Anti-contraception crew still at work at HHS
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 mentioned 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,
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 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 mentioned 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, 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.
About this post: posted by Cristina Page at
2/11/2009 09:28:00 PM
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While I share your concern that this amount of money is going towrd this project, the decision to fund it was made by the Bush folks last fall. I can't imagine that the new appointees will be making similar decisions.
One is blown away with your powers of insight and analysis! It seems that sucking in deep breaths and exhaling with ooooohs and aaaaahs now passes for intellectual debate and comment.
The Catholic Church, and its orders, has founded more hospitals and universities than any other group. It has been doing so for over 2,000 years. States doing such things is very recent by comparison. Perhaps informing yourself of the facts may help with a more balanced opinion in future pieces.
This is just silly.
I can't understand why there would be opposition to integrating natural family planning into the array of contraceptive options being studied and made more effective and offered as a choice - CHOICE - to people who want it? What is the underlying message here - that the "poor" are too stupid to be able to do anything besides take a pill or better a long-term fertility reducing shot? Why not then just go back to the old forced-sterilization program of people we consider undesirable to prevent their reproduction?!?
Besides the fact that your effectiveness statistics are bogus, you are absolutely wrong to suggest that it is only conservative religious people who want to learn it. Toni Wechsler's feminist book, Taking Charge of Your Fertility, is a bestseller and NOT because she's Catholic. As far as I know, she's not. Catholics go to other sources for NFP instruction anyway. Because most poor people would not want to use it, that's a reason to make sure they never EVER get the chance to, or that ways of working with it are NEVER EVER devised to make it effective for them?
I used to teach NFP in a liberal midwest college town. I had tons of non-religious women who were anxious to learn about it because it is an effective, natural option. No Title X recipients, of course, but some low-income people are capable of having questions about the safety and efficacy of fertility-altering chemicals.
This grant "aroused" your "suspicions"? Suspicions that somewhere, someone might choose something natural rather than technological to control their fertility and the pharmaceutical companies might cease to produce synthetic hormones and chemicals altogether?
That someone somewhere might exercise their freedom of religion (there might even be one or two faithful Catholic poor people - and I agree that it is their own Church who should be providing them with NFP instruction, and many Catholic orders, including Mother Teresa's do so) and be able to rely on a safe, effective, well-researched method of natural birth control rather than always have to resort to technological means?
I think this paranoia that anything that anyone who might be slightly religious may have ever promoted, used or even once heard-about should be stamped out just on principle is a real threat to freedom.
As an advanced practice nurse, I would encourage you to take the time to really look at what the research says before presenting such horrible statistics. When I review textbooks in OB and women's health I often come accross this misunderstanding and misrepresentation of statistics which you have shared in your e-mail. NFP statistics typically consist of ALL forms of "family planning" other than barrier or hormonal bunched into one. This includes those couples who use nothing (and got pregnant), withdrawl (as you pointed out having a 27% success rate), rythm, as well as "other - undefined" methods. So when you look at that statistic of 25% it is not a pure statistic but rather a "catch all" for anything not subsidized by a drug company etc. There are many wonderful SOLID scientifically based methods out there that have been around for 30+ years that are incredibly effective at not ONLY avoiding pregnancy but also helpful for couples who are trying to achieve or monitor fertility (Creighton, BIllings etc.). I would encourage you to really do some research before misleading others. As other's have commented, I am also a NFP instructor and will tell you that the MAJORITY of my couples or single women are NOT Catholic, rather they are attracted to the method because of the effectiveness to both avoid or achieve which is all back up by SOLID RESEARCH in addition to no negative side effects!! If your suspisions were "aroused" that this is a Catholic thing...why then you are very perceptive because guess what, they are one of the strong groups that see the value and inherent dignity of women and why wouldn't they want to promote what's effective and non detrimental to the woman's health?? If it works cooperatively with the woman's body and is effective on so many levels how could you take issue with that? How is that different from the drug company promoting their product which is less effective when you really look at the STATISTICS, or the condom companies which are even lower? Again, please take the time to truly inform yourself!!
