FOR THE SERVICE OF LIFE. F.M.GUY. Rome. 9.déc.1992. (1)

ROME. SUMMIT MEETING ON THE NATURAL METHODS OF REGULATING FERTILITY. PONTIFICAL COUNCIL FOR THE FAMILY.

PALZZO S. CALLISTO. DEC. 9-11 1992

FOR THE SERVICE OF LIFE

Drs. François et Michèle GUY (Grenoble, France)

It is a great honour for us, as a couple, to have been invited to this "Summit Meeting": we thank Cardinal LOPEZ TRUJILLO and al1 those who have made our presence here possible... It is a great joy for us to take part in the work of this group: without doubt, we have been given this privi1ege because of having been associated, for more than thirty years, with this extraordinary adventure, both human and spiritua1, which allows couples to take charge of their own ferti1ity through a better understanding and respect for its functioning.

There are, it seems to us, severa1 possib1e APPROACHES to the Natura1 Methods of Ferti1ity Regu1ation (or methods of self observation): that of the Bio1ogica1 Sciences, and that of Theo1ogy,

for examp1e. Both are presented in the course of this meeting by expert wor1d specia1ists.. But there is a third approach, that "of the experience of so many couples and data from different human sciences" (F.C.32): Which has had, for us, priority, as based on circumstances we experienced in France, Mauritius, in Africa and e1sewhere of PEOPLE AT GRASSROOT LEVEL, witnesses of the daily rea1ity of men, women and couples of every culture and every condition, and since we have been able to work on many occasions with psycho1ogists, socio1ogists, demographers... from many countries.

In the time given to us we will aim to divide the presentation into three parts:

- first1y, we want to put OUR SELVES into the context by a brief record of the main milestones on the road we have followed since 1961.

- secondly , we will make a quick inventory of the LESSONS that we have extracted, for you, from this experience.

- third1y, we will remind you of the RESEARCH undertaken, our thoughts and points of ref1ection which a1though ours, no doubt are the same as yours.

1. MILE STONES

We wi11ing1y admit that in 1istening to the needs and prob1ems of the married and fami1y 1ife our plan of action has developed in a series of concentric circ1es.

- We advocated the TEMPERATURE METHOD in 1961, just as campaigns for the 1ibera1isation of contraception increased. We taught it at first in France with CLER, which we founded with Charles and Abeth RENDU, Fr. De LESTAPIS and Fr. D'HEILLY. Circumstances were such that we were then invited to participate in the development of Action Familiale in Mauritius, begun in 1953 by Mgr. MARGEOT.

- We therefore began with a TECHNIQUE of observation which we put together 1ittle by 1ittle, and comp1eted thanks to the new information we got from John and Lyn BILLINGS, Erik ODEBLAD, on the observation of Cervical Mucus, with Edward KEEFE on the changes of the Uterine Cervix, etc.

This is how for us, little by little, it was built up into what was finally called the SYMPTO-THERMIC METHOD. Whilst recognising the evident progress given by changes found in cervical mucus, we always remained faithful to the temperature method as the only sure objective sign (apart from urinary tests) of the beginning of the post-ovulatory period. We have never stopped teaching this method, encouraged in this by the affirmation of JEAN-PAUL II (8-06-84): "We must be convinced that it is providential that diverse natural methods of family planning exist which can answer the needs of different couples. The Church does not give its exclusive approval to anyone natural method, but demands that all methods should be accessible and respected." .

- As doctors, we have been aware of the numerous discoveries made in the domain of the biology of fertility, be it in the formation of the follicle, spermatogenesis, fertilisation, implantation or lactation. AlI these have reinforced our interest (and admiration) for the precision of the human mechanism.

As teachers we have tried to explain and present the basic facts to the women and couples we have encountered.

- We rapidly discovered that technique alone was not sufficient, that it was necessary TO ASSIST THE COUPLES on their way, first in the field of fertility, in exploring with them the richness and the ambivalence of their DESIRE TO HAVE A CHILD, or the reality of CONTINENCE experienced as a positive element of their married life.

- But, leaving aside the questions posed by the regulation of fertility, we have met aIl the other problems of daily life for the couples and we have thus been led to establish some psychological help services, rnarriage counselling and family psychotherapy, to develop in

parallel with the preparation of young people for their life and their responsibilities as adults, and, in other frameworks, marriage preparation.

- This is not the place, for us, to give a catalogue of activities, but to underline how life itself and the questions of those couples we have met have led to developing services in response to the dernands. We know that these needs evolve without ceasing, as new problems emerge (as has happened, for example, by those which are posed to families and couples by the spread of AIDS). If the message to be transmitted stays the SaIne, in its essence, we must unceasingly be ready to question our method of presenting it, ready to discover new ways. Our associations have again a rich range of development before them.

