Anti-Contraception Crew Still at Work at HHS
by Cristina Page, Moderator, OnCommonGround
February 13, 2009 - 8:00am (Print)
A perplexing story popped up in my Google alerts the other day. It was from The Hoya, Georgetown University's college newspaper, and the headline read: "Med Center Receives Research Grant for Natural Family Planning." Georgetown is a Catholic university which aroused my suspicions; after all, in the 21st century, the Catholic Church still bans contraception for its adherents. The research grant was from HHS, for $600,000. Not much as research grants go, but in this economy spending money to research a quote-unquote contraceptive method with a failure rate of 25% seems pretty lavish.
I poked around the website of the grant recipients, The Institute for Reproductive Health (not to be confused with the National Institute for Reproductive Health
to which I am a consultant) and, unlike most natural family planning
endeavors, there were actual MDs at work on the project--in particular
those with real field experience in family planning. Several were former USAID and UNFPA employees.
I also happened to have a chat with a colleague with impressive
pro-choice credentials who described the lead researcher, Dr. Victoria
Jennings, in glowing terms. Typically, this would be enough to put my
mind at ease and dim the flashing warning sign. That's if it weren't
for the following passage in the article,
The $600,000 award will enable researchers not only to make natural family planning methods accessible for Title X clients, but also "to test strategies to overcome barriers that limit the availability and use of natural family planning methods by individuals who get their health care through this government-funded program," according to a medical center press release.
Wha?! The goal is to integrate "natural family planning" into the array of contraceptive services offered to Title X recipients. First of all, it's worth repeating that the typical failure rate is 25%. (Withdrawal is 27%.) And that's of those dedicated 2% of Americans who even try it, a slim percentage who are most likely very religious and fervent in their belief that natural family planning works. Now, a few Title X facts could come in handy. 70% of Title X clients are unmarried. 28% of Title X clients are teens. If natural family planning which requires a couple to have sex only at prescribed times of the month, and doesn't work within stable relationships, imagine how impressive the failure rate will be among the actively dating.
Here's my real suspicion. The Bush appointees are still running the shop over at the unmanned HHS - recall that the Daschle debacle left the agency without a head - of which the Title X program is a subset. It seems this grant is like the baubles Madoff sent to family members in the weeks after his scam was exposed. The anti-contraception crew is still at work at Title X off loading the family's jewels to friends. These are the officials, remember, who defended the abstinence-only approach in the face of conclusive evidence it fails and who think contraceptives are "demeaning to women."
Getting a prestigious university like Georgetown, with its Vatican-mandated anti-contraception agenda, to endorse natural family planning for the poor appears to be a slick way to make crisis pregnancy centers eligible for Title X funding. What witting or unwitting role the esteemed MDs are playing in this is not yet clear. But don't forget that crisis pregnancy centers refuse to tell women grappling with unwanted pregnancy the most effective way to prevent another. A long-term goal of the anti-contraception movement is to validate, in a scientific-seeming way, the anti-contraception "contraceptive." This is the Bush administration still at work, the very people who lead the campaigns against contraception still at the wheel and driving funds to those who support their ideology.
We should get loud about this. If only as a way to vent about the anti-contraception stunt staged during the stimulus debate. They moaned about spending money on contraception, which by the way, turned out not to be in the bill, but never mind. Meanwhile the Bush team is cutting checks and mailing them to friends.
I disagree. I think that natural family planning should be right there, alongside all the other methods. I worked in fp over 20 years ago, and we were trying to figure out the best way to teach it to folks back then. I still think it's a good thing: it promotes women understanding their bodies. True, it does mean to have to avoid sex at certain times (or use a condom or something else at those times) but I think it's a valuable method. It shouldn't be the ONLY method presented, and true, the failure rates can be high. But, it's a method that can be very empowering (also for when a woman WANTS to get pregnant).
"I worked in fp over 20 years ago, and we were trying to figure out the best way to teach it to folks back then."
Back when it was The Rhythm Method? It didn't work very well back then either. Indeed it was so discredited (because, once again, the faulire rate was so hight) that the religious right had to treat it like they treated 'Creationism' , wrap it up in a new package, give it a new name and call it 'science'.
"I still think it's a good thing: it promotes women understanding their bodies."
