In This Issue. . . . . . . . . . . . . . . . .
We remember and celebrate the life of Bishop James T. McHugh, the founder of the bishops' national NFP efforts.
- Tribute to Bishop James T. McHugh
- A Tribute to the Most Reverend James T. McHugh
Susan Wills, Esq
Excerpts from Cardinal Law's Homily, December 15, 2000
"Lessons in Christian Servitude"
- NFP Ministry and Hispanic Catholics
- Hispanic Development: The Challenge of Our Times
"A Couple's Witness"
A Doctor's Reflection on Human Sexuality in the New Millennium
Jose R. Fernandez, MD
- NFP Around the World
- Crossing the Border to See the Barriers: The TransBorder Institute NFP Project
NFP in Central America
A Study in Guatemala
- News Briefs
10 December 2000
Priest, diplomat, indefatigable advocate for life, beloved friend.
May the Lord bless his continued work in the Kingdom!
"In the Catholic tradition responsible parenthood is based on an openness to childbearing and child rearing. It is premised on recognizing the innate value and dignity of every child from conception on -- a dignity that flows from God's creative love and providential care. Each child is an individual person, one who, from the earliest moments of existence, shares in God's own life and has title to an eternal destiny with God in heaven. This openness to life . . . . empowers married couples to take on the challenges of child rearing, to plumb the depths of their own interpersonal love."
James T. McHugh on the occasion of the 20th Anniversary of Humanae vitae, 1988
A Tribute to the Most Reverend James T. McHugh
Susan Wills, Esq.
On December 10, the Catholic Church and the pro-life movement in America lost a leading light in Bishop James T. McHugh of Rockville Centre. With no trace of hyperbole, Cardinal Bernard Law said of Bishop McHugh's contribution: "I am certain that no other bishop in the United States will emerge more important than he in having forged the Church's efforts in support of life and the family." The loss is, quite simply, incalculable. Bishop McHugh died in Advent, just before Christmas, the season of hope. Perhaps it seems discordant to dwell on the untimeliness of—and the suffering which attended—his death from cancer. But there are several excellent reasons why such reflection is appropriate.
First, a great mystery of Christmas lies in the extremely humble circumstances of God's coming into this world. Meditating on this aspect of the Christmas story is an annual source of fresh insights into God's love and how He wants us to live our lives. To see how we ourselves can live out this message, we need look no further than the example of Bishop McHugh. He was indifferent to, and unimpressed by, wealth and power. He was modest and unassuming, never seeking credit for personal accomplishments—but content to work tirelessly behind the scenes, building successful programs and coalitions. Second, when we find ourselves weary from the enormity of the challenges facing us, it is heartening to recognize how blessed we are to be part of an enterprise that calls us to be our best selves, working alongside people who give their all. Bishop McHugh exemplified all the best that the pro-life and NFP communities embody:
- an unwavering trust in God
- a clear and prophetic understanding of what is at stake in the abortion and contraceptive culture
- a willingness always to speak the truth
- utter selflessness
- innumerable sacrifices
- the humility to carry out this work, not for
personal recognition, but from love for God
- gratitude and charity in victory and
- in defeat, renewed creativity and resolve rather than discouragement.
Bishop McHugh's final act was to concelebrate Mass on the feast of the Immaculate Conception, two days before he died. Because he never sought recognition for his achievements, many people are unaware of his pivotal role in laying the foundation of the pro-life movement and in designing the framework for the Church's response to the advancing culture of death. A precis follows.
Reverend James T. McHugh was ordained a priest for the Archdiocese of Newark in 1957. In 1965, he joined the staff of the National Catholic Welfare Conference (later NCCB/USCC) and two years later was named the director of the Family Life Bureau and then --simultaneously--director of the Office for Pro-Life Activities when it was created in 1972 to focus on issues involving direct threats to human life. He was the chief architect of the Pastoral Plan for Pro-Life Activities, adopted by the bishops in 1975 and reaffirmed in 1985. The plan activates the resources of the church in programs of pastoral care, education, prayer and public policy to end abortion and build up a culture of life. This comprehensive approach is still today the blueprint for Catholic pro-life efforts nationwide.
Bishop McHugh left the Conference in 1978 to pursue advanced studies in Rome, where he earned a doctorate in sacred theology; he also studied sociology at both Fordham and The Catholic University of America.
As a monsignor, Bishop McHugh was one of the team of experts invited to take part in the 1980 Synod on the Family from which the great Apostolic Exhortation Familiaris consortio was the product. As a direct result of that synod in 1981 Cardinal Terence Cooke asked him to direct the Diocesan Development Program for Natural Family Planning (DDP/NFP). He worked to strengthen NFP programs throughout the country during the 1980s and continued to direct the DDP/NFP until his death.
Bishop McHugh was named an auxiliary bishop for Newark in 1987 and Bishop of Camden in 1989. In February 1999 he was installed as coadjutor bishop of Rockville Centre, becoming the head of the diocese on Bishop McGann's retirement in January 2000.
Since 1983 Bishop McHugh served as an advisor on population issues for the Holy See's Permanent Observer Mission to the United Nations, and he served as a delegate or observer at most of the major UN conferences between 1974 and 1994.
In his 13 years as a bishop, he was a key member of the Committee for Pro-Life Activities, offering wise counsel, sound strategy, and always the latest research findings, from the NFP literature to population issues to end-of-life care and everything in between. How he managed to read scholarly journals while fulfilling all the duties of a bishop is explained by his discipline and 16 -17-hour work day.
Susan Wills is an attorney and Associate Director for Programing in the NCCB's Secretariat for Pro-Life Activities. She develops the annual Respect Life Program and edits Lift Insight.
Excerpts from Cardinal Law's Homily, December 15, 2000
In keeping with his self-effacing modesty, Bishop McHugh asked Cardinal Law to deliver a homily–and not a eulogy–at his funeral Mass. As in the case of others who knew him well, Cardinal Law found it difficult not to hold up and celebrate Bishop McHugh's extraordinary life of service to the Church. Here are excerpts from Cardinal Law's homily:
In 1997, before the onslaught of cancer, Bishop McHugh reflected on the meaning of Advent in his weekly column for the Catholic Star Herald. He wrote: "As we approach Christmas, the end days of Mary's pregnancy and her preparation for Jesus' birth become the dominant theme. Mary invites us to a better understanding of God's providential plan, the generosity of His love and our own part in the drama of redemption. Mary shares with us her greatest secret--her intimacy with God."
He continued: "Each year as I follow the Church's path through Advent, I come to a deeper appreciation of my own need, and the need of the world, for a more quiet and spiritual preparation for Christmas."
As we reflect on today's readings in the light of the Church's faith and in the context of Bishop McHugh's death, may this time be for us "a more quiet and spiritual preparation for Christmas."
Last week Bishop McHugh called me with the news that his death was imminent. He also asked me to preach at his funeral. In that characteristic candor which revealed him to be a man of unfailing integrity, he told me that I was a substitute. He had asked Cardinal O'Connor to be homilist.
They had forged a deep friendship through their commitment to the pro-life cause. Ironically, it would be terminal cancer that would strengthen their bond of friendship as each ministered to the other. . . .
Bishop McHugh did not ask me to preach a eulogy, he specifically requested a homily. Let me simply note that his has been a singular contribution to the Church in the defense of life, in support of the family, and in the promotion of natural family planning. When sufficient perspective allows an objective appraisal of these past thirty years or so, I am certain that no other bishop in the United States will emerge more important than he in having forged the Church's efforts in support of life and the family. His contributions as a priest serving the National Conference of Catholic Bishops, as a bishop, and as a collaborator with the Holy See's efforts before the United Nations have helped to chart the contemporary Church's efforts in the support of a culture of life.
One of his lay collaborators during the past two decades, Richard Doerflinger, has put it so well: "I came to see him as a mentor—a model of professionalism, deep love of the Church, absolute dedication to the pro-life message, and a readiness to bring that message to the highest level of reasoned debate. His lack of pretension was equally absolute. ... On first impression, people could be intimidated by his strong intellect and no-nonsense style; those who knew him better saw integrity, humility and a wonderful sense of humor" . . . .
