Responsible pRocReation,

paRenthood, and population:

A Guide for Catholic Marriage Counsellors

SEPTEMBER 2015
Suggested citation: Kaufa, A. and G. Buleya. 2015. Responsible Procreation,
Parenthood, and Population: A Guide for Catholic Marriage Counsellors.
Lilongwe, Malawi: Futures Group, Health Policy Project.
Foreword
Since its establishment in 1901, the Episcopal Conference of Malawi (ECM) has
been a development partner of the Government of Malawi. Through this partnership,
the ECM has helped the nation develop, not only pastorally, but also socially and
economically—especially in the areas of health, education and governance.

The rapid growth of Malawi’s population over the past several decades is undermining
these gains. Malawi is one of the fastest-growing countries in sub-Saharan Africa in
terms of population. Our country’s population has more than tripled over the past 40
years, and is expected to triple again within the next 25 years.* The pace of growth
is posing legitimate questions about the linkage between population growth and
the ability of Malawians to access basic needs such as nutrition, shelter, health, and
education.

As issues of our country’s growth and development become increasingly urgent,

it is important for the Catholic faithful to be guided by a Catholic understanding
of marriage, procreation, and responsible parenthood that is both firmly rooted in
the teachings of the Church and relevant to the context of the times—a context that
includes rapid population growth, climate change, and development challenges.

The Episcopal Conference of Malawi (ECM), through this booklet, wishes to help
Catholics and all people of good will to put population issues in the right perspective
enlightened by the Church’s teachings on responsible procreation. This booklet is
designed to help Catholics better understand population and family planning issues
from the perspective of the Catholic faith. This is in keeping with the Church’s
mandate to be ‘the salt of the earth and the light of the world’ and with its quest to
remain a credible and supportive partner to the Government of Malawi.

The pastoral statement of Catholic Bishops in 2013 observed that in recent times
there have been an increasing number of campaigns related to population growth
and family planning in Malawi. For this reason, the Catholic Church sees a need to
engage its members in constructive discussion concerning the role of their faith in
these matters.

Catholic Marriage Counsellors are instrumental in this effort. In the Church, marriage
counsellors can help youth, married couples, those contemplating marriage and
all stakeholders in the Church ministry to fully understand population and family
planning issues in the context of the social teachings of the Catholic Church.

* Ministry of Finance and Development Planning. RAPID: Population and Development. Lilongwe: Ministry of Finance and
Development Planning and Ministry of Health, Reproductive Health Unit, 2012.

l i
In some dioceses, marriage counsellors organize retreats and workshops for different
age groups to deal with premarital and marital issues, beginning with the youth around
the age of puberty. These programs are tailored to meet the needs of participants, who
include youth in schools and colleges, young men and women either contemplating
or preparing for marriage and married couples of all ages.

To be successful, marriage counsellors must have guidance, training, and authentic

tools such as manuals and resource books to support them in their work. Unfortunately,
there are substantial gaps in currently available tools and resources. For instance, most
books that marriage counsellors use in our dioceses are old and need to be updated to
reflect new realities—such as the linkages between population growth, responsible
parenthood, and development. There is also lack of harmonization regarding resource
books for marriage counsellors across the ECM’s eight dioceses. In fact, in almost all
dioceses, training of marriage counsellors has not been regular.

In keeping with the Church’s service to respect for life and the dignity of the human
person, the Catholic Bishops believe that this booklet is an important step towards
addressing these gaps. This booklet is intended to help marriage counsellors to provide
more effective support and guidance to congregants on issues related to reproduction,
planning of families, and responsible parenthood.

The Church is grateful to the Ministry of Finance, Economic Planning and

Development (MoFEPD) and the partners who have provided technical and financial
support towards the realization of this booklet. We commend the tireless effort of
the drafting task force composed of the lay Catholics from associations such as the
Catholic Family Movement, Catholic Women Organization, the Diocesan Pastoral
Secretaries, the Catholic Secretariat, and the technical staff of the Health Policy
Project, funded by the United States Agency for International Development (USAID).
We look forward to continued partnership of this kind.

On behalf of my brother Bishops of the Episcopal Conference of Malawi, I request

Marriage Counsellors and all relevant pastoral agents, to ensure that this booklet is
put into use in the Catholic Church in Malawi.

May the Almighty God bless our efforts as we undertake our responsibilities as
stewards of the earth and God’s co-creators.

Archbishop Thomas Msusa

Chair, Episcopal Conference of Malawi (ECM)
September 2015

ii l
Contents

Acknowledgments...................................................................................................................iv

1. Introduction..............................................................................................................................1

2. The Role of Marriage Counsellors in the Catholic Church Today.....................................3

3. What Every Catholic Must Know About Marriage............................................................10

4. Responsible Parenthood........................................................................................................16

5. Family Planning......................................................................................................................20

6. Methods of Family Planning.................................................................................................27

7. Conclusion...............................................................................................................................43

Bibliography................................................................................................................................45

l iii
Acknowledgments
This publication was developed by the Health Policy Project, with funding from the
United States Agency for International Development (USAID), and the Episcopal
Conference of Malawi (ECM). This document was written by Father Andrew
Kaufa smm* with theological guidance from Father George Buleya and technical
input from Rebecca Mbuya-Brown, Laston Mteka, Olive Mtema, Erin McGinn, and
Carol Miller.

* Missionaries of the Company of Mary (Montfort Fathers)

iv l
1 Introduction
The Episcopal Conference of Malawi (ECM) is responsible for the planning, running,
and management of the Catholic Church’s pastoral and social development activities
in the country. It does so inspired by Sacred Scriptures and the Catholic Church’s own
social teachings.

In carrying out its social development activities, ECM works as a development

partner of the Government of Malawi, particularly in the areas of education, health,
and other social services. In 2013, the government, through the Ministry of Finance,
Economic Planning and Development, produced a National Population Policy. This
document acknowledges that Malawi is facing social, economic, and development
challenges because its population is growing so quickly.1

According to the National Population Policy, Malawi’s population grew from 4

million in 1966 to 13.1 million in 2008, reaching 15.3 million by 2013. If this rate
of growth continues, the population will reach 40 million by 2050. The speed with
which the population is growing is causing numerous challenges, such as:

• Scarcity of resources including land, food, and water.

• Insufficiency of education and health facilities.
• Poor education and health services in Government institutions.
• Unemployment

The rapid growth of population is undermining the government’s efforts to provide

high-quality social services, including education, health, and food security. The speed
at which the population is growing accelerates environmental degradation, which
in turn affects livelihoods and sparks conflict as people scramble for land and other
natural resources. Population growth also puts strain on the country’s economy and
results in fewer jobs being available, especially for young people.

The overall goal of the government’s population policy is to improve standards of

living and quality of life for people in Malawi. This goal cannot be achieved without
addressing the negative impacts of population growth on

• Education services.
• Health services.
• Agriculture, land use, and food sustainability.
• The economy, labour force, and employment.

l 1
High fertility rates and family size are the major factors contributing to the growth of
Malawi’s population. Therefore, Malawians ought to be more aware and active about
issues related to population growth, family planning, and development.

The Catholic Church, inspired by the Sacred Scriptures and committed to promoting
the dignity of the human person, is concerned with population issues in so far as
they negatively affect people’s livelihoods. Therefore, marriage counsellors should
understand the linkages between responsible procreation, parenthood, and population
issues. They should use their own understanding to teach others about these issues,
especially youth, those preparing for marriage, and married couples. It is in this context
that Catholic Bishops find it important to offer guidance to marriage counsellors on
how best to help Catholics respond to population issues responsibly as Christians—
hence, this booklet.

Endnotes
1. Government of Malawi. National Population Policy. Lilongwe: Ministry of Finance, Economic Planning and Development, 2013.

2 l
2 The Role Of Marriage Counsellors in the
Catholic Church Today
The Catholic Church attaches great importance to sexuality, marriage, and family.
Marriage counsellors play an important role in helping members of the community
understand the Church’s teachings on these issues and put these teachings into practice.
It is important for marriage counsellors not to think of themselves as “fire fighters,”
i.e., only working with couples in crisis. Instead, marriage counsellors should work
with couples to keep crises from arising. It is important for marriage counsellors to
understand how population issues affect married couples and families, as well as the
Church’s teachings on these issues. They should share their knowledge with youth,
those preparing for marriage, and married couples before crisis levels are reached.
This requires meeting with clients repeatedly over time to build a relationship of trust.

