Contraception & Chemotherapy

A reader writes:

       First off before I start I am absolutely convinced that the Church is
correct in its teaching regarding contraception. I do not want the
Church to change it ever because the Church is right about the proper
place of conception in the context of marriage.

       But I have a problem.  My wife is battling for her life…she has Stage
IV metastatic cancer.  One thing that is never in the debate is what
about the scenario where someone is taking Chemotherapy and they MUST
use birth control (or abstain completely) if they are to be on it.
Additionally with something like her type of cancer there is the added problem
that someone who is fighting it hard is likely to be on Clinical trials
which absolutely require the use of contraception.

       OF COURSE I could abstain.  And truthfully I try very hard to do that.
But what do I do in the instance where my wife comes to me needing the
comfort that the marriage act can provide?  I MUST comply with her
desires and CAN NOT REFUSE her. It is morally wrong for me to in the
normal course of events so it is certainly reprehensible for me to
refuse her when she needs the comforts of the marriage act.

       I can’t even say that SHE is sinning (at least not willfully) when she
requests this of me. So I have come to the following conclusion.  My
will is severely compromised in this regard.  I cannot risk my wife’s
harm and I cannot deny her needs.  As a result, this is simply not a
mortal sin for me.  Don’t get me wrong…I don’t want to commit even the
slightest venial sin (and this is NOT a trivial sin it is very serious)
with abandon, but this is an issue that is impossibly difficult for
me.

       The problem I have is this logic is what caused the Anglican communion
to head down the slippery slope of even accepting abortion.  I don’t
want to contribute to the "contraceptive mentality" and perhaps I am a
victim of it.

       So the long and short is this…dare I ever mention this in a public
forum?  It seems to me that this sort of struggle is one that couples
with cancer are just going to face if the want badly to be faithful
Catholics.  I would gladly give my Life for the faith.  But to sacrifice
the love of someone I love for the faith…that is the kind of caritas
that only the greatest of saints can have.  I fear I just will never be
capable of that kind of sanctity (God forgive me).

First, let me say that I grieve for your situation and I ask all my readers to pray for you and your wife and all in similar situations.

I will do my best to shed what light I can on the moral aspect of the situation.

It is not clear to me the reason why the use of chemotherapy–or this kind of chemotherapy–is thought to require the use of contraception. I can see two possibilities: (1) If it is hormonal contraception, it is to regulate a woman’s hormones since the chemo somehow messes with those (i.e., the use of the Pill has a therapeutic effect in this case) or (2) it is to prevent the conception of a child, either because the child could suffer birth defects, could miscarry, could not be carried to term, or because getting pregnant would further harm the mother’s health. The latter could be either hormonal or non-hormonal contraception.

If the first is the case then the use of the Pill is not contraceptive; it is therapeutic. As a result, it is potentially justifiable under the law of double effect. In that case, the contraceptive effect would be a side effect of the hormone regulation. It would not be a means or an end of the hormone regulation. For a sufficient reason, a side effect of infertility can be tolerated under the law of double effect.

If, however, the intention behind the act is to prevent the conception of a child–for whatever reason–or if it is to prevent the conception of a child in order to help the mother’s health then the contraceptive effect is either an end or a means, and the act of contraception is not morally justifiable.

Here it is not clear to me whether the reader’s wife is currently using contraception or not. If she is using contraception and cannot reasonably be dissuaded from using it (e.g., if she is too emotionally strained and alarmed by her situation to be able to grapple with the question) then the Church would not hold that it is a sin for the reader to pay the marriage debt to her.

Catholic moral theology recognizes that, when one partner (culpably or inculpably) insists on using contraception then it is possible to continue conjugal relations if other partner does what is possible to change the situation (e.g., praying about the matter and waiting for a favorable time to revisit the situation) and as long as he (or she) is not being required to do anything immoral (as would be the case, for example, if a wife insisted on her husband using a condom; that would require the husband to do something immoral, or alternately if a husband insisted on his wife using the Pill, which would require the wife to do something immoral). Further discussion of this matter is provided in the Vademecum for Confessors (see section 3:13).

If, however, the reader’s wife is not currently using contraception or if she can reasonably be dissuaded from using it then this is what needs to be done. It does not seem to me, however, that this automatically means a discontinuation of marital relations.

Your wife has a grave reason to be on chemotherapy, and it is justified that he remain on it. The question is what kind of conduct is morally appropriate given that fact.