The Book of Lamentations captures the anguish and sense of loss which death brings. Jim was a young sixty-nine. He brought his characteristic order and discipline to diet and exercise. How wrong it all seemed as the impact of the cancer made itself known. Indeed we might well have said: "Remembering it over and over leaves my soul downcast within me." When I visited the Bishop last Friday, the Solemnity of the Immaculate Conception, however, those were not his thoughts. Rather, he spoke of his illness as a time of great grace. In the uncommon quiet of his last Advent on earth, living in the shadow of death, he was able to recognize his illness as a grace. For our conversation last Friday, the Bishop's column of 1997 provides an interpretive key. Hear his words again: "Mary invites us to a better understanding of God's providential plan, the generosity of His love, and our own part in the drama of redemption." As Jim experienced dying as his own part in the drama of redemption, a deeper meaning was given to the words of the Psalmist from which he chose his episcopal motto:
How shall I make a return for all the good he has done for me?The Catechism of the Catholic Church so beautifully expresses the meaning of Christian death. We read: "What is essentially new about Christian death is this: through Baptism, the Christian has already 'died with Christ' sacramentally, in order to live a new life; and if we die in Christ's grace, physical death completes this 'dying with Christ' and so completes our incorporation into him in his redeeming act."
The cup of salvation I will take up, and I will call on the name of the Lord;
My vows to the Lord I will pay, in the presence of all his people."
(Psalm 116; vv.12-11)
As we talked last Friday, Jim focused on the Eucharist. Quite simply he stated how, more and more, he experienced Eucharist as the heart of his life. I had the sense that he was peeling everything else away and focusing, with Mary, on intimacy with God as the greatest of all gifts. The Gospel for today reveals to us in all its power the mystery of the Eucharist, the source and summit of the Church's life. Here, on this altar, there is made present the redemptive sacrifice of Christ upon the cross under the appearance of bread and wine. Here, in our Holy Communion, we are made more fully one with the Risen Lord. Paul's words to the Corinthians are a salutary reminder to us: "Every time, then, you eat this bread and drink this cup, you proclaim the death of the Lord until he comes." Last Friday, a little before noon . . . I concelebrated Mass [with Bishop McHugh] . . . . . [he] was vested, and actively took his part as concelebrant. After Communion, he knelt, and remained kneeling for some time after Mass. As we came upstairs, he told me he was tired, and needed to rest. Before leaving the house, I visited him briefly in his bedroom. I asked for his blessing. He then asked for mine. We bade one another goodbye - and I left. Later that afternoon, he took a dramatic turn for the worse. He did not rally—and died at 3:15 in the afternoon of Sunday, December 10th. The words of his Psalm come to mind: "Precious in the eyes of the Lord is the death of his faithful ones." His last conscious act on earth was the celebration of the Eucharist. What greater grace could God have given him, or given us. The Book of Lamentations, with which we began, serves us well as we conclude: "Good is the Lord to one who waits for him, to the soul that seeks him; It is good to hope in silence for the saving help of the Lord."
Cardinal Law, Archbishop of Boston, has served on the Bishops' Committee for Pro-Life Activities along with Bishop McHugh for many years.
The staff of the Pro-Life Secretariat convey our deepest gratitude for the many cards, letters, calls, and e-mails from Bishop McHugh's friends. The following are a few samples of your sentiments.
"I was privileged to serve with Bishop McHugh for 12 years on the DDP National Advisory Board.... he will be missed by all of us who worked with him and loved him. When Bishop Jim McHugh held a baby in his arms, his eyes always lit up with joy and happiness. My prayer is that he has lots of babies to hold in Heaven who have waited so patiently for him to arrive. They know how hard he fought for them and how much he loved them."
"He was such a good priest and so hard working. I am sure we can all pray to him."
"Not long after the Spring of 1980 we volunteered to start an NFP program in the new Diocese of Metuchen, and soon after that, we began to meet with then-Msgr. McHugh and other NFP pioneers at the Archdiocese of Newark's Family Life Center . . . . We remember those Saturday morning fondly, and recall in particular the give and take with Msgr. McHugh. His strength of conviction was inspiring, and his suggestions of how best to promote and run an NFP program were always helpful. . . . . Bishop McHugh knew that the state of mind that finds abortion to be acceptable is only a short step or two away from that which finds nothing wrong with contraception . . . . he knew the immense importance of educating married couples about the many benefits of NFP . . . . we knew him as a man of warmth, who enjoyed listening as much as talking, and who was passionate in defense of the Church and those who ministered in its behalf. He was the most courageous priest we have ever met. All involved in Pro-Life and NFP will miss him terribly; thank God we will always have his inspiration and example to follow."
"I learned so much from Bishop McHugh. He was a great help to me, especially in those early years in this office. He always went above and beyond. I am confident that from heaven he will continue to support us and all that is good and beautiful."
"Bishop Jim McHugh was a true leader. He was sharp tongued and quick witted as benefits his Irish-Italian New Jersey ancestry. I was with him at his invitation at a meeting of the Pontifical Council for the Family . . . . it was clear to me that of all the prelates present, he was the one that . . . was respected for his knowledge about family planning and population issues at the highest levels of the Church. He was devoted to the Church . . . but his intellect and religious authority did not interfere with his love of people and especially those working in the vineyards of NFP and Pro-Life. . . . . he was a man's man as a priest. I can clearly see him as one of the apostles, a tough guy who looked at Jesus and said, "Yep, this is the real thing and I am going to work as hard as I can to see that everyone knows about it."
"We first met him many years ago . . . . We will enter a tribute to him in the next issue of our quarterly Bulletin . . . . Lyn and I will remember to pray for him and for those who have suffered a great deal by their loss of a good friend."
"We all are aware of his tremendous work in Pro-Life activities and in NFP. I remember several meetings with him . . . . I very much regret he is no longer with us fighting against an age of death. We all will pray for him."
"I also was fortunate in meeting many times Bishop McHugh. I confirm that he was very respected and was consulted at the highest levels in Rome . . . . We are glad that we have in Heaven another saint helping us."
"A great man who cared about us so much he counted us during fire drills and worried when we went to New York, prayed with us when family troubles struck and helped us grow NFP. Now in his memory let's bloom!"
"I often found that many people did not fully recognize all the good that Bishop McHugh did. I'll never forget his metaphor of 'the train is moving, who is going to get on?' as he laboriously went around the country to network and form unity among dioceses and NFP providers. I have always felt blessed to know him."
"On behalf of all the components of this Pontifical Institute John Paul II for Studies on Marriage and Family that has benefitted of the collaboration of His Excellency McHugh as Professor of General Elements on Demography in the academic year 1982-1983. . . . I wish you my very best . . . . ."
"Bishop McHugh was our friend during the Synod for the Family in . . . 1980. . . We worked side by side . . . and saw him many times afterwards. . . . As you say, the NFP community now has a strong advocate before the Lord God--we need his support very much indeed!"
"A dedicated Churchman, a brilliant man, a gentleman, a friend. We'll miss Bishop McHugh greatly. Having had the privilege of knowing and working with him for many years, we have so many good memories. We could address his depth of understanding of the Church's teachings and his profound love for the Church that professed them. We could address the many hours that Msgr. McHugh spent at meetings, at conferences and in phone calls (sometimes from the United Nations!) helping us understand them. . . . When I think of the man, I think of his love for little ones, and the many times we saw him holding or playing with them. A number of years back, I invited him to our diocese to address the theology behind NFP to our clergy. In addition to his talk, I was to do an overview of NFP, and some couples were to witness to NFP's effect on their lives. One couple had brought a toddler, who wanted to share his picture book with McHugh. And so, sitting in a small conference room, he thoroughly explained the Church's teachings related to marriage, family and sexuality, and answered questions, while holding the toddler on his lap and pointing out pictures on the book's pages."
"Today the family is a target of many enemies the whole world over. I am sure Bishop McHugh will intercede for all of us. . . . Count on our prayers for Bishop McHugh's soul and for all of you . . . . Please, remember Bishop McHugh is enjoying heaven and is now able to help the families more than before."
"Lessons in Christian Servitude"
In what was to be a trademark of our friendship, I first met Bishop McHugh over the phone. It was June 1984 and I was an out-of-work high school religion teacher on her way to full time graduate study in theology. One of my priest friends had called to say that he lived with "a priest who needed help." "What kind of help?" I asked. I wasn't a theologian--at least not yet and had no practical office experience. "No matter," said Fr. Manny, "let me introduce you to McHugh." And then I met him. A deep voice, intense and precise, he quickly told me what he needed done. He asked me about my schooling--long pause, very long pause (I would later learn that he would think during the pauses)--then he asked if he could meet me the following day. I said "yes" and, as they say, "the rest is history."