2. LESSONS LEARNT

A). The very conditions in which our action has developed close to farmilies and couples have, to some extent, dictated some GENERAL GUIDELINES to which we have never ceased to be faithful.

- We have had the chance, as we have noted at times, of putting them into action even before the publication of HUMANAE VITAE: The experience has certainly taught us that the Encyclical was difficult to present to the world of today, that it did not achieve wholesale approval. The sense of THE MESSAGE itself ran parallel to what many couples had told us and we knew from experience that its application was possible.

We will never forget that the first two letters of congratulations we received in July 1968 came from a Mauritian Hindu pandit and a non Christian psychoanalyst !

- The spontaneous interest, and the adhesion to the principle, at times the enthusiasm of those hearing about this approach, whatever their culture or religion ("natural methods are a method of first choice," said a Regional Health-Director, a Muslim, in an African country. "They are a sign of confidence, of responsibility and of freedom.") show at what point they unite the FUNDAMENTAL ASPIRATIONS of human beings. Even if putting it into practice is often difficult, this clearly underlines that we are often only the CATALYST of the profound needs of people. as JOHN PAUL II (1.03.84) said: "This teaching that you have reverberated in their ears is already written in their hearts: man and wonan must be helped to read in depth this writing in their heart." .

- Strong in this conviction, we have been encouraged to give firstly a POSITIVE IMAGE of the life of the couple and its fertility. (Be "missionaries of Love and Life", said JOHN PAUL II. F.C.54), rather than putting on guard against their possible distortions... "The positive

consideration of the values that can be discovered and esteemed before the consideration of a ru1e that one must not infringe." (Orientations Educatives..1983. No.19).

JOHN PAUL II recalls in his recent Constitution Apostolique FIDEl DEPOSlTUM, regarding the aims of Vatican II, that "..there must not be wholesale condemnation of the mistakes of our times, but apply oneself to show serenely the strength and the beauty of the doctrine of the Faith." (11.10.92).

- A French Theologian recalls that, for the Magisterium, "the natural methods are the ones that are most likely to have a humanising benefit, and if this same Magisterium makes this the norm, it is because that norm has as its function to be the path of habitual HUMANISATION." (Xavier THEVENOT. Repères éthiques pour un monde nouveau. Salvator .1982. p. 75.82).

These are, for us, the essential GUIDELlNES: -the natural methods of fertility regulation merit our attention because they correspond to the most fundamental aspirations of the individual (knowledge of self, responsibility, autonomy).

B). ln the same way, in general, experience at GROUP level has provided us with several deep-rooted convictions:

- We have taken part in numerous meetings and debates in one or other of the related spheres in human fertility and its control and we have been able to see how programmes have been received and applied, at national level of countries. This has allowed us to have a more realistic vision of the situation, to make certain comparative judgments, certain programmes .

It is certainly not for us to open a debate on a subject which has recently been made the object of reflection within the Pontifical Council for the Family. But we are pleased to see that it is rare today to find those who still think that birth regulation is easy to apply, and is the main solution to the problems of the developing countries.

We have just read, with great interest, the recent interview (13.11092)in Mauritius of our Friend, Cardinal Jean MARGEOT, who recalls that "the root of poverty is not found in the population explosion but in the indifference of the rich countries towards the 'poor' countries.". This confronts us more with our own responsibilities and brings us new areas for reflection and action.

- in order that couples may validly use the natural Methods of fertility regulation in which they have shown interest, it is necessary to put them into systematic action at national level in each country, in each area of life: in a prominent position. It is not sufficient to organise conferences for information, it is necessary to create locally the necessary CENTRES, trained teachers who will have the task of following up couples. Our associations, such as FIDAF.IFFLP, define, in their programmes, a stage of awareness, followed by a stage of

demonstration. It is lengthy work, which demands patience and unselfishness, but we know from experience that, in the countries with which we have been in contact, throughout the world, the only successful ones are those which have agreed to set in motion and take charge of these STRUCTURES OF TRAINING AND EDUCATION.

- This equally presupposes structures of COORDINATION at an international level under the auspices of one or other of the Federations which are represented here today which allows us an exchange of experience, teaching aids, and the setting up of wider enquiries. This is being done, for exarnple, by the European Zone of IFFLP to which we belong, thanks to its three Sub Committees (Teaching and Training, Research, Marriage Counselling and Family Life Education). We know (*) that such work entails much tirne,

persistent work, sometimes difficult, given the diversity of sensitivities, but its importance is considerable.

C). ON A PERSONAL LEVEL

Without wishing to repeat what we have often said and wri tten we are more than ever convinced, like most of you here, that the natural Methods, whatever the obstacles in practice constitute an original radical approach.