It is true (I assume) that the state you and your wife find yourself in is one in which there would be dangers to a child you might conceive, but there are many couples who are in that situation naturally–quite apart from chemotherapy. Lots of couples are in situations–due to genetic factors, physical factors, or other factors–where any child they conceive is at risk. Some are incapable of carrying a child to term, so every child they conceive will automatically miscarry, or they have genetic disorders such that every child they conceive will have birth defects.

Yet the Church has never told these people that they must stop having sex or stop trying to conceive a normal child if, by some miracle, they were able to have one.

The children they have might have birth defects and might die, but these are physical evils, and one thing is true of all physical evils in this life: They are temporary. It doesn’t matter how deformed a child is in this life or how short his life is. Those things won’t apply in the resurrection. In the resurrection, God will give any child you conceive infinite physical life in perfect health. These factors have to be taken into consideration when making decisions about what risks are acceptable in conceiving a child that might have birth defects or a short life in the present age. We cannot proceed from a caculus that treats this life as if it is all there is and that regards birth defects and death as horrible, irremediable evils. They’re just not.

If the choice is between not having a child at all and having one who will live only a finite amount of time, to be followed by an infinity of physical life without suffering then the latter would seem to be the one that benefits the child. Never having existed is a worse fate, if I may put it that way, than living only a short time and then having endless life without suffering.

It is true also (I assume) that getting pregnant could harm your wife’s health and limit her chances for survival. But it is up to her to determine what risk she would be willing to take in this matter. Knowing the odds regarding survival with or without a pregnancy, if she determines that lovemaking involves an acceptable level of risk then you should respect that decision. It is not a sin. The situation is similar to that of the many women whose health or life for natural reasons could be jeopardized by a pregnancy but who decide that they are willing to accept the risk.

I therefore do not see the continuation of chemotherapy as requiring a choice between contraception and abstinence, and Catholic moral theology certainly looks with compassion on the situation of a husband and wife seeking to comfort each other as they face a grave, life-threatening situation and make decisions about how to spend the time they may have left with each other.

Before closing, I’d like to touch on one additional point. I hate to look at one part of the situation here with cynicism, but I suspect that much of the "You must go on contraception" pressure that the couple is getting is due simply to the desire of doctors not to be sued. They don’t want to be sued if a child is born with birth defects, or if a child miscarries, or if a pregnancy harms a woman’s health. They are thus likely exaggerating any "need" for contraception in this case.

In this connection, the reader mentions that the clinical trials available to his wife absolutely require contraception, and he may mean that you have to agree to use contraception in order to be let in on these clinical trials. Again, the pressure is likely to be due simply to doctors’ desires not to be sued.

So fine. Don’t sue them. If need be, have a lawyer draw up papers saying that you waive any right to sue that you might have in case of birth defect, miscarriage, or pregnancy. If you really need to, use a mental reservation regarding the use of contraception. But don’t let them tell you that you need to use contraception when you don’t.

In conclusion, this is a complex situation, I hope that everyone will keep the reader and his wife in prayer as they deal with the situation and ask that God will give them special comfort and wisdom and surround them with his life.

THIS POST IS SUBJECT TO RULE 20.

Author: Jimmy Akin

Jimmy was born in Texas, grew up nominally Protestant, but at age 20 experienced a profound conversion to Christ. Planning on becoming a Protestant seminary professor, he started an intensive study of the Bible. But the more he immersed himself in Scripture the more he found to support the Catholic faith, and in 1992 he entered the Catholic Church. His conversion story, "A Triumph and a Tragedy," is published in Surprised by Truth. Besides being an author, Jimmy is the Senior Apologist at Catholic Answers, a contributing editor to Catholic Answers Magazine, and a weekly guest on "Catholic Answers Live."

60 thoughts on “Contraception & Chemotherapy”

  1. Praying for this couple…
    And Jimmy…wow…that was absolutely amazing counsel…so full of grace…thank you for your ministry.

  2. There are additional considerations:
    1. One can draw up legal papers promising not to sue, but if your doctors do not agree, what good are the papers?
    2. Enrollment in a clinical trial may be limited. If a person is not sincere about following the rules and then drops out or is kicked out of the program, it may mean someone else who could have been enrolled in that trial was excluded from potentially lifesaving treatment by your decision.

  3. What of the abortifacient properties of oral contraceptives? Do these not also play a role in this decision? (By this, I mean that one of the ways in which oral contraceptions work is that they prevent implantation of an already-conceived human being. In other words, use of contraception AND sexual intercourse can be tantamount to murder.)
    So how does that play into this?