On first glance there was nothing extraordinary about Bishop McHugh. He never claimed to have mystical visions or interior locutions. There was no "odor of sanctity" around him. He was simply smart, efficient, faithful, at times "grouchy," but had a great sense of humor, and was the quintessential "John Wayne" of the Church. Loyal to family and friends, he was also logical, reserved in his expressions of emotion, and "matter of fact" about lots of things. In reality there was nothing "matter of fact" about him. Bishop McHugh was God's true servant on earth.
Despite all the variables which comprise the human person, I can tell you that it was perfectly natural for Bishop McHugh to do God's will. It was almost as if he received his "marching orders" weekly from the Lord God, and he faithfully fulfilled them. Indeed, when God created James Thomas McHugh, one could almost hear Him say, "I think I will make a real soldier for My Son's Church--Hmm, better yet, a General." This is what I experienced in my friendship with Bishop McHugh. He was made to be a leader in the Church. I instinctively knew that I would not stray from the Lord and His Church so long as I listened to and learned from Bishop McHugh. His life presents a story which offers the kind of hope that the servants of God bring into the world. On a personal level, I learned my life's lessons on what it meant to be a servant of God.
I met Bishop McHugh at the beginning of my study of theology, truly at the cross roads of my life. As most young adults, I didn't have a clue as to how ignorant I really was. As a committed Catholic I thought I had a firm handle on the Church and the truth of what we believe. But in reality I was not conscious of the great seduction which our culture had already worked on my faith. In my first meeting with Bishop McHugh he told me "we live in a permissive society." I thought he was maybe "overreacting" like other people of my parents' generation, but there was something which also said "pay attention" and I did. That summer I worked as his personal secretary helping him prepare for the United Nations Mexico City meeting. It was meant to be "part-time" work and then I would be off to graduate school. Little did I know that despite three years of graduate study, I would find myself still working for him seventeen years later!
During the early years of my work with Bishop McHugh we had the luxury of time to often discuss the Church's teachings on human sexuality, conjugal love, responsible parenthood, and family life. He would often lean back in his chair, put his feet up on the desk, munch on an apple (with a good helping of peanut butter on it) and listen to my every naive question. In those moments he never laughed at or was patronizing to me. In thoughtful and respectful discourse he treated each of my questions. He never told me what to believe, he simply laid out the truth for me to see and then challenged me to think about it. In those days, and beyond I learned what it took to serve in the Church.
Those were lessons that were not choreographed. Bishop McHugh was not the kind of teacher who "planned" what he would teach the apprentice. He taught by his example. In his many dealings with people who disagreed with him or the Church, I learned to "listen" to what was being said. No matter the tone or even personal attacks, Bishop McHugh listened intensely and answered with an even temperament. Once when I asked him why he didn't take offense to a particularly irate person he said "he" was not the issue the person was reacting to. He explained that it was critical to discover what propelled a person's thinking. He underscored that there are always more than one side to a story and that one should not "jump to conclusions." In working on strengthening diocesan NFP programs he would often tell me to "make the machinery work." This meant that I had to learn how a given diocesan structure operated and find a means to insert NFP ministry into the midst of it. When developing a resource or project, I learned that it was critical in today's world for leaders in the Church to acquaint themselves with experts. Bishop McHugh consistently sought input from respected professionals--he made it clear that "the job" could not get done by only one person. At the same time, he also made clear the fact that as a bishop--the buck stopped with him! In keeping with his sense of personal responsibility in the Church he disciplined himself to stay current on a host of issues. He avidly read the secular papers, political magazines, theological and demographic journals. Depending upon a particular issue that he had to treat, I would also learn "what was what" on breast-feeding, genetics, or palliative medicine. One was never bored in Bishop McHugh's company!
Probably the most important lesson I had learned from Bishop McHugh was to put aside my ego--even the desire or need for praise. "It's not about me" was a motto that he could have easily adopted. He never bragged, he did not seek to have his name appear on everything he wrote, he often down-played his significant contributions. The only important thing was to do God's will. He understood that it was the Lord's projects that had to be realized through our efforts. Make no mistake about it, all who worked with McHugh were expected to work hard, to build the Kingdom as quickly as we could. I once admitted to him that I periodically fell into despair over how hard our work was--that I often felt estranged from God Himself. McHugh's counsel? "Theresa, you know who God is and what you have to do." He was right. persevere in prayer and "keep at it," that is the work that God has given us. Above all, TRUST. God is faithful even when we aren't.
On the day that Bishop McHugh died, I was studying for my comprehensive doctoral exam on 19th and 20th centuries of Church history. At about 3:00 in the afternoon I was sitting on the floor of my bedroom taping some notes to my wall. I looked up at this massive time-line I was creating-- complete with pictures of the popes from 1800 to 1956--and I was thinking of the many servants who have labored in the Church. Just at about 3:15 my neighbor in the apartment above began to play the piano. I recognized the hymn--it was "Here I Am Lord"--as I was struck by the utter beauty of the love and dedication of the multitude of laborers in the Church through time, it hit me-- "he's on the other side." "Bishop McHugh is there." On the second Sunday of Advent, at about 3:14 in the afternoon, Bishop McHugh passed into Heaven. I am sure that he was greeted with a strong "Well done my good and faithful servant!"
Theresa Notare shepherds the work of the Diocesan Development Program for NFP.
NFP Ministry and Hispanic Catholics
Throughout the dioceses in the United States strong communities of Hispanic Catholics can be found. This large and faithful community presents a formidable challenge to diocesan NFP ministry whose resources are often stretched to their limits. Currently, the bulk of diocesan NFP services is reaching middle-class, Anglo-America. Understandably in this scenario, any differences in language and culture will adversely impact NFP outreach. But NFP coordinators have a responsibility to attend to all the faithful in their dioceses. Indeed, the bishops' Standards for Diocesan NFP Ministry insist on providing NFP services "appropriate to the culture and language of the diocesan population" (section one, H, p. 8). Therefore, finding, or creating, effective Spanish language materials for instruction is key to NFP instruction of Hispanic Catholics. In addition, identifying potential Hispanic teachers is also essential. The following articles are offered to inspire strategizing to build NFP services for Hispanic Catholics in the dioceses.
Hispanic Development: The Challenge of Our Times
The most recent report from the Bureau of the Census indicates that as early as 2005, Hispanic-Americans will grow to be the largest minority group in the country — even larger than the African American community. If we accept what the numbers indicate, and consider that at least 70 % of Hispanic-Americans are Catholic, then there is no doubt that the future of the Church in this country is closely related to the future of Hispanics.
As Director of Hispanic Development for the Couple to Couple League International (CCLI), I have learned to be aware of the educational level of those who receive our services because it plays a substantial role in the success or failure of any project. The educational profile of the U.S. Hispanic community reveals a range that includes people of science and medicine as well as people who cannot read or write in their own language. Through our years of working with the Hispanic community in the U.S., we have discovered that those with higher levels of education depend on Spanish materials than do those with less education. Those who are well educated often read in Spanish and English, while those with less education are dependent on Spanish language materials. Often excellent translations are published only to receive very poor acceptance because they are written at a level which does not correspond to the abilities of those who would read them.
It is necessary to point out that the level of education is not the same as the level of intelligence. There are many people with a low level of education who are very intelligent. School training enables people to learn, to think and to express themselves using abstract thinking. In contrast, those with less formal training learn, think and express themselves from a more concrete (physical) and visual perspective. For those more educated, the ideal way to communicate the message is through conferences, brochures, books, etc. This group benefits from topics related to specific philosophical and theological content. A great part of their learning process occurs at an intellectual and abstract level.
On the other hand, those with less formal education benefit from materials that include less text and more illustrations. Group discussions, witnessing from everyday experiences, and workshop settings are more effective than conferences or books. At this level, effective communication is not based on a speaker's credentials, but in the personal contact and honesty which a speaker offers.