Marriage counsellors should support unmarried people and families to live a good
life in accordance with Christian values and morals. They can do this by:
• Working with youth long before they become engaged—helping them
understand the principles and purposes of Christian marriage and the Church’s
teachings on population, marriage, and sexuality (remote preparation).
• Helping engaged couples prepare for the roles and responsibilities of marriage,
including discussing their plans for the spacing of children and the overall
number of children (proximate preparation).
• Providing ongoing support and guidance to help couples build loving, healthy
marriages and helping parents raise their children in a dignified manner,
thereby ensuring their well-being (accompaniment).
• Helping parents guide their children to grow into a culture of appreciating the
Church’s teachings on population and human sexuality (accompaniment).

2.1 Why Do Marriage Counsellors Need to Talk about

Family Planning?
An impression has been created in society that the Catholic Church literally promotes
the begetting of children to fill the earth (Gen 1:27). However, the truth of the matter
is that the Catholic Church does not take human reproduction as an area to be left to
instinct, hazard, or fate. The creation stories (Gen 1-2) teach that man and woman
were created in the image of God. Therefore, they are collaborators with Him in the
mission of building the world. For this reason, on transmission of life, the Vatican
Council II document “On The Constitution of The Church” (Gaudium et Spes
[GS]) clearly spoke of parents as co-operators with the love of God the Creator and
interpreters of that love. Gaudium et Spes says:

l 3
 Married couples and Christian parents should follow their own
proper path to holiness by faithful love . . . They should imbue their
offspring, lovingly welcomed as God’s gift, with Christian doctrine
and evangelical virtues . . . In this way, they stand as the witness and
co-operators in the fruitfulness of the holy mother Church; by such lives
they are a sign and a participation in that very love with which Christ
loved his bride and for which he delivered himself up for her (GS. No. 41).

On this basis, the Catholic Church calls for respect of God’s law when discussing
procreation, parenthood, and population. Therefore, marriage counsellors ought to
emphasize the ability of parents to use their power of reason to make appropriate
decisions about questions such as how many children to bear. When talking about
family planning and population issues with clients, marriage counsellors should
make it clear that, ultimately, parents have a responsibility to regulate human fertility
in a manner that will enable them to adequately respond to the needs and aspirations
of their families and children.

The Catholic Bishops of Malawi made a pastoral statement related to these issues
in 2013, “Catholic Teaching on Human Sexuality, Abortion, Population and Birth
Control.”2 Marriage counsellors are expected to educate couples about the importance
of responsible parenthood. They should also help couples understand the impact
of population growth and the linkages between population, family planning, and
development from the perspective of the Church’s teachings on marriage, procreation,
and human sexuality.

Catholic marriage counsellors should talk about family planning to help their clients
understand and take up their responsibility as Christians. They should emphasize
several key points:
• There are obvious linkages between family size and the socioeconomic and
development challenges facing Malawi.
• The problems arising from these linkages are affecting us as a nation so much
that they call for our Catholic response.
• Human beings are made to be stewards of God’s creation, which implies that
men and women have an obligation to take care of themselves and of the earth
and its natural resources.
• Family size and birth spacing affect a family’s health and socioeconomic
well-being in many and different ways.
• There is great need to promote Natural Family Planning (NFP) methods,
especially stressing the advantages of NFP over artificial methods.

4 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
2.2 Counselling Youth about Marriage, Family Planning, and
Responsible Parenthood

It is important for marriage counsellors to begin educating young people about these
issues long before they marry so that they may cultivate an attitude of responsible
parenthood from an early age (remote preparation). When a young man and woman
are preparing for marriage, counsellors have an even more important role to play.

Youth and those preparing for marriage should be taught and given enough
information about:
• The properties and purposes of Christian marriage.
• The importance of responsible parenthood.
• The Church’s guidance on family planning.
• The linkages between population growth, family planning, and development.

Above all, they should be encouraged to talk about issues, such as:
• Abstinence
• Faithfulness
• Love
• Commitment
• Trust
• Family planning

Youth, especially those in schools and colleges, should be encouraged to delay

marriage and concentrate on studies and entrepreneurship. This will help them build
a solid foundation for marriage and parenthood, reduce the health hazards that come
along with early pregnancy, and may reduce the number of children they will have
during their lifetime.

As described above, Catholic marriage counsellors should not be “fire fighters”.

Instead, they should be companions to their clients, who are in need of advice,
guidance, and accompaniment. Marriage counsellors may not necessarily need
to provide professional psychological help. However, to take up their roles more
effectively, they need to acquire some basic counselling skills along with adequate
knowledge of Catholic teachings on procreation, family planning, and population.

The Role of Marriage Counsellors in the Catholic Church Today l 5

2.3. Principles of Marriage Counselling

The basic principle of marriage counselling is to strengthen individuals—helping them

make personal life decisions that embrace inherent human dignity and convictions.
A counsellor is not there to make decisions for an individual, family, or community.
Rather, as a trained or experienced person, he or she is there to offer exceptional
advisory service to those in need of guidance.

Given this understanding, marriage counsellors’ duties include:

• Providing support and guidance to youth related to issues of marriage, sexuality,
procreation, family planning, and population (remote preparation).
• Providing support and guidance to young people who are contemplating
marriage (proximate preparation).
• Advising married couples on specific problems and challenges (accompaniment).
• Leading married couples in a process of identifying, clarifying, and solving
problems (accompaniment).
• Advocating for adherence to Catholic Social Teachings as they are confronted
with issues of parenthood, family planning, and population.

In the context of procreation, family planning, and population issues, Catholic

marriage counsellors must accompany young people by giving them guidance in a
manner that strengthens them to face these challenges and responsibly take moral
decisions. In this way, they will be empowered to address family and population
issues in a manner that truly reflects Christian values—values that are consistent with
Catholic Social Teachings.

2.4. Benefits of Marriage Counselling on Responsible

Procreation and Parenthood
Today, the average couple in Malawi has between five and six children. In the context
of current population issues, family planning advocates consider this to be a high
fertility rate, which has become a driving force behind secular campaigns for use of
contraceptives.3

The Catholic Social Teaching emphasizes the good of children. Begetting children
whose dignity will not be respected is perceived by the Church as tantamount to
sinning. This is the case regardless of whether population is high and increasing (as is
the case in Malawi), or low and decreasing (as it is in many other countries, especially
in Europe). Nevertheless, a high fertility rate often goes contrary to God’s desires and

6 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
plans for both parents and children—especially when it negatively impacts the quality
of their relationships and family members’ lives. In fact, the Church acknowledges
that there are many benefits when a couple is in a good relationship with each other
and with God and are carrying out their responsibilities in consistency with her
social teaching.

Catholic marriage counsellors have a responsibility to help their clients look

objectively at the current situation in Malawi, not so much to be compelled by the
secular agenda but rather to appreciate the moral imperative to have the good of
their children and that of mother Malawi in mind. Furthermore, it has been reported
by some members of Catholic Family Movement (CFM) that many couples who
received specialized counselling from CFM and Catholic Marriage Encounter (CME)
have had positive experiences with responsible procreation and parenthood.4 They
report the following experiences:
• It deepens intimacy.
• It builds the existing relationship between husband and wife.
• It helps foster dialogue and mutual growth of the couple.
• It helps the couple develop stronger and more effective communication skills.
• It enables them to find ways to reduce conflict and express anger in a
healthy way.

When done consistently with Catholic Social Teachings, timing and spacing of
pregnancies, responsible procreation, and parenthood can:
• Improve the health of the woman and reduce risks of death and illness.
• Increase children’s chances of survival.
• Contribute to gender equality by allowing girl children and mothers to have
more time to better their lives through education and other opportunities.
• Benefit Church leaders, since married couples live with reduced stress and
are better able to meet their family needs, leading to happier families.
• Benefit the Church, as parents have more time to engage in social and
pastoral activities at various levels.
• Benefit the nation, as the government can improve the availability of social
services and better meet the needs of the population.

The Role of Marriage Counsellors in the Catholic Church Today l 7

2.5. Steps in Marriage Counselling

A Catholic marriage counsellor must be someone who has received a basic training
that enables him or her to give guidance on personal, social, or psychological
problems. Generally, counselling should be a process of dialogue and consultation,
which involves:
• Listening to one another.
• Identifying the issue or problem.
• Clarifying the issue or problem.
• Finding ways to deal with the issue or problem.

For couples preparing for marriage in the Catholic Church, counselling on

responsible procreation and parenthood must involve the following steps:
i. An introductory meeting between the marriage counsellor and client(s).
ii. A premarital evaluation and discussion.
iii. Marriage preparation classes or sessions.
iv. Lessons about family planning methods, especially NFP.
v. Consultation with a priest, deacon, or any other recommended pastoral agent.
vi. Identification of the way forward for continued education following
the wedding.

