Natural Family Planning Instruction as a Marriage Requirement a Retrospective Analysis of the First Two Years' Experience in the Diocese of Covington()
Manhart, M. D. (2012). Natural Family Planning Instruction as a Marriage Requirement a Retrospective Analysis of the First Two Years' Experience in the Diocese of Covington(). The Linacre Quarterly, 79(4), 487-498. https://doi.org/10.1179/002436312804827136
Manhart MD. Natural Family Planning Instruction as a Marriage Requirement a Retrospective Analysis of the First Two Years' Experience in the Diocese of Covington(). Linacre Q. 2012;79(4):487-498. doi:10.1179/002436312804827136
Manhart, Michael D. "Natural Family Planning Instruction as a Marriage Requirement a Retrospective Analysis of the First Two Years' Experience in the Diocese of Covington()." The Linacre Quarterly, vol. 79, no. 4, 2012, pp. 487-498.
Covington's NFP class requirement drew 66% then 77% of couples
Required natural family planning classes reached 66 percent of couples who married in one diocese in 2009 and 77 percent in 2010. The retrospective analysis used Couple to Couple League records. Attendance was counted out of 411 weddings in 2009 and 408 in 2010. Of responding couples, 95 percent said they understood their fertility better after class.
Study at a glance, retrospective cohort study of 411 weddings: Required NFP classes reached most couples in one diocese. Source: Manhart MD, 2012, PMID 30082991.
Key Findings
Couples taught by the Couple to Couple League (CCL) averaged 47 per year in 2003 to 2008, then 273 in 2009 and 317 in 2010.
Attendance at a CCL NFP class equaled 66 percent of the diocese's 411 weddings in 2009 and 77 percent of 408 in 2010. The figures are unadjusted for exemptions or other providers.
Among engaged couples, 40 percent (21 of 52) attended solely as a marriage requirement before the mandate, versus 74 percent (308 of 421) after (p < 0.001).
Current hormonal contraceptive use was 53 percent (245 of 461) among engaged couples and 8 percent (4 of 48) among married couples (p < 0.001).
On the end-of-class questionnaire, 95 percent (110 of 115) reported a better understanding of their fertility. 83 percent (109 of 131) would recommend the class to a friend.
Interpretation
This retrospective cohort study tracked Couple to Couple League class records in the Diocese of Covington from 2003 to 2010. After the diocese required classes, attendance rose from about 47 couples a year to 273 in 2009 and 317 in 2010. The requirement also changed why couples came to class. Before it, 40 percent of engaged couples attended solely because a pastor required it. Afterward, 74 percent did. Hormonal contraceptive use was far lower among married couples than engaged couples, at 8 percent versus 53 percent. The authors note the records came from ongoing class and counseling work. The findings support longer, prospective studies of NFP class requirements.
RRM Context
Among U.S. women of childbearing age, national survey data cited in the paper found less than 1 percent used periodic abstinence. Couple to Couple League classes teach the Sympto-Thermal Method to both partners. Each partner learns to read fertility signs. Couple-centered, cycle-charting-informed care is a shared principle across restorative reproductive medicine.
Our editorial summary of this paper, not the article's abstract.
Abstract
Beginning January 1, 2009, the Roman Catholic Diocese of Covington mandated that all engaged couples take a full course of NFP instruction as part of preparation for marriage within the Church. Using data from the Couple to Couple League and its Covington-based instructors, overall NFP instruction and characteristics of the couples attending classes before and after the mandate were examined. In the first two years, 66 percent and 77 percent of couples who married in the diocese, respectively, attended an NFP class. The mandate shifted the reasons for couples taking NFP instruction; prior to the mandate, 40 percent of engaged couples attended classes solely due to a pastor's requirement while 74 percent of engaged couples did so afterward (p < 0.001). Hormonal contraceptive use was common; 54 percent reported current use while another 23 percent reported former use. Current hormonal contraceptive use was significantly more common among those attending solely due to the mandate compared to those attending for multiple reasons (59 percent vs. 41 percent respectively, p = 0.004) and was significantly more common among engaged compared to married couples (53 percent vs. 8 percent respectively, p < 0.001). Cohabiting engaged couples were significantly more likely to have ever used hormonal contraceptives (91 percent vs. 71 percent, p < 0.0001), compared to engaged couples who were not cohabiting at the time of NFP instruction, and were significantly less likely to both be Catholic (55 percent vs. 70 percent, p = 0.002). Overall, implementation of mandatory NFP instruction as part of marriage preparation was successful; in post-class surveys, over 90 percent of couples acknowledged they had a better understanding of their fertility, and 83 percent would recommend the classes to a friend. Longer-term prospective follow-up is needed to evaluate the long-term impacts to couples exposed to such a requirement.
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