Monday, December 12, 2005

Natural Family Planning and SDM in the Local Church

At the plenary assembly of the Catholic Bishop’s Conference of the Philippines (CBCP) in July 2003, two consensus votes were taken with regard to family planning. The first vote was a no to collaboration with the government’s total family planning program. The second vote, however, was a yes to the diocese’s use of the Standard Days Method (SDM) in its own program of natural family planning (NFP) — without any contraceptive component and without collaboration with government.

The first vote maintained the Church’s critical stance against the government’s population program, which was still perceived to be dictated by a contraceptive mentality. This apprehension among bishops persisted even if the present administration of President Gloria Macapagal- Arroyo, a devout Catholic, had earlier indicated its preference for natural family planning methods.

Indeed, this preference for the NFP methods by government was heightened by the introduction of a new and simpler NFP method, called the Standard Days Method. Ironically, however, objections to SDM came not from government quarters but from several church-related groups, particularly those who were promoting the earlier-recognized NFP methods such as the Basal Body Temperature method (BBT), the Billings Ovulation Method (BOM), and the Sympto-Thermal Method (STM).

For them, SDM was suspect because it was being promoted by government, presumably with some back-up contraceptive methods; the research for SDM was funded by USAID; the method was not yet fully tested; and it was nothing more than the old calendar-rhythm method that had already been discredited as unreliable. Moreover, SDM could not be considered as NFP because it did not involve the daily examination of bodily signs and symptoms.

This then is the significance of the second vote at the CBCP assembly. Notwithstanding these objections, the bishops as a body recognized SDM in itself as a natural family planning method. Provided it is not mixed with contraceptives, is not seen as a government program with its cafeteria approach, and is accompanied with the proper value formation to avoid a contraceptive mentality, the bishops did not voice any objections to the inclusion of SDM in the local church’s program for natural family planning. Indeed, since the CBCP has distanced itself from the government’s NFP program, all the more should the local church promote its own comprehensive NFP program that includes SDM.

What is the Standard Days Method in the first place? SDM is a new calendar-based method of family planning based on fertility awareness. It helps a woman know her fertile days by simply counting the days of her cycle, starting with the first day of menstruation. It identifies days 8-19 of the cycle as the fertile period when pregnancy may occur if there is intercourse. Days 1-7 and the rest of the days after day 19 are identified as non-fertile days.

SDM’s “fertile window” of days 8-19 has been standardized and is applicable only for women whose menstrual cycles range from 26 to 32 days. It is made clear from the outset that SDM is not applicable to all women. In this sense, despite its simplicity, SDM cannot be the exclusive NFP method for the local church to promote; but neither should it be the excluded method.

SDM was developed by the Institute for Reproductive Health (IRH) of Georgetown University, the oldest Catholic university in the United States. It is the result of an extensive research process spanning sic years since the mid-90s, involving pilot sites in Bolivia, Peru and the Philippines. The concept of SDM was first validated through computer simulation of over 7, 600 cycles provided by the World Health Organization from its ovulation method trials. It has since then been clinically tested with a high effectiveness rate of 95.25% in the three countries where almost 500 women were followed up for 13 cycles.

To help women track the days of their menstrual cycle, IRH devised a necklace of cycle beads consisting of 32 colored beads, representing the day of menstruation (red), the fertile days (white), and the infertile days (brown). Hence, couples can easily know the days when they should abstain from intercourse if they wish to avoid pregnancy. Or they may also use the same beads to achieve pregnancy.

Currently, SDM is being introduced in 14 countries, including India, Turkey, and Egypt, and several smaller countries in Africa and Latin America. In the U.S. as well as in other parts of the world, the cycle beads for SDM are being sold over the internet. Following its mandate, IRH-Georgetown continues to test and develop other simplified NFP methods. Earlier, it had developed the Lactational Amennorhea Method (LAM), which is now widely promoted by both government and church agencies. It also continues to streamline teaching aids for BOM and STM promoters.

