Archive for August, 2020

Natural Family Planning and Cervical Mucus

Sunday, August 30th, 2020

Your Right to Know: Cervical Mucus

It may seem strange in 2013 to write about your right to know about cervical mucus as a fertility marker, but outside the NFP movement proper education about cervical mucus as a sign of fertility seems to be hit-or-miss at best. For example, a study about the fertility awareness value of cervical mucus was published online just this past July 12, 2013 in Fertility and Sterility. This information is so basic that it’s amazing to see it reported in a scientific journal. You certainly have a right to know about the value of cervical mucus, and you also have a right to know about its limitations.
•Almost every fertile-age woman can identify it.
•It is a positive sign of the fertile time.
•It can work well for purposes of avoiding pregnancy, but it works better when used in a cross-checking way with waking temperatures.

Cervical mucus was known to the ancients. Aristotle described a white discharge as well as a red discharge. In the story of the two daughters of Lot who got their father drunk so that he would impregnate them (Gen 19:30ff), a question is raised, “How did they know the right days?” (I heard Dr. John Billings raise this question in a lecture years ago.) A number of researchers had something to say about cervical mucus starting in the 18th and 19th century. In 1855 Dr. W. Tyler Smith noted that cervical mucus “appears to afford a suitable medium for the passage of the spermatozoa through the cervix uteri into the uterine cavity.” (Jan Mucharski, History of the Biologic Control of Human Fertility)

Many others commented on it, but the first to introduce the observation of cervical mucus into natural family planning instruction was Dr. Edward F. Keefe, a New York City OB-GYN doctor who taught it to his patients. He first did this in 1949 by instructing users of his Ovulindex thermometer to note on their temperature charts “a clear vaginal discharge, seen for a few days before ovulation.” In his 1953 Ovulindex booklet, he included a drawing to show how “cervical mucus can be drawn out to a long, thin thread” a day or two before ovulation. Mucharski notes that “He also pointed out that a woman can determine ‘the approach of the fertile time in the falling temperatures and the changes of the cervical mucus; the end of the fertile time in the rising temperatures’.”

“In 1954, in an exhibit at the Chicago meeting of the American College of Obstetricians and Gynecologists, Keefe emphasized that ‘the probable date of the next ovulation cannot be predicted from calendar calculations or from basal body temperature studies alone without observation of cervical mucus’ ” (Mucharski). That was ten years before Dr. John Billings published his book on the sympto-thermal method of natural family planning.

Dr. John J. Billings taught the mucus sign in conjunction with the temperature sign in 1964, but by 1973 he had decided to use only the mucus sign by itself. What especially characterized the work of Dr. Billings and his wife Dr. Evelyn L. Billings, was their focus on the peak symptom that we describe as the last day of the more-fertile mucus before the drying-up process begins. Mucharski reports that hormonal research with 22 women found that the peak day “occurred in five women on the day of ovulation, in nine women one day before, and in four women two days before. The onset of the mucus occurred on the average of 6.2 days before the estimated day of ovulation.” That accounts for 18 of the 22, but what about the other four? In later research Hilgers would find that ovulation sometimes occurs one or two or even three days after the peak day.

The Doctors Billings and their supporters vigorously promoted what they called the Billings Ovulation Method that relied solely on the mucus signs to determine the limits of the fertile time. That raised questions about its effectiveness relative to the other available natural systems. A study in Australia (1978) found as follows: “(1) the symptoms-and-temperature method combined with preovulatory calculations [such as the 21-day rule] generated 1.5 percent failures per 100 woman-years of use; (2) the symptoms-and-temperature method combined with preovulatory cervical mucus appearance [instead of something like the 21-day rule] generated 3.39 percent failures (3) the ovulation method alone generated an associated failure rate of 11.2 pregnancies per 100 woman-years.” It is not clear from Mucharski if these rates were perfect-use or imperfect-use or a generic total rate.

An NIH study in Los Angeles found an OM imperfect-use rate of 39.7 and an STM imperfect-use rate of 13.7 pregnancies per 100 years of use. The OM group experienced six perfect-use pregnancies; the STM group experienced zero perfect-use pregnancies.

The advocates of the mucus-only systems continue to claim great effectiveness in avoiding pregnancy based on their own studies and methods of evaluating pregnancies. However, whenever a comparative study has been conducted, it has shown that those couples who use cross-checking signs have much higher effectiveness rates in terms of avoiding pregnancy.

One of the great advantages of cervical mucus is its advance indication of fertility. The woman who is well experienced in mucus observations and interpretations will be able to put this knowledge to good use during the irregularities of premenopause and during the delay of postpartum fertility especially when breastfeeding.