  4. All I can say is God bless this man and his wife, as a dilemna like this is something that no one should ever consider to judge
    A very good friend of ours just gave birth, and while pregnant was diagnosed with breast cancer. She was induced and gave birth and is now undergoing treatment for the breast cancer, but is refusing chemo and getting only radiation because of her age (39) and that chemo leaves you infertile for a long time as well as possible birth defects due to the chemo, it is not recommended to conceive or even try, and they want another child right away and dont want to have to wait. Knowing about breast cancer, the best survival is when treated with chemo it seems as well as studies, but again I am not a doctor
    I am not sure though that the church would go along with using birth control though, as one could use NFP, but again there is a possibility of pregnancy, and as a spouse he wants to satisfy his wife, one could only pray for them

  5. The big question to me here is why must the wife be on birth control. But I agree 100% with Jimmy’s assessment as usual.

  6. God is honored by people who grapple so hard with a difficult moral issue out of love and obedience. I pray that this couple and others like them will receive an abundance of graces.

  7. I’m curious if the gentleman has researched NFP and abstaining during her fertile period while she undergoes treatment.I think it would be a valid use of NFP, no?
    Someone correct me if I’m wrong.
    -Ann

  8. I just read that the Mayo clinic came out with a study that shows the pill to be a class one carcinogen. Of course, it’s getting no media attention.

  9. “I think it would be a valid use of NFP, no?”
    Most assuredly… it seems like a textboof example, in fact.

  10. My wife and I are facing a somewhat similar, though much less serious, situation. My wife has a serious reason to start taking a medication that has a high incidence of birth defects associated with it, and the only alternative medications also are associated with a high incidence of birth defects. But her doctor (who *does* agree that she needs the medication) will not prescribe it unless we are using artificial contraception, or unless we agree to abstain completely, 100% of the time. We explained natural family planning (NFP) to this doctor, and how we used NFP successfully at an earlier time in our marriage in a similar situation, when my wife temporarily needed to take a different drug that could cause birth defects, but this doctor is very secular and her mind seems to be closed to considering anything positive about NFP.
    So now we are looking for another doctor, but we have had very little success, since we live in a rather remote area, and since we need to find a particular type of specialist. We may end up having to drive a five-hour round trip to find a doctor who is willing to work with us.
    So even though our situation is far less serious than the one described above, I certainly can understand the frustration that comes with such situations. To the original writer, you have my prayers.

  11. There was just a somewhat big study that came out recently that showed that NFP is just as effective as the pill, if I recall. It wouldn’t be the first study to show this, either. The doctor who is closed minded about NFP is closed minded about science.
    Consequently, if the reason that the fellow’s wife is required to use contraception has to do with Jimmy’s second reason, NFP would seem to be a good solution.

  12. Anon1,
    Jimmy mentioned something about a mental reservation in his answer to the original question. I wonder if this would work for you. Could you just sign the thing that says you will take the Pill and then just take one and throw the rest away, or something like that? Just to get the doctor to give you the prescription for the real drug you need?

  13. Anon,
    I hope it works out for you, and I admire you for being willing to work so hard to make sure you’re doing what’s right.
    What nobody seems to get about NFP is that it’s an adjustable method. If a couple has an extremely serious reason to avoid conception, they can just abstain completely in the beginning of the cycle, and add a day or two to the date they calculate is the beginning of the infertile phase at the end of the cycle.
    I sure sympathize with the problem of not being able to get a doctor to take this information seriously. I had this problem several times with ob/gyns, who insisted on dating my pregnancy from the beginning of my last period, even though I could prove I had ovulated very late in the cycle. One ob/gyn wanted to induce me two weeks before my due date, which was really a whole month early. It worked out in the end, but with the next baby I ended up actually lying (it was a sin) about the dates in order to avoid the problem. The _next_ pregnancy I found an honest solution. Nurse: when was the first day of your last period? Me: well, I ovulated on such and such a date, so you can just subtract two weeks from that, and write down such-and-such a date.

  14. Pipah, I would think that the abortifacient properties of oral contraceptives also fall under the law of double effect that Jimmy mentioned.