For married couples, the counselling process should follow the same steps, with
some variations:
i. An introductory meeting between marriage counsellor and client(s).
ii. A marital evaluation and discussion, which should explore the state of the
couple’s marriage and family relationships, including their sexual life, family
size, and the family planning methods they use.
iii. A joint identification of issues and problems.
iv. Clarification of issues/ problems.
v. If needed, discussion of the importance of seeking specialized consultation
with the priest or other appointed pastoral agent.
vi. Identification of the best way forward.

8 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
Conclusion
Catholic marriage counsellors have an important role to play among youth, those
preparing for marriage, and married couples. It is our experience that people need
and seek advice at various stages of growth. Although marriage counselling does
not necessarily involve providing professional psychological help, there are certainly
some basic skills that are required and some steps that must be followed. Based on
testimonies of those who have undergone marriage counselling through the CFM and
CME, marriage counselling supports Christians in marriage to build relationships
that echo the love that God has for them and for their children.

Endnotes

2. Episcopal Conference of Malawi (ECM). Catholic Teaching on Homosexuality, Abortion, Population and Birth Control: A Pastoral
Statement. Balaka: Montfort Media, 2013, p.16-17.

3. Episcopal Conference of Malawi (ECM). Sexual and Reproductive Health (SRH) Policy. Balaka: Montfort Media, 2013, p.7.

4. Although CFM has done no specific study, this statement is based on the testimony of Mr. Rodney Nglanade, a member of CFM
and a specialized trainer of marriage counsellors, during an interview held at the Catholic Health Commission offices in Dedza on
June 10, 2015.

The Role of Marriage Counsellors in the Catholic Church Today l 9

3 What Every Catholic Must Know
About Marriage
Every Catholic marriage counsellor must have a good understanding of the Catholic
Social Teaching about marriage, sexuality, and procreation, for “you cannot give
what you do not have.” These teachings are central for Catholic couples to live a
married life that is based on the Catholic faith.

3.1. The Purpose of Marriage

According to the Catholic Church’s teaching, “Marriage is a covenant by which a
baptized man and a woman establish between themselves a partnership of their whole
life, and which of its very nature is ordered to the well-being of the spouses, to the
procreation and upbringing of children . . .” (Can. 1055). This partnership must be
characterized by human love and the love of Christ over his Church (Eph. 5:1ff).
Thus the purpose of marriage is threefold (marriage counsellors may refer to Vatican
II document Gaudium et Spes (GS. 41); Gen. 2:18; 24 and Mt. 19:6 and highlight the
following three purposes of marriage):
• The well-being of both spouses
Through mutual love and partnership, both husband and wife should enjoy
the marriage bond as a God given gift.
• Procreation
Children are a gift from God, the fruit of married love. Through sexual union
within the state of marriage, the couple is able to participate in the divine task
of co-creation.
• Caring for children
Family is the nucleus where Christian faith first blossoms. As such, parents
are responsible for care—addressing both the spiritual and physical needs of
their children. Parents should provide for their children and teach them to live
a life that is grounded in Catholic faith and morals.

It is also important for married couples to understand what the Catholic Church
truly teaches about the multiple purposes of marriage. Some have misunderstood
the Church’s teachings to mean that procreation is the only purpose of marriage.
According to the Catholic Church’s teaching, husband and wife may be unable
to bear children but this does not mean that their marriage is invalid as some
cultures hold.

10 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
Therefore, marriage counsellors should help couples to:
• Understand and appreciate the gift of marriage as taught by the
Catholic Church.
• Encourage those that are able to have children to responsibly procreate.

For couples that for one reason or another cannot bear children, marriage counsellors
should help them to:
• Accept God’s will.
• Avoid blaming each other.
• Love and support each other.
• Consider adopting a child.

3.2. Principles of Marriage

A good Christian marriage must be guided by principles outlined in the Bible and
the teaching of the Catholic Church. We highlight just a few of these below for the
purpose of supporting marriage counsellors in their work.

Love
Marriage is a sacred, loving covenant entered into between a man and a woman.
• “Be imitators of God, as beloved children, and live in love, as Christ loved
us and handed over for us a sacrificial offering to God for a fragrant aroma”
(Ephesians 5:1-2).
• “Husbands, love your wives, even as Christ loved the Church and handed it
over for her to sanctify her, cleansing her by the bath of water with the word
. . .”(Ephesians 5:25-26).
• “And above all these put on love, which binds everything together in perfect
harmony” (Colossians 1:14).
• “Whoever is without love does not know God, for God is love” (1 John 4:8).

Hence the following are the key points:

• Love is essential to a Christian marriage, as matrimony is modelled on the
loving relationship between Jesus Christ and the Church.
• Christian love impels husband and wife to develop a positive Christian attitude
towards one another.
• As human beings, husband and wife must accept one another’s weaknesses
and forgive each other.

What Every Catholic Must Know About Marriage l 11

Partnership and Mutuality
Right from Genesis 1-2, the Bible teaches us God’s revelation that marriage is a
partnership of man and woman.

Partnership
“It is not good for the man to be alone. I will make a suitable partner
for him.” (Gen 2:18).

Here, the Book of Genesis points to partnership as one of the most important reasons
for entering into marriage and emphasizes that Christian marriage is an intimate
partnership, in which man and woman come together in marriage as loving partners to
care for, help, and support each other as they fulfil their physical, social, economic, and
spiritual needs.

Mutuality
Marriage is built on the basis of mutuality—the idea that husband and wife support
one another, each according to his/her unique gifts.
• Mutuality is created through the manifestation of various qualities,
including honesty, trust, openness, submission/obedience, respect, tolerance,
understanding, faithfulness, and partnership support (Gen 2:24).
• In the same spirit of partnership and mutuality, husband and wife
must share equally the benefits of marriage, including those coming from
their economic activities.
• When husband and wife live in this spirit of loving partnership and mutuality,
peace and comfort prevail in their marriage.

Commitment
Marriage is a commitment that requires self-giving.
• God’s unconditional and perpetual love for us is the model of Christian love
in a family (John 3:16).
• In fact, in the Scriptures, marital love is compared to the love and
commitment between God and human kind, or rather to the relationship
between Christ and His church (Colossians 3:19; and Ephesians 5:25-33).
• In marriage, husband and wife offer themselves fully for the good of the other.
• Each gives up their independence and self-interest, and transfers their energy
and will towards the goal of mutual happiness.

12 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
Life of Prayer
The Bible also shows that marriage should be entered into and sustained by a life
that is characterized by prayer precisely because marriage is a relationship instituted
by God.
• Prayer is communicating with God and with one another.
• In prayer, husband and wife must enter into dialogue with God
(Jeremiah 33:3).
• Husband and wife must engage in dialogue with each other on all issues that
affect their life, including those relating to sexuality and procreation.
• Husband and wife must seek God’s guidance (Proverbs 16:3).
• Husband and wife must sustain their marriage by seeking God’s help in all
things, for it is through God’s grace that we are able to flourish (I Peter 3:7).
• God’s relationship with humankind is the model of the marriage relationship.
• Marriage must be modelled on the relationship between Jesus and the Church
(Ephesians 5:25).

Intimacy
Married life involves both spiritual and emotional intimacy.
• Within marriage, one of the ways that man and woman express and build their
intimacy is through their sexual intercourse.
• Sexual satisfaction and emotional support, together with openness, is key to
establishing and nurturing intimacy (I Corinthians 7:3-5; Ephesians 5:1-33).
• Marriage is the place where man and woman legitimately enjoy
sexual intercourse.

3.3. Purpose of Sexuality

The Creation narratives of Genesis (1-2) are a plausible point of reference to
understanding human sexuality.
• Male and female God created them, and they express themselves as sexual
beings (Gen. 1:26-27).
• Sexuality, or rather sexual feelings, is a fundamental component of being
human, willed by the Creator and commended by Him at creation that it is
good (ECM Sexual and Reproductive Health Policy, p.8).
• Through sexual faculties, male and female express themselves as sexual beings.
• Sexuality is a fundamental way in which male and female express their
relationship with the material world.

What Every Catholic Must Know About Marriage l 13

 • Based on this understanding, sexual acts in the context of the marriage are
aimed at expressing total submission, intimacy, commitment,
complementarity, and mutual love between the spouses.
• Human heterosexuality is the work and plan of the Creator in the continuation
of creation.5

3.4. Understanding the Place of Sex in a Christian Marriage

In a society marred by confusion of minds and growing relaxation of morals, it is
imperative that marriage counsellors better understand human sexuality and even
spell out the “do’s” and “don’t’s” in the sexual arena, while providing a sound and
plausible ethical context to sustain that right understanding of our sexuality.
Three points ought to be highlighted:
• “Sexual intercourse is realized in a truly human way only if it is an integral
part of the love by which man and woman commit themselves totally to one
another until death.”6
• The Catholic Church considers extramarital sexual intercourse as sinful.
• Not any sexual pleasure should be condoned, but only that which is
connected to genuine joy of love between man and woman—that sexual
pleasure which is capable of giving thanks to the God of creation from whom
all good things come.7
There is also a twofold understanding of the purposes of sex in a Christian
marriage8:
a) To express the mutual love and respect of husband and wife, and to deepen
their intimacy.
b) To procreate, i.e., where conditions are adequate to have children even
though this is not the sole purpose of marriage9 (Gen. 2:18).
Therefore, according to the Catholic Church, sex within marriage is both a physical
and a spiritual act.

