Park, S. (2020). 'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea. Ui sahak, 29(1), 81-120. https://doi.org/10.13081/kjmh.2020.29.81
Park S. 'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea. Uisahak. 2020;29(1):81-120. doi:10.13081/kjmh.2020.29.81
Park, Seungmann. "'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea." Ui sahak, vol. 29, no. 1, 2020, pp. 81-120.
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Korean Catholic bishops approved only the Billings Method
A 2020 history of church and medical journals finds that Korea's Catholic bishops approved only the Billings Method in 1976. A group of gynecologists had proposed a pill to induce ovulation. A Philippine adviser likened it to the birth control pill, and later bishops' documents omitted it.
Key Findings
In spring 1973, a research committee centered on a St. Mary's Hospital gynecologist told the bishops' conference it would develop Ovulation Regulation, which uses an estrogen-progesterone pill to induce ovulation.
Its supporters argued that nature means original completeness, so a drug that restored the natural cycle was a justified intervention. Billings Method supporters defined nature as the absence of human intervention.
The Philippine bishops' medical adviser concluded Ovulation Regulation resembled an oral contraceptive, because the drugs changed cervical mucus and at times suppressed ovulation itself.
On 25 June 1976, the Korean bishops' pastoral letter named the Billings Method as the natural method. No bishops' document after 1973 mentioned Ovulation Regulation.
A Chuncheon diocese bishop reported teaching about 2,000 believing and about 2,000 non-believing couples. The paper says this experience was not rigorously controlled.
Interpretation
The paper is a historical analysis of church periodicals, hospital association journals and medical articles. It traces how Korean church leaders came to choose one method, and it reports no pregnancy rates for either method. The couple counts come from a bishop's own report. The author argues that the meaning of nature settled the debate, and that technical merit came up only afterward. The findings describe Catholic family planning in 1970s Korea and cover no other setting.
RRM Context
The Billings Method is a fertility awareness-based method. Users track cervical mucus to find the fertile window. Restorative reproductive medicine uses cycle charting and works with ovulation. The Korean debate shows an early split between methods that watch the cycle and drugs that set its timing.
Our editorial summary of this paper, not the article's abstract.
Abstract
This article reviews the competition of two natural family planning methods in the mid-1970s when the Catholic Natural Family Planning program was underway in Korea. The Catholic Church, emphasizing the natural law, has recommended Natural Family Planning (NFP), a method of regulating childbirth by abstinence during the fertile period, since the mid-twentieth century. However, a group of gynecologists working at St. Mary's Hospital, a Catholic general hospital in Korea, questioned the utility of NFP. As an alternative, they proposed the method of Ovulation Regulation (OR), which regulates the menstrual cycle by inducing ovulation with steroids agents. This seemed to be no different than contraception with oral contraceptives disapproved of by the Catholic Church, but many doctors who advocated OR thought that this could be a new 'natural' family planning method to replace NFP. What is noteworthy here is the fact that not only NFP advocates, but also OR advocates attempted to justify their methods based on the authority of the 'nature.' In the debate over natural family planning methods, nature's legitimacy was given premise, not the object of doubt. Rather, the issue was the definition of nature. First, 'nature' in NFP signifies 'innate nature,' which excludes human intervention. According to this point of view, OR with steroids agents could not be natural. On the contrary, a group of doctors who advocated OR considered nature 'primal completeness.' If the natural order of the menstrual cycle could be restored, the artificial intervention of the administration of steroids was not a problem. Thus, both groups defended their arguments by redefining nature, rather than raising an issue of nature itself. The competition between 'innate nature' and 'complete nature,' a proxy war between NFP and OR, resulted in the victory of the former as the meaning of nature became fixed. Advocates of NFP pointed out that OR inhibits other physiological functions in the process of inducing ovulation, suggesting that the idea of 'complete nature' could never be achieved. The meaning of nature could no longer be controversial. Since the intervention was unnatural, nature meant innateness, the absence of intervention. Accordingly, the Catholic Bishops of Korea approved the Billings Method, a kind of the NFP, as the official family planning method, and gynecologists at St. Mary's Hospital of Korea also focused on the development and supplementation of the Billings Method. In short, the debate over the methods of natural family planning in mid1970s Korea was a clash of 'innate nature' and 'complete nature.' As a result, this confirmed the limitations of medical practice and reconfirmed the power of magisterium, the church's authority over medical practice.