- in that they take into account all the PARTICIPANTS OF FERTILITY: the man, the woman and the child. Fertility, we gladly say, is not an illness that doctors will treat, but a power that must be given back to the couple.

- through dialogue between the couple on their own sexuality and all aspects of their everyday life.

- in the rneasure in which the value placed on the CHTLD from its conception, it is precisely because of this positive love of the child that the natural methods are most welcome where fertility remains culturally an essential value, as in Africa. "It is the love of a child which leads to family planning," said Alfred SAUVY, and not its rejection.

(*) one of us (Michèle G.) is a member of the Administration Council of FIDAF/IFFLP (International Federation of Family Life Promotion. Washington) and Director of the European Zone.

It is perhaps here, surely, and by way of considering the failures of family planning that shows up the division between the TWO APPROACHES. Where one has failures of birth control it is noteworthy that of the two methods - the one artificial or technical, the other through knowledge of one's own body - the unwanted child, even though its birth.might create problems, is more often accepted after failure of the second method rather than the first. For the couples using artificial methods the birth represents failure, for the other the failure represents a child.

3. SOME TRENDS IN RESEARCH

A. We are pleased to have participated in several international surveys on the EFFECTIVENESS OF NATURAL METHODS of birth regulation, including l'Action Familiale in Mauritius, CLER, FIDAF (FAIRFIELD) and more recently, with CLER, European multinational use-effectiveness study of natural methods; Dusseldorf - Prof. FREUNDL whose rigorous scientific testing was much appreciated. each publication brings us new useful data (as in the last publication by R.T. KAMBIC & coll.). But it seems to us that in the matter of effectiveness THEORY of the methods, nothing very new is being said, we follow wi th much interest the analyses of PRACTICE and EFFECTIVENESS, of which the great variations observed seem to us to illustrate the variety of the psychological realities and socio-cultural behaviour underlying this whose study is far from being finished.

B. (F.G.). One of us, while taking part in a theological training course has undertaken research into the LAW OF GRADUALISM (or "stepping stones to knowledge" F.C.9), from recent French documents (Cardinal LUSTIGER, Mgr. EYT, Fr. Pierre GUILBERT & Fr. Alain YOU, etc.) in response to the concerns of numerous family counsellors and teachers.

But it is in two qui te different directions that we have, one or the other, extensively searched two topics which have particularly interested us, in the rich itinerary which we have followed, in the field of natura1 methods (or from se1f-observation).

C. (M.G.). MATERNAL BREAST-FEEDING AND RETURN OF FERTILITY in the Post- Partum has been, since our stay in Mauritius, one of these two topics of priority research. Our interest in the natural methods has led us in effect to encourage breast-feeding for two reasons:

1. Beyond the evident benefit for the child from better feeding and better immunity protection, breast-feeding is the most sure way to establish a lasting MOTHER-CHILD BONDING: we well know today that a good mother-child relationship does not always happen by itself.

2. But it is also a fact that NATURAL INFERTILITY resulting from complete breast-feeding is the only true 'natural method' of spacing births. Also we have been very pleased to get to know the BELLAGIO CONSENSUS. 27 years after the rules that we have established in

Mauritius: we would already ask, at that time, the breast-feeding Mauritian woman, the following question: "have you already become pregnant, whilst fully breast-feeding, before having had a period?" (Dossier de l'Action Familiale. B.6.l966). If she replied NO, she and

her husband could restart sexual intercourse if they wished, so long as fully breast-feeding continued, and as long as the periods had not restarted. She would only have to start the observation of signs at the first weaning bottle or the appearance of the first period after

delivery. She would thug be able to devote herself to the child and to her husband, without the worry of daily self-observation in the first months of the life of the child (where the care that it demands is often very demanding) and without periods of abstinence, which proved, in the end , not to have been necessary.

Certainly the BELLAGIO CONSENSUS limits the date to six months, and suggests from the first child. For us, that could last much longer, based on her observation of breast-feeding previous child/children. But we are very pleased to verify this similarity and to see established worldwide What we said in Mauritius in 1965.

D). (F.G.). An investigation on the INCULTURATION OF ACTION FAMILIALE was initiated by one of us, after a long series of visits to Africa, between 1976 and 1989, because of the gap often existing between the excellent welcome given to our data on human fertility and its awareness, on the one hand, and, on the other, the difficulties sometimes insurmountable encountered at the time of setting up local programmes. These difficulties could, most certainly, be explained by the problems of recruitment, competence, availability (amongst outside intervening parties as well as among the potential local animators); but it appears, on reflection that the obstacle was above all round at the level even of the INTERCULTURAL DIALOGUE arising out of our activities.