I don't have anything against women 'understanding their bodies', I do, however, have a great deal against selling NFP as a viable method of preventing unwanted pregnancies and particularly when 70% the women being sold this bill of goods are unmarried, 28% are teens and all are poor. There are good reasons why only 2% of the population uses NPF for birth control. Most women don't find the 25% failure rate acceptable.
"But, it's a method that can be very empowering (also for when a woman WANTS to get pregnant)."
This is the best BC method for a woman if she wants to become pregnant but, see, we're talking about women who want to be responsible and do not wish to become pregnant. And there is nothing empowering about being pregnant when you don't want to be.
There's something very sick and cruel about the religious right's obsessive interest in forcing women to gestate children they cannot afford to feed or care for. Nobody who endorses NFP is serious about reducing the number of unwanted pregnancies and, thus, abortions.
But what most NFP advocates want is for NFP to receive special treatment. They don't want honest information about its high failure rate, and they want it to get more attention and promotion above other methods that work better, are easier to use, and give control to women. NFP is remarkably hard for women to control, since it relies on women repeatedly telling pushy male partners no. Considering that it's promoted by the same people promoting very old-fashioned gender roles---where you can't say no to your man when he tells you to do the dishes, much less have sex with him---it's especiallly obvious that the whole point of promoting NFP is not to give women a tool to control their fertility, but to get them pregnant while condescendingly pretending to respect their rights.
Now, some granola hippie types use it effectively. But it requires a level of respect for women's right to say no that is not evident in any religious tradition that pushes the "different roles" view of the genders.
I understand your suspicion about the HHS grant, but I have to admit I'm tired of hearing this kind of attitude about natural family planning. First, let's clear on something: Natural family planning is NOT the rhythm method.
To achieve the lowest failure rates, NFP requires basal body temp charting and the use of a back up method during certain points in a woman's cycle, and good partner communication. Clearly, it is not going to be a good choice for women who aren't in steady, monogamous relationships, or who don't communicate well with their partner. These conditions do not automatically exclude every woman that gets her reproductive health care from a Title X clinic.
Moreover, it's not just the choice of the "very religious." I'm an atheist working in development for a large family planning/abortion care clinic, and I've been using it for about two years. And while the pill was easier in many respects, charting has helped me improve my understanding of my body and cycle, and has made contraception the responsibility of both me and my partner.
NFP could be a great addition to full range of contraceptive options offered at Title X clinics, but only if clinic staff really understand the method and when it is appropriate to recommend it.
While we should be on guard against anything that might open up crisis pregnancy centers to Title X, we should not let that prevent us from providing the fullest range of contraceptive options to low income women.
"These conditions do not automatically exclude every woman that gets her reproductive health care from a Title X clinic."
The notion that those are the only two disqualifers for a 'contraceptive' method with a failure rate of 25% is not very compelling.
There are many considerations that women should take into account when choosing a contraceptive method. But what is the difference between a woman visiting a traditional ob/gyn office and a Title X clinic?
Income.
And I don't believe that income should be a barrier between women and the best method for their life/relationship/reproductive health plan.
To the person who pointed out that NFP isn't the rhythm method: good methods of NFP aren't the rhythm method. But the one they're promoting IS - CycleBeads are a visual way to teach rhythm'n'blues method. From what i can tell from the coverage, the grant isn't for promoting mucus or sympto-thermal methods, it's for promoting guess'n'check methods.
Sorry. I'm a fan of NFP but i think a $600,000 grant to promote rhythm method is a bad idea all round.
Read some of their work that they've already published before you condemn it. They found a 95% effectiveness rate for their cycle beads in developing countries. Only a fraction of women have cycles sufficiently regular for this method, but for those women, it's essentially free and requires only that they move the ring around the bead every day to count days. Women report liking that both they and their partners feel involved. On the safe days they can have sex without protection and on the unsafe days they have to either abstain or use condoms, so it also helps with reality that not everyone can afford as many condoms as they need.
I agree with the previous posters - I'm pro-choice, and depended on Title X in the past, and I just wanted to chime with about my love of the Cycle Beads developed by Georgetown's Institute for Reproductive Health. I believe fertility awareness is an option or addition to other forms of birth control that is cheap, safe, and relatively effective when used correctly (and even more safe and effective when combined with condoms and/or spermicide).
