Humanae vitae's legacy: two views.

John D. Hagen Jr.

A few years ago in Commonweal, a young Catholic scholar referred to older colleagues "whose intellectual clocks stopped in 1968 with the ecclesiastical politics of Humanae vitae." He challenged this older cohort of Catholic academics to desist from end lessly "fighting the old battles" and reciting the old grievances (see Christopher Ruddy, "Young Theologians," April 21, 2000).

Leslie Woodcock Tentler's recent essay on contraception ("A Bitter Pill," April 23) unfortunately fits this paradigm. Tentler attacks the U.S. bishops' project to publish "an easily understandable booklet" explaining official church teaching on contraception. Tentler marshals data that start in 1875 and end with the "rhythm method" and other twice-told tales of the 1960s. The last specific item of evidence she cites is a survey that was taken in 1969.

As a member of Tentler's generation, I can vividly recall the angst surrounding Humanae vitae. The encyclical was obscurely reasoned and the "rhythm method" didn't work. The church seemed fecklessly resistant to population-control imperatives and to the spirit of the times. But the clock didn't stop in the late 1960s. Here are a few important points that we've learned in the intervening years:

Natural family planning works. The rhythm method was superseded twenty-five years ago. Modern NFP, based on daily anatomical observations, is easy to learn and is nearly 100-percent effective (see The Journal of Reproductive Medicine, June 1998).

Artificial contraception has abortifacient properties. Birth-control pills primarily work by suppressing ovulation. However, occasionally "breakthrough ovulation" occurs. In such cases, birth-control pills can cause early abortions. Hormones contained in them thin the endometrium (the lining of the uterus), making it difficult for embryos to implant. Intrauterine devices (IUDs) may also interfere with implantation (see the National Catholic Bioethics Quarterly, Spring 2004).

Artificial contraception poses serious risks to women's health. A 2003 study sponsored by the National Cancer Institute showed a significant increase in breast cancer risk for young women using oral contraceptives (see www.nci.nih.gov). Many breast-cancer risk factors correlate with estrogen exposure, and hormonal birth control may have helped cause the burgeoning breast-cancer rates of the past few decades. The pill and the IUD have been linked to numerous other health complications. NFP, by contrast, involves no risks to women's health at all.

Pope Paul VI was an accurate prophet. In Humanae vitae, Paul warned that a contraceptive culture would lead to a general breakdown of sexual morality and exploitation of women by men. We all scoffed at this in 1968, but it proved to be sadly accurate. As Francis Fukuyama, a thoroughly secular scholar, shows in The Great Disruption, contraception paradoxically led to an increase in out-of-wedlock births and abortions all across the developed world. He states, "The main impact of the pill and the sexual revolution that followed was ... to change male behavior.... [M]en felt liberated from norms requiring them to look after the women whom they had gotten pregnant." The logic of contraception promotes a breakdown of sexual inhibitions; the logic of NFP does not.

The foregoing points would go a long way in helping to frame the "easily understandable booklet" that our bishops hope to issue on birth control. Such a booklet couldn't have been written in 1968. It can be written now, based on the lived experience and the increased biological understanding of recent years. And that's to say nothing of the "theology of the body," lucidly articulated by Pope John Paul II and embraced by many young Catholics.

I have been in a good position to observe the latter point. For the past two decades, I've been engaged in young-adult ministries with the parish that serves the University of Minnesota. I know dozens of young couples who use NFP and attest to the fact that it not only works but strengthens their marriages. A recent theology of the body seminar in the Twin Cities attracted more than a thousand people. Almost every priest I know below the age of forty confidently espouses NFP.

I understand the lingering hurts expressed by Tentler and her priest-interviewees from the 1960s. But those hurts have little to do with conditions on the ground for young people today. On the one hand, they live in a hypersexualized culture (a direct result of the birth-control pill). On the other hand, many of them find great credibility in the vision articulated by John Paul II. The enormous success of the World Youth Day assemblies demonstrates this.

The church's teaching on birth control is unlikely to change, not because of obstinacy but because the course of events has shown the teaching to be sound. Humanae vitae was obscure, but it contained a deep wisdom which has been vindicated with passing decades. Many people dissented in good faith from the encyclical, but the data we have are decisively different now. Young Catholics increasingly recognize this. Older Catholics preoccupied with the battles of the late 1960s run the risk of becoming a sort of Jacobite league or Confederate veterans' association, aging and dwindling and increasingly marginalized in the life of the church.

The pressing issue now, as Tentler correctly states, is steering our youth through "the churning seas of adolescence" roiled by the hypersexualized entertainment and advertising media. We need all hands on deck for that task. To meet the enormous cultural challenges of the present day, we need to lay to rest the ecclesiastical grievances of the 1960s.

John D. Hagen Jr. practices law in Minneapolis.

Leslie Woodcock Tentler

I plead guilty to aging, but not to being intellectually mired in 1968. The intervening years have made me a sadder but wiser girl. Unlike John Hagen, I no longer have much appetite for indiscriminate broadsides against moral corruption, and even less for one-size-fits-all solutions to complex problems. In this chastened spirit, let me respond to each of his "important points."