3.5 Marriage and Parenthood

The Church teaches that the integrity of human sexuality and the procreative,
relational and erotic dimensions contained therein require the right context in which
sexuality can be honoured.

14 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
 • Children are a gift that God gives man and woman united in marriage
(Ps 127: 3-5, 128: 3, Gen. 46; 22: Job 5. 7; GS 50; Familiaris Consortio No. 14).
• While not the only purpose of marriage, procreation is one of the benefits that
can result from marriage (Genesis 1:28).
• Procreation in marriage is perceived as collaboration with the God of love
and so must be exercised with responsibility, prudence, and generosity.
• In begetting life, husband and wife fulfil one of the highest dimensions of the
Christian calling, which is to become God’s co-worker and co-creator.
• As such, responsible cooperation with God in the arena of human sexuality
cannot be reduced to the ideology of fertility and indiscriminate procreation
of children at all cost.10

Conclusion
Marriage counsellors have a great role to play in helping Christians to understand
the Catholic Social Teaching about marriage. Marriage is a life-long covenantal
relationship between a man and a woman, characterized by human love, and open to
procreation (Can. 1055; Eph. 5:1ff). On this basis, the Church emphasizes a few points:
a) That sexual love must be enjoyed within the Divine parameters;
b) That spouses look after one another’s well-being;
c) That a couple must procreate where possible;
d) That a couple who procreate must fulfil their responsibility as parents.

In a nutshell, family is the nucleus where Christian faith must blossom and where
parents exercise their proper responsibility in caring for both the spiritual and
physical needs of their children. Therefore, Christian marriage must be grounded in
Catholic faith and morals.

Endnotes
5. Episcopal Conference of Malawi (ECM). Catholic Teaching on Homosexuality,
Abortion, Population and Birth Control: A Pastoral Statement. Balaka: Montfort Media, 2013, p.8, no.2.1.

6. ECM. Sexual and Reproductive Health (SRH) Policy. Balaka: Montfort Media, 2013.

7. Ibid, p.11.

8. Ibid, p.10.

9. Ibid, p.9, no.2.2.

10. Ibid, p.12

What Every Catholic Must Know About Marriage l 15

4 Responsible Parenthood
Church documents such as Gaudium et Spes (GS) and Pope Paul VI’s 1968 encycli-
cal “On Human Life” (Humanae Vitae [HV]) introduce us to the concept of respon-
sible procreation. In the same line, the Catholic Bishops in Malawi produced the
Pastoral Statement “Catholic Teaching on Homosexuality, Abortion, Population and
Birth Control” in 2013, which addressed issues related to responsible parenthood
and family planning. The Catholic Bishops called for unwavering orthodoxy on
these matters.

4.1. What Is Meant by Responsible Parenthood?

According to the Catholic Social Teaching,

“Those are considered to exercise responsible parenthood that

prudently and generously, in their marital union, maintain
openness to life, while taking into consideration the good of the
prospective children and the limited nature of natural resources.” 11

The underlying fact here is that, in the eyes of God, parents have great responsi-
bility to their families. The Catholic Social Teaching emphasizes that parents, as
co-creators with God, have the responsibility to decide on the number of children
they can care for as they cooperate with God in this noble task (HV No. 10, 1 Timo-
thy 3:5). Thus the following three points ought to be highlighted:
• While God commanded man and woman to beget children and fill the earth
(Gen. 1:28), God has also made parents responsible for the physical,
emotional, and spiritual needs of their children (1 Timothy 3:5).
• Parents are better able to meet this responsibility when the number of
children in a family is reasonable and manageable.
• Parents should not reproduce carelessly—having many children yet failing
to give those children the care they deserve.

As such, responsible procreation implies:

• Begetting children whose dignity will not be respected is virtually
sinning— regardless of whether Malawi’s population is low or high.
• Catholic couples must discuss and make decisions together regarding the
regulation of birth in the family.

16 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
 • The family must provide a conducive environment for the development and
protection of children.
• Parents should respond to the psychological and material needs of their
children, as well as their aspirations in terms of education and career.

This may sound new to many Catholics, yet it has been the Church’s teaching since the
Vatican Council II, whereby Bishops emphasized human and Christian responsibility
when dealing with matters pertaining to the transmission of human life (GS no. 41;
HV no.7).

If properly understood and practiced, responsible parenthood can have a positive

impact on the socioeconomic development of a country, including helping to ease the
challenges caused by rapid population growth. As such, marriage counsellors must
help youth, those considering marriage, and those already married to understand the
importance of responsible parenthood.

Again, since “you cannot give what you do not have,” to do this properly, marriage
counsellors must:
• Be familiar with Biblical teachings and Catholic Social Teaching.
• Be able to link the concept of responsible parenthood to issues of
population growth as they affect the country’s socioeconomic development.12

4.2 What Does Responsible Parenthood Entail?

Responsible parenthood begins with an attitude of openness to life. This is
due to the fact that in transmitting life, parents are co-operators with the love
of God the Creator and interpreters of that love (GS 50).13 Thus, responsible
parenthood entails:
• Awareness of and respect for the sexual functions of human bodies as created
by God.14
• Deciding together (as husband and wife) when to have a child.
• Use of human reason by both parents to control their innate sexual desires to
carry out this joint decision.
• Evaluation by husband and wife of their motives regarding
sexual intercourse.
• Exercise by each spouse of his/her conscience to interpret God’s will,
knowing that in procreating they must respect God’s will.
• Fulfilling the parental role with a sense of human and Christian
responsibility (GS 50).

Responsible Parenthood l 17
4.3 Why is Responsible Parenthood Important?
Human reproduction is designed by God. In this design, it is intimately connected with
personal (the bodily and erotic dimension) and social interests. As such, reproduction
should be regulated in a responsible way.

Without contradicting Biblical teachings, the Church is aware of and sensitive to

the signs of the times with regard to population issues, including environmental
degradation, scarcity of natural resources, and climate change.

Thus on these matters, the Catholic Bishops in Malawi, guided by Sacred Scriptures
(such as 1 Tim 3:5; 5:8) and Catholic Social Teaching, advocate for responsible
parenthood through the use of Natural Family Planning (NFP) methods. As stated
above, this teaching is based on the understanding that:
• Children’s dignity must be respected.
• Care of children and of natural resources is a moral imperative whether
population is low or high, increasing or decreasing.

Therefore, marriage counsellors should understand that:

• Human sexuality is a divine invitation to human beings to be God’s workers
and co-creators.
• The teachings of the Catholic Church advocate for a Christian sense of
responsibility among parents when dealing with issues of procreation, caring
for children, and stewardship of natural resources.

Conclusion
Marriage counsellors must understand that responsible parenthood has many
benefits not only for children but also for parents, society, and the Church (see
Section 5.2). For instance,
• It enables children to grow in an environment conducive to healthy spiritual,
moral and social development.
• It helps parents become better role models for their children, raising them
with integrity to be good citizens with the ability to make appropriate moral
choices and become good parents in their turn.
• It fosters unity and co-operation between husband and wife as they strive to
fulfil their mutual obligations together.
• It promotes family stability by helping husband and wife discuss their
problems and solve them peacefully.

18 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
Endnotes
11. ECM. Sexual and Reproductive Health (SRH) Policy. Balaka: Montfort Media, 2013, p.12.

12. Ministry of Finance and Development Planning. RAPID: Population and Development. Lilongwe: Ministry of Finance and
Development Planning and Ministry of Health, Reproductive Health Unit, 2012. Refer also to Population Action International
and the African Development Institute for Policy Research, 2012.

13. ECM. Sexual and Reproductive Health (SRH) Policy. Balaka: Montfort Media, 2013, p.11-12.

14. Ibid, p.10.

Responsible Parenthood l 19
5 Family Planning
Family planning is one of the topics and challenges affecting the Catholic Church in
Malawi. As she unwaveringly remains orthodox in her teaching on matters pertaining
to sexual morality, there is a perception in the society that the Catholic Church
literally does not allow family planning. However, the truth is that the “Catholic
Church does not take human reproduction as an area to be left to instinct, hazard
or fate.”15 The Catholic Church’s Social Teaching on family planning clearly states
that recourse to artificial methods of family planning is not permitted because such
practices undermine people’s ability to abstain from sexual intercourse during a
woman’s fertile periods. Instead, the Catholic Church permits the use of Natural
Family Planning (NFP) methods.