True, NFP, or "NFP plus" as I like to call it, isn't right for everyone, but neither is any specific form of birth control. Single women and young women deserve access to these options as much as anyone else. As long as the money isn't being funneled away from supplying other forms of birth control or the provision of health services, it's OK with me. :)
Cristina, I'm glad that it is not just a prolifer like me raising these arguments here in favor of fertility awareness/natural family planning as a good option for many people, just as worthy of consideration and access as any other contraceptive method available.
It's a mistake, I think, to regard FAM/NFP as just an "antichoice" imposition from those who shudder at any kind of family planning and equate it with abortion or a "culture of death."
As for effectiveness, when condoms, diaphragms, and pills are not practiced diligently and correctly, they don't work, either.
FAM/NFP can have feminist benefits in a relationship, because it requires male/female cooperation and open communication at all times. Also many couples choose during the fertile period especially to have forms of sex other than penis-vagina, which can make for a more varied, imaginative, and enjoyable sex life.
FAM/NFP also has low ecological impact, and can be readily adapted to low-resource settings all over the globe. It is a method where people rely on knowledge of their own bodies more than any manufacturing processes.
Family Planning: A Global Handbook for Providers, the manual in use by the World Health Organization, includes FAM/NFP:
http://www.infoforhealth.org/globalhandbook/
Another very interesting website is Katie Singer's Garden of Fertility, which is welcoming for people of all faiths and none:
http://www.gardenoffertility.com/
Nonviolent Choice Directory, http://www.nonviolentchoice.blogspot.com
Weren't you saying before that you're one of those pro-lifers we hear about who is sincerely pro-contraception? It's more than a little odd that you're devoted to a form of family planning with a ridiculously high failure rate and a dependence on levels of male cooperation that most women will never have access to. I'd think a genuinely pro-prevention pro-lifer would be most interested in promoting forms of contraception that give all the control to women and require no male cooperation, which means that they're the most likely to be used correctly to prevent pregnancy, since women put a higher priority on that than men on average.
Very interesting. You didn't even mention that NFP can be used in conjunction with condoms during fertile periods to truly reduce your risk. As someone who claims to be 100% feminist and pro-prevention, that's a fascinating omission of useful information that could actually help women.
If it's essentially free, why do they need $600,000 for it?
What makes you think it's not available already? How unavailable could a timing-based method be?
And it wouldn't save much money on condoms. MOST days are potentially-fertile days; the truly safe days are only a few days a month, some cycles contain no safe days at all.
This is all doublespeak; Georgetown's project is essentially about LOBBYING women to rely on an unreliable method.
There is a name for people who use the NFP method, they are called parents.
It's great to know about one's body (people need to know about their reproductive organs and women about their cycles), however NFP is highly ineffective. Sperm can live inside a woman for up to 7 days, if one has sex on a "safe day" and then the woman ovulates 4 days later, she could get pregnant due to the possibility of sperm still being inside her....
When is comes down to it, there aren't many "safe days" after all.
Withdrawl and the NFP are better than nothing and should be taught but we need to emphasize birth control methods that are more than 95% effective.
There is a name for people who use the NFP method, they are called parents.
It's great to know about one's body (people need to know about their reproductive organs and women about their cycles), however NFP is highly ineffective. Sperm can live inside a woman for up to 7 days, if one has sex on a "safe day" and then the woman ovulates 4 days later, she could get pregnant due to the possibility of sperm still being inside her....
When is comes down to it, there aren't many "safe days" after all.
Withdrawl and the NFP are better than nothing and should be taught but we need to emphasize birth control methods that are more than 95% effective.
while nfp, also known as the fertility awareness method, isn't for everybody, when practiced properly it is a very effective method (98-80% effective)
it only requires abstinence or a back-up method during about 1/3 of ones cycle
and in my experience, taking your temp avery morning and observing cervical fluid throughout the day is no more hassle than any other method
i think its nice to see some credit being given to a bcp method that isn't hormonal, isn't visible (like norplant or a bcp patch), isn't invasive (like depo or an iud), isn't messy like a spermicide, doesn't require last minute fumbling (like condoms, diaphrams, sponges ...), doesn't require a prescription or a visit to the healthcare provider, gives the male some portion of responsibility, gives the female a deeper body knowledge....