When developing a program in the Sympto-Thermal Method (STM) of NFP for Hispanic-Americans, it is crucial to keep the above elements in mind. At CCLI, we have developed two programs in Spanish — our regular program and a basic (simplified) one. The regular program includes detailed information on the scientific basis for the method and the moral background required to make good use of NFP. It includes a text book, brochures, chart booklets and a thermometer. All of this is presented in the format of four classes which the couples attend. For those who cannot attend the classes, we offer the Home Study Course, where the users can learn the same program in their own home at their own pace. The basic program presents the moral context and the foundation to practice NFP through a manual which combines an easy-to-read text with several illustrations. We combine a short presentation with a series of workshops conducted by either the couple or the group. Here the emphasis is placed on learning by doing rather than interpreting. This format has proven to be very effective when dealing with couples with less formal education. The purpose of the program is to offer a practical experience that teaches the basics of the STM to couples with a lower level of education and to provide the company of a certified couple with whom they can share their questions and concerns. We have been working with and developing this Basic program for more than two years and we hope to have it available for the public early next year.
Serving the needs of the growing Hispanic-American community is one of the biggest challenges that we have to face as a Church in the U.S. This has been affirmed by both the NCCB's study, Hispanic Ministry at the Turn of the New Millennium and the National Association of Hispanic Priests. Today it is critical to have materials translated into Spanish. It is also necessary to produce these materials at a level in which individuals and families can benefit. If not, we will have our parishes filled with Spanish materials that the Hispanic parishioners will glance at but will not read. Finally, we must also be aware that resources without personal contact will be limited in their effect to change behavior. Experiences of communion and personal relationships must be created for Hispanic-Americans. It is in the personal exchange of friendship and understanding where conversion can happen.
Erick Carrero is the Director of Hispanic Development, Couple to Couple League International.
"A Couple's Witness"
My wife Maria and I have been practicing NFP since we were married. Using this method has been a great blessing for us. On one hand, its effectiveness has helped us to plan our family without the use of costly contraceptives or suffering their secondary effects. On the other hand, it helped us to understand our sexuality better as a couple and to communicate more deeply. This would not have been possible if the parish we belonged to hadn't offered natural family planning classes. Those classes gave us the opportunity to practice the teachings of the Church with respect to the family. They have also given us the elements to form our young family in the area of sexuality within the Catholic tradition.
Unfortunately, thousands of Latin/Hispanic Catholics in this country don't have access to these classes. My wife and I realized this when we moved from Oregon to another state. When we called our new diocese to ask about this type of formation, we discovered that it wasn't available. Motivated by our personal experience, we decided to start something ourselves. We got the support of a priest who was working in one of the diocesan offices and in a matter of months, we began to give classes in English and Spanish. In the beginning, someone commented that the class material and the practical applications were too complicated for people with little academic experience. In our experience as instructors, that factor has never been an impediment. Couples with different levels of academic formation have successfully learned and applied the method that we teach. What's essential is that the couples are motivated to learn and have the necessary support to be successful. All things considered, it's important to offer these classes, especially in English, in as many parishes as possible. We strengthen ourselves then by giving the faithful the necessary tools to live by the teachings of the Church and enjoy their abundant blessings...just as God would want.
Alejandro Aguilera-Titus, Associate Director, Secretariat for Hispanic Affairs, NCCB
A Doctor's Reflection on Human Sexuality in the New Millennium
Jose R. Fernandez, MD
As a family doctor, I have had the pleasure of caring for the entire family, beginning with the expectant mother to the new born child, the adolescent, the parents and grandparents. My youngest patient is one month in the womb and the oldest is ninety. In my practice, I see the results of sexual responsibility and irresponsibility as well as people who don't understand that their sexuality is a gift.
When I speak to people about their sexuality the first thing they think of is genital sex. Typically they are confused and wonder why it has to be discussed. When I speak with mothers and fathers about teaching their children about sexuality, they feel that they're not prepared for the subject. Why is this? What is our responsibility as couples in our marriages, as parents, and as neighbors in our society ? As a doctor I believe that it is important to know what unhealthy and even dangerous sexual messages our society promotes. As a Catholic I believe that the Church understands the gift of human sexuality which in turn we need to share with our neighbors.
Society and Sex
Today our children are constantly tempted and pressured to live a promiscuous life. Our children lose their virginity at an early age and are forced to live an adult's life well before it is time. Despite parental guidance, research tells us that peers often have as strong, or stronger, an influence on our children. It is clear that society in general does not support abstinence. Virginity is usually made the punch line of jokes. Many people speak of the threat of diseases which sexual activity can bring, but few publicly question the wisdom of a "sexually liberated" society. Sex is used to sell products. It is treated as an activity of consenting people. It is spoken of as something which people "need" and cannot control. The message society promotes in schools, on TV, in popular music, etc. is one that devalues the true nature of sexuality--as God designed it. Complicating matters is also the fact that many in our culture are trying to change the definition of gender, marriage and family.
The Church & Sex
What does the Church teach about sex? The Catechism notes that "God is love and lives in Himself a mystery of personal communion of love. Creating his image...God inscribes in the humanity of the man and woman the vocation, and consequently the capacity and the responsibility of love and communion." God wants us to accept our sexual identity as part of our humanity. He wants us to understand the physical, moral and spiritual differences that essentially serve as complementary ideals. These differences are oriented towards the good of marriage and the development of the family. The harmony of the human couple and society depends in part on the manner in which couples live.
As an Hispanic Catholic, I also appreciate what the Church has said in the document Today's Guide for the Catholic Hispanic Family. A couple's happiness, the Guide says, is directly dependent upon the fruitfulness of their married life. The "garden of intimacy," as it is referred to, is the heart of married life. The center of that garden is the couple's experience of being "one flesh." The value of this experience can not be overstated, because when it is an expression of personal love, it fosters a deeper love.
The Second Vatican Council said that spousal love is "uniquely expressed and perfected with the marital act." A couple's sexual life can deepen personal intimacy when that sexual expression communicates the personal intimacy that already exists. If sex is something impersonal, then it doesn't deepen the marriage. If love isn't communicated with words, then sexual communication will not have the fullness of personal intimacy that it could have. When it comes to the human, spiritual and sacramental depths of sexual love, personal communication can make all the difference. A deeper union between the spouses has a lasting effect on the couple's relationship. Their sexual intimacy must be a basic expression of their marriage, their "personal sacrament." A couple's sexual intimacy further maintains and deepens the family union in Christ.
We must teach our youth the virtue of chastity if we want to consider ourselves responsible parents. If we do not give direction within our own families and within the Church, we are going to lose our children. I understand most parents want to preserve their children's youthful innocence, but we've got to motivate the young to understand their bodies-- particularly how God designed them. The importance of our fertility in the context of chastity must be discussed. A chaste person maintains the integrity of the forces of life and love that are a crucial part of their being. This integrity in particular assures the unity of the person and opposes the type of behavior that can destroy them. Chastity indicates a certain self-mastery, an element of individual freedom. The alternative is clear: man controls his passions thereby obtaining peace, or he allows himself to be dominated by his passions, thereby, losing his freedom.
Young people understand that life entails a lot of decision making. They also need to understand they must chose between right and wrong. But how do they learn to choose correctly? It is up to us--faithful Catholics. We must teach them to pray, to resist the temptations that plague society, and to wait for a partner that shares their same pureness of heart. In addition to instructing them by word of mouth, it is our duty to be a living example of these same virtues.
"We are going to give our children a future filled with peace," said Pope John Paul II. "If we help them and love them, then they will bring peace to the world." Our children need to learn peace just as they need to learn about their sexuality. And it is in the context of the family that this learning of sexuality should take place. As a father and a Catholic doctor, I have learned that human sexuality is a gift from God. But as husband and wife, mother and father have to learn to accept the gift as a means of creating a peaceful world. I am also aware that understanding and accepting our sexuality is difficult especially since we do not talk openly about it (much less within the Christian community). Most of today's "sex ed" is learned in the streets or by word of mouth--the quality of it suffers greatly. Parents often neglect talking about sex with their children. Too often leaders in the Church do the same. Our society has perverted and even destroyed the meaning of sexuality. Unfortunately, our children are the ones who are suffering from the repercussions of this sexual revolution. This is precisely the reason that it is necessary we accept God's gift of sexuality. By doing so, we come to be complete human beings with hearts and minds open to His will.
Christ always identified himself with children and asked that his disciples be innocent like children. I think its important for adults to meditate on this. Think back to when you were a child. Concentrate on your curiosity in particular. As a doctor, I am very much aware of the curiosity that children show to their own bodies. As children grow, they demonstrate different levels of curiosity about their bodies and how they work. We can all remember questions that were asked at one point that flustered us and bothered us especially since we were unable to answer them. Each question that is asked cannot be ignored. We should look at each question as an opportunity to guide our children and instill in them certain values as well as teach them right from wrong. And we can expect that as our children get older, the questions will become more challenging; however, each question provides us with another way to influence the lives of our loved ones. I have noticed that when questions are left unanswered, children will go elsewhere. Are we going to let anyone guide our children?