  15. “In this connection, the reader mentions that the clinical trials available to his wife absolutely require contraception, and he may mean that you have to agree to use contraception in order to be let in on these clinical trials. Again, the pressure is likely to be due simply to doctors’ desires not to be sued.”
    Um, no. Any clinical trial will already involve extensive, voluminous and overly broad “informed consent” documents that essentially waive the right to sue for all of the potential adverse effects of the trial drug or treatment.
    The reason for the insistence upon contraception for admission into the clinical trial is most likely, almost certainly, that pregnancy would require discontinuation of the treatment, thus require dropping-out of the trial, and reducing the number of study participants.
    It’s not about fear of the big-bad trial lawyers and their “tassled-loafers”, it’s about big pharma’s fear of losing a little money.

  16. I’m keeping this man and his wife in my prayers. I’ve lost alot of people to cancer in the past few years.
    Jimbo

  17. re: Abigail
    It does seem that it makes everyone happier when the charts are filled out just right. I find you very clever to be able to express yourself to the medical personnel in a way that fits their charts properly.
    I, too, once gave an ovulation date, but the nurses did not seem to understand what I meant, and recorded it as a last day of menstruation. The doctor was very distressed to see a discrepancy between the given “last date of m.” and the age indicated by the ultrasound. From that experience, I learned that, while they may ask for your information, they consider the ultrasound information more reliable. I am not totally unsympathetic to that reasoning.
    whimsy

  18. Concerning the following:
    In this connection, the reader mentions that the clinical trials available to his wife absolutely require contraception, and he may mean that you have to agree to use contraception in order to be let in on these clinical trials.
    Is there a doctor in the house?
    I’d like to know the actual medical reasoning behind this.
    Also, what happens if in the clinical trial, the participant in the study actually receives a placebo instead?
    To have actually gone to this extent unnecessarily only to be treated with a placebo is somewhat outrageous!

  19. For years women had their uterus removed to stop estrogen based cancers or for other valid reasons.The purpose of taking the pill, in this case, is to stop the cancer not “artificial” birth cancer. There is no valid reason to abstain and it may be morally improper to abstain. Both people need to accept all the strength and support God gives them.
    On a personal note, in May 2000, my wife was diagnosed with breast cancer which spread to her liver. She was informed she had 4 to 8 months to live. Our prayers were answered. She requested a treatment she thought up, but which was being considered as an experimental treatment by some doctors. We found a wonderful doctor who tried it. That was seven years ago next month. She has been out of treament since August 2005 and has had no new growth. God grant your wife the same.

  20. Re clinical trials, a lot of the clinical trials I’ve been seeing lately have been requiring that female participants be “post-menopausal or surgically sterile,” and contraception or abstinence is deemed satisfactory for the “female partners of male participants.”
    I wonder if there’s been problems with compliance on both artificial contraceptives and NPF/total abstinance. Pills have to be *remembered*, and if couples are supposed to abstain, they’ve got to actually, you know, *abstain*. As in, no little oopsies where cuddling to comfort during an emotional crisis goes a little beyond first base, then a *lot* beyond. And even a single woman who’s not dating could fall victim to a sexual predator

  21. John Henry: In what way IS it a violation of Rule 20?
    I asked a question.
    Is it a violation of Rule 20 to remind people (or to inform them for the first time, since many are unaware) that the Pill has abortifacient properties?

  22. Jimmy A’s answer was right on
    Patrick-my thoughts and prayers with you and your wife. Both myself personally and family have been touched by this horrible disease, and it seems that all of the activism goes to diseases such as AIDS which is basically preventable where Cancer for the most part is not
    Humanae Vitae
    http://www.vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html
    Lawful Therapeutic Means
    15. On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever. (19)

  23. Esquire:
    I may well be wrong, but I would imagine it’s more than “a little money” at stake. I would think that if people drop out of clinical trials, at some point the whole thing may have to be scrapped. I know nothing about medical trials, but I do know something about sampling and polling, and you need both a certain size, and also, certain balance in representation, or else the survey is invalid.
    If that applies to these medical trials (anyone know if it is), then not only would a lot of money be at stake (and that’s perfectly legitimate a concern), but also progress on needed research.
    I’m not saying it’s okay to pressure anyone into contracepting, but I am saying I can see a legitimate concern on the part of those conducting, and paying for, the research.

