First things first: I adore NFP instructors.
Well, not every last single one of you, but in general, I admire and appreciate folks who go into this field. It’s never gonna be a money maker, and you don’t do it because it makes you popular. Modern NFP is heavy on science and medicine, but teachers also have to be good communicators (which is not the same as understanding a topic); and they have to be sensitive and patient with clients who may be going through a wide range of emotional and psychological ups and downs as they navigate the trials of trying to achieve or avoid pregnancy. NFP instructors put up with a lot of jeering and skepticism from a world that sees their work as some combination of new-age, phony sorcery and old school religious oppression. And they probably put up with more interruptions from clients’ kids than any other health professional.
So! To all NFP instructors — really, all of you: Thank you. You’re doing a noble job in an ignoble world. God bless you and keep you.
THAT BEING SAID. Having practiced NFP off and on for many years, and having talked to countless women and men who’ve struggled with every aspect of living the NFP life, I have some advice for their instructors. Pleas, really.
- NFP is medical information. If you’re teaching it, you must act like a medical professional. First off: HIPAA is a real thing, and it’s here for everyone’s protection. Couples learning NFP are exceptionally vulnerable, and the personal information they reveal to you is private. If you’re a health professional (as all certified Marquette instructors are required to be), you are legally bound (with rare exceptions) to keep your client’s name and identifying information private unless you have the client’s permission to discuss it with someone else.If you’re not a medical professional and/or you’re teaching some other method NFP, you are still morally obligated not to blab private stuff to other people.
2. Please make it clear what category of advice you’re giving. The Catholic church has pioneered the study of fertility, so chances are good you and your client have some association with Catholicism. You may be teaching the spiritual aspects of NFP along with the biological aspects. I salute you! That’s a tall order. But when you’re teaching your clients how to gather information and how to act on it, make sure they understand what kind of information it is. The client deserves to know the difference between “Here is how you should behave if you want to avoid pregnancy” and “Here is how you should behave if you want to avoid mortal sin.” These are adults, and should be trusted with full and accurate information.
3. Please be clear about what kind of advice you are trained and prepared to give, and do not give advice you are not trained to give unless the client requests it. It is unwise and possibly dangerous to dispense casual wisdom about things about which you have only casual knowledge. There is nothing wrong with saying, “I’m sorry, that issue sounds so hard, but I’m not really qualified to give advice about that topic. You might want to call a [priest, therapist, marriage counselor, pediatrician, nutritionist, exorcist, etc.] for advice about that.” Or at very least, make it clear when your advice is only your personal opinion, and does not come from a place of authority.
4. Please let us have our emotions. If you can’t deal with listening to emotional clients, this may not be the job for you. NFP is hard. It’s hard when we want to get pregnant and don’t, and it’s hard when we don’t want to get pregnant and do. It’s super hard when we’re following all the rules and NFP still lets us down.
I can’t personally speak about how it feels to suffer through infertility, but I can tell you how it feels to have a method failure pregnancy. It feels like the end of the world, and it can shake our faith not only in science but in God. It’s a big freaking deal, and we can’t just immediately vault into a place of trust and peace.
The instructor, who taught us the method and should understand better than anyone how terrifying it is to find a flaw in it, may be the only one we can talk to about the experience. It is vital for the instructor to acknowledge that method failure pregnancies are real, and that the emotional fallout can be intense. There is no shame, sin, or weakness in c client feeling horrified, betrayed, panicked, or despairing if we become pregnant at a bad time. The best response an instructor can offer is abundant sympathy and gentle encouragement. An instructor who criticizes or shames a struggling client is failing her client, and may be putting her at risk of severe depression, self-harm or neglect, or even suicide. This is, to put it mildly, not pro-life.
5. Please respond. I know you’re only one person, and I know you have a life and a family and a need for personal time. No one should expect you to be on call 24/7. But it’s only common courtesy to let your clients know how promptly they can expect to hear from you, and, if possible, to suggest a back-up instructor they can contact with urgent questions. Too often, I’ve seen women posting on message boards, “My instructor hasn’t gotten back to me in five days. Can someone answer my question?” — and then she gets bad information from well-meaning but ill-informed amateurs.
6. Please remember that the client is more important than the method. I know the NFP-skeptical medical community loves to joke about Vatican Roulette, and it probably feels like you’re always on the defensive, having to insist over and over again that NFP is scientifically sound and effective. But that defensiveness should never translate to an urge to throw struggling clients under the bus. Please never massage statistics to make it seem like NFP is more effective than it really is. Please never minimize the struggles of clients whose experience doesn’t match the cheerful pamphlet they gave out in Pre-Cana. NFP is about people, not about promotion. When the method’s reputation comes first, everyone loses.
7. Intra-method sniping is so off-putting. The best method is the one that suits the client’s needs. Your method may not be the best match for every client, and that’s okay. It’s great to be enthusiastic about the method you teach; it’s appalling to make snide remarks about other methods and the people who use them. Yes, I’m looking at you, Billings.