Today, many factors, including population issues and public campaigns promoting
the use of artificial family planning methods, are affecting people’s attitudes so much
that some Catholic families have begun using the artificial planning methods, which
are contrary to the teachings of the Church. Catholic marriage counsellors must
help couples make choices that support responsible parenthood and are inspired by
Biblical teachings and Church doctrine.

According to the National Population Policy document (2012):

• The average couple in Malawi has between five and six children.
• Almost 45% of pregnancies are unintended or mistimed.
• 46% of the population of women of child-bearing age are using a family
planning method.
• Fewer than 16% of women and only 6% of men correctly reported when the
fertile period occurs.16

This means that:

• More than half of the population of couples treat family planning as a
taboo topic.
• Knowledge of women’s fertility and reproductive cycle is also low.

This is an important finding for us given that the understanding a woman’s fertility is
vital to correctly using the NFP methods embraced by the Catholic Church. Obviously,
marriage counsellors have an important role to play in improving the understanding
and awareness of fertility. Family planning happens when married couples make
informed choices about how many children to have, when to have a child, and how
much time to wait between births.

20 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
Loving couple talking about planning their family. Illustration by R. Chilemba

5.1 What is Family Planning?

Family planning happens when married couples make informed choices about how
many children to have, when to have a child, and how much time to wait between births.

Couples in Malawi ought to start discussing their plans for a family before they marry
and continue talking about this throughout their marriage as their options, decisions,
and life circumstances may change over time. While they make responsible choices
about how many children to have and how best to space their children, Christian
couples should consider their economic capabilities, the good of their offspring, and
the good of the rest of the created world which is “our common home.”17 Couples
should also teach their children about the importance of family planning—preparing
them to become responsible parents when they reach adulthood.

Family Planning l 21
The ECM Sexual and Reproductive Health Policy reports that between the years
2000 and 2006, the utilization of NFP in Catholic families was as low as 4.1% while
the utilization of artificial family planning methods increased from 28% in 2004 to
42% in 2010.18 Ironically, the observation of some members of the Catholic Family
Movement in Malawi is that there is great demand today for more education on NFP
among couples.19

Furthermore, ongoing research findings on several NFP methods, including the

lactational amenorrhea method (LAM), Standard Days Method (Cycle Beads) and
the Two-Day Method, show good efficacy rates when these methods are practiced
correctly and consistently (about a 2% to 5% failure rate, but if not practiced properly,
failure rates range from 15% to 25%).20 Findings also show that when a couple has
strong communication skills and practices mutual respect and decision-making, NFP
can be more effectively used.21 These points support the argument that it is regrettable
that many Catholic nurses, marriage counsellors, and pastoral agents do not have
sufficient knowledge about NFP methods, so much so that NFP is given very little
attention in pastoral programs.22

In order to address this silence among pastoral workers about NFP, there is a need
for Catholic nurses, pastoral workers, and marriage counsellors to be well trained so
that they are able to educate youth, those preparing for marriage, and married couples
about responsible parenthood and convincingly urge them to use the NFP methods
that are endorsed by the Catholic Church as opposed to using artificial family planning
methods. They must at least make it possible for couples to make choices that are in
harmony with their Catholic moral values.

In essence, when dealing with issues of family planning, marriage counsellors should:

• Encourage and help married couples and those preparing for marriage to have
these sensitive conversations—which require mutual respect, understanding,
tolerance, faithfulness and sacrifice.
• Emphasize that when it comes to procreation in a Christian marriage,
ultimately the outcome is in God’s hands. Therefore, if a married couple
cannot have a child, they must accept their situation and continue to love one
another (Romans 8:28).
• Speak about birth regulation, family planning, and responsible parenthood
rather than “birth control.”
• Advocate for unwavering orthodoxy on matters of sexual morality and
birth regulation.

22 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
5.2 Benefits of Family Planning
The Church absolutely disagrees with the secularist agenda on “artificial methods”
of family planning. However, she acknowledges that family planning has many
undeniable benefits and endorses the NFP methods precisely because they respect the
natural law and are in accordance with the Catholic Social Teaching.

The following are some of the benefits of family planning.

Happier marriage
• A good marriage is a foundation for responsible planning of families.
Likewise, family planning can contribute to healthy marriages by reducing
the stress that can be placed on marriages when couples are struggling to
meet their children’s needs.
• Family planning strengthens marriage through increased communication
and intimacy. Family planning requires communication, co-operation, and
joint decision-making. Using NFP methods in particular can deepen intimacy
and strengthen the marriage bond.

Family Planning l 23
Healthier family
• Better nutrition and care for children: Fewer children mean more food and
more time for each child.
• Improved child survival: Family planning can prevent infant deaths caused
by closely spaced births. Children born less than two years after a previous
birth are more than twice as likely to die before the age of 5 as compared
with those born at least three years after a mother’s last birth. In fact, infants
of mothers who die as a result of giving birth are at greater risk of death and
poor health.
• Better maternal health: Preventing pregnancy-related health risks can save
women’s lives. Unintended pregnancies increase the risk of death and
disability for mothers and children, especially when pregnancies are too early
(before age 18), too many (when the mother has had many previous
pregnancies), too late (when the mother is older than age 35), or too frequent
(when pregnancies are spaced too close together).

Economically better quality of life

• Household income is sufficient to meet the family’s needs.
• Parents have increased time to devote to the emotional and spiritual needs of
their children.
• Parents (especially mothers) have increased opportunities for social
interaction, education, and pursuing career goals.
• Children can be provided with better education and support—improving their
life opportunities.

Benefits to the nation

• Healthier communities
• Increased availability of social services
• Increased availability and sustainability of natural resources
• Reduced conflict over land and other natural resources

5.3 What Does the Bible Teach about Family Planning?

Procreation is a primary value in the Old Testament, and a number of Biblical
texts can be used to support this argument, most notably Gen. 1:28: “Be fertile and
multiply; fill the earth and subdue it . . .”

24 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
However, this verse and other Bible texts ought to be looked at from a contextual
perspective. When God commanded Adam and Eve to “be fertile and multiply,” the
population on earth was tiny. The population challenges we face today did not exist
at that time. Marriage counsellors should highlight this context to help husbands and
wives appreciate the Catholic Social Teaching on family planning—the NFP method.

5.4 What Does the Catholic Church Teach about Procreation

and Family Planning?
She advocates for openness to God, to one another and to children:
• There are obvious connections between human sexual feelings and the
dignity of procreation in marriage.
• The Church has always held in high esteem the primacy of reproduction
in marriage.
• The Catechism of the Catholic Church teaches Christian couples to be open
to children (CCC 1652-1654)—for marriage, by its nature, has the goals of
the procreation and education of children.
• The Church teaches that procreation is a gift from God (Gen. 1:28). When
spouses conceive new life, they participate in God’s creative power.
• For many centuries the Church has been opposed to the separation of married
couples’ sexual acts from their natural procreative end.

She advocates for responsible parenthood:

• The Church encourages families to have children they can afford to support
(GS 50).
• She recognizes that human reproduction is important and that it must be
guided and regulated in a responsible way (ECM Pastoral Statement, 2nd
March 2013, no. 3.3.2).
• She teaches members that the modern question of spacing and limiting births
in marriage is important. However, it must be considered with respect to
God’s design for married love (Pope Paul VI, HV, 1968).

She advocates for Natural Family Planning (NFP) methods:

• The methods of birth regulation that Christians may use must be respectful to
the sanctity of life (ECM Sexual and Reproductive Health Policy, no. 2.6).
• She teaches that life is a gift that ought to be valued. As such, she specifically
and strongly recommends NFP methods as the only methods morally
acceptable to Catholic Social Teaching (Evangelium Vitae; ECM SRH, no. 2.6).

Family Planning l 25
 • She teaches that Catholics must go for natural ways of family planning, not
artificial ways, for the NFP methods are in agreement with Catholics’ aspiration
to the good and to the truth and with what human beings really are, preserving
the meaning given to creation.
• She recommends that instructions about NFP methods be part of marriage
preparation lessons so that those preparing for marriage are taught how
to read and interpret signs of fertility and infertility to help them avoid
pregnancy and achieve child spacing.

Conclusion
The Catholic Bishops expect that marriage counsellors are Catholics who are in a
position to help others appreciate the difference between the artificial methods of
family planning and the NFP methods, and why. This requires that they acquire ample
knowledge regarding the Catholic Social Teaching on these matters, which are the
focus of Chapter 6 below.