Given the very real health and environmental concerns about hormonal contraception, and the mantra of choice, why should not a smidgeon of research money go towards helping research and promote natural methods of family planning? Why are you so bothered by this?
The risks of estrogen containing contraceptives are well-documented, including as much as a 10-fold increase in the risk of advers cardiovascular events (for a woman in her 20s, the risk of such an event is 1/60,000 if not taking hormonal contraceptives, which increases to 1/6000 if taking hormonal contraceptives). Birth control pills (and probably the patch and the ring) have well-documented effects on lipid profiles in terms of increasing the level of triglycerides, changing the balance of HDL and LDL in an unfavorable manner and increasing the overall cholesterol level (this does vary according to the choice of progestational agent). Decreased libido is another known side effect (you should have to sit in my office day after day as women complain about their lack of libido during their annual exams - maybe this also contributes to the effectiveness of birth control pills?).
TANSTAAFL - there ain't no such thing as a free lunch. If you support family planning as a general concept, why do you discriminate against a method that gives control to the woman, is cheap and readily available, is instantly reversable, and is reasonably effective?
Below are some references for the effectiveness of various modern methods of NFP, BTW.
1. Maclyn E. Wade, Phyllis McCarthy, et al., "A Randomized Prospective Study of the Use-Effectiveness of Two Methods of Natural Family Planning," Am J. Ob. and Gyn. 141:4(Oct 15, 1981) 368-376.
2. World Health Organization, "A Prospective Multicentre Trial of the Ovulation Method of Natural Family Planning. II. The Effectiveness Phase," Fertility and Sterility 36:5 (November, 1981) 591-598.
3. Frank J. Rice and Claude A. Lanctot, "Results of a Recent Study of the Sympto-Thermal Method of Natural Family Planning," Linacre Quarterly 45:4 (November, 1978), 388-391.
4. Josef Roetzer, "The Sympto-Thermal Method: Ten Years of Change," Linacre Quarterly 45:4 (November, 1978) 370.
5. G.K. Döring, "The Reliability of Temperature Records as a Method of Contraception," (Über die Zuverlassigkeit der Temperaturmethode Zur Empfangnisverhutung) Deutsche medizinische Wochenschrift 92:23 (June 9, 1967), 1055-1061. Abstracted in 1968 Yearbook of Obstetrics and Gynecology, p. 354.
6. B. Vincent et al., Methode Thermique a et Contraception: Approaches medicale et psychosociologique (Paris: Masson, 1967) 52-73.
7. Frederick S. Jaffe, "Commentary: Some Policy and Program Implications of 'Contraceptive Failure in the United States,'" Family Planning Perspectives 5:3 (Summer, 1983) 133-142. Delayers (spacers) are reported to have these pregnancy rates with the various methods: Pill, 7%; IUD, 15%; condoms, 21%; diaphragms, 25%; foam, 36%; douche, 47%.
8. Judith Willis, "Comparing Contraceptives," FDA Consumer 19:4 (May, 1985) 28-35.
9. Mario Jaramillo-Gomez and Juan B. Londono, "Rhythm: A Hazardous Contraceptive Method," Demography 5:1 (1968) 433-438.
10. Jorge E. Medina, M.D., "Comparative evaluation of two methods of natural family planning in Colombia," Am J. Ob. and Gyn. 138:8 (Dec. 15, 1980) 1142-1147.
11. F.J. Rice, C.A. Lanctot and Consuelo Garcia-Devesa, "The Effectiveness of the Sympto-Thermal Method of Natural Family Planning. An International Study." (Mimeographed reprint of an address given June 23, 1977, at the scientific congress held in conjunction with the First General Assembly of the International Federation for Family Life Promotion in Cali, Colombia.) p. 8.
Most modern forms of Natural Family Planning have a method effectiveness rate of 99% as shown by many researchers and studies. Do some more research before quoting statistics.
Many people choose to use NFP because it does not involve any hormones or chemicals. It is "going green in the bedroom."