Natural Family Planning
The Church calls us, in Humanae Vitae, to be responsible parents, and also to teach our children the importance of self-mastery. How can we become these so-called "responsible parents" without any kind of formal training? One of the greatest contributions to helping couples live responsible parenthood has been the scientific advancements in the area of natural family planning (NFP). NFP is sound in its science, not physically harmful and inexpensive. NFP is much more than birth control as it serves to strengthen family life. By observation of the woman's fertility cycle, the couple is able to improve methods of communication by deciding if they will try to achieve or postpone pregnancy during this cycle. It has been noted that the majority of dialogue between couples and sexual interest go hand in hand. Many couples later find out that NFP serves to show them just how much control God has over their lives.
NFP helps us to understand that sex is much more than genital contact. Learning NFP teaches that when you love someone, you love them in their totality. In my instruction as a Creighton Model teacher, we refer to the acronym S.P.I.C.E to explain what authentic sexuality is comprised of--Spiritual, Physical (and psychological), Intellectual, Creative (and communicative), and Emotional. For example, as soon as I wake up in the morning, I begin to show my love to my wife by putting toothpaste on her toothbrush, putting the seat down on the toilet, and bringing her a glass of orange juice. If you notice, I have not even given her a kiss, but yet I have spent all morning demonstrating my love for her!
When couples practice NFP they begin to treat fertility as healthy and normal. We live in a society in which fertility is regarded as a disease which is why many people think it is necessary to treat it with chemicals or even surgery. Man, woman and God are united in the garden of intimacy where fertility is in tact. This is the garden that is shared between husband and wife in a marital relationship, and it is where the peace and happiness of the Holy Spirit are found. It is by becoming "one body" that marital love gives life to the Body of Christ and thereby to the world. We have a marvelous message to share with our neighbors. In the words of the Holy Father, "we must not be afraid." Each one of us is called to live the Gospel and to share the gifts our Celestial Father has given us.
Dr. Fernandez is in family practice in Kissimmee, Florida. He has studied NFP at the Pope Paul VI Institute, Omaha, NE.
Where Can I Find NFP Resources in Spanish? The following providers offer materials in Spanish.
Billings Ovulation Method Association USA [OM]
P.O. Box 16206
St. Paul, MN 55116
Couple-to-Couple League [STM]
P.O. Box 111184
Cincinnati, Ohio 45211-1184
4290 Delhi Pike
Cincinnati, OH 45238
Family of the Americas [OM]
P.O. Box 1170
Dunkirk, MD 20754
Northwest Family Services, Inc. [STM]
4805 N.E. Glisan Street
Portland, OR 97213
Pope Paul VI Institute [FertilityCare System]
6901 Mercy Rd
Omaha, NE 63106
The following dioceses can be contacted to discuss their efforts to create Hispanic NFP education:
Archdiocese of Chicago [OM]
Maria Garcia, Hispanic NFP Coordinator
155 East Superior St.,
Chicago, IL 60611
Archdiocese of Los Angeles
Victoria Ramirez, NFP Consultant
Marriage and Family Life
3424 West Wilshire Blvd.
Los Angeles, CA 90010
Diocese of Phoenix NFP Center [STM]
Peggy Frei, Director
400 No. 30th St.
Phoenix, AZ 85008
Diocese of San Antonio [OM]
Henrietta O'Connor, NFP Coordinator
2718 West Woodlawn
San Antonio, TX 78228-0410
210-734-2620 ext. 213
Diocese of San Diego NFP Teacher Training Program [STM; OM]
Dr. Terence McGoldrick, Director
P.O. Box 85728
San Diego, CA 92186
Diocese of Tucson [OM]
Luz-Elena Shearer, MS, RD, NFPP, Coordinator
Natural Family Planning
St. Joseph's Hospital
Carondelet Health Network
350 North Wilmot Road
Tucson, AZ 85711
NFP Around the World
Crossing the Border to See the Barriers: The TransBorder Institute NFP Project
The activities of the TransBorder Institute at the University of San Diego (USD) endeavor to increase understanding and collaboration between peoples who live in border communities, especially those at the United States-Mexico border. The TransBorder Institute (TBI) supports cross-border interaction by providing information, seminars, internships, academic exchange partnerships, service-learning opportunities, and research grants. The TBI funded a natural family planning (NFP) research project that facilitated interaction between members of the USD community and NFP providers in Tijuana, Mexico.
Mexican Socio-Economic Barriers
Approximately 90% of the population in Mexico is Catholic. Still, most Mexicans do not have easy access to NFP. As in the United States, popular acceptance of a need to "plan one's family" and the availability of contraception make it more difficult. Planning a family is a significant responsibility for all married couples. In Mexico unplanned pregnancies present difficulties often more severe then in the U.S. A contributing factor is the unbalanced Mexican economy with extreme differences in personal income. In Mexico this economic unbalance is associated with many social problems, including the destabilization of families and high rates of crime and infant mortality. Although there is a growing middle class, approximately 30% of the Mexican population lives in abject poverty. Many families need income from more than one member just to meet basic needs. Although Mexican law protects women from employment discrimination and provides them with paid maternity leave, a Human Rights Watch investigation has found that pregnant women are often denied jobs and working women who become pregnant are often pressured to resign.
To discourage employees from becoming pregnant, many maquiladoras--the mostly foreign owned export processing companies that have flourished along the border since the enactment of NAFTA--distribute contraceptives to their employees. This practice has governmental support. The maquilas are a vital sector of the border economy and wages they pay are better than those in other sectors of the economy. As a result, their presence has encouraged migration from the southern states. In many cases, however, wages at maquilas are not high enough for a single wage earner to support a family, so both parents typically work outside the home to make ends meet. Approximately 50% of maquila employees are women.
Two-parent family life is highly valued in Mexican society, but single parent households are not uncommon. Extended family members offer considerable support, but recent immigrants do not always have family members nearby. When parents encounter economic difficulties, sometimes their only option is to intrust their children to orphanages with the hope that they will eventually be reunited. According to one estimate, 90% of all children in Baja, CA orphanages come from single parent households in which the parent is working, but simply cannot afford to raise the child or pay for day care.
The difficult economic pressures impact Mexican behavior regarding family life. In the past, the Mexican government attempted to reduce levels of poverty through policies designed to improve the economy and influence demographic trends. These efforts forged unsastisfactory alliances. In the early 1970s, demographic trends in Mexico led to a population with an extremely low median age. Policy makers were concerned that the economy would not produce jobs fast enough to employ the future generations of workers. A high demand for jobs, combined with a limited job supply, would have pushed wages downward, resulting in increased poverty. To offset this danger, the government, which was controlled by the anti-clerical Revolutionary Institutional Party (PRI), formed a partnership with Planned Parenthood International to decrease fertility rates. Together, they created a system of family planning services which does not include the promotion of the natural methods.
Today's new government inherited this family planning structure. President Vicente Fox understands that the people of Mexico are ready for a change. He envisions a bright future for his country, but knows that he faces many challenges. Tight fiscal management and failing oil prices led the previous administration to reduce spending on family planning programs, even though roughly 14.2% of couples have an "unmet need" for these services. The natural methods of family planning are safe, effective, and by far the most cost-effective over time. If the new administration is to increase access to NFP, it must be aware of the difficulties to be overcome. The primary barriers to wide acceptance and availability of NFP services worldwide include:
- most family planning providers lack accurate information about the modern methods of NFP;
- many providers/users of contraception have difficulty dealing with the behavior issues associated with the successful teaching/using of NFP;
- the operational structure (client scheduling, management information systems, cost recovery, etc.) of most family planning clinics do not support the "distribution" of methods that rely on education and follow-up;
- most providers of family planning prefer "medical" (provider controlled) methods over methods that rely more heavily on user understanding and modification of sexual behavior;
- ideological differences among family planning providers often precipitate actions that consume resources but do not result in increased access to NFP.