  24. I wanted to point out that chemotherapy recieved at the time of conception or soon after is likely to be much more of an abortifacient than birth control, ironically. At such an early stage of development, such a powerful drug would usually cause such disastrous changes in the rapidly developing cells that the result would simply not be compatible with life at such an early stage that a woman would not even be aware of the pregnancy or its ending. On the other hand, since birth control usually prevents conception and only rarely causes failure of implantation, it’s actually a much milder abortifacient. Now, if the chemo was given a few weeks after conception, then it might cause just enough damage for birth defects but still compatible with life. I only point that out because so many people think that birth control is so terribly murderous when really, many, many drugs will cause a similar early abortion. The first few days of life are the most tenuous days. by far. Any little problems and… a silent, unnoticed spontaneous abortion occurs.
    I did have a question, then… if the contraceptive is absolutely required for the study merely because of the way the study rules are written up but not because it is necessary for the health of the patient, and yet truly the woman is only taking the drug because she is required to for this cancer treatment (remembering that chemotherapy itself is an extreme abortifacient) then she is not actually taking the drug for the purpose of preventing or getting rid of pregnancy. Of course in this case the DOCTORS might be insisting upon it for those reasons plus some possible other reasons. Considering that the pregnancy will not be maintained in any case due to the entire cocktail of drugs, wouldn’t that fit under the double effect rule?

  25. In other words, as long as her intent is pure, does it matter what the doctors’ intent is?

  26. “…chemo leaves you infertile for a long time as well as possible birth defects due to the chemo, it is not recommended to conceive or even try, and they want another child right away and dont want to have to wait.”
    Actually, with the chemo cocktail they use for most breast cancer (a/c or a/c/t), it can leave you *permanently infertile*, depending on your age and how close you are to natural menopause. For instance, my friend came out of ‘medical’ menopause 6 months after treatment, at 32 years old. I, on the hand, have been menopausal (and thus unable to conceive) since I finished treatment at 38.
    Also, the benefit of chemo on breast cancer depends on several factors, among them: whether the cancer is aggressive (invasive/infiltrative as opposed to ductal in situ) or not, whether it is hormone sensitive, whether or not you test positive for HER-2, and of course the stage of cancer. If you have a stage-1, hormone sensitive, non-invasive (ductal in situ, etc.) cancer with a negative HER-2 reading, they’ll usually do a lumpectomy and give you 6-7 weeks of radiation, but not always chemo. Same scenario but at a higher stage, they will probably throw in chemo. If you’re stage 1 with invasive cancer, cancer that is NOT hormone sensitive, and/or a positive HER-2 reading, you’ll likely get 4-6 cycles of chemo plus radiation, on top of the lumpectomy (or mastectomy, if you opt for that). Believe me, I know: I was stage 1 with invasive and a strongly positive (I had 19 markers where I should’ve had 2) HER-2 test result. That = a lumpectomy, 4 rounds of chemo, 7 weeks of radiation, and 5 years of tamoxifen. One interesting thing I found out while in treatment: a European treatment, that my doc at the Big East Coast Cancer Center was trying to get me to undergo (before getting all the tests back and realizing that chemo was my best option), was something called ovarian ablation — they give you longterm under-the-skin contraceptive to suppress your ovaries. (Can’t remember what that contraceptive option is called, sorry!)
    One thing to keep in mind vis a vis contraception and chemo: I do agree that, to some extent, cynicism about doctors fearing malpractice suits or big pharma not meeting their study goals may be warranted. But bear in mind, also, that when you’re talking about someone with Stage IV metastatic cancer, you’re also talking about someone who may die before the baby is developed enough to survive birth. I can see a doctor being concerned about that, however misguided it may or may not be theologically speaking.
    However you slice it, the situation for this man and his wife is just 100% heartbreaking, and they will be in my prayers.

  27. Since this was mentioned in Jimmy’s post (section 3-13 in the Vademecum for Confessors, I’d greatly appreciate some clarification. Without going into great detail as to the why’s and wherefore’s, I’m in one of those “unequally yoked” marriages, where my wife insists on artificial contraception, while I have come to accept the Church’s teachings on the prohibition of its use. That being said, she insists that I use a condom. Now, I pray every day that the Lord softens her heart (as he did mine years ago)and that she comes to the same understanding of the Church. In the past I have asked her to consider going to NFP classes – the last time I brought it up, she came very close to threatening divorce if I bring it up again (suffice it to say she’s actually hostile towards the Church’s teaching on artificial contraception) – so I believe I’ve met the conditions in the Vademecum.
    In the eyes if the Church, to what degree am I culpable? Am I in the situation of being sinned against? Let me add a couple more facts – I refuse to buy the condoms, making that her responsibility, and I won’t put on one until she says.
    Short of permanent continence, am I left with any options? I don’t want to adopt the attitude of “well, this is her sin, not mine, so anything goes” – this is a heart-breaking situation for me, not for my own sin (should I be fully guilty), but for the sin of my wife and the incompleteness of our relationship.
    Let me finally add that my spiritual advisor has told me that I’m doing all that can be expected in this situation and am not in a state of mortal sin, so I guess in a roundabout way, I’m also asking for a heck of a lot of prayers from my fellow blog readers and contributors. I have seen the joy that other couples experience who practice NFP, and that’s a joy I desire for my wife and myself. Thanks for your prayers, and God bless you all.

