Monday 15 August 2011

Too much information: NFP and the Eeeew! factor

** gentle warning - the following blog entry dips into the nitty gritty of fertility awareness, just a little bit. If that kind of thing makes you feel queasy, then perhaps read about one of my favourite cities here **

Girls only sign @ nomads, Byron Bay, Australia
Picture credit: Joaopisco
Not everything needs to be shared... 

A long, long time ago in the bad old days women used to give birth surrounded by birth attendants (midwives, doctors, nurses) while the father nervously paced outside the birth-room anxiously awaiting the arrival of his child. Then, in the 1970s, a pioneering French obstetrician called Michel Odent introduced (amidst some excellent obstetric reforms) the notion of the father being present at the birth. From the exception, the presence of fathers at a birth became the rule. In time, Fathers who were not present at their children's births were considered to be insensitive oafs, even if their fretting often became a distraction to the birth attendants and a source of stress to the labouring mother. These days the norm is that the father is present at the birth, and if he chooses not to, it is considered odd. And yet... and yet... Michel Odent has changed his tune. He says that he never meant the presence of fathers at the birth to become an orthodoxy. He never meant it to be compulsory. He simply didn't want to exclude those fathers who wanted  -- and were wanted by their wives -- to be present at the birth of their child. Now he says that the new orthodoxy of having fathers present - whether they want to or not -- is bad for the birthing woman and, crucially for my point below, bad for the relationship of the parents. Put simply - being down at the "business end" of a birth is traumatic for many men, and can affect their relationship with their wife.

I have similar thoughts about NFP. Done properly, a sympto-thermal approach to fertility awareness involves recording temperature, the position of the cervix and texture/colour of cervical mucus as well as any minor symptoms. Is it really either necessary or desirable for a husband to get involved with this? What possible positive outcome can a discussion of cervical mucus have? The breakfast table conversation just doesn't bear thinking about.

I know there's a tendency for "new men" to like to demonstrate that they are incredibly sensitive and understanding of their women's trials and tribulations. There's even a syndrome whereby men believe themselves to "suffer" from morning sickness when their wives are pregnant (ahem!). But surely it's madness to expect a couple to "discuss" a woman's fertility symptoms on a regular basis? Even the idea of a couple in together with an instructor to be "trained" in fertility awareness / NFP seems a bit eeeeew.

Is the inclusion of men simply a nod to political correctness - if men are supposed to be at the birth of their child, the least they can do is involve themselves with the fertility business beforehand? Is this an echo of the contraception mantra that "men must take responsibility too"? As Catholics we know that men and women were made differently: our bodies are different, and so are our roles. Any attempt to make fertility awareness a "team effort" is a sham: the best a man is going be able to do is nod sympathetically; further involvement is, as the French say, grossière (a nice amalgamation of coarse, vulgar and yuck!).

Fertility awareness is a really valuable tool, it's helpful for a woman to understand her cycle, to know what's normal and what's not. Recording fertiliity data can helpful in diagnosing the reasons for infertility, secondary inferility, or point towards causes of miscarriage. The issues around the information gleaned from practicing fertility awareness could be useful to a couple - for example being aware that cycles are (likely to be) fertile again after a birth - and subjects for legitimate discussion. However I don't see any rationale for including men in the teaching of fertility awareness or NFP. For Catholics, sex is about much more than the mechanics. Including men in the practice of NFP  focuses the mind on the body rather than the whole person.  It seems like a cringe-making bit of political correctness, and surely is unhelpful to a couple's intimate life. What wife wants her husband to be thinking "Temperature - check! Cevical mucus - check! Cervix open - check!" rather than a simple "Wow, I really love this person!"?


  1. I remember my mother telling me that my father was outside in the corridor smoking a cigarette when she gave birth to my younger sister. How times change!

    Another incident was at a Crystal Palace match I attended as a boy. An announcement was made over the loudspeakers: "To Mr John Smith. Congratulations! Your wife has just given birth to a baby girl." Perhaps that's taking things a bit too far :-)

    I do agree about the details of NFP. As a priest I now disappear discreetly into the presbytery when the NFP talk gets underway. More information than I really need.

  2. I have never used NFP so can't really comment on it, though I know my husband would be appalled at the thought of it, but I was very interested to hear that it is not supposed to be mandatory. When I had my youngest child everyone: parents, sisters and friends took it for granted he would be present during labour as it had recently become the norm When I had my other children it was unthinkable. I asked my husband if he wanted to, and to my utter relief he said he'd rather not. I was even more glad he wasn't there when I was in labour. I have very easy births and spent the time between contractions dozing or saying Hail Marys and I was glad I didn't have to chat. Since then it seems to have become compulsory and I've often wondered what it does to marriages and how it truly affects men. Glad to know others have doubts too.

  3. I personally don't even go there re the cervix examinations! I agree with your reservations re be honest nfp isn't can accept babies as they come without resorting to spacing techniques..just my 2 cents!