Natural family planning works. Perhaps it does--I haven't the expertise to judge, particularly in light of the paucity of rigorous research on the subject. As a historian, however, I know that the same was said of the rhythm method from the 1930s forward--not just by priests, but by Catholic physicians and medical researchers too. Hagen's claim in this regard is eerily parallel to past pronouncements, which typically asserted that rhythm was as effective as the best contraceptive then on the market. Certain Catholic spokesmen in the 1960s asserted, presumably in good conscience, that rhythm was just as effective as the pill. Rhythm's proponents were also quick to tout the most recent improvements to the method, only then admitting that earlier approaches were not in fact as effective as once claimed. Hagen does much the same. The essential components of Natural Family Planning--the basal temperature method and analysis of cervical mucus--were known by the later 1950s. Legions of Catholic women then were engaged in "daily anatomical observations," although sometimes without the desired outcome.

Natural Family Planning today may well be more effective than the rhythm method practiced by many older Catholics. We don't yet have the kind of proof we need, however, given rhythm's troubled history. Absent such proof, I could not in conscience advise a young Catholic woman to rely on the method--not if she wished to plan her family in concert with paid employment. (Feminism, which Hagen does not mention, has shaped the expectations of even my most devout students, nearly all of whom anticipate careers as well as families.) But what if medical research were to provide incontrovertible evidence that NFP was "nearly 100-percent effective"? That would indeed be good news, but not necessarily a reason for the church to exclude all other modes of family planning. Some women might decide that "daily anatomical observations" were not consonant with their understanding of personal dignity. Others might have cause to worry that regular bouts of abstinence would have a deleterious effect on their marriages. In cases like these, why should couples not be free to elect an alternative mode of family limitation, even if its effectiveness did not match that of NFP?

Artificial contraception has abortifacient properties. Hagen makes a startlingly blanket claim here, but does not establish it. He asserts that two contraceptives--one of which, the IUD, is not much used in the United States--may on occasion have abortifacient properties. Following his logic, we would have to say that Catholics who insist on using contraceptives should opt for condoms or diaphragms. A contraceptive that is clearly abortifacient should be regarded by Catholics as morally unacceptable; the so-called majority report of the papal commission on birth control said as much, in 1966. It is far more difficult to make a compelling moral argument with regard to a highly effective contraceptive--to wit, the pill--that was not designed to work as an abortifacient and when functioning normally does not do so. Catholic spokesmen in the past--a few as late as the 1950s--sometimes equated contraception with murder. Hagen's argument here seems perilously close to this theologically dubious logic.

Artificial contraception poses serious risks to women's health. Catholic spokesmen have been making this particular claim since the early years of the twentieth century. And yet the same century saw an unprecedented increase in women's life expectancy, particularly in the developed nations, where contraceptive use is most widespread. Certain contraceptives have in fact been physically harmful: the Dalkon Shield, a no-longer-marketed version of the IUD, did dreadful damage to some of its users, while the earliest version of the pill contained what many researchers now regard as dangerously high levels of estrogen. But alarmist claims about pill use and breast cancer have not been borne out; the most recent epidemiological studies dispute a once-suspected correlation between the two. More important, American women today live longer, healthier lives than ever before. If this says anything at all about contraception, it would seem to suggest that birth control is good for women, at least in a physiological sense.

Pope Paul VI was an accurate prophet. The pope, in fact, didn't know the half of it. That was my spontaneous reaction upon first reading the "doomsday" paragraphs of Humanae vitae, where the pope predicts widespread moral collapse should the church permit contraception in marriage. Viewed from 2004, his litany of moral disasters seems rather tame--a contemporary reader is immediately tempted to embellish it. Who can doubt that we live in a hypersexualized culture? That courtship among the young has been increasingly displaced by a crude exchange of sexual favors? That marriage is a vanishing institution among certain vulnerable segments of our population, and in trouble among the rest of us? Dire symptoms, however, mandate careful diagnosis. How do we know that contraception is the root cause of these disorders? High rates of teenaged pregnancy in the United States predate the pill. Americans had the world's highest divorce rates when it was still illegal to send contraceptive information through the mail. The rate of abortion in the mid-nineteenth-century United States, when contraception was unmentionable in polite public discourse, was probably almost as high as it is today.

If one accepts as an article of faith that contraception is the cause of all our sexual woes, then Hagen is surely right. The bishops should indeed press ahead with their "easily understandable booklet." As a historian, however, I find this leap of faith eludes me. Our present woes have multiple causes. Contraception, moreover, is here to stay--no matter what the bishops say. Far better, in my view, for Catholic leaders to begin to speak about living the vocation of Christian marriage in the real world--about marriages that are communities of life and love, where fidelity to spouse and family is what makes every act of marital intercourse simultaneously unitive and procreative. Once we can speak honestly about marriage, we will be in a much better position to guide our young people through the sexual jungle that is their unhappy inheritance.

Leslie Woodcock Tentler is professor of history at The Catholic University of America.