8. We need apps. Yes, need. If you’re not gonna give us an app, please at least stop promising an app. For crying out loud. Yes, I’m looking at you, NaPro.
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Whew, that’s a lot. Most instructors I’ve met already know all this and then some; and I’m sure most instructors could write their own list of things they wish their clients understood. Feel free to leave suggestions in the comment box! They may make it into a future post. It’s always good when we understand each other better, especially when the stakes are so high.
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Obligatory plug: I did literally write the book on NFP. It’s The Sinner’s Guide to Natural Family Planning, and it doesn’t teach you how to chart, but it talks about how to live while you’re charting. How to stay close to God, how to understand your spouse better, and how to deal, in general. Available in paperback, ebook, or audiobook.
Image: via Pexels
Note to readers: I have deleted an extremely disturbing comment posted 10-13-19. I have reason to believe it was written by a troll, and not in earnest, but I am doing my best to find out for sure, and if I do discover that it was written in earnest, I will contact her diocese and make sure they take action.
Wait…do you mean that you lie to a couple to get them pregnant? That you decide when they should have their first child instead of letting them and God choose that timing? How widespread is this?
I did some digging and the email address Jenny provided seems to be fake. I think this may have been a troll trying to undermine the credibility of NFP teachers. If not, Lord have mercy.
I will say that I’ve talked to countless NFP teachers in the last several years and have never encountered anyone expressing anything close to this approach. But there are some insane and terrible people in the world.
I’m a Billings instructor, and I’m often the one pushing for more use of apps and such. There is an app that works for Billings (nfpcharting); I wonder if it can also work for Creighton, since they use the same stamps, though used differently. When I go to continuing ed to renew certification, I tend to be the only one who uses the app, the only one who just doesn’t do paper charts. I mean, I give my clients that option, but I also emphasize the technology. I also think we should be reaching out more to the secular fertility awareness apps out there, to work together.
Then again, I also feel I’m the odd one out a lot of times because I will happily find an instructor in a different method for someone if they feel Billings just isn’t a good fit for them. In my opinion, the best NFP method is the one you like and learn well. We all have different preferences about what we’re comfortable with, and that’s ok. Let’s work together.
NaPro’s app has been held up a few times, based on what I’ve heard.
I’ve done software development everywhere, and asked my instructor if they needed help, but she said they didn’t….still no app yet.
I’d develop my own if I had the money for hosting/security.
At this point, I honestly doubt it’s a software development issue. I think they don’t want an app because then people might go rogue.
LOL, yeah – I’ve got to agree with you there. I think they want to lock it down so that only instructors can sign up their clients, but, I think that people should be able to just download an app. If they want their instructors to see their data, the app should let them search for instructors in their town and grant them the permission to do so.
I have to say, though, I really don’t like marquette’s app.
App that might be useful for some…
https://femmhealth.org/our-app/how-it-works/
I think it would help if the mandatory NFP classes covered postpartum NFP more. Many young Catholic couples are happy to have a baby early in their marriage, and then after the baby is born, that’s the first time they seriously want to avoid. But then nothing makes sense and they need to order a new textbook to find out what to do, and the book says that they basically need to use Billings, which is not the method they learned in the marriage prep class.
Meredith, your comment about applying NFP for postpartum mothers is spot on. Especially as it can be very frustrating if ovulation doesn’t begin again for the best part of a year after having a baby.
Oh man, #4 all day long. I got pregnant while strictly practicing NFP (I still have no idea how it was biologically possible) and then miscarried the pregnancy just when I embraced it. Fellow Catholics have trouble understanding why I was so shaken about the NFP failure, and my non-Catholic friends didn’t understand how I had gotten so attached to an 8 week pregnancy that I didn’t want in the beginning. I’m still bouncing back faith-wise from the whole thing even though it was years ago. It really is important to be sensitive to people who go through that type of thing.
Here’s one for the NaPro instructors: Please don’t suggest, over and over again, that we see a NaPro doctor after learning that our Catholic, NFP-trained OBGYN has advised against it. Please especially don’t warn us that if we don’t see a NaPro doctor for fertility testing after one miscarriage we may lose more babies we could have saved — as if we somehow don’t know what’s at stake. Guilt and obsessing over treatment in the midst of fertility problems are already bad enough.
Agreed. Also, please understand that even if we wanted to, not all of us can afford to see a NaPro physician. Learning Creighton model costs a bundle and it would have cost several hundred dollars to see a NaPro family doctor (no NFP ObGyns in our area) just for an initial consult. None of it was covered by insurance. I had a heart-to-heart with my secular ObGyn and he ended up doing what a NaPro doc would have done anyway and it was 100% covered.
NaPro docs need to be conscious of their own limitations. A family doctor can help, but Creighton’s training is no replacement for residency and years of experience in obstetrics. Recurrent miscarriage may be caused by a luteal phase defect, that is not always the answer.
All that said, my husband and I are instructors and I am deeply grateful for teachers of all methods. It is hard, hard work and requires tremendous sacrifice.