  28. In what way IS it a violation of Rule 20?
    Because “use of contraception AND sexual intercourse” is not “tantamount to murder” in the scenario described, and suggesting it is will only lead to further difficulty for the couple in question.

  29. Jimmy,
    Thanks for the recent posts on NFP. It is always educational to watch how you work things out.
    One small point: I know of no way that birth control pills can be used to regulate hormones. Normally, a woman’s hormones move in a predictable pattern during a cycle. Roughly put, before ovulation there is high estrogen and low progestorone, and after ovulation there is high progesterone and low estrogen. To my knowledge, birth control pills only induce the second state except when the placebo pills are taken. Regulation of a woman’s cycle would take much more fine tuning than the pill offers.

  30. Someone recommended “monk powder” as a way to eliminate the desire and thereby the temptation. Apparently we need to distribute this powder amongst our clergy and orthodox members as another means of NFP.

  31. Between a rock and a hard place:
    I see nothing in what you wrote to lead me to disagree with what your spiritual advisor says; I think you can have a clear conscience in that regard — though I can appreciate how difficult this all is.
    One option for you, if you wanted, and your wife did not object, might be to observe several days’ continence, since that is what you would do if you were using NFP. Ideally, you would be doing that at the very time your wife is most prone to conceive–but of course, that requires you both to use NFP methods, so I assume that’s not possible.
    Being peaceful toward your wife, and not bringing it up, at all, and meanwhile praying, is a good approach.

  32. Thanks, Fr Fox. And I appreciate your prayers, too. Say a few masses for us, if you would be so kind. God bless!

  33. Between the Rock and a hard place: You have my prayers (and, I’m certain, the prayers of most here).

  34. I’m in a somewhat situation to “Rock and a Hard Place”, except that I’m a wife who wants to use NFP although my husband doesn’t. (Actually, what I really want is to have another child right now and would prefer to be trying to conceive, but he absolutely does not.) I do NFP charting and attempt to encourage abstaining during the fertile time, but more often than not he insists on having relations during that time and uses a condom. This is causing significant strife in our relationship.

  35. My wife and I practiced NFP for years, but have had pretty serious financial problems lately. She is early-menopausal and began to complain of difficult periods. For her, this all added up to justification for going on the pill, which she did.
    I suggested she might try natural/herbal or nutritional treatments, along with exercise, but she was not really open to that. I think she is so stressed over our finances, and so afraid of becoming pregnant again that the difficult periods just pushed her over the edge. I would much prefer that we continue with NFP, but to question her decision (that she needed the pill for medical reasons) would not help our marriage. I pray about it, and leave it in God’s hands.
    She is my wife, and I don’t question that, in her mind, the pill is a medical necessity. In the end, that is her decision, and I have to trust her.

  36. My prayers are with you all. Keep praying, and know that the Lord is intimately aware of your struggles and your desire to please Him.

  37. I wanna play with technicalities a little. Would anyone in his situation be responsible for asking the reason for being required to use contraception or is it possible for him to assume unless he hears otherwise that it is for hormonal regulation?

  38. cdm014, I’d be interested in this, too. The problem I keep running into is that doctors keep trying to throw bc pills at me for everything from upset stomach to light but painful periods to pain from adhesions from abdominal surgery I underwent years ago to INFERTILITY. But I can’t take them because I’m Catholic and married and well, I just don’t like the idea of altering my hormones in that way especially with the abortifacient properties of the pill and when at least some of the problems they attempt to fix won’t be addressed by those pills anyway.
    And when I’ve told the doctors I won’t take them, they just go, “Well, then I can’t help you. Everyone should be on birth control.” I even have a coworker whose doc told her that every woman should be on bc at some point in her life for at least five years, “to even things out.”
    My point is that in my experience, so many doctors automatically prescribe these things with little justification and without ever considering all of the implications.

  39. Could somebody reply to what Fr. Fox said? All medicines, drugs, and other substances which alter a woman’s endometrium in a way which can inhibit implantation of an unborn human being need to be designated Schedule I controlled substances.