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I agree with what other posters have said. You don't know what you're talking about. You are under the mistaken impression that all natural methods of contraception, ranging from the imprecise and high-failure rate Rhythm Method to modern sympto-thermal methods, are one, and you are quoting the highest possible failure rates associated with the least accurate of these methods. Moreover, you conflate organizations and methodologies with religious underpinnings with those that are secular. I have my own objections to the Georgetown grant, but only because the method of Fertility Awareness they have chosen to fund is not one that empowers and educates women, nor is this method particular flexible, thus it will only work for a narrow range of women. (Women for whom it will not work should be excluded in screening, just as women who smoke should be excluded from screening before hormonal contraception is prescribed.) There are many women in this country who have learned Fertility Awareness (a secular form of Natural Family Planning), and are not only delighted to have done so, they are angry that this information was not shared with them at a much earlier age, so that they could have made more informed decisions about their birth control options. I suggest that you read Taking Charge of Your Fertility by Toni Weschler. Fertility Awareness may not be your choice for family planning, but as a reproductive rights activist, I would think that you would support a wider range of safe contraceptive options, as well as comprehensive sex education and empowerment of women around their reproductive health.
In Japan more than 25% of women use an effective symptothermal NFP method with high-tech thermometers.
http://www.craigmedical.com/Ovulation_comp.htm
A large number of women MD's in India used NFP as their family planning method. An in China millions successfully use the Billings NFP method. There should be MORE NFP research in any administration. Most medical school obgyn departments are bought off by the pharmaceutical industry and do not engage in the type of research taht would be most helpful to women.
The Standard Days Method, used with CycleBeads, which this project is working with, has a typical failure rate of 12%, which is similar to condoms. The "perfect use" failure rate is 5%.
Please get your facts straight with regard to the effectiveness rates of the methods which fall under the generic name "Natural Family Planning."
If a client is taught well, understands the method guidelines for pregnancy avoidance,and implements the guidelines according to her family planning intention (i.e., spacing or limiting births), the rates are as high as 97%-99%. If any of these factors are not in place, the client could achieve rates simiar to all barrier methods (80%-95%).
This blog clearly exaults artificial methods in its assumption that all contraceptives are good for women. They are not, and in fact, most have dangerous contraindications.
Why not expose the underbelly of artificial methods and help women understand what is at risk when using many of these drugs and devices? Why not also do something counter-cultural? Why not study the natural methods of family planning and help women (and men), have information that provides real choices in family planning--choices that may actually be healthy for them and that may actually support a couple's relationship?
NFP Programming, Washington, DC
Whoa! Cristina, you have one person named Anonymous cramping your style here.
I wonder: does Anonymous use "natural family planning" methods as his/her sole form of birth control?
Uhh, because my INCREDIBLY Catholic sister-in-law used it...5 babies and counting....
My mother tried that because she didn't think birth control pills had been studied enough 30 years ago...and she got pregnant during the WORST time of her college education...
For women who are actually REALLY trying not to get pregnant because (a) they would like to finish school (b) they already have children and cannot afford another (c) um....sex is fun and should not always result in a kid maybe? or any of the other major reasons a woman doesnt want to be considered a baby machine.
Thanks, Cristina- you rock. Your book rocks. You are a massive inspiration to feminists everywhere. Anonymous: Natural family planning is FLAWED. Inherently. It should not be relied upon by women. Women have this choice to make for themselves--but they have a right to know they have a 1 in 4 chance of getting pregnant by using this method. Hey, if state legislatures think that women are so stupid that they have to be shown an ultrasound picture to fully comprehend an abortion, or that they have to be told inaccurate non-scientific bullshit 24 hours before, why the hell wouldnt we want women to know these statistics, too?
Or maybe you just want women to know stuff that keeps them firmly in place in our society as breeders. Hmm?
"it’s a theological attack on women to always require that abstinence during the time of the wife’s peak sexual desire (ovulation) for the entire duration of her fertile life, except for the handful of times when she conceives." Anyone who thinks denying women the right to engage in sexuality when they're most receptive, especially in their 30's is asking for frustration, anger and isolation to crop up between the couple. Why is that the women are ALWAYS asked to sacrifice for God's will, and not the men?
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