I just wanted to point out one thing in case you didn’t know. Some Napro docs did their whole fellowship and training through the Pope Paul VI Institute, with the most advanced medicine for preserving fertility. Some of the other medical consultants only did a short stint of training in Creighton. My point is that fellows do have residency and years of training in obstetrics.
@Maea, starting a new thread because it won’t let me answer directly. No, it’s not a sin to purposefully have sex that can’t result in a pregnancy. Infertile people may marry and have sex. Old people may marry and have sex. Fertile people may marry and have sex at times when they think they are unlikely to conceive.
Thanks for this Simcha, my husband and I have been a teaching couple for eight years and he is a family doctor as well who is sought out because he is nfp only. We therefore deal with couples from all walks of life and all methods. There is nothing to be gained by degrading other methods, as you said different methods fit different needs. Our training really emphasized the importance of client privacy and the need for empathy and support. It seems like recently the trend has been to really criticize nfp instructors for all the ways they aren’t doing it right. Nfp is a really really tough sell, for us it’s a ministry, something we teach and promote because we believe in the church’s teachings, but also because it has helped us address my own cycle issues more effectively. It takes a lot of courage and patience to continue to do this work when at times we never see any fruit.
From my personal experience with an NFP instructor, I’d say #s 4 and 7 applied. Without getting into too much detail, my husband is okay with contraception and he didn’t appreciate the instructor’s plugs. I guess you could say #6 also applied, because he thought she was inconsiderate and believed some of her comments were borderline demeaning.
Needless to say, the experience didn’t warm him up to NFP.
I’ll put in a plug for the Marquette fertility tracker app; that, together with the monitor, have been incredibly helpful in my most recent postpartum phase. The app asks what your goal is (avoiding or achieving pregnancy) and then, on a scale of 1-10, how committed you are to the goal. We are very committed to avoiding pregnancy for now, and so the app makes very, very conservative rules for when phase 2 begins and ends. It’s been great for our peace of mind.
The topic discussed here is the professionalism of the NFP teacher. It is (or should be) learned in their NFP teacher education programs. The content has to do with “professionalism” (which includes “confidentiality”) and understanding one’s “role as an NFP teacher” (which means “know your limits” and refer to trusted sources, e.g. an NFP-only physician, etc.). For most NFP teachers who are not healthcare professionals, they do not need to formally follow HIPPA. That said, a mark of a well trained NFP teacher is his/her competence and professionalism.
Your readers should know that the competence and professionalism of the Catholic diocesan NFP teacher is a concern of the bishops in this country. “The Standards for Diocesan NFP Education” (Administrative Committee, USCCB; view at, http://www.usccb.org/issues-and-action/marriage-and-family/natural-family-planning/diocesan-ministry/standards.cfm), spell out the general guidelines for not only diocesan NFP teachers but also diocesan NFP ministry and the teacher training programs that supply the dioceses with trained teachers.
All of this said, no standard can control an individual teacher from not performing well. In those cases, it is always important for the people who have uncovered the problem to contact either that teacher’s training program or the Catholic diocese where he/she may volunteer.
Generally speaking, I can tell you that the majority of diocesan NFP teachers are comeptent, professional, and devoted. The Church cannot offer NFP ministry without their help!
Actually, HIPAA is fairly broad in who it applies to. Basically it’s anyone who is in possession of or has knowledge of personal medical/health information of an individual. Therefore, it applies to gyms, PTs, dentists, lawyers, insurance companies, schools, and the gamut of medical professionals and their support staff (including receptionists, copy clerks, and bookkeepers). And if you violate the HIPAA laws you can be heavily sanctioned by the courts.
Simcha, I recently read online from an Orthodox Christian that he and his wife felt that the way NFP is being taught is “creepy.” I’m Catholic, and have had NFP training, so I found his comment odd. But he thought the idea of a instructor indicating what days were fertile vs. not-fertile was weird. Aaaand while another Catholic corrected him about what NFP actually aims to do, he responded that he and his wife wanted to avoid such “sophistication.”
What are your thoughts? Or perhaps, you have some resources to direct me to?
“he thought the idea of a instructor indicating what days were fertile vs. not-fertile was weird.”
So, uh, what else would an NFP instructor do?
Probably you could start by explaining that the word he was looking for was “sophistry” rather than “sophistication.”
I don’t even understand the objection, so I wouldn’t know how to respond! Is it that he thinks sex and marriage should be oh-so-natural and it ruins everything to get all scientific about it?
I think his objection is that NFP invites sin, because in his view the spirit of the practice is to have sex without conceiving.
I guess the burden would be on him to explain why that would be sinful.
I think some people have a sort of visceral reaction against how regimented NFP can be, and it feels so unnecessary and contrary to what they want, they persuade themselves it’s sinful. But we don’t judge sinfulness by how something feels!
Now, if the spouses both agree that they just don’t need NFP, then there’s no compelling reason they should chart (despite what some Catholics argue).
Well, is it a sin to purposefully have sex that can’t result in a pregnancy? Is that different from sex that may or may not be procreative?
Thank you for mentioning number seven. I’ve seen some effects of that one. :/