Greff D et al., 2023·Reprod Biol Endocrinol·Free full text on PubMed Central
Metformin is the gold standard insulin sensitizer, which is widely used to treat insulin resistance in polycystic ovary syndrome (PCOS). However, metformin may induce gastrointestinal side effects. Inositols have long been debated as a potential alternative for metformin in treating PCOS. Therefore, the present systematic review aimed to evaluate the efficacy and safety of inositols in treating PCOS. The present systematic search was performed in CENTRAL, MEDLINE, and Embase from the inception until October 20th, 2021. Eligible randomized controlled trials (RCTs) included women diagnosed with PCOS and compared any inositols with metformin or placebo. Our primary outcome was cycle normalization, whereas secondary outcomes were body mass index (BMI), parameters of carbohydrate metabolism and clinical and laboratory hyperandrogenism. Results are reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs). Twenty-six RCTs were identified, including data of 1691 patients (806 inositol, 311 with placebo, and 509 metformin groups). In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo. Moreover, the inositols showed non-inferiority compared to metformin in this outcome. In the case of BMI (MD = -0.45; CI: -0.89; -0.02), free testosterone (MD = -0,41, CI: -0.69; -0.13), total testosterone (MD = -20.39, CI: -40.12; -0.66), androstenedione (MD = -0.69, CI: -1,16; -0.22), glucose (MD = -3.14; CI: -5.75; -0.54) levels and AUC insulin (MD = -2081.05, CI: -2745.32; -1416.78) inositol treatment induced greater decrease compared to placebo. Inositol increased sex-hormone-binding globulin significantly compared to placebo (MD = 32.06, CI:1.27; 62.85). Inositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin. PROSPERO registration number: CRD42021283275.
Hubacher D et al., 2009·Contraception·Free full text on PubMed Central
The copper intrauterine device (IUD) can cause side effects in some women; increased uterine bleeding and pain may cause early removal. Because of simplified reporting from previous research, little is known about how side effects might change over time. This is a secondary analysis of a prospective study of 1947 first-time copper IUD users. Over a 1-year period, we collected detailed information on side effects and looked for trends using generalized mixed-effects regression modeling. During menses, most bleeding and pain side effects were found to decrease over time (p<.05). During intermenstrual intervals, overall spotting and pain complaints remained unchanged, but the number of days with these problems increased (p<.05). Serious side effects that prompted either a clinic visit or IUD removal had varied patterns over time, depending on the type of problem. Side effects from the copper IUD can be troubling for both user and clinician. Some problems improve over time, while others do not. This information may be helpful in counseling women who are considering IUD use and current users who are contemplating IUD removal due to side effects.
Brisken C et al., 1998·Proc Natl Acad Sci U S A·Free full text on PubMed Central
Recently generated progesterone receptor (PR)-negative (PR-/-) mice provide an excellent model for dissecting the role of progesterone in the development of the mammary gland during puberty and pregnancy. However, the full extent of the mammary gland defect in these mice caused by the absence of the PR cannot be assessed, because PR-/- mice do not exhibit estrous cycles and fail to become pregnant. To circumvent this difficulty, we have transplanted PR-/- breasts into wild-type mice, and we have demonstrated that the development of the mammary gland in the absence of the PR is arrested at the stage of the simple ductal system found in the young virgin mouse. Mammary transplants lacking the PR in the stromal compartment give rise to normal alveolar growth, whereas transplants containing PR-/- epithelium conserve the abnormal phenotype. Chimeric epithelia in which PR-/- cells are in close vicinity to PR wild-type cells go through complete alveolar development to which the PR-/- cells contribute. Together, these results indicate that progesterone acts by a paracrine mechanism on a subset of mammary epithelial cells to allow for alveolar growth and that expression of the PR is not required in all the cells of the mammary epithelium in order for alveolar development to proceed normally.
The following is an address presented to a summit meeting on natural family planning sponsored by the Pontifical Councilfor the Family in December, 1992
I am honored and privileged to have this opportunity to be with all of you at this summit meeting on natural family planning. I wish to thank Alfonso Cardinal Lopez Trujillo for his invitation and all ofthe members ofthe Pontifical Council for their generosity and hospitality.
I have been asked to discuss with you what has become known as the Creighton Model Natural Family Planning System. This system obtained its name from my personal association, in its early days of development, with Creighton University School of Medicine in Omaha, Nebraska. This discussion will be, by its very nature, a summary of work that has been done and work that is currently ongoing.
The Creighton Model is referred to as a "model" as opposed to a "method" because it is an integrated education, research and service oriented system which meets the demands of the allied health and medical professions in the field of natural family planning. This system was specifically built to accomplish accountability and competency through a strong professional infra-structure. At the same time, it has been built within the context of a Catholic ethical and moral service delivery framework. It uses a standardized modification of the Billings' Ovulation Method in accomplishing these goals.