Machismo is thought to be a major hindrance to NFP acceptance in Mexico. Since the days of the conquistadors, machismo has been a strong historical force in Mexico. Similar to sexist attitudes in other cultures, machismo assumes that males are superior to females. In Familiaris consortio, Pope John Paul II deplores this assumption as humiliating to women and harmful to the family (25). Another facet of machismo is the idea that men need and have a right to unrestricted sexual activity. Since machismo is perpetuated through gender socialization, transforming such assumptions is difficult--especially since some characteristics associated with machismo are highly valued. Macho men are admired for their courage, aggressiveness, commanding actions, and sexual prowess. Machismo is manifested in acts of heroism and/or sexual conquests. The assumption that men are not interested in using NFP is because it requires periodic abstinence which "macho" men will not or cannot accept. Some people fear that if couples use NFP, the need for periodic abstinence will lead to an increase in extra-marital affairs. However, NFP promoters in Tijuana testify that when men understand the value of using NFP, machismo is not a hinderance. They point out that abstinence is required at many times in life and that both men and women are able to sublimate their sexual energy when needed. Perhaps men influenced by machismo are able to employ their courage to help them refrain from intercourse when needed. A better understanding of how couples from various cultures manage periodic abstinence would benefit efforts to increase confidence in people's ability to use NFP.
Many factors, including cultural attitudes toward gender roles, influence people's choice of family planning method. Successful NFP use requires an understanding of its physiological basis, communication skills, commitment, motivation, and behavior modification. Increasing acceptance of NFP will require contributions from many disciplines. The faculty supervisor of the TBI project, Sandra Sgoutas-Emch, Ph.D., has contributed her knowledge of health behavior to this project. The TBI team members recognize that psychological research can support the work of NFP professionals. We hope to collaborate with the Diocese of Tijuana to perform a study based on theories of health behavior.
Collaboration with The Diocese of Tijuana
The Tijuana diocesan NFP program was initiated by Maria de los Angeles in 1980. She and her husband, Jesus Lujan direct the program. Maria and Jesus testify that NFP has enriched their lives in so many ways. Jesus explains that using NFP has increased his understanding of the human body and human relationships, which has lead him to develop a profound sense of awe for creation. He notes that using NFP has helped him see that God is enough, that God makes everything perfect. During the past twenty years, in addition to raising their family and pursuing their careers, Maria and Jesus have given their time, treasure, and talents to build the program.
Supported in part by the Family of the Americas Foundation, the program has taught NFP to thousands of couples. Of the 280 couples who attend the diocesan marriage preparation classes each month, NFP instructors are able to make brief presentations about NFP to approximately 150 couples. Roughly 10% of these couples enroll in NFP classes. Instructors donate their services so that classes can be offered at no charge. New instructors are recruited from the pool of NFP users, so increasing the class sizes should in turn increase the number of instructors, and allow the program to expand.
Members of the TBI and the diocese of Tijuana NFP program have designed a survey measuring the needs, concerns, attitudes about family planning and other bio-psychosocial data of the couples involved in the marriage preparation program. Once funding is secured, this survey will be done on both sides of the border to observe cultural differences. Latin American societies can offer prospectives on sex, gender, and family which are important compliments to the more individualistic tradition that exists in the United States. Once completed, this project will help explain why some couples enroll in NFP classes, while others do not. The results will also allow us to address the most significant barriers to NFP use encountered by couples in Tijuana.
I look forward to the "Posadas sin Fronteras" (Posadas without borders) that is co-sponsored by faith communities on each side of the border, and I am grateful for Jesus and Maria, who reveal Christ to our border community. Their love is manifested in their service to others and in their relationship with each other, their children, Jesus and Jasmine, and their grandchildren, Margarita and Jesus. I pray that the peoples of the Americas will continue to learn from each other and serve each other as we journey into the new millennium. I pray that each of us will open wide our doors to the Christ who lives next door.
Susan Jacobi is the Project Coordinator for the TransBorder Institute NFP Project.
NFP in Central America
Many couples in Central America use some type of natural family planning. However, most have had no formal training, and often do not understand how to use it. Periodic family health surveys conducted in Central America reveal that the prevalence of artificial methods is higher than that of natural methods. Nevertheless, the majority of those surveyed report having used traditional or natural methods, such as rhythm or periodic abstinence, at some time during their life. It is worrisome that, according to these surveys, women's knowledge of their fertile period is low. For example, only 43% of Guatemalan women using natural family planning methods were able to identify the fertile period of their menstrual cycle, while in Honduras the percentage was 56%.
The overall prevalence of family planning is 50% in Honduras – with 41% using artificial methods. Approximately 9% of the population use "other" methods. It is important to note that the percentage of traditional method users is higher than the prevalence of the IUD (8.5%) and is close to that of oral contraceptives (9.9%). Only 3 percent of these "other" method users, however, are using an established natural family planning method, namely the Billings Ovulation (BOM) or Calendar-Rhythm method.
Most Latin American NFP organizations have limited capacity, and few artificial family planning programs provide information needed for clients to select and effectively use a natural method. Clearly, strategies are needed to expand the availability of NFP services. Traditionally, NFP services have been offered by private groups affiliated with, or belonging to the Catholic Church. However, the nature of these organizations tends to limit their ability to expand their coverage.
Central Americans usually receive family planning services from the public health system or from family planning organizations. These services overwhelmingly favor artificial methods and label the natural methods as too "ineffective" to offer to their clients. When interviewed, health providers are "confident" with their knowledge of the natural methods; however, in reality they have had neither the practical experience, nor the training to support this confidence. Saddly, very few recognize the need for their systematic training in the subject. In general, public health providers maintain their opposition to the natural methods because they do not believe women would use them correctly. The emphasis on artificial methods, combined with
the lack of public health staff NFP training, provider bias, combined with the limited availability of NFPservices and materials, contribute to minimizing awareness of NFP.
Historically, family planning policy in Central America has been oriented towards slowing population growth. Due to this preoccupation with lowering birth rates, priority has been given to contraceptive prevalence, regardless of method mix. However, this focus has been replaced by a more integrated vision of family planning services. This new orientation emphasizes the overall welfare of the individual rather than the number of contraceptive users. This paradigm shift has created an opening to increase access to NFP services.
Georgetown University's Institute of Reproductive Health (IRH) has created a strategy to increase access to NFP by building them into existing family planning services. IRH has conducted a number of studies to assess the state of NFP in the region and is currently conducting operations research to test strategies to make NFP services available to more people. In 1998, IRH documented a successful strategy for increasing the availability of NFP services in several countries. This strategy is based on the development of partnerships between NFP organizations, such as COCEMOB members, and family planning providers such as ministries of health and family planning. In 1999, IRH finded a COCEMBO study to explore the feasibility of incorporating NFP, and, specifically the Billings Ovulation Method (BOM), into the services offered by public and private sector family planning.
Three Honduran organizations teamed up to look at new ways of offering NFP. The Honduran Ministry of Health (MOH) recognizes the important role that natural methods play in the overall provision of family planning services, and is interested in expanding their capacity to offer these methods within their overall program. CEVIFA is a program of the Catholic Church founded in 1992 to provide NFP and family life education. RENAFE has developed a cadre of 400 volunteer couple instructors who implement a well-organized program of NFP and family life education. The MOH recognized RENAFE's expertise in the area of education and promotion of the Billings Ovulation Method.
To take advantage of RENAFE's expertise in expanding access to NFP methods, RENAFE and the MOH agreed to work together to incorporate a paid RENAFE-Instructor one morning a week in MOH centers in the capital city, Tegucigalpa. The MOH's interest was to gradually increase and improve the availability of these services within their facilities. In 1998, RENAFE agreed to test a different strategy – the training of MOH auxiliary nurses to provide natural methods. IRH conducted a diagnostic study to document this experience. The study was designed to allow comparisons between four different service delivery models: 1) non-integrated services provided exclusively by RENAFE instructors; 2) integrated services within the MOH offered by paid RENAFE Instructors; 3) integrated services within the MOH provided by RENAFE-trained auxiliary nurses; and 4) integrated services provided by ASCH volunteers.
The study concludes that RENAFE has been successful in gradually expanding the provision of NFP. The success of RENAFE's non-integrated services depend largely on the internal organization of the Catholic dioceses—and are stronger in areas where dioceses are well organized. RENAFE has been able to expand its services greatly since it received financial support from UNFPA in 1996, allowing them to train more instructors. The two "integrated services" models were not equally successful in terms of numbers of new users. The paid-RENAFE instructors provided assistance to 346 uses from twelve MOH centers, greatly surpassing the MOH's previous average of 30 users. The auxiliary nurses trained by RENAFE-instructors did not yield such high numbers, but did achieve 76 users. This later strategy was deemed to be the most practical by the MOH for future activities since it will not require paid instructors, and therefore, is more sustainable.