Summary. Cervical mucus is essential for mutual fertility since it provides a medium for sperm transport and an environment favorable to sperm life. Its presence can be noticed by almost all women at the most fertile time. Its use in fertility awareness was first promoted in the United States by Dr. Edward Keefe in the 1950s in conjunction with other signs of fertility and infertility. Comparative effectiveness studies about avoiding pregnancy favor using mucus in a cross-checking way with other fertility markers instead of just by itself.

And that is something you have a right to know.

John F. Kippley

Natural Family Planning and Ecological Breastfeeding

Sunday, August 23rd, 2020

Your Right to Know: Ecological Breastfeeding

In these blogs I begin focusing on your God-given right to know certain facts about natural family planning. The order of my topics will follow a more or less chronological order according to which the process or sign was practiced or discovered.

Let’s start with ecological breastfeeding because this is the sort of breastfeeding that was practiced for many thousands of years and was significantly responsible, according to some demographers, for keeping the world population quite stable for many centuries. This is the kind of baby care in which mother takes her baby with her wherever she goes and allows her baby to nurse whenever he or she wants. The result is frequent and unrestricted nursing.

The 19th century Malthusians drew attention to population issues, dropped the morality of the Rev. Thomas Malthus, and were soon promoting contraception. Among the social classes in which women breastfed their own babies, there was a general if confused knowledge that breastfeeding somehow delayed the next pregnancy. This led Dr. Leonard Remfry of British Columbia to study the effect of lactation on menstruation and pregnancy, and in 1895 he published that only six percent of the breastfeeding women in his study became pregnant before their first postpartum menstruation . Dr. Konald Prem of the University of Minnesota Medical School surveyed nursing mothers and found in 1971 that only five percent became pregnant before they had a first period.

Research was more plentiful in the second half of the 20th century, and Sheila has summarized this at . When she attended La Leche League meetings in 1963-1967, the League promoted the idea that “total breastfeeding” spaces babies, but among mothers who gave their babies nothing but their breast milk there was still a wide variation in the length of breastfeeding amenorrhea (the absence of periods). The mothers would discuss this, and one of them, Nancy Hornback, really encouraged Sheila to research it.

That she did, and the combination of the research and the experiences of nursing mothers led her to formulate a hypothesis. She wrote her first book, Breastfeeding and Natural Child Spacing, and included a survey. That survey showed that those mothers who followed what we now call the Seven Standards of Ecological Breastfeeding averaged 14.6 months of breastfeeding amenorrhea. See .

Some years later she analyzed a much larger number of surveys and found almost exactly the same results, 14.5 months .

Other researchers have found similar or almost identical results. The evidence is clear. The frequent suckling of ecological breastfeeding naturally postpones the return of menstruation and fertility. On average, if the mothers become pregnant soon after their first period, their babies will be spaced about two years apart, and that’s beautiful. Ecological breastfeeding is an excellent form of natural baby spacing.

Everyone has a God-given right to know this information. It is truly God’s own way of spacing babies, and the frequent suckling both maximizes all the benefits of breastfeeding and maintains a mother’s milk supply.

So why doesn’t every Church-related NFP course teach ecological breastfeeding as a normal part of its instruction? I don’t know. Should the Catholic Church insist that all NFP programs related to diocesan or parish efforts promote and teach ecological breastfeeding? Well, why not? Isn’t it part of God’s natural revelation? And doesn’t the Catholic Church have to teach both the natural and the divine law? And isn’t it obliged to do what it can to help couples live out the teaching of Humanae Vitae? And what could be healthier?

My conclusion: Since ecological breastfeeding is God’s own plan for spacing babies, you have a God-given right to learn it, and the Catholic Church has a God-given obligation to teach it to engaged and married couples. In fact, it should be taught by respectful teachers in seventh or eighth grade.

John F. Kippley

Natural Family Planning Using Ecological Breastfeeding Only

Sunday, August 16th, 2020

A couple is thankful for taking our natural family planning classes where they heard how to space their children using only breastfeeding.  The note below was sent to a couple who taught their class.

“We took  NFP classes from you and your husband about twenty years ago.  We have eleven children—thanks be to God!  You sold us on ecological breastfeeding and it’s all we used.  Our oldest is 26 and our youngest is 3.  Thank you both!”

The couple who taught them told us:  “She reluctantly came to the NFP class expecting a newborn any day.  It was her second child (and final child, she said!) I convinced her to breastfeed this infant, but she thought of herself as a career woman who would be going back to work in 6 weeks.  Well, obviously she followed the advice and found a blessing in it.”

Sheila Kippley
The Seven Standards of Ecological Breastfeeding: The Frequency Factor (the book on how to space the birth of babies)