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Learning to listen to the female body

· ​Interview with Elena Giacchi ·

In Humanae vitae Paul VI, having accepted the possibility of birth control by natural methods but knowing full well that research into this subject had soon run aground, sought the help of doctors in order to continue in this direction. Several medical researchers responded to the Pope’s appeal and two couples in particular. We talked about it with Elena Giacchi, a doctor and researcher.

To begin with, could you explain what natural methods actually mean and what conception of procreation and of human relations they imply?

The modern natural methods, the Billings method and the sympto-thermic methods (Retzer and Camen), enable us to recognize the rhythms of fertility on the basis of observations and the assessment of specific physiological signs present in women during their fertile periods.

The natural methods are generally considered only to be contraceptives based on natural elements; instead they are far more than this. The two pairs of doctors who studied them and worked them out had experience of them and explained them clearly: Dr John and Dr Evelyn Billings, who developed their method in the 1950s in Melbourne and Dr Joseph and Dr Margareta Roetzer (who conceived of the sympto-thermal method), were not only scholars and scientists but also witnesses to the complexity of relations and of the ways of knowing ourselves, our bodies and the relationship which unites the couple, a complexity which stems from these methods. Indeed, working as a couple meant they understood that it was not only a question of closer observation and deeper knowledge of their bodies by women themselves – something to be lauded in itself, as moreover feminists have always maintained – but also of a path to wisdom and the reciprocal maturing of the couple.

John Billings asked women to record all the symptoms that accompanied their menstrual cycle, because at the beginning there was a plea to improve the ability of women to listen to the signals given by their own bodies. The literature on this topic had already recorded studies of the cervical mucus as an important factor in fertility and the Billings were amazed to note that the women involved were able to recognize all the variations linked to the hormonal fluctuations in their cycle, and formulated their method from this case study. It is important to stress that the method’s accuracy was confirmed by the clinical studies on the fluctuations of female reproductive hormones carried out by Professor Brown of the University of Melbourne. The approach taken to verify the method thus corresponded with the strictest scientific criteria.

These natural methods have really put science at the service of the individual so that, through knowledge of the precision and harmony of the mechanisms that regulate fertility, it could respond to the need for responsible procreation.

One very important aspect of the method is educational, and in this area Evelyn Billings’ involvement – which happened later – proved to be extremely positive, for as a woman she was able to understand the nature of the symptoms and therefore to teach other women to recognize them.

Indeed women played a central role in the transmission and learning of the method from the outset, and it must be added that as well as making women responsible for their own fertility, the method was found to have a positive effect on the couple’s bond. In fact it strengthened the habit of mutual reciprocal attention, of dialogue and of communication.

Both sexes were involved: although it was women who had to recognize the signs of fertility in their own bodies and decipher their meaning, it was up to men to be informed about these signs and it was from this dialogue that responsible sexual behaviour sprang, based on reciprocal listening.

Do you doctors who spread the Billings method have any idea of its effect on a couple’s life?

It is of course a deep path to knowledge, of the kind that puts weak relationships in couples to the test, yet at the same time it offers a great opportunity for growth in love because it creates a conscious communion of life.

It is nevertheless a method which presupposes a relationship between two people as a couple; it certainly doesn’t lend itself to being used in a life of casual relations unbound by any bond, of the sort that the sexual revolution has fostered and has rendered normal for young people.

The method requires that women learn to come into contact with their own bodies in order to know them. This is a very interesting aspect because it seems to run counter to what in past years was taught in Catholic environments, where it was preferred to ignore any preparation for sexual life. Nor did the recent Synod on the Family address the subject of natural methods....

There have naturally been and still are difficulties and embarrassment in getting this clear, concrete and coherent discourse with Humanae vitae accepted in the Church and, what is more, criticism by people who were unaware of the method’s sound scientific basis frequently came from the secular world, almost as if their criticism was a devotional practice. Among our enemies we must list above all the pharmaceutical companies which make large profits from the sale of contraceptives. The natural methods have the “defect” of being free... and furthermore they are not limited to being effective with regard to a need but make it possible to integrate knowledge of one’s own corporeity into all the person’s dimensions (affective, rational, spiritual), for a real development of his or her identity and personality. This is therefore a profoundly human dimension whose value many people today do not recognize. In this sense the outreach and value of Humanae vitae has not yet been fully appreciated. This Encyclical truly opened up a new way of conceiving the relationship with the body, but I am confident that the dialogue between us users of the method and the ecclesial world, ever active, will help us to grow in the direction pointed out by Paul vi.

For this reason training people how to use the method is very important and requires teachers trained in the basic medical disciplines and who are expert in the didactic methodology of teaching couples. It must not be forgotten that natural methods are not haphazard but apply scientific ideas to an itinerary of self-awareness and are disseminated throughout the world in specific educational forms according to the different situations.