  40. Not trying to contravene rule 20 here, but questioning your/your readers idea of nuptial privacy – is this really the place for us all to be dissecting this man and his wife’s most intimate sphere? Do you have the wife’s permission to be discussing her sex life, or are you indulging one spouse’s pity party “But I have a problem” at the other’s expense?
    With some experience with my husband in peer-to-peer Christian marital ministry (Retrouvaille) and reading lots of JPII, it leaves a nasty taste in my mouth – they have the problem, right, ie they are a conjugal unit, acting mutually as one? The marital bond must be built on more than physical vigor to survive the inevitable decline in such potencies as we age – why not encourage couples to develop multiple means of “communio personarum” for maintaining their sacramental state of grace – risk tapping into the emotional vulnerability of writing love letters to each other, composing or performing music for each other, craft or build by hand an item of beauty for the beloved, or compose a spiritual journal together to share with one’s children in the sad event that the spouse loses their battle with cancer before the children reach adulthood. You may be surprised at what heretofore unknown virgin territory you’ll discover! Sadly with our cultures preference for worldly ways, we get lazy in using ALL of our bodies/gifts to express ourselves.
    I’d be more comfortable if you redacted such posts making them “general case” so that contributors aren’t risking a near occasion of sin of voyeurism by entertaining all manner of salacious “what-ifs”.
    I’m praying for healing for the wife – even if it means the rest of her life she requires low-dose chemotherapy. Life is worth living even with continency/impotency!

  41. The one thing that must be remembered is that hormonal contraception has a forseeable reality of abortus conceptus. In that case that one can forseeably prevent this by abstinence, one should. Their are 4 conditions for double effect. we have to remember all four.

  42. Matthew: That’s very interesting. Would you care to go over those four conditions for us?

  43. My situation is the reverse of the reader’s who wrote about the contraception/chemotherapy conundrum…
    I am a wife who was diagnosed with cancer. (Diagnosed just 2 weeks after the birth of our 9th baby) Chemotherapy consisted of 6 months. Standard protocol is to put the patient on BC. We refused and chose abstinence for that time period instead. Even our (Catholic) ob/gyn insisted that we were surely *the exception* and that priests could not know what it was like to be in a marriage so God would surely *understand*. That made it more difficult than ever, not to have the support of the medical community and to feel judged for doing what we felt was right.
    It is a heavy, heavy cross to be faced with the possibility of your own death and not receive the closeness and comfort and expression given in the marital embrace–to wonder if you will ever receive the consolation of the embrace again, or will you die? Temptations of all sorts enter your mind. If you die, who will care for your children? Will your husband remarry? Will she be more loving, more holy than you? Will he be driven to someone else because you had to abstain for a long period of time and he is under stress? Will he become unattracted to you because you become bald, and gain weight from the chemo, or because you are depressed and down? These thoughts enter your mind and affect your relationship. The temptor offers these thoughts to you and it takes every ounce of your energy to dispel them and send them away, knowing they are unjustified. You remind yourself of the vows you took and the strength you receive from the sacrament of Matrimony. You know that although you feel the well is dry, you muster up faith that you do not FEEL to remember God will guide and is with you both, and loves you and your spouse more than you could possibly love eachother….
    It is an additional source of stress for the person whose health prevents that embrace because he/she can feel guilt over the situation, adding to the normal amount of stress in such a circumstance. The other spouse can feel guilty too for wanting to be close, and wondering if he/she is insensitive for desiring that. (Guilt, I might add, is not necessarily justified but exists nonetheless)…
    The doctors told us that a pregnancy should NOT occur for 2 years afterwards. After the 6 months of treatment, NFP was CAUTIOUSLY undertaken (no *risks*, highest level of counting, monitoring, etc., even while considering that God of course can supersede our plans at any time and bless us with new life.)
    We are now on the downside of this experience. Declared *cancer free*, although the 2 year period is not yet up. It would have been VERY helpful to find guidance for this stressful time. Trying to do research and get words of Catholic encouragment while battling cancer is exhausting. Thank God for my patient and loving husband, for whom this was also a great trial. It is, in many ways, a blind leap of faith, suffering with trust and hope,not knowing what the outcome will be.
    More priests need to address this. More couples need to speak of their experiences and offer support to one another.
    Millions of people are diagnosed with cancer yearly. Most are married. Many are Catholic.
    God bless. 😉

  44. I would like to clarify that chemotherapy often *does a number* on a woman’s hormones, thus rendering NFP difficult during that time–signs are hard to read. She may stop ovulating or double ovulate or do anything in between…