  4. @Jean - I think it needs to be down to the couple to decide, unfortunately these days there seems to be a lot of pressure for *all* fathers to be at the birth, which in many cases isn't any good for anyone. What you say about your births reflects the evidence that women birth more effectively in calm situations where they aren't called to use their higher faculties; experienced midwives often point out that talking to a woman in labour, asking her questions, expecting her to come out of herself and talk, slows labour down and stops the "flow". I find it really interesting that the Obstetrician who pioneered fathers being present is now trying to clarify the situation (he's a good egg, Michel Odent :-).

  5. @Jackie - cervical exams are the weak link as the baseline has to be "relearned" after each birth due to changes in the cervix. Rather pointless, particularly for lucky mothers of large families who would have to start from scratch, say, 10 times! ;-) Totally agree that it isn't necessary, but think that fertility awareness is useful knowledge. You'd be amazed how many women simply don't know how their bodies work! Surely *that* (a basic understanding of one's own biology) should be the point of any "sex education" rather than all the all the poisonous stuff that's taught!

  6. @Fr Finigan - I'm not surprised, I'd be off like a shot too! Books and one-to-one teaching seem like a more reasonable way to tackle the subject. Like sex-ed in schools, I'm not sure that in-depth NFP/fertility awareness is really suited to group discussion.

  7. *Disclaimer* - I'm a single/childless Catholic. However, I'm also very interested in midwifery, and almost all of my friends are Catholics with several children, so these topics come up a lot in conversation.
    Now, I agree with some of what you say: while part of me thinks that men should be present during labour and birth to help their wives and see what they go through, I also realize that they may be bothered by this to the point of harm, and completely agree that labouring women generally do best if left alone in peace and quiet and the care of a competent midwife (I've read, and agree with, some of Michel Odent's writings). And personally, I'm not sure I'd want the man I love to witness me sweating, grunting, and going through all the frankly gross stuff that accompanies the birth of a child - so I don't actually disagree with leaving men out of the delivery room.
    About NFP, though - what's so wrong with shared responsibility? I thought, contrary to what you wrote above, that it was the artificial-contraception group that was all about putting the responsibility on the woman (unless the man didn't trust her to "take care of it", and grudgingly did something himself); get her on the pill, get her tubes tied, or do one or more of the other ghastly things they do to women in trying to fend off fertility. While I'm not at all Christopher West-ish, it does seems more Catholic for the man to have some understanding of his wife's fertility and to, therefore, share the responsibility and awareness of her - or rather, their - fertility in some way. I'm against the all-too-common practice of every Catholic couple constantly using NFP regardless of grave need - it seems, in those cases, to be all about "planning" families with the contraceptive mindset rather than loving each other and trusting in God - but I've also seen plenty of cases of "good Catholic men" using their wives whenever they want, with little or no regard for her health, and I don't think that's how God wants marriage to be either. While I wouldn't want to be consulting charts and checklists every single day (unless, of course, there was a serious need) (I mean, seriously, talk about a romance/moment killer!), might not some knowledge of the wife's physical processes promote understanding at certain times in the relationship?

  8. @Talitha Cumi - thanks for your comment, you've raised some interesting points. I think that the birth question really depends on the couple. Odent's point was that either should be acceptable. I also think that the method of birth can make a difference to a husband's perception: a natural active birth where a woman is upright or kneeling and can be partially clothed, can move around and so forth is far more dignified than an obstetric birth where a woman is often in a supine or semi-supine position, feet in stirrups etc. A woman is far more exposed in an obstetric birth; in a natural birth there's often little or nothing to "see". I have had my husband at my births, but they've been quiet, natural births at home and he's just let me get on with things, while I've been happy just to have him *around* - I don't want to engage. Many men, particularly when they perceive their wives to be in pain, want to help and this "help" often gets in the way of the birthing woman and/or her attendants. One top tip is to get a TENS machine and ask the husband to figure out how to use it (on himself) during the labour (as a "helpful" thing to do) -- quite often the baby will be born before he gets the hang of the machine.

    Re. NFP - I'm not against men having a basic understanding of biology (obviously!), but I'm really uncertain as to the benefit of a couple's intimate life being dissected in front of a stranger into information about cervical position and openness, changing secretions, and so forth. I think everybody should understand the headlines, but I think the rest falls under "too much information".

    As for the "cases of 'good Catholic men' using their wives whenever they want, with little or no regard for her health" - I think the first thing to say is that clearly these men are not "good Catholics" (which is presumably why you've used quotation marks) secondly there are obviously profound problems if one person is "using" another with "no regard for her health" as that utterly contradicts the Catholic understanding of marriage, sexuality, and so forth. I'm not sure that a tutorial on the minutiae of cervical mucus would improve that situation, but I'm so utterly shocked by what you describe that I'm at a loss to suggest anything. If these men are consciously going against Catholic doctrine for their own satisfaction, I think they need a more profound conversion than a NFP course is going to offer.