Endnotes
15. ECM. Sexual and Reproductive Health (SRH) Policy. Balaka: Montfort Media, 2013.

16. National Statistical Office (NSO) and ICF Macro. 2011. Malawi Demographic and Health Survey 2010. Zomba, Malawi and
Calverton, MD: NSO and ICF Macro.

17. Pope Francis, Laudato Si: On the Care of Our Common Home. Papal Encyclical, 24 May, 2015.

18. ECM. Sexual and Reproductive Health (SRH) Policy. Balaka: Montfort Media, 2013, Art.1.2, pp.6-7 (citing the Malawi
Demographic and Health Survey reports of 2004 and 2010 comparatively).

19. Mr Rodney Ngalande. Interview held on wednesday 10 June 2015 at Catholic Health Commission offices, Dedza.

20. World Health Organization, Fact Sheet No 351, May 2015, Available: http://www.who.int/mediacentre/factsheets/fs351/en/;
Trussell J. Contraceptive Efficacy. In Hatcher RA, Trussell J, Nelson AL, Cates W, Kowal D, Policar M. Contraceptive Techology:
Twentieth Revised Edition. New York NY: Ardent Media, 2011.

21. Interview with Mr Rodney Ngalande, Dedza Catholic Health Commission, Wednesday 10 June 2015. 22. Sr Kelechi J. Agugo,

22. Marital Intimacy and Communion: A Mutual Vocation to Holiness. Lagos: Fourth Man Creations, 2013, pp. 145-148.

26 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
6 Methods of Family Planning
As discussed in Chapter 5, the Catholic Church teaches and advocates for the use of
natural methods as a form of birth regulation. She supports these methods because
they do not interfere with the natural functioning of the human reproductive system as
designed by God. Natural methods are in agreement with what human beings really
are in the eyes of the Creator—images of God and co-creators. They preserve the
meaning given to sexuality. In fact, using NFP methods helps couples better realize
that together they are the sanctuary of the bond between love and life.

The ECM Sexual and Reproductive Health Policy (2013, p.13) presents the following
moral criteria that ought to be taken into consideration when a Christian family is
choosing family planning methods:
• Respect for the total truth of the sexual act in its love and
procreative dimensions.
• The good and welfare of the unborn child.
• The good of the entire creation in the world.

Looking at them with an eye of Catholic faith, the major differences between
artificial family planning methods and NFP methods are as follows:
• NFP methods imply a marriage that is life-directed, and where using natural
methods of regulating fertility, the couple is at the service of
responsible parenthood.
• Artificial family planning methods imply a marriage where sexual union is
separated from procreation and, using artificial contraceptives, it is deprived
of its natural openness to life.

Nevertheless, it must be mentioned that “the Church does not at all consider immoral
the use of contraceptive pills as ‘therapeutic means’ (i.e., the use of the pills for non-
contraceptive uses) when this is truly necessary to cure diseases or menstrual issues”
(ECM Sexual and Reproductive Health Policy, 2013, p.14).

6.1. Natural Family Planning (NFP)

In keeping with the teachings of the Catholic Church, NFP:
• Allows couples to live responsible parenthood in line with God’s design.
• Unifies marital sex with the possibility of procreation.
• Fosters respect for the sacredness and wonder of human life.

l 27
In other words, the couple places themselves before the eyes of God, and marriage
is the just place given to the sexual desire and pleasure between husband and wife.

NFP methods strengthen the marriage bond. They do so by the fact that they:
• Allow the full sexual and spiritual self-giving required to perfect the
marriage bond.
• Require the clear understanding, continuous cooperation, and commitment of
both spouses, which promotes male involvement in family planning.
• Help in improving communication and strengthening marriages through their
commitment to abstaining from sexual relations on fertile days.
• Help married couples learn about and appreciate their bodies and fertility
because NFP requires being aware of body changes and keeping track of
fertile days according to the rules of the specific method.
• Deepen the husband’s understanding of his wife and her reactions and moods.
• Require periods of abstaining—a practice that encourages sexual self-control
and helps the couple to perfect their chaste life and set a good example of
chastity for youth.

6.1.1. NFP methods characteristics

• There are no side effects or health risks.
• They are effective immediately.
• They are reversible immediately.
• They do not require any procedures and usually do not require supplies.
• They are free of charge—no cost attached!
• They involve long periods of abstaining from sexual intercourse.
• They do not interfere with breast-feeding.
• Both women who want to become pregnant and those who want to avoid
pregnancy can use NFP methods to identify fertile days.

6.1.2. How NFP methods work

• By keeping track of when the fertile time of a woman’s menstrual cycle
begins and ends.
• By abstaining from sexual relations during the woman’s fertile days.

28 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
6.1.3. Methods available to keep track of fertile days
There are several methods available for keeping track of fertile days. These methods
can be used alone, or in combination.

Furthermore, there are three types of NFP methods:

1. Calendar-based methods
These involve keeping track of days of the menstrual cycle to identify the start and
end of the fertile time:
• Standard Days Method
• Calendar rhythm method

2. Symptoms-based methods
These depend on observing signs of fertility in a woman’s body:
• Cervical secretions (Two-Day Method, Ovulation/Billings method)
• Basal body temperature (BBT)
• Combination (sympto-thermal method)

3. Lactational amenorrhea method (LAM)

LAM is a temporary method based on breastfeeding, which is effective for up to six
months after childbirth.

It is important to note that newer fertility awareness methods, such as the Standard
Days Method and Two-Day Method, are easier to use correctly than some of the
older methods.

6.2. Natural Family Planning (NFP): The Methods in Detail23

6.2.1. Calendar-based methods
The following are important to note when using these methods:
i. Use caution with these methods when menstrual cycles have just started or
have become less frequent or stopped due to older age, as identifying the
fertile time may be difficult.
ii. Delay using calendar-based methods when the woman has recently given
birth or is breastfeeding—delay until she has had at least three menstrual

iii. In cases where the woman recently had a miscarriage, delay until the start
of her next monthly bleeding.

Methods of Family Planning l 29

X Standard Days Method
A woman can use the Standard Days Method if most of her menstrual cycles are 26
to 32 days long.

If she has more than two longer or shorter cycles within a year, the Standard Days
Method will be less effective and she may want to choose another method.
• Keep track of the days of the menstrual cycle: a woman keeps track of the days
of her menstrual cycle, counting the first day of monthly bleeding as Day 1.
• Abstain from sexual relations on Days 8–19: these days are considered
fertile days
• Use memory aids: the couple can use Cycle Beads—a color-coded string of
beads that indicates fertile and non-fertile days of a cycle, or they can mark
on a calendar or use some other type of memory aid.

© 2007 Rita Curtis Meyer/CCP, Courtesy of Photoshare

How to Use Cycle Beads:

• Each bead represents a day of the menstrual cycle.
• On Day 1, the first day of the monthly bleeding, move the rubber ring to
the red bead.
• The next day, move the ring to the next bead.
• White bead days are days when the woman can become pregnant. She should
avoid sex.

30 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
 • Brown bead days are days when pregnancy is unlikely and she can have sex.
• If monthly bleeding begins again before reaching the dark brown bead, her
menstrual cycle is shorter than 26 days—the couple should use another method.
• If monthly bleeding does not begin before reaching the last brown bead, her
menstrual cycle is longer than 32 days—the couple should use another method.

X Calendar Rhythm Method

• Keep track of the days of the menstrual cycle: Before relying on this method,
a woman records the number of days in each menstrual cycle for at least
6 months. The first day of monthly bleeding is always counted as Day 1.
• Estimate the fertile time: The woman subtracts 18 days from the length of
her shortest recorded cycle. This tells her the estimated first day of her fertile
time. Then she subtracts 11 days from the length of her longest recorded
cycle. This tells her the estimated last day of her fertile time.
• Abstain from sexual relations during the fertile time.
• Update calculations monthly: A woman must update these calculations each
month, always using the six most recent cycles.

© 2009 Rafael Avila, Courtesy of Photoshare

Methods of Family Planning l 31

6.2.2. Symptoms-based methods: Methods based on awareness of
cervical secretions
These methods require a woman to observe
her cervical secretions. When a woman sees
or feels cervical secretions, she may
be fertile. She may feel just a little
vaginal wetness.

Caution:
• If a woman has a vaginal infection
or another condition that changes
the cervical mucus, these methods
will be difficult to use.