IRH found that certain factors facilitated these partnerships to take place. These include: 1) the openness of the Catholic Church towards the MOH; 2) the interest of the MOH in improving access to natural methods; 3) the recognition of segments of the population which desire natural methods; and 4) the existence of an organization, like RENAFE, which has the technical expertise to teach the BOM and which is open to coordination with other institutions. All of these factors contribute to increased access and availability of quality services for NFP methods in Honduras and serve as important examples for other programs looking to integrate NFP.
IRH conducted a regional policy study to explore the feasibility of expanding NFP through existing organizational structure. The results showed that significant infrastructural and programmatic weakness of NFP organizations limit their ability to provide natural methods. Multi-method family planning providers were confident of their ability to provide natural methods, despite having no formal experience or training in NFP and having incorrect knowledge of basic concepts. Most respondents stated their willingness to form partnerships to offer NFP.
Public sector family planning programs in Central American offer limited information about NFP. Only in Honduras is there evidence that the BOM has been integrated into the family planning services offered in government health services in Tegucigalpa and other regions of the country. The Honduran Secretariat of Public Health collaborates with CEVIFA, an organization affiliated with the Catholic diocese of Tegucigalpa. As a result of this collaboration, to date, over 2,000 couples are using the BOM.
Encouraged by these results, CEVIFA approached other NFP organizations in Central America to explore the possibility of replicating this experienced. In 1997, these organizations joined forces to form the Central American Commission on the Billings Ovulation Method (COCEMOB), a consortium dedicated to the promotion of the BOM throughout the region.
Results of this study suggest that in despite of the considerable obstacles, there are also opportunities that may facilitate the mainstreaming of NFP. These include the willingness of the Catholic Church to collaborate with governmental health services. Public sector family planning programs are open to the idea of integrating NFP into existing services. Interest in NFP services. The majority of NFP organizations have well-trained, committed NFP instructors. These valuable local resources function on a volunteer basis and could be incorporated at minimal cost.
The IRH is testing strategies to integrate NFP into ongoing family planning services. The Institute has conducted similar studies on public-private sector collaboration in several countries, including the Philippines and Honduras. The results of these studies suggest that collaboration between Ministries of Health and NFP organizations can increase the accessibility of NFP. These studies have documented four major strategies to integrate NFP into secular family planning services. These include: 1) placing BOM instructors from NFP organizations in government health centers; 2) training health providers to offer NFP methods; 3) forming teams with staff with NFP and multi-method organizations to collaborate in the provision NFP services; and 4) implementation of a system to refer women to NFP services.
In 1999, IRH collaborated with COCEMOB, a consortium of organizations which provide the Billings Method in Central America. Member organizations were from Guatemala, Belize, EL Salvador, Nicaragua, Costa Rica, Panama and Honduras. Interviews were conducted in each country with representatives from the Ministries of Health, Catholic Church, NFP organizations, family planning organizations, non-governmental organizations and donor agencies. The study found that almost all of the NFP organizations possess precarious organizational structures and suffer from administrative and management deficiencies. None have an effective management information system. NFP services are organized around the efforts of volunteers who offer their services in their own parishes and are highly dependent on the Church. These NFP institutions typically have weak organizational structure that lack clearly defined goals and objectives. Nevertheless, they have enormous potential owing to their volunteer workforce that enables them to function with minimal infrastructure.
The Ministries of Health personnel interviewed expressed their willingness to incorporate NFP into family planning services. Nevertheless, the public sector has traditionally emphasized the promotion of artificial methods, and it is unlikely this will change in the future. Family planning organizations expressed interest in collaborating, however provision of NFP services will depend on the ability of these programs to contribute to or at least not hinder their self-sustainability. Throughout Central America, health professionals consider NFP methods ineffective and difficult to use. However, this perception may be the result of inadequate training in NFP.
The Need for NFP Education
A diagnostic study in Honduras determined how couples decide whether or not to use NFP, and whether multi-method family planning providers offer adequate information on NFP. Study findings suggest that women receiving family planning services in Honduras do not receive adequate information to ensure informed choice regarding natural methods.
A diagnostic study to assess the lack of education on natural methods was conducted by ASHONPLAFA, a family planning organization, and the Ministry of Health in Honduras. ASHONPLAFA suspected that their providers were not offering the option of a natural method to their clients, while the MOH had been collaborating for five years with a local church-based organization to integrate Billings into their services. Most women had already selected which method they wanted to use before seeking care. This decision was based on information provided them by their relatives, husbands, friends, and doctors. About one-third had been recommended rhythm or withdrawal. Although virtually all of the women knew where to go to obtain an artificial method, very few knew where to go to learn about NFP.
Only 25% of the simulated clients visiting ASHONPLAFA received a natural method, compared to 60% of those seeking services at the MOH. Typical comments were; "Well, maybe someone else would have more luck, she only told me that it would not be a reliable method"; and "...they don't know how to manage (explain) natural methods." While most simulated and real clients felt free to choose a method for themselves, they reported that they did not receive sufficient nor adequate information regarding natural methods. For example, one client stated, "She made me feel that it was a very difficult method and that the men didn't like it, actually she only explained to me its disadvantages."
Both real and simulated clients perceived that providers felt insecure explaining natural methods, and did not believe them to be a reliable option. Their perceptions were confirmed by the results of checklists to debrief the simulated clients and the provider interviews that showed that even an introductory explanation of NFP was neither complete nor correct.
Strategies and Future Steps
Based on the results of these studies, IRH is testing new strategies with partners in Central America to expand the availability of NFP services in the region. In Nicaragua, IRH is supporting efforts to replicate successful elements of the Honduran model to incorporate the BOM into public sector family planning services. In another strategy to expand access to NFP, IRH is testing the introduction of the Standard Days Method into community development and family planning programs in Honduras and Nicaragua.
The Standard Days Method –or SDM—is a simple, calculation based method of NFP. Developed by the IRH, the SDM is based upon recent research that identifies more precisely when during the reproductive cycle a woman can become pregnant. The method is based on the identification of a fixed "window" of fertility. For women with cycles between 26 and 32 days, this window is from day 8 through day 19 of their menstrual cycle. This fixed "window" makes it easier for women to know when they are likely to become pregnant.
In Honduras, the SDM will be introduced into both clinical and community based programs of a family planning organization and the Ministry of Health. In El Salvador, the SDM will be introduced into a water and sanitation project that previously offered no family planning. This operations research will look at how efficiently the method can be integrated into this type of community program. It will also test the importance and effect of directly targeting and involving men in the use of this "couple" method. CEVIFA, a church-based Billings organization, will also test the incorporation of the SDM in their program. CEVIFA will test offering the method to couples in rural areas of Honduras, many of whom use a form of rhythm ineffectively. Through this research the staff of IRH hopes to identify more efficient strategies to promote the natural methods of family planning.
Rebecka Lundgrer is the staff person who works on Central American projects at the Institute for Reproductive Health, Georgetown University.
A Study in Guatemala
Family of the Americas, in an effort to encourage families and to prove the errors in the artificial birth control mentality, coordinated a study on Natural Family Planning. It should be our most important contribution to the Catholic Church's teaching on the evils of contraception, as it confirms the validity of the teachings of the Church. The study in Guatemala is halfway finished in so far as statistics are concerned. The detailed questionnaire is providing us with the most comprehensive statistical evaluation of the Ovulation Method ever conducted anywhere in the world. This is confirmed by the preliminary results in the attached report. We have been teaching the poorest of the poor and thus far the statistics are proving an effectiveness rate of 99%. There is no excuse anymore to pretend that only those with strong religious convictions can follow Natural Family Planning.
The initial funding of the Guatemala study was made possible through a government grant of $800,000 to establish permanent centers to teach approximately 16,000 couples. Eighty experienced teachers who have been teaching strictly on a volunteer basis since the 1970s, were given a modest salary for the first time. They trained and provided materials to over 500 physicians and nurses of the Ministry of Health. The teachers were equipped with the most current audio-visual equipment, (monitors, VCRs, and overhead projectors). The regional sites were provided with staff and computers, printers, copiers and teacher training materials and supplies in order to ensure maximum efficiency in managing the information gathered. Two vans were also provided to allow the regional coordinators to visit the regions and do random checking of the participants in the study.
