new baby made me so much more vulnerable to his abuse, in so many ways,” she says. “NFP is supposed to be for the ‘difficult cases,’ but the factors that make cases difficult are the same factors that make NFP impossible.”


When women are trapped in this kind of situation, they aren’t the only ones who suffer.

Maria is the eldest child in a family of 11. Her father ignored doctors’ advice that her mother needed time to heal after giving birth. Her mother’s commitment to church teaching left no way to avoid pregnancy: Babies were spaced one to two years apart, and Maria was forced to take on a parental role as her mother’s health deteriorated.

“By the age of 4 I was changing diapers,” Maria says. “By age 15, I was staying up all night with a fussy baby or comforting young children from nightmares and then getting up to serve my siblings breakfast.”

Maria says her mother was deeply unhappy, always in pain, and “couldn’t admit that she was, because she felt that if she did it would mean she regretted God’s ‘gracious gift and miracle of life.’”


Like many children born into large, faithful—but dysfunctional—Catholic families, Maria ultimately rejected the Catholic Church. “I could see how the church convinced women to suffer without acting to help them,” she says. “My childhood had already been sacrificed to this ideology. I didn’t want to be a martyr like my mother—and I didn’t want to do that to my kids.”

In Humane Vitae (On Human Life), Paul VI writes that a “man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires, no longer considering her as his partner whom he should surround with care and affection.” 


But the reality is that Humanae Vitae reveres women’s fertility to the exclusion of our needs, wants, limitations, physical and mental health, or even our lives. The stories I heard reveal that the practice of NFP sometimes undermines a woman’s physical and emotional equilibrium, reducing her to a mere instrument of procreation. Many women are left with no recourse against unwanted pregnancy and are more vulnerable to exploitation. And even in good, loving relationships, relying on NFP can sometimes pose problems, including financial stress, damage to marital unity, and serious risks to a woman’s health.

In the years since Humanae Vitae’s publication we have become more aware of the problems of sexual coercion and spousal rape and of the importance of consent and mutual desire in building healthy marriages. In addition, the problems and abuses that may be concealed behind the pious facade of a large, “happy” Catholic family have become more visible. People are less willing to equate respect for a women’s dignity with respect for the functions of her reproductive system—especially when those functions endanger her happiness, health, or broader good.


The church needs to revisit this issue in a way that more fully recognizes the burdens that NFP places on already burdened families. The problems cannot be reduced to “sin” or “weakness”: There are too many situations where responsible parenthood is a moral necessity, and NFP just doesn’t work. Catholics in those situations need solutions that don’t boil down to “suffer and pray.”

Image: Pexels/Tima Miroshnichenko