  45. I also neglected to mention that I turned to the Pope Paul VI Institute for help. My difficult case was assigned to an angel named Margaret Howard. She spent hours on the phone with me, helping me chart, learn the *extra* rules, was patient and kind, even when I was ready to give up or did not call her back because I had been reduced to tears at a chemotherapy session. She brought my case before the doctors at the Institute, and they further studied my circumstance and offered suggestions. I suspect that if more *difficult* cases sought help at the Institute they would learn more and could, in turn, help more couples.
    http://www.popepaulvi.com/about.htm

  46. I’m in the same type of situation as Between the rock and the hard place. To be honest, it’s not a comfort to go to confession hear that I’m not culpable because my spouse insists on contraception. That doesn’t help to change the fact that we aren’t treating our marriage as a vocation, that we’re missing out on the grace of experiencing the Communion of the Trinity in the communion of the marital act. The advice of “you’re not in mortal sin so don’t worry about it” is technically correct, but I feel it treats the situation as if we’re all just worried about following rules instead changing our hearts. It’s not the pills or the latex that are sinful, its our desires be selfish instead of selfless in our sexuality.

  47. Dear Pseudonym,
    Have courage. Your suffering can be redemptive. You suffer because your wife does not *see*. You are following Christ, picking up your (undesired yet embraced) cross, even to the extent that it causes you great personal suffering. In this world of Catholic-Christianity saints-in-the-making often must act blindly and in raw faith despite no assurances. Jesus himself felt abandoned, alone, rejected, misunderstood. Yet He took upon His suffering willingly for our sake. He is offering you a tiny sliver of the cross, which may, just may, be part of His plan for your wife’s salvation (or another cause). He offers this to you in Love. It is a gift to suffer with Christ crucified. He understands your desire to please Him. Your faithfulness in this matter will bear much fruit in blessings. The suffering won’t last forever. I’m praying for you as one in Christ who has suffered also.

  48. I have just discovered this site, and wish to offer a comment.
    The drugs that are used in chemotherapy work by preventing cells from dividing and growing. As cancer cells divide and grow a lot faster than normal healthy body cells, this allows them to do more damage to the cancer than to the body.
    If a woman gets pregnant then the baby’s cells divide and grow a lot faster than normal body cells, and this can lead to serious birth defects (if the baby makes it) or to a miscarraige because the defect is not compatible with life.
    So the reason you can’t get the drug is that the prescribing doctor/hospital/pharmaceutical company is not willing to take the risk of being sued because of birth defects.
    I have had a similar situation in prescribing an anti-acne drug to a teenager. The pharmaceutical company says that the girl must avoid pregnancy and just cannot that 17 year old girl can remain chaste, even though she comes from a Christian family (Baptist in this case) and attends church regularly.
    I think that one of the bottom lines here is that following Jesus Christ is not easy.
    I hope this helps. If it doesn’t, just delete it.
    Dr. Sean J. Fennell

  49. I have just discovered this site, and wish to offer a comment.
    The drugs that are used in chemotherapy work by preventing cells from dividing and growing. As cancer cells divide and grow a lot faster than normal healthy body cells, this allows them to do more damage to the cancer than to the body.
    If a woman gets pregnant then the baby’s cells divide and grow a lot faster than normal body cells, and this can lead to serious birth defects (if the baby makes it) or to a miscarraige because the defect is not compatible with life.
    So the reason you can’t get the drug is that the prescribing doctor/hospital/pharmaceutical company is not willing to take the risk of being sued because of birth defects.
    I have had a similar situation in prescribing an anti-acne drug to a teenager. The pharmaceutical company says that the girl must avoid pregnancy and just cannot that 17 year old girl can remain chaste, even though she comes from a Christian family (Baptist in this case) and attends church regularly.
    I think that one of the bottom lines here is that following Jesus Christ is not easy.
    I hope this helps. If it doesn’t, just delete it.
    Dr. Sean J. Fennell

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  51. I think that there is another issue going on here other than that of birth control. My husband is struggling with cancer. We were told that in addition to potential problems with a baby should we conceive while he is on therapy, having intercourse would be harmful to me because of the possiblity of the drugs that he is receiving passing into his semen and then into me. As a result, the doctors are insisting that we use a condom if we want to have intercouse. We’re not sure if there really is a potential harm to me, or if the doctors are simply upset that we are using NFP and think that if we agree to use a condom then we definitely won’t get pregnant. Are there any doctors who have any thoughts on this?

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