"it only requires abstinence or a back-up method during about 1/3 of ones cycle"
"Only," huh? Perhaps some of us don't want to be abstinent for "only" a third of the month. And there are women whose male SOs certainly wouldn't stand for that, and would pressure them for sex (or force them into it).
"and in my experience, taking your temp avery morning and observing cervical fluid throughout the day is no more hassle than any other method"
Your experience != everyone else's.
The natural method will not work. This happens alot more frequently than most people realize even in marriage. This is such a waste of time. Women need REAL protection all the time from monster men.
Personally, I refuse to define my contraceptive choices by the remote possibility that I will be the victim of rape. Your argument is worryingly similar to the anti-choice rhetoric of 'It's your fault if you are pregnant from rape, you should have been on the pill if you didn't want babies'.
I am not saying that rape does not occur, or that it isn't a serious problem but I feel that to make the assumption that it is likely to happen to me is admitting defeat. I would rather take action to decrease the number of rapes (better sentencing procedures, change of 'rape-culture', etc) than have my actions ruled my attempting to pre-emptively minimise the consequences.
As it turns out, I am on the pill but this is because I am in a relationship and wish to have pregnancy-free consensual sex. There are downsides to my method of bc (mood swings, yeast infections, breast changes, etc) but I choose to put up with them because I want to be having sex. By your argument I ought to inflict these on myself from menarche to menopause regardless of whether I have any intention of being sexually active or not.
Are you suggesting that girls as young as 10 need to go on hbc if they have started their periods?
In addition to ruling out FAM / NFP your argument would equally condemn all barrier-methods of contraception.
I tried the NFP method Cycle Beads. While it was nice to figure out what was happening in my body when, relying on it for birth control was horrible. We are still trying to avoid having kids because we have no means of supporting them, and don't want to ask anyone else (family, the gov't) for the money. We almost never had sex because there were so few "safe" days, so we'd go months, even seasons, without sex. There was no good time to let my husband touch me, so i was constantly pushing him away, so he turned to porn instead, which built more resentment. Then my cycle went irregular and the NFP method was absolutely useless.
I've read some Catholic NFP literature that claims that artificial contraception hurts marriages--bullcrap, the NFP almost killed mine.
Hi, me again! I'm the Anonymous who posted "I tried the NFP method".
I wanted to make clear that I didn't particularly want to go with the NFP, but after I had an awful side effect of a certain brand of Pill, I was reluctant to do anymore hormonal methods, so tried it as a last resort. I was also between GYNs, and when I did get a new Dr., he was able to prescribe a Pill that I tolerate better. The Cycle Beads did help me recognize my cycles' varying lengths and helped me get Polycystic Ovaries diagnosed, so that was good, but as BC, no.
This discussion is fascinating - not so much for the content - everyone has their opinion and should be allowed to make their own choices for everything related to reproductive health (I have been in the field for 26 years advocating for the unbiased presentation of ALL methods to all women, letting them make their own choices and choose their own level of risk-taking),but for the vitriolic tone coming from the RH Reality Check staff - shooting down everyone else's opinions that are different from their own with sarcasm, anger and a tone that I have only seen before in arguments about abortion, between anti-choicers and pro-choicers...how about interviewing someone from Georgetown or asking them to discuss the project in a rational way? I know the project, and it's only goal is to implement yet another choice into the options for women, with full informed consent, and in no way to promote any method over another. So, why not tone it down a bit and remain passionate and concerned while being thoughtful,professional and calm? This kind of attacking of other women never helps us.
I totally agree with the last Anonymous comment.
I think its incredibly ironic that feminists would rather be consumers of the big pharma than take control of their own bodies by understanding their natural rhythms.
Actually, controlling to the day the timing of my period, and reducing 5-6 day flow to 2.5-3 very light days, was incredibly liberating.
I think its incredibly ironic that feminists would rather be consumers
of the big pharma than take control of their own bodies by
understanding their natural rhythms.
Wow, sorry we aren't able to live down to your expectations. I find it amusing that the religious right believes feminists are stupid enough to fall for this line of crap.
NFP is the 'family planning' method one uses when one wants to concieve a child.
I thought you folks were all enthused about preventing unwanted pregnancies. I thought you were interested in lowering the abortion rate, You're not going to accomplish that by pushing a 'family planning' method with a typical failure rate of 25%.