Guatemala's present government is anti-life. They have launched a massive campaign to sterilize couples and also provide artificial methods of birth control (including abortifacients), to young people and couples throughout the country. This same government has denied additional funding for the completion of our NFP project and has threatened to remove all the equipment from the sites unless we can provide funding to continue the project. Sadly we are suffering from the trend in industrialized nations (with the assistance of the UN) who lobby legislators of the developing nations to pass laws to decriminalize abortion. It is of critical importance to alert pro-life legislators to investigate their own Constitutions and laws that would enable them to prohibit such actions. The industrial nations' taxpayers unwittingly contribute to the unjust implementation of population control programs that promote abortion and dispense abortifacients at home and overseas. We need to embark on a massive campaign to alert and defend our faith, especially in Latin America, denouncing the systematic attack and destruction of the family through the contraceptive mentality. We need to expose other pernicious programs being imposed on women, men, and young people all over the world.
Mercedes Wilson is the Executive Director of Family of the Americas.
Erratum: In our last issue, the phone number for the Family Life Institute in Manassas, VA where you can obtain the book, Begotten, Not Made by Steve Bozza was incorrect. The correct phone number is: 703-3656-7281 and the website is: www.familylifeinstitute.com
American Academy of Natural Family Planning (AANFP) is seeking research abstracts for the 2001 Science and Research Forum. This forum will be held in Lincoln, NE from July 25-28, 2001. Contact: Peter Danis, M.D., Mercy Family Medicine, 615 South New Ballas Road, St. Louis, MO 63141; 314-569-6012; FAX: 314-995-4127; Email:email@example.com
International Registry for Breast-feeding Research provides the scientific community with a registry of potential volunteers for studying human lactation under special circumstances. These circumstance include certain medical conditions, problems with lactation, and use of specific drugs during breastfeeding. Women who are currently breastfeeding and/or women planning to breast-feed after delivery are included in this registry. Contact: Thomas W. Hale, PhD, Associate Professor of Pediatrics, Texas Tech School of Medicine, 1400 Wallace, Amarillo, TX 79106. Email: firstname.lastname@example.org
Sacred Heart Mercy Health Care is looking for physicians interested in providing pro-life health care. Contact: Sacred Heart Mercy Health Care, 803 Fourth Street, Jackson, MN 56143;507-847-3571.
Long Time N.Y. NFPer Retires
After 35 years of work in NFP in the New York area, Margaret (Peggy) Furlong-Maloy, R.N. has retired. In a personal correspondence to us, Peggy reminisced about her life's work in NFP:
My late husband, Dr. James Patrick Furlong began teaching the "art" of Natural Family Planning in 1966 in his medical offices in Albany, New York. The Family Life Information Center, Inc. was created shortly after this. Jim was able to get small grants for NFP education from the Department of Health, Education and Welfare (HEW) by offering screening for breast and uterine cancers (a requirement of the HEW grant). Working with Dr. Whelan (the then Commissioner of Health in New York State), Jim received a medical license for the Family Life Information Center, Inc. We thus became the second NFP program to receive government funding (the first was Dr. McCarthy's program in Pittsburgh, PA.) Dr. Furlong was designated as the primary NFP teacher for the state of New York and presented the program in all the regions of the state. For example, he was invited to present his NFP program in the Diocese of Ogdensburg, N.Y., at the request of the bishop. Along with five volunteer couples, he began teaching NFP at the office of Catholic Charities and later at St. Peter's Hospital in the Diocese of Albany. They were funded by the Capital Area Family Resources Incorporated through Title X. I was the part-time Executive Director and Secretary. During this time we especially serviced the NFP needs of the Diocese of Albany.
I was appointed Executive Director of the Family Life Information Center in 1982, and my office was transferred to St. Peter's Hospital. We were under the jurisdiction of the Commissioner of Health, Family Planning office in Albany. It was not until 1995, when the NFP program was absorbed by the Obstetric/Gynecology Department of St. Peter's Hospital that I became the official NFP Coordinator for the Diocese of Albany. I resigned my position on January 15, 2001, however I continue as a consultant for the diocese.
During my tenure as Executive Director, Dr. Furlong and I presented programs in the Catholic schools in the Albany diocese, stressing abstinence for teenagers. We presented programs at retreats, Confirmation classes, public and private schools and government agencies.
Throughout our work we never wavered from our commitment to NFP ministry. To the remark "you have to live with your conscience," Jim would quip, "you also have to die with your conscience." It was a life long dedication that has been most enriching.
February 3-10, 2001, Creighton Model Teacher Education Program, Phase 1 in Salt Lake City, Utah. Conducted by FertilityCare Center of Kansas City. Contact: Phyllis White, CNFPE, Program Director; 816-229-1473.
February 11-17, 2001 National Week of Chastity. This annual event, now in its fourth year, is
sponsored by American Life League. Contact:Cathy Brown, Director, National Week of Chastity,
P.O. Box 1350, Stafford, VA 22555;540-659-4141; FAX 540-659-2586; Email: email@example.com
February 26-March 2, 2001, Northwest Family Services will hold a STM Teacher Training Education and Certification Program in Portland, OR. Contact: Rose Fuller, Executive Director, 4805 N.E. Glisan St., Portland, OR 97213;503-215-6377; 503-215-6940 FAX;Email: firstname.lastname@example.org;Website: www.nwfs.org
March 10, 2001, Family Life Ministries of the Archdiocese of Newark, N.J. will host a seminar at Seton Hall University. Entitled "Contraception: A Couple's Friend or Foe?" the featured speaker is Janet Smith, PhD. Contact: Judy Miller, Director, 973-497-4325.
March 23-24, 2001, The Institute for NFP at Marquette University's College of Nursing is sponsoring a two day conference on 21st Century Natural Family Planning. Much of the conference will focus on new research and developments in the field of human fertility. Contact: Richard Fehring, D.NSc, Marquette University, 414-288-3802.
March 24, 2001, the California Association of Natural Family Planning (CANFP) will hold its 8th annual conference at St. Mary's Cathedral in San Francisco. Contact: CANFP, 1217 Tyler St., Salinas, CA 93906; 877-33-CANFP, 831-443-3746 FAX; Email:email@example.com Website: www.canfp.org
May 19, 2001, The Department for Marriage and Family Ministry of the Diocese of Cleveland will be offering a Teacher Training Institute in Cleveland, OH. Classes will conclude on November 10, 2001. Contact: Diocesan NFP Coordinator, Marriage and Family Office, 1031 Superior Avenue, Cleveland, OH 44114; 216-696-6525, ext. 4290 or 800-869-6525, ext. 4290.
August 15-18, 2001, 20th anniversary celebration of Familiaris consortio will be held in Arlington, VA. Sponsored by the Committee on Marriage and Family and the Committee for Pro-Life Activities of the National Conference of Catholic Bishops, the symposium will explore the four classic themes of the Apostolic Exhortation. Contact: DDP/NFP, 202-541-3240.
The Medical Institute for Sexual Health has unveiled its new web page: www.medinstitute.org. The site contains current and comprehensive information and resources about STDs, sexual health and abstinence.
Good News About Sex and Marriage, Christopher West's new book is available from Servant Publications. This book seeks to help Catholics understand our beliefs on sex and marriage. It is based upon Pope John Paul II's writings. Contact: Kolleen O'Meara, Publicist, 734-677-1274. Email: firstname.lastname@example.org
NFP: A Preachable Message is ready! This audio tape was produced to encourage clergy to preach on the message of Humanae Vitae in sermons. The tape features personal testimonials from a variety of bishops, priests and deacons. All clergy speak of their lived experience of sharing the Church's teachings on conjugal love and responsible parenthood with the people of God. Some of the clergy featured are: Cardinal Francis George, Chicago; Archbishop Harry Flynn, St. Paul/Minneapolis; Archbishop Charles Chaput, Denver; Rev. Kenneth Baker, editor, Homiletic & Pastoral Review; Rev. Ronald Lawler, Pittsburgh; Msgr. Bob Gust, New Orleans; Rev. William Kurtz, Marquette University; and Deacon Bob McDonald, M.D., Canada. The tape is $5.00 each plus postage (an invoice will be included with the exact postage added). Contact: St. Cloud Diocesan Office of NFP, 1-800-864-6225.