X Two-Day Method
• Check for secretions: The woman
checks for cervical secretions
every afternoon and/or evening, on
fingers, underwear, or tissue paper, © 2007 Rita Curtis Meyer/CCP, Courtesy of Photoshare
or by sensation in or around
the vagina.
• As soon as she notices secretions of any type, she considers herself fertile
that day and the following day.
• Abstain from sexual relations during the fertile time.
• Resume sexual relations after two dry days, i.e., days without secretions of
any type in a row.

X Ovulation method (also known as Billings method)

This method requires the woman to check cervical secretions daily. She must check
every day for any cervical secretions on fingers, underwear, or tissue paper or by
sensation in or around the vagina.
• Abstain from sexual relations on days of heavy bleeding: Ovulation might
occur early in the cycle, during the last days of monthly bleeding, and heavy
bleeding could make mucus difficult to observe.
• Resume sexual relations until secretions begin: Between the end of monthly
bleeding and the start of secretions, the couple can have sex, but not on two
days in a row. Avoiding sex on the second day allows time for semen to dis
appear and for cervical mucus to be observed.

32 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
 • It is recommended that they have sex in the evenings, after the woman has
been in an upright position for at least a few hours and has been able to check
for cervical mucus.
• Abstain from sexual relations when secretions begin and until 4 days
after “peak day.”
As soon as the woman notices any secretions, she considers
herself fertile and avoids sex.
She continues to check her cervical secretions each day. The secretions have
a “peak day”—the last day that they are clear, slippery, stretchy, and wet.
She will know this has passed when, on the next day, her secretions are
sticky or dry, or she has no secretions at all.
She continues to consider herself fertile for three days after that peak day.
• The couple can resume sexual relations on the fourth day after her peak day
and until her next monthly bleeding begins.

6.2.3. Methods based on awareness of body temperature

These methods require a woman to observe and track her body temperature.
A woman’s resting body temperature goes up slightly after the release of an egg
(ovulation), when she could become pregnant. Her temperature stays higher until the
beginning of her next monthly bleeding.

Caution:
• If a woman has a fever or other changes in body temperature, methods based
on awareness of body temperature will be difficult to use.

X Basal body temperature (BBT) method

• Take body temperature daily:
The woman takes her body temperature at the same time each morning,
before she gets out of bed and before she eats anything. She records her
temperature on a special graph.
She watches for her temperature to rise lightly—0.2oC to 0.5oC
(0.4oF to 1.0oF)—just after ovulation (usually about midway through the
menstrual cycle).
• Abstain from sexual relations for three days after the temperature rise
• Resume sexual relations on the fourth day, until her next monthly bleeding begins.

Methods of Family Planning l 33

6.2.4. Methods based on awareness of multiple signs of fertility
These methods require a woman to observe and track several signs of fertility to
identify her fertile days.

X Sympto-thermal method (BBT, cervical secretions and other fertility signs):

• Abstain from sexual relations on fertile days.
• Identify fertile and non-fertile days by combining BBT and ovulation
method instructions.
• Women may also identify the fertile time by other signs such as breast
tenderness and ovulatory pain (lower abdominal pain or cramping around the
time of ovulation).
• The couple must abstain from sexual relations between the first day of
monthly bleeding and either the fourth day after peak cervical secretions or
the third full day after the rise in temperature (BBT), whichever happens later.
• Some couples who use this method resume sexual relations between the end
of monthly bleeding and the beginning of secretions, but should not have
sexual relations on two days in a row.

6.2.5. Lactational amenorrhea method (LAM)

This is a temporary family planning method based on the natural effect of
breast-feeding on fertility. “Lactational” means related to breastfeeding. “Amenorrhea”
simply means not having monthly bleeding. LAM provides multiple benefits for the
mother and best feeding for the infant.

• LAM is effective for up to six months after childbirth—as long as bleeding

has not returned, and the woman is fully or nearly fully breastfeeding.
• LAM requires three conditions, whereby all three MUST be met:
i. The mother’s monthly bleeding has not returned.
ii. The baby is fully or nearly fully breastfed and is fed often, day and night.
Almost all the baby’s feeding should be breast milk.
iii. The baby is less than 6 months old.
• “Fully breastfeeding” includes both exclusive breastfeeding (the infant
receives no other liquid or food, not even water, in addition to breast milk)
and almost-exclusive breastfeeding (the infant receives vitamins, water, juice,
or other nutrients once in a while in addition to breast milk).

34 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
 • “Nearly fully breastfeeding” means that the infant receives some liquid or
food in addition to breast milk, but the majority of feedings—more than
three-fourths of all feeds—are breast milk.

How LAM works

• It works primarily by preventing the release of eggs from the ovaries (ovulation).
• Frequent breastfeeding temporarily prevents the release of the natural
hormones that cause ovulation.

Who can use LAM

• Any woman (including those who are HIV-positive) who meets the three
criteria listed above.

Who should not use LAM

• Women whose menses
have returned.
• Women who are not fully (or
nearly fully) breastfeeding.
• Women whose babies are more
than 6 months old.

When to initiate
• Start breastfeeding immediately
after birth.

Client instructions
• Breastfeed baby fully or nearly
fully (see above).
• You will need another method
when your period returns or
baby is over 6 months of age.

Side effects
• None. © 2007 Rita Curtis Meyer/CCP, Courtesy of Photoshare

Known health risks

• None

Methods of Family Planning l 35

Known health benefits
• Helps prevent pregnancy.
• Encourages the best breastfeeding patterns, with substantial health benefits
for both mother and baby.

Correcting common misunderstandings about LAM

• It is highly effective when a woman meets all three LAM criteria.
• It is just as effective among fat or thin women.
• Women with normal nutrition can use it—no special foods are required.
• It can be used for a full six-month period without the need for supplementary
foods. Mother’s milk alone can fully nourish a baby for the first 6 months of
life. In fact, it is the ideal food for this time in a baby’s life.
• It can be used for six months without worry that the woman will run out
of milk. Milk will continue to be produced through six months and longer in
response to the baby’s suckling or the mother’s expression of her milk.

36 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
 Calendar-based Methods
Standard Days Method Calendar Rhythm Method
Keep track of the Keep track of the days of the menstrual • Record number of days in each menstrual cycle for at
fertile days least six months.
as Day 1. • First day of monthly bleeding is “Day 1.”
• Subtract 18 from the length of shortest recorded

• Subtract 11 days from length of longest recorded

cycle—this is the estimated last day of fertile time.
Abstain during Abstain on Days 8–19.
fertile days (estimated using calculation above)
Couples can use memory aids such as Cycle Update calculations monthly—calculations must be
Beads to help them keep track of fertile days. based on the six most recent menstrual cycles.
Note: Women with cycles not within 26–32
days cannot use the method.

Methods of Family Planning

l 37
38
Symptoms-Based Methods

l
Two-Day Method Basal Body Temperature Ovulation Method Sympto-Thermal Method
Method (Billings Method)
Identify fertile Vaginal secretions Body temperature Vaginal secretions Body temperature
days based on: Vaginal secretions
Other symptoms of fertility
Step 1: Check for secretions Take body temperature daily at Check for secretions every First day of monthly bleeding and
Identify every afternoon and/or the same time each morning, afternoon and/or evening. either the fourth day after peak
Fertile Days: evening. before getting out of bed or Secretions of any type indicate cervical secretions (see p.33) or the
Secretions of any type eating. that woman is fertile. Secretions third full day after the rise in
indicate that woman is Record temperatures on a have a “peak day” (see p.33). temperature (BBT), whichever
fertile that day and the special graph. happens later.
Woman should be considered
following day. Watch for temperature to fertile for three days after that
rise slightly (0.2–0.5 C)— “peak day.”
indicating ovulation.
Fertile days—three days after
the temperature rise.
Abstain from Day secretions are For three days after the When secretions begin, until 4
sexual relations observed, and the temperature rise is observed. days after “peak day.” bleeding and either the fourth day
on these days following day. Days of heavy monthly bleeding. after peak cervical secretions or the
third full day after the rise in
temperature (BBT), whichever
happens later.
Resume sexual After two dry days (two Fourth day after temperature Between the end of monthly Between the end of monthly bleeding
relations days in a row with no rise—until next monthly bleeding and the start of secre- and the start of secretions (but avoid
secretions) bleeding begins. tions, (but avoid having sexual having sexual relations on two days
Recommends couples relations on two days in a row). in a row).

Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
engage in sexual Recommends couples engage in
relations in the evenings, sexual relations in the evenings,
after the woman has after the woman has been in an
been in an upright upright position for at least a
position for at least few hours, and has been able to
a few hours, and has check for cervical mucus.
been able to check for
cervical mucus.
6.3. Artificial Family Planning Methods

Artificial family planning methods involve a deliberate medical intervention before,

during, and/or after the conjugal act (sexual relations between a husband and wife)
to prevent pregnancy. The Catholic Church does not allow the Catholic faithful to
use artificial family planning methods for the reasons that were already discussed
in Chapters 4 and 5. However, this booklet includes descriptions of these methods
because Catholic families may come to marriage counsellors with questions related to
artificial family planning methods. Therefore, it is important for marriage counsellors
to be aware of and to have accurate information regarding these methods.