I personally became involved in natural family planning with a research project I did as a senior medical student in 1968. As I investigated the salivary albumin concentrations in women during the course of their menstrual cycles, I was looking for a reported decrease in albumin around the time of ovulation. Unfortunately, a project which I had no doubt would solve the problems related to natural family planning (sic), proved to be not a very good idea. . .
Billings JJ, 1993·BMJ·Free full text on PubMed Central
good of all, and above all, for the protection of the weak."2I submit that, no matter how appealing a marketplace model may seem for the NHS, it is a business model.As such the destruction of either purchaser or provider is eventually certain, with the barbarisation of the survivor.It is not too late for consortiums of purchasers and consortiums of providers to join forces and become one NHS again.
There is renewed interest in natural family planning (NFP) as the Philippine Population Program enters the 1980s. Much of this interest is due to the realization that, properly practiced, NFP can be a highly effective means of birth spacing. In 1978 the Special Committee to Review the Philippine Population Program recommended that more efforts be made to promote NFP. The different methods of NFP are reviewed. Sex without intercourse, coitus interruptus, and prolonged nursing are not officially recognized as NFP methods by the Program. The rhythm method was first described independently by Drs. Hermann Knaus of Austria and Kyusaku Ogino of Japan in the 1930s. Ogino's method of calculating a woman's fertile period is based on the lengths of the last 12 menstrual cycles which she recorded on a calendar. The advantages of rhythm are that it is inexpensive, it requires only the cost of charts which may be homemade, there are no physical side effects, control is in the woman's hands, and it is acceptable to people who consider it their duty to follow religious teachings. Disadvantages include: keeping constant, accurate records of cycles for long periods of time; the need for perseverance and correct interpretation of the chart; the possible need for medical advice and help; and the fear that something might upset a woman's cycle and change the time of ovulation. The continuation rates of rhythm acceptors in the Philippines are unimpressive. A study of 142 women revealed a high pregnancy/failure rate--25% for a 12-month period compared to 0 with oral contraception (OC) and the IUD's 2%. The basal body temperature method helps determine the unsafe period with some accuracy. Its premise is that there are slight but detectable changes in a woman's body temperature during her cycle. These changes herald ovulation. A special thermometer must record temperature changes of 0.1 degree Farenheit. This instrument and the charts are the only expenses involved. The reviewers of the Philippine Population Program noted that since the end of the unsafe period can be indicated only by the temperature, the total period of abstinence becomes long, although the basal body temperature method gives more or less 10 successive days for intercourse. The cervical mucus method, also known as the Billings method, takes into account the cervical secretions during the menstrual cycle. Appearance of this mucus is an indication of fertility. All that is required of a practitioner is to learn to distinguish the different sensations of wetness and dryness. The disadvantage is that the method becomes ineffective in areas where there is cervicitis or infection of the cervix. The symptom thermal method is the basal body temperature method combined with other NFP techniques and is widely used. With this method an accurate record of the 6 immediately preceding menstrual cycles is established. The start of the fertile period is set by substracting 20 days plus 1. The woman watches for symptoms like pelvic heaviness, breast softness, and mucus discharge.
Reliable indicators to detect the fertile and infertile phases in the menstrual cycle are now available, largely due to the intensive scientific research into fertility over the past decade. This means that couples who follow the rules of the different NFP methodologies have a highly effective means of birth control, without the introduction of hormones, chemicals or devices into the body. New scientific techniques can be expected within the next couple of years which will simplify the detection of the fertile phase and hopefully help to elucidate the grey area of the early fertile days, where most of the unplanned pregnancies occur. Fertility awareness by both partners is an important positive contribution to the whole sexual relationship and emphasizes that NFP is an educational delivery system rather than a technological one. The modification of sexual behaviour and the motivation of both partners for the successful use of NFP may initially present a problem to some couples. On the other hand, many partners find the discipline enhances their sexual relationship and dialogue. Whatever the motivation, today more and more couples are happier to be in autonomous control of their bodies and their fertility.
Ethics and Policy › Reproductive Ethics › Conscience Protections
Sunjune Park
S Park
PMID 32418977 32418977 DOI 10.13081/kjmh.2020.29.81 10.13081/kjmh.2020.29.81 Park et al. 2020, Park 2020
Cite this article
Park, S. (2020). 'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea. Ui sahak, 29(1), 81-120. https://doi.org/10.13081/kjmh.2020.29.81
Park S. 'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea. Uisahak. 2020;29(1):81-120. doi:10.13081/kjmh.2020.29.81
Park, Seungmann. "'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea." Ui sahak, vol. 29, no. 1, 2020, pp. 81-120.
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