While in school, training, or practice, medical doctors, nurses, nurse practitioners, physician assistants or any health care worker for that matter, will be dealing with issues of family planning almost on a daily basis. They may also encounter these issues in their personal lives.

While most religions allow artificial methods of family planning, the Roman Catholic Church has been steadfast in opposing any form of such artificial methods. The only method allowed is the so called "fertility awareness" method. This is based on the premise that avoidance of sexual intercourse during the fertile time of a woman's menstrual cycle will avoid pregnancy. Medical advances have certainly made the fertility awareness method more accurate, but determining this fertile time of the cycle still requires some effort and dedication by the woman and her partner. Nevertheless these natural methods work well and with a great deal of effectiveness when applied by such dedicated and educated couples and when the woman has relatively regular menstrual cycles.

However, in less than these ideal circumstances, like in developing countries or refugee camps, where people often live in squalor and poverty, lack food and basic necessities, have no or little medical care, and where women do not have regular menstrual cycles, these natural methods have a high failure rate. A high failure rate results in unwanted pregnancies which add to the family's burden and are a factor in increasing even further their poverty status. Thus creating a vicious cycle.

Under the conditions just described, families need highly effective contraceptives measures. On his return from a visit to the Philippines Pope Francis recently advocated catholics to limit the size of their families to a manageable number. This is great and welcome advice but in the same interview he reaffirmed the church's opposition to any artificial means of contraception. This seems rather unfair to me. On the one hand he tell catholics to limit their family size and on the other hand he denies them the effective methods of doing so.

Ever since Francis became Pope he has indicated that he is willing to listen to the pressing needs facing, not only catholics but all people and possibly consider bringing the teaching of the Church into the twenty first century. There are certainly a number of indications that changes may be in the offing. First he has organized a Synod of the hierarchy of the Church in Rome last year to discuss all matters related to the family. When that Synod of "fizzled" out he has call for a follow up Synod later this year. He has made a number powerful statements and overtures towards homosexuals and divorced people and has strongly supported a strive for women's equality. He has even made some overtures to women who have had an abortion. Why not also open up the issue of contraception, so sorely needed in the world as I argued above?

If the catholic church were to allow artificial methods of family planning, catholic medical practitioners and in fact all catholics, would no longer face the dilemma in their daily activities: adhere to the teaching of the church and deny their clients the effective means of limiting the size of their families and in doing so risk an unwanted pregnancy; or ignore the teaching and continue to use, prescribe, advice, insert, inject, operate to provide their clients with the effective contraception they want and need, but thereby feel marginalized by the church they love. There is already much evidence that a majority of catholics in the world follow this latter path.

We can only hope that the Pope will listen to the experiences of couples from all walks of life and that he will solicit the input of catholic medical providers. May be, just may be, common sense and desperate needs will prevail, but do not hold your breath.

Submitted by: William J. LeMaire MD
Emeritus professor of Obstetric and Gynecology
University of Miami Miller School of Medicine
Miami, Florida USA 33155

Authored By DR William LeMaire on Sunday 6th September 2015