Marriage counsellors must be well prepared to educate their clients about the Catholic
Church’s position on the use of NFP methods as opposed to the artificial methods.
They should make the Church’s position on these methods very clear and/ or refer
any medical questions to health providers and experts where necessary.

Key Points for Catholic Marriage Counsellors:

Artificial family planning methods are NOT in keeping with the teachings of the
Catholic Church because:
• These are deliberate and artificial interventions to render sexual relations
between man and wife infertile (temporarily or permanently).
• These are a deliberate and concrete action taken to separate sexual intercourse
from its procreative dimensions.
• Sexual relations between a husband and wife should be connected with the
possibility of procreation: medical methods remove this possibility, suppressing
the fruitfulness of human love.
• Generally these methods require supplies and/or surgical procedures.
• They may have physical side effects. There are several types of artificial family
planning methods:23

6.3.1 Barrier methods

These are methods used to create a barrier to prevent sperm and microorganisms from
gaining access to the reproductive tract.

X Condoms
Male condoms: Thin latex sheaths that may be treated with a spermicide for added
protection. They are placed on the penis once it is erect. The majority of condoms are
made of thin latex rubber.

Methods of Family Planning l 39

Female condoms: A soft, loose-fitting polyurethane or latex sheath with two flexible
rings that the woman inserts into her vagina before sex so that during intercourse the
penis slips inside the female condom.

6.3.2 Hormonal methods

These methods primarily prevent the release of eggs from the ovaries (ovulation).

X Contraceptive pills:
• Combined oral contraceptives (COCS): These are pills that contain low
doses of two hormones—a progestin and an estrogen—like the natural
hormones progesterone and estrogen in a woman’s body.
• Progestin-only pills (POPS): These are oral contraceptive pills containing
one synthetic hormone known as progestin, similar to the natural hormone
progesterone. They are also known as mini-pills. POPs do not contain
estrogen, and so can be used throughout breastfeeding and by women who
cannot use methods with estrogen.
X Injectable contraceptives:
These are injectable contraceptives containing a long-acting synthetic hormone
(usually progestin) for the prevention of pregnancy.
X Intrauterine contraceptive devices:
These are small, flexible, plastic frames inserted into the uterine cavity to prevent
pregnancy. Available types are made of plastic and are medicated with copper, or
progestin [most readily available in Malawi].
X Implants:
These are thin, flexible rods made of a soft rubber-like material and filled with a
synthetic progestin hormone that are inserted just under the skin of a woman’s
upper arm by means of a minor surgical procedure.

6.3.3 Voluntary surgical contraception methods

These are minor surgical procedures for permanently terminating fertility in both
men and women.

40 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
6.4. Men’s Responsibility

On matters of family planning, the general norm is that marriage counsellors ought
to encourage married couples to discuss issues together. They should come to joint
decisions about when to seek pregnancy, when to regulate birth, and how to avoid
or delay pregnancy. As such, a few points ought to be highlighted as follows:
• Husbands have an important role to play in relation to family planning,
especially in terms of the NFP methods that the Catholic Church supports.
• Active cooperation of both spouses is required to use these methods
successfully. It is important for both spouses to understand how these
methods work and how to use them.
• Catholic marriage counsellors must encourage couples to talk together about
sexuality and family planning and encourage joint decision-making.
• This type of open communication can deepen intimacy and trust between
spouses, help reduce marital conflicts related to child-bearing and sexuality,
and help couples make and carry out realistic plans as a team.
• Marriage counsellors must provide accurate information and correct any
misperceptions especially about NFP methods.

Conclusion
It is particularly important for marriage counsellors to correct common
misunderstandings about the Catholic Church’s position on family planning methods.
The Catholic Church advocates for use of NFP methods and does not allow use of
artificial family planning methods. The Catholic Social Teaching on family planning
gives a clear theological explanation for the position of the Church. The Church
recognizes the benefits of birth regulation both to the mother and to the child, as well
as to the family at large. By encouraging couples to abstain from sexual intercourse
during fertile days, the Church also advocates for use of NFP methods and for couples
to wait until the youngest child is at least 2 years old before a woman becomes
pregnant again by. Therefore, marriage counsellors must help couples to embrace
NFP methods and appreciate the abstinence from sexual relations during fertile days.

Endnotes
23. Definitions of medical family planning methods are drawn from the Malawi National Reproductive Health Service Delivery
Guidelines (2014-2019). Sections 6.2 and 6.3 also draw heavily on Family Planning: A Global Handbook for Providers (2011
update), produced by the World Health Organization Department of Reproductive Health and Research (WHO/RHR) and
Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for
Health Project.

Methods of Family Planning l 41

7 Conclusion
Sexuality is a fundamental component of being human—man and woman. As such, it
is imperative that youth, those preparing for marriage, and married couples are helped
to understand the mystery of human sexuality as presented in the Bible (Gen. 1:27-
28) and as further elaborated by the Catholic Social Teaching, especially the Vatican
Council II document “On the Constitution of the Church” and other relevant Church
documents. Reference to Biblical sources about the creation of man and woman
serves to underline the Catholic Church’s long-standing conviction not only about
the parameters of human sexuality but also responsible procreation, parenthood, and
the population issues.

As the population of Malawi rapidly grows, the country is experiencing dwindling

resources and environmental challenges that are bringing forth climate and other
socioeconomic challenges. As men and women of faith, the Catholic Church
in Malawi invites us to appreciate the tradition of reading signs of the times and
responding to them.

Therefore, this booklet has been prepared for use by marriage counsellors so that the
content of their counselling reflects issues of responsible procreation and parenthood
in the context of the rapid population growth that Malawi is experiencing. The books
and manuals that marriage counsellors have used up to now have been effective in
many ways. However, they did not adequately enlighten youth, people preparing for
marriage, or married couples on population growth and the linkages with Christian
responsibility as co-workers with God the creator of humanity and natural resources.
For this reason, this booklet comes out at the right time especially now as the
Church continues to seek new ways of evangelization. Through use of this booklet,
it is hoped that Catholic marriage counsellors will empower our married brothers
and sisters—youth, those preparing for marriage and those in marriage—to fully
understand the Catholic teaching about their responsibility with regard to family,
sexuality, procreation and parenthood.

Today, pastoral agents, married couples and youth must be at the forefront to address
the rapid growth of Malawi’s population but as guided by their faith and unwavering
orthodoxy. Marriage counsellors ought to uphold Biblical truth while enlightening
the people of God on these issues as guided by the Catholic Social Teaching.

42 l Responsible Procreation, Parenthood, and Population: A Guide for Catholic Marriage Counsellors
The Catholic Church has a clear position regarding the methods of family planning
and emphasizes our being co-creators with God (Gen. 1:28ff). As such, the expecta-
tion of the Catholic bishops in Malawi is that marriage counsellors shall play their
role in advocating for NFP methods—methods that respect the purpose of human
sexuality and marriage and uphold human dignity. In this way, they will enable the
faithful to approach population issues with a sense of Christian responsibility as
stewards of God’s creation.

l 43
Bibliography
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Episcopal Conference of Malawi (ECM). Catholic Teaching on Homosexuality,

Abortion, Population and Birth Control: A Pastoral Statement. Balaka:
Montfort Media, 2013.

ECM. Sexual and Reproductive Health (SRH) Policy. Balaka: Montfort Media,
2013.

Flannery, A. Vatican II Council: The Conciliar and Post—Conciliar Documents.

Bombay: St Paul Publications.

Pope John Paul II, Evangelium Vitae (The Gospel of Life). Vatican: 1995.

Pope Paul VI, On Human Life (Humanae Vitae). Nairobi: Paulines Publications
Africa, 2001.

Vatican. Catechism of the Catholic Church, Nairobi: Paulines Publications, 1995.

Other References

Government of Malawi. National Population Policy. Lilongwe: Ministry of

Finance, Economic Planning and Development, 2013.

Government of Malawi. Malawi National Reproductive Health Service Delivery

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The Canon Law: Letter and Spirit. A Practical Guide to the Code of Canon Law.
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Trussel, J. Contraceptive Efficacy. In Hatcher, RA, Trussel J, Nelson AL, Cates W,

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l 45
 Futures Group (Health Policy Project)
Amina House, Unit 8
Off Paul Kagame Road — Opposite Cash Build
Lilongwe, Malawi