In this regard it is useful to underline that the Billings method is not just “the method of the Catholic Church”, but was, for example, adopted by the State in China from the 1960s, where it found dissemination and confirmation. An epidemiological study carried out in China also records a reduction in abortion rates among users of the Billings method in comparison with those using other methods. This fact is explained not only by the method’s effectiveness in preventing unwanted pregnancies, but also by the strength of its transmission of values which educate people in the meaning of and respect for life even in profoundly secularized societies.

Knowledge of one’s body was developed by feminism in the 1950s but the feminists never relied on natural methods for ideological reasons.

People preferred to delegate their responsibility to technical instruments rather than to developing an awareness of their own bodies linked to their personal responsibility. Our proposal does not mean the rejection of techniques and self-referentiality, indeed on the contrary, the natural methods have a great interdisciplinary vocation because of their prognostic value. Thanks to the refined ability to recognize the symptoms, it is possible to be oriented towards the cure of the cause rather than the cure of the symptom, thereby contributing to a more correct medical practice.

The Billings method is very little known, how do couples find you?

There is a great variety of ways but the first source is a user who has had a positive experience of it and passes the word on in his or her own circles. To paraphrase Paul vi, our epoch has no need of teachers but rather of witnesses....

We mentioned earlier the difficulty in getting these methods accepted by the young .

The reality we know through conversations with students is that often consumerism is applied to their sex lives or they seek for a release from tension or for transitory pleasure. And it is in these instants of momentary pleasure that the relationship between people is depleted. Instead, this natural method transcends the moment and fills a sexual experience with meaning, making it profoundly human. One might say that the terms of confrontation are affective instability and insignificance on the one hand, and stability and personal development on the other… but young people often don’t even know that there is an alternative to sexuality lived in a shallow and irresponsible freedom.

We must learn to spread this experience using the language of the young in such a way that its beauty can be known. In this sense this entreaty of Humanae vitae is still prophetic.

However we have also had very positive feedback in many countries (China, Arab countries and India to mention but a few): the use of these natural methods is spreading wherever they are correctly passed on and applied. This is both because of their very high efficacy in birth control and because of the easiness of learning the methods (which do not depend on a person’s educational level), because they can be applied everywhere and because they cost nothing. Those who teach the Billings method are all volunteers; this restricts the number of people who can be reached by the method but strengthens its educational value.

There is widespread misinformation concerning the effectiveness of the natural methods. Can you give us some facts and figures to support them?

Scientific literature shows that if it is used correctly the Billings method has an effectiveness greater than or equal to 98-99 per cent in preventing conception and its efficacy may be compared to that of the birth control pill. As for the other natural method, the sympto-thermal method, its efficacy is more or less the same.

The failures (about 6-9 percent) do not derive from a weakness in the method’s scientific foundation but rather from an incorrect use of it.

The natural methods have also proved to be a very effective means of managing and resolving pathologies of infertility, both in highlighting the causes of infertility and in identifying the most suitable behaviour in order to encourage conception. Moreover it is known today that barrenness is a serious problem that is dramatically increasing.

As regards the effectiveness of the Billings method for achieving conception, one of our studies followed 155 couples (of whom 117 had risk factors) and demonstrated an effectiveness of 95 per cent for couples without risk factors, and of 63 per cent for couples with risk factors, even in the presence of pathologies.

In conclusion I would like to say that this is a method with instructions for its use, and these instructions constitute a lifestyle that is indispensable if one is to recognize the riches of the total and fruitful love of which Humanae vitae speaks.

Mariella Balduzzi

Elena Giacchi

The married couple, John and Evelyn Billings

A gynaecologist at the Centro studi e ricerche per la regolazione naturale della fertilità [Centre for Studies and Research on Natural Birth Control] of the Catholic University of the Sacred Heart in Rome, she is concerned with responsible procreation and natural birth control. She was one of the first collaborators of Professor Anna Cappella, a pioneer in the dissemination of natural birth control methods in Italy and in various countries across the world. The author of about 100 publications, she has held important offices in both Italian and international scientific institutions. These include the Italian Confederation of Natural Birth Control Centres (cic-rnf) where, from 2008 to 2014, she was President, a member of the Administrative Council and President of the Technical and Scientific Committee; the World Organization Ovulation Method Billings (woomb) of which she is is currently scientific consultant and from 2003 to 2008 she was President of the Italian Section.

From 1987 to 1990 she was also a member of the European Commission for teaching natural methods at the Fédération Internationale Action Familiale (fidaf).




St. Peter’s Square

Feb. 25, 2020