by Mandy Cox
The use of Natural Family Planning (NFP) continues to increase as access to scientifically developed, professionally delivered methods expands. Most engaged couples are exposed to the basics of NFP during their marriage preparation, and some dioceses even require NFP classes as part of marriage preparation in the Church. There is also an expanded awareness of the insights NFP offers into common health issues, such as irregular cycles, endometriosis, polycystic ovarian disease (PCOD), miscarriage, infertility, and more (Are we abandoning women? | Catholic Benefits Association)
DIFFICULT CIRCUMSTANCES
There are many difficult circumstances that women and couples can face due to reproductive health issues. When these circumstances arise, there can be serious questions about using contraceptives to help.
- The young woman experiencing painful periods and considering dropping out of college because she has missed school so often. Is the birth control pill her only solution to stop the pain?
- The mother experiencing severe postpartum depression or psychosis, and her husband who feels helpless in supporting her. Are condoms or barrier methods their only answer?
- The couple facing serious reasons to permanently avoid pregnancy due to severe health issues. Is sterilization their only choice?
- The couple diagnosed with “unexplained infertility” or irregular cycles. Will going on the pill help regulate her cycles to help them achieve pregnancy later?
In many of these cases, women may be given only one solution: artificial contraceptives or sterilization.
As a member of CBA, your organization does not cover artificial contraceptives in its health plan. If an employee brings one of these issues to you, are you prepared to provide guidance to address these serious issues?
EVALUATING THE ETHICS – MOTIVATION MATTERS
The use of a hormonal contraceptives or sterilization procedure may not be immoral, but the motivation matters.
The Ethical and Religious Directives for Catholic Health Care Services provide guidance to Catholic institutions, but they also provide clarity for issues around health care. Paragraph 53 states, “Procedures that induce sterility (temporarily or permanently) are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.”
In other words, treatments that seek to address a health issue are moral, as long as the contraceptive action is not the primary motivation. This would be the case if a woman had her ovaries removed due to ovarian cancer. The medical treatment for her serious condition is to remove the diseased organ. The resulting infertility is only tolerated, but it is not the primary motivation for the treatment.
However, this would not be the case in all serious situations. A couple facing a serious reason to avoid pregnancy, like cardiomyopathy, cannot morally use hormonal contraceptives to avoid pregnancy. The hormonal contraceptive is not treating the health issue, which in this case would be the heart; it instead is only being used for contraception.
The pathology must be serious in nature and there must not be a simpler treatment. The treatment must directly target the pathology, not simply acting as a contraceptive in hopes of avoiding a pathology brought on by pregnancy or childbirth.
THE CHALLENGE OF ABORTIFACIENTS
An even greater issue presented by many types of birth control is that they can cause early abortions. The hormonal birth control pill and intrauterine devices (IUDs) have a primary mechanism of action the interference in the ability for a newly conceived life to successfully implant in the mother’s uterus. This means that they are not strictly contraceptive but act as an abortifacient.
Most women and couples are not educated on the abortifacient action of some “contraceptives”. If an employee has been prescribed hormonal contraceptives or an IUD to treat an issue, it is important that they are provided education on how these treatments could affect a future pregnancy.
PREPARING FOR DIFFICULT CONVERSATIONS
Women and couples facing difficult circumstances deserve guidance and help. If an employee comes to you with a request for coverage for a contraceptive, it is important to understand the circumstances behind the request. If the request for this coverage is intended to address an underlying health issue, it can help to evaluate the following:
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Is the health issue directly improved or treated with the contraceptive?
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Is the motivation for using the contraceptive primarily to avoid pregnancy, or is the contraceptive function only tolerated in hopes of improved health for an underlying issue?
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Is there another option for treatment that is already covered on your health plan?
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Should you ask the employee to get a second opinion to confirm the recommended course of treatment?
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Are their local resources you can refer the employee to for a morally-aligned opinion?
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If the contraceptive is approved for the time being, is there a plan you can put in place to help her find life-affirming, morally-aligned solutions?
NAPROTECHNOLOGY AND NATURAL FAMILY PLANNING
The teachings of the Catholic Church are not simply a “no” but instead provide authentic answers to human problems. For serious gynecological health issues, the Church strongly supports medical treatments that identify and treat underlying conditions at their source.
Couples who have serious reason to avoid pregnancy should have access to professionally delivered methods of Natural Family Planning. These couples deserve NFP methods that help them effectively navigate their fertility without the moral and physical danger of abortifacient pills. One simple thing you can do is ensure your employees know what methods of NFP are available in your area.
NaProTechnology is a women’s health science that respects fertility and treats causes of gynecological health issues. This medical approach does not rely on hormonal or barrier contraceptives or abortifacients to mask symptoms, but instead identifies and treats health issues at their source. This is the answer for women and couples facing gynecological health issues who desire a treatment that respects fertility.
WHAT YOU CAN DO
As a Catholic organization, your health plan should provide access to life-affirming health care. This blog can help you discover what care should be covered on the health plan, Catholic Employers Should Cover and Promote NFP and NaProTECHNOLOGY in Their Health Plans | Catholic Benefits Association.
Now is the time to build a comprehensive list of resources available in your area. Most methods of modern NFP offer virtual learning opportunities with trained teachers. Many NFP-only physicians and NaProTechnology providers offer telemedicine or take long-distance patients. Saint Paul VI Institute in Omaha, NE has helped women from around the country and beyond to receive evaluation and treatment of serious health issues, check them out here Evaluation and Treatment Programs – Saint Paul VI Institute.
Finally, it may be time to look at expanded resources offered by your health plan and employee benefits. Here are some things to consider:
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reimbursement or funds to receive NFP education
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Catholic providers who should be covered on your plan
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Telemedicine options, like MyCatholicDoctor, MyCatholicDoctor – Faithful Healthcare You Can Trust, that can be added to your benefits offerings.
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Create a local resource list to have on hand for difficult conversations.
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Create employee education resources that align with the Catholic mission of your organization.
HELP IS ON THE WAY – Catholic Professional Development: Formed Leaders Form Culture
In 2025 CBA will be rolling out Catholic professional development. This resource will help leaders at Catholic organizations who are tasked with these employee conversations. This formation will aid you is clearly expressing how the mission of your organization is reflected in the structure of the benefits it offers. It will include resources and tools that you can share with the employees you serve.
Need help now, remember to reach out to CBA. We are here to help.
Need a refresher:
Evaluating the Ethics: Family Planning Methods | Catholic Benefits Association