But, even as the debate continues, both sides are agreed that natural family planning methods should be promoted as an option for couples. Indeed, DOH Sec. Manuel Dayrit has pointed out that health workers under Ligtas Buntis are first enjoined to discuss fertility awareness to enlighten couples that they are capable of practicing NFP even before discussing various methods of family planning. In effect, according to him, the campaign is “the greatest opportunity the country has ever enjoyed to promote Natural Family Planning.” It is in this light, that our pastoral experience in the Prelature of Ipil over the past three years may offer some on-the-ground perspectives.
I. From BBT and BOM to All-NFP
Since the mid-70’s, the Prelature of Ipil, which was then a Jesuit Mission District of the Archdiocese of Zamboanga, has been a pilot area for the earlier NFP methods – such as the Basal Body Temperature method (BBT) and the Billings Ovulation Method (BOM). However, with the dissociation of the church from the government’s family planning program at that time and the end of outside funding by the mid-80’s, the NFP program reached a plateau and slowed down.
In October 2001, however, some of our prelature workers visited Impasugong, Bukidnon, where a new NFP method, called the Standard Days Method (SDM), was being piloted among small farmer couples. The prelature followed this up with a seminar in February 2002 on Family Life and Responsible Parenthood for all our parish priests, religious sisters and selected lay workers.
Because of its simplicity in teaching fertility awareness with the aid of a string of cycle beads, practically all the parishes agreed to include SDM in, what we now call, the All-NFP program for the prelature. A team translated the training manuals provided by the Institute of Reproductive Health (IRH) of Georgetown University which had been developing SDM since the mid-90’s. These manuals were also complemented by our value formation modules for our family life apostolate.
In February 2003, during the prelature’s Family Day, held as an echo of the Fourth World Meeting of Families in Manila held the previous month, the prelature formally launched its NFP-SDM program. In July of the same year, at the CBCP plenary assembly, the bishops passed a consensus vote recognizing SDM as an NFP method, provided it was not combined with contraceptives.
Training seminars were conducted at the vicariate level and in some parishes. However, the approach was still haphazard, leaving the task of covering all the 19 parishes to a few prelature workers. After a series of consultations, by June 2004, the prelature designed a five-step program for each parish. This would systematize and decentralize the All-NFP program to reach every chapel community (kapilya) or barangay.
Fig. 1 delineates this step-wise progression from the parish to the kapilya and household levels. The five steps comprise: (1) an orientation talk on responsible parenthood and NFP for parish leaders and kapilya representatives; (2) a providers’ training on All-NFP methods for kapilya representatives; (3) an orientation talk on All-NFP for the kapilya community; (4) individual counseling of couples by the kapilya-based provider; and (5) periodic reporting from the kapilya to the parish up to the prelature levels.
In September 2004, our NFP parish coordinators underwent a four-day refresher course on all NFP methods, given by the IRH staff. Starting with an overview of fertility awareness, the IRH staff went on to discuss the distinctive features of each method to enable the participants to have a comprehensive view of NFP. This has since been the content of the providers’ training seminars being given at the parish level.
Table 1 gives a six-month progress report on the service providers’ training in 13 of the 19 parishes. A total of 218 participants, including 53 couples, have taken the training so far. They represent 113 kapilyas or 18% of the total number of 626 chapel communities. A kapilya is usually coterminous with a barangay, although some large barangays may have two or three kapilyas. Not all the kapilyas were represented in the initial seminars either due to distance or lack of volunteers. A second round of seminars for clusters of parishes is being planned to reach out to the rest of the kapilyas.
What then have been the results of our All-NFP program so far? Table 2 gives the breakdown of starting and continuing users, including those who have dropped out. As of March 2005, there were 627 continuing users. Of these, 434 (or 69%) are SDM users, while 164 (or 26%) are BOM users. There are also 25 breastfeeding mothers, while four prefer the temperature method or its combination with the mucus method. The lack of thermometers, however, has been a problem for BBT users.
From the parish coordinators’ reports, 59 NFP users have dropped out for various reasons – e.g., wrong use of the method, lack of interest, pregnancy, etc. It is instructive to note, however, that only one or two users have ascribed their pregnancy due to a failure of the method itself. Two parishes were not able to provide their reports due to reorganizational difficulties.
Although the number of NFP users is still a fraction of the total number of couples, it is a promising figure for a program that has reached out so far to only a fifth of the total number of chapel communities. Prelature and parish workers have also been advised not to fast-track the program – to make sure that seminar participants are properly trained to become service providers and that each couple receives adequate counseling.
II. Objectives and Pastoral Guidelines
What are our vision and objectives for the All-NFP program in the prelature? These are based on the current situation we find in the prelature as well as perhaps in the rest of the country.
First, couples themselves have expressed a desire and felt need for family planning. This is verified by the parish priests’ interviews of couples preparing to get married. Invariably, couples want to limit the number of their children or space their births.
Secondly, many couples have expressed a growing awareness of the health risks of contraceptives such as pills or intrauterine devices. Indeed, many of our NFP users have shifted from the earlier use of contraceptives due to these health reasons. Husbands have also signified their concern over their wives’ health in this regard.
A third reason is economic: government health centers are no longer supplying free contraceptives. In contrast, NFP methods are practically cost-free or incur a one-time cost for purchasing a thermometer or a set of cycle beads. In the long run, NFP for rural households is more sustainable.
From a national perspective, the latest Philippine demographic and health survey indicates that only 33% of currently married women are using modern contraceptives, 16% are using traditional methods, and less than one percent are adopting modern NFP methods. Conversely, 51% of all couples do not have any family planning method at all (Table 3).
Despite more than three decades of government-sponsored promotion of practically free contraceptives, the question can then seriously be raised why only one third of all couples have accepted contraceptive use. Is it because the other two-thirds of Filipino couples are still looking for a family planning method that is safe, reliable — and natural?
On the other hand, a similar question can be raised why less than one percent of currently married women are adopting modern NFP methods. Has the government – as well as the church – failed to promote NFP? Or are the earlier NFP methods too difficult to adopt?
This then is our vision: to mainstream NFP by reaching out to the majority of Filipino couples who are looking for a family planning method that is safe, reliable, practicable, suited to their own circumstances, and in consonance with the Church’s moral guidelines.
The objectives for our NFP program include the following:
1. To adopt a proactive pastoral approach to address the felt needs of couples for family planning;
2. To offer an All-NFP program by making available information on all modern, scientific NFP methods – i.e., Basal Body Temperature (BBT); Billings Ovulation Method (BOM); Sympto-Thermal Method (STM); Lactational Amenorrhea Method (LAM); and Standard Days Method (SDM).
3. To promote the value formation that is integral to our Family Life Apostolate and to enable couples to make an informed and responsible choice, based on the formation of a right conscience.
In the light of these vision and objectives, we have adopted four pastoral guidelines for our All-NFP program in the prelature (cf. Fig 2).
We are pro-life. This is our first principle. We are at the service of life from the moment of conception. Hence, we are against abortion, which is also proscribed by our Constitution.
We are for Responsible Parenthood. This is our goal – to enable parents to be aware of their rights as well as their duties in the procreation and education of their children. Planning one’s family in order to adequately care for every child that comes into the world is the right and duty of Christian parents.
We are for Natural Family Planning. This is our recommended means in consonance with the moral teaching of the Church. NFP means the practice of periodic abstinence according to the natural fertility rhythm of the human body. Our promotion of NFP should include all modern, scientifically-tested NFP methods.
We are for enabling couples to make an Informed and Responsible Choice. Within the context of a secular and pluralistic society, the government’s focus is to refrain from coercion and to provide information on all family planning methods that it deems necessary and legally acceptable for couples to make an informed choice. This should eventually redound to the common good of society.
On the other hand, the church’s focus should be to provide information on all NFP methods and to help couples form a right conscience so that they are able to make not only an informed but also a responsible choice. For the majority of couples who are not using any family planning method at all, the question can be raised whether or not these couples are forced by circumstances to make uninformed and irresponsible choices in a matter that is crucial to their family life.
Ultimately, neither the government nor the church can make this choice for couples. It is their inherent right and duty as responsible parents and citizens to have this freedom of choice for themselves. This is the goal of Responsible Parenthood that both Church and State subscribe to.
III. Looking Ahead
What have been our learnings so far over the past three years in promoting a revitalized NFP program in the prelature?
First, natural family planning is not only a question of methods but more so of a way of life. Hence, the church’s value formation, starting with our understanding of the human person, is essential to motivate couples and to help them appreciate the integral soundness of NFP for their family life. Indeed, our NFP program is viewed as a ministry and part of our Family Life Apostolate.
Secondly, NFP methods require more time and patience to teach. This includes a basic understanding of the fertility rhythm of the human body, as well as the observation of the various natural signs related to ovulation. In this regard, NFP service providers have to be properly trained to provide adequate counseling for individual couples. This is in contrast to the “quick fix” mentality often associated with dispensers of artificial contraceptives.
Thirdly, there is a whole range of modern scientifically-tested NFP methods and approaches that are available today. Couples interested in NFP appreciate being given an overview of all the methods to enable them to choose a particular method suited to their own circumstances. Even as we take exception to the government’s “cafeteria” approach in presenting all methods, it is a pastoral imperative on our part to make available information on all modern NFP methods that could help couples make an informed and responsible choice.
Fourthly, among these various methods, our NFP promoters have found the Standard Days Method the most widely acceptable because of its simplicity. On the other hand, we have also noted that not a few NFP users have learned to combine NFP methods or have moved from one method to another (e.g., from SDM to BOM, or vice versa). Moreover, couples using a traditional rhythm method with their home-made formula of fertile and infertile days can readily shift to SDM without much difficulty.
It is for these reasons that we enjoin other dioceses as well as government agencies to recognize SDM as a modern NFP method that can more readily be taught to interested couples. There should be no mixing with contraceptives, and only women whose cycles fall within the cycle range of SDM should be counseled to adopt this method. Leaving out SDM from the “generic” family of NFP methods would likely exclude 70% of potential NFP users, based on our records.
Fifthly, much of our NFP promotion in Ipil Prelature has been done by resident volunteers – women, men, and couples – who view NFP as an integral dimension of their own family life. Except for the prelature and parish coordinators who receive minimal allowances, the day-to-day services and counseling are done by ordinary housewives and husbands without a fee. Along these lines, the NFP program has been greatly facilitated by our Basic Ecclesial Community structures at the chapel and neighborhood cell levels.
Volunteerism in this regard can be seen as both an asset and a liability – an asset because it highlights the sense of Christian altruism of many workers, but also a liability because there are few full-time workers, and logistical support for trainings, transportation, etc. is limited.
Sixth, if government is sincere in pushing for a responsible parenthood program that is sensitive to the religious sentiments of the majority of Filipinos, it should consider a two-track system for providing information and services for family planning. It could set aside public funds separately for local church communities or non-government organizations that promote an inclusive NFP program, which should not be seen as connected with contraceptive use at all.
In the prelature, we have noted that when barangay health workers of the government present all family planning methods together, there is a tendency for them to focus on “instant” contraceptives, or to adulterate NFP methods by suggesting contraceptives as a back-up method.
Finally, the advocacy of many church groups against the government’s agenda for reproductive health and population management could be reinforced and gain more credibility if it were matched by a concrete program for natural family planning at the local levels.
Indeed, at the 8th Plenary Assembly of the Federation of Asian Bishops in Korea in August 2004, with its theme, “The Asian Family Toward a Culture of Integral Life,” the Philippine delegates strongly recommended that “responsible parenthood and natural family planning be given particular importance in all dioceses and parishes.”
Notwithstanding the oftentimes acrimonious debates that are heard over family and life issues, much can be gained if church and government can enter into a working relationship to promote a comprehensive NFP program that no one is against – but apparently no one else has tried out either. Indeed, our All-NFP pastoral experience in Ipil Prelature indicates that NFP is a valid, viable, and vital option for a growing number of couples.
Antonio J. Ledesma, S.J.
Bishop, Prelature of Ipil
 “Ligtas Buntis 2005 campaign” information flyer.
 Summarized by Congresswoman Josefina Joson, Chair, Committee on Women, House of Representatives, at the Breakfast Dialogue on “Responsible Parenthood and Population Management Act of 2005,” sponsored by the Bishops-Businessmen’s Conference for Human Development, Makati, 16 March 2005.
 Atty. Jo Imbong, Executive Secretary, CBCP Legal Office, “Reckless and Irresponsible, The Legal Implications of Population Control,” 25 January 2005; and Archbishop Fernando Capalla, CBCP President, “Hold on to Your Precious Gift,” Manila, 18 February 2005.
 Manuel Dayrit, Secretary of Health, Letter to Brothers and Sisters in Christ, 28 January 2005.
 CBCP, Selective Analytical Index, Plenary Assemblies 1945 – 2003, Manila, 2004, p. 62 & 131.
 Another NFP method that may be disseminated soon by IRH – Georgetown, after several years of testing, is the Two Days Method.
 “Christian parents must exercise responsible parenthood. While nurturing a generous attitude towards bringing new human life into the world, they should strive to beget only those children whom they can raise up in a truly human and Christian way. Towards this end, they need to plan their families according to the moral norms taught by the Church.” (Acts and Decrees of the Second Plenary Council of the Philippines, CBCP, Manila, 1991, no. 583.)
 “Periodic continence, that is, the methods of birth regulation based on self-observation and the use of infertile periods, are in conformity with the objective criteria of morality. These methods respect the bodies of the spouses, encourage tenderness between them and favor the education of an authentic freedom.” (Catechism of the Catholic Church, Vatican City, 1994, no. 2370.)
 “The state has a responsibility for its citizens’ well-being. In this capacity it is legitimate for it to intervene to orient the demography of the population. This can be done by means of objective and respectful information, but certainly not by authoritarian, coercive measures. The state may not legitimately usurp the initiative of spouses, who have primary responsibility for the procreation and education of their children. In this area, it is not authorized to employ means contrary to the moral law.” (CCC, no. 2372)
 Archbishop Paciano Aniceto, Chairman, Episcopal Commission on Family and Life, Report to the CBCP Plenary Assembly, 23 January 2005.