This hypothesis of work has given rise to lengthy research which it is not possible to present here. However, three points can be made:

. the international organisations have only recently become aware, of this problem as is shawn, for example, FNUAP.UNFPA mention for the first time in its 1989 REPORT the impact of the sociocultural factors in the family planning programmes.

.On the other hand, this notion has for a long time been well known in the Catholic Church, for whom inculturation is firstly a process of evangelisation with its double enrichment: of the culture encountered, made better by the spirit of the Gospel, and the Gospel is enriched by

the diversity of the human resources of this new culture. (cf. for example: John Paul II. Familiaris Consortio 10).

. It seems that, by analogy, all intervention in the field of the family, of the relationship man-woman, and above all the ferti1ity, occurring in an area particularly rich in customs, marks an authentic process of inculturation, with its dual specific movement: listing and

promoting the cultural values of families (be they African or others) on the one hand, and the insertion in this same culture of new awareness and further knowledge concerning fertility, and married and family life, on the other hand. This conviction would lead to a study of these customs and behaviour, before setting up programmes, which would be able to take into account the fundamental attitudes of the persons concerned.

If we look, today, at the past, it seems to us that, in thirty years, we have made considerable progress in the knowledge of the workings of fertility, in the observation of the signs of fertility and infertility, in married and family psychology, in the theology and the philosophy of responsible procreation: but there are still areas to explore: and possible discussion topics for future meetings!

Francois & Michèle GUY

r SOME REFERENCES-l

We have only quoted here the studies (mostly personnal) which have a bearing on one or other of the points mentioned in this paper. Most of theses studies have a complete bibliography of the authors and textes, be they Pontifical teachings (Encyclicals, Exhorta- tions or Addresses) , as weIl as scientific studies (J.and L. BILLINGS, R.and I.ECOCHARD, A.FLYNN, J.ROETZER, etc.) or Medical Theses on the natural methods with which we have some time been associated.

- F.M.GUY. Comment aider un foyer à comprendre la courbe thermique? (Dossiers de l'Action Familiale.B.5. Ile Maurice. Mai 1966)

- F.M.GUY, Y.NALLETAMBY. P.PIAT. Le Post-Partum ou les suites de l'Accouchement. (Dossiers de l'Action Familiale. B.6. Ile Maurice. Juillet 1966)

- F.M.GUY. Ile Maurice, régulation des naissances et Action Familiale. (Xavier Mappus. 1968).

- F.M. GUY. L'Allaitement maternel (Cahiers de l'IREC. B.6. Grenoble. juin 1978. 3eme édition, juin 1984).

- F.GUY. Action Familiale, Bénévolat et Institution. (Université des Sciences sociales de Grenoble. Mémoire de Maitrise: Sciences de l'Education. 1979).

- F.M.GUY. Le meraviglie della vita umana. (Le Famiglie al Sinodo. 26 sett.25 ott.1980. Liberia Editrice Vaticana. 1981).

- F.M.GUY. Comprendre et servir la vie (Pirogue. Nos 47.48. Paris. 1983)

- F.GUY. Vingt ans d'action familiale ou : pourquoi persévérer? . (Congres international: Philosophie et Théologie de la procréation responsable. Institut Jean.Paul II pour l'étude du Mariage et de la Famille. Juin 1984).

- M.GUY. R.ECOCHARD. Some remarks concerning the infertile and fertile phases of cycle. (3d national and international Symposium on NFP. Emmanuel College. Boston. June 24-27, 1984).

- F.GUY. Coutumes, rites et sexualité: ici et ailleurs (Amour et Famille. CLER. No.155. janvier. février 1986)

- R.ECOCHARD, R.FREY, N.BLANCHE, I.ECOCHARD, F.PINGUET, M.O.COSTE, M.GUY, F.GUY. L'analyse des Post Partum antérieurs peut-elle donner des éléments pronostiques du retour à la fertilité après l'accouchement? (4eme Congres International de la FIDAF.IFFLP. Ottawa, juin 1986)

- F.GUY. 500 jours en Afrique (Amour et Famille. CLER. No.160. novembre.décembre 1986)

- M.GUY. L'enfant, dés sa conception (Amour et Famille. CLER.No.173- 174. Janvier-avril 1989).

- F.GUY. Action Familiale et Inculturation. (Centre de Théologie de Meylan. 1991-92)

- Cardinal Jean MARGEOT. La Vie Humaine, valeur et dignité (Port- Louis. 1991).

- F.GUY. Amour et Gradualité (Amour et Famille. CLER. No.196. novembre.décembre 1992)

- F.M.GUY. Contribution of Natural Methods to communitary health. (Third International Symposium on advances of Natural Regulation of Fertility. Malaa 5.7.nov.1992).)

TRANSLATION : F. KEETLE, F & D O'CONNELL