In October 2003, a training workshop for NFP-SDM providers was hosted by Malaybay Diocese and opened to other dioceses in Mindanao. Five dioceses sent participants. The majority came from seven pilot parishes in Bukidnon, including the parish of Phillips. Spanning three decades since the mid-70’s, Camp Phillips had hosted the interdiocesan training program on the earlier-known NFP methods. This was sponsored periodically by the Episcopal Commission on Family and Life.

In their sharing, the participants saw the usefulness and need for a simplified method like SDM to be included in the church’s NFP program—particularly for those who found it difficult to keep daily records of body temperature or mucus characteristics. This assessment of SDM was reinforced during their field visits to two pilot barangays where SDM had been introduced over the past two years with the help of a non-government organization.

In one site, SDM was found to be widely acceptable not only among Catholics but also among couples of other religious affiliations. A notable number of couples had chosen to shift from the use of contraceptives to SDM. In the other site, a mother described how SDM was now being passed on to the next generation: her own 16-year old daughter was the one reminding her to move the cycle beads everyday.

Moreover, in other parts of Mindanao, Muslim couples have also expressed their interest in SDM as an NFP method. During the first quarter of 2004, two more training workshops for NFP-SDM providers were hosted by the local churches of Basilan and Sulu for their family life workers, including several Muslim women. The participants were enthusiastic about SDM as a practicable method that could easily be taught to both Christian and Muslim communities.

It is in this light that all these participants were perhaps simply reflecting the sentiments of Fr. Vicente San Juan, S.J., former ECFL executive secretary, and prime mover for many years of the NFP training course in Phillips. Although now in semi-retirement, Fr. San Juan had no qualms in endorsing SDM as a new NFP method, remarking that the principal criterion should be “what a method does to a couple’s life.”

In the Prelature of Ipil, we have included SDM as an added option in our natural family planning program under our family life apostolate. Even as we continue to promote the earlier-known methods, we note that the couples themselves have found SDM a much easier method to learn. “Why did you not teach this to us earlier?” has been a common reaction. We have also devised a less expensive string of “vertical beads” to help couples track the days of the menstrual cycle.

However, because the practice of NFP entails a way of life, our family life workers have made sure to include formation life values in the promotion of NFP-SDM. Part of this value formation is to enable couples to choose NFP as a truly human and Christian option, without combining it with other artificial contraceptives. The rule-of-thumb criterion for NFP is made clear: “no DIDO,” i.e. “no drugs, injections, devices, or operations.” Compared to the earlier NFP methods that our family life workers have been teaching over the past two decades, we find that the rate of acceptance of SDM in our pilot parishes over the past two years has increased markedly.

Indeed, couples themselves who have shifted from contraceptives to SDM tell us that the main reason they did so was SDM is natural. In this light, the prelature has included SDM in the array of modern NFP methods that we are making known to couples—first, as an added option for couples in their desire to follow the moral guidelines of the church; and secondly, as a pastoral imperative for the local church, to enable couples to make an informed and responsible choice with regard to family planning. Over all, in our 19 parishes, as of June 2004, our family life workers have tallied 366 current users of natural family planning methods: 261 with SDM, 102 with BOM, and one each with BBT, STM, and LAM.

“The future of humanity,” points of Pope John Paul II, “passes by way of the family.” The same thing can be said of the population issue confronting developing countries like the Philippines today. Population management cannot be done by government alone; ultimately it rests on countless couples exercising responsible parenthood through family planning. For Catholic couples, this means natural family planning. And the more NFP options we can make available to them, the more we can empower them to exercise responsible parenthood.

In commemorating last year the 40th anniversary of the encyclical, Pacem in Terris, Pope John Paul II reminds us his predecessor’s teaching that every human right involves a correspondingly duty. The same reminder can be made with regard to the whole area of family life. Couples should exercise their rights as well as their responsibilities of parenthood.

Going beyond structures to reach out people, the Holy Father invites us to engage in “gestures of peace” in our present-day world. Couples adopting NFP methods, including SDM, are hopefully among those who manifest these gestures of peace—and development—for the good of their families and the common good of their nation.

No comments: