PROBLEMS OF PARENTHOOD

By John Ryan, F.R.C.S.
THE letters of "Devon" in the CATHOLIC 1-11-.BALL) of August 30 and of "Pater" in the issue of September 6 concerning the Rhythm method of family planning are very disquieting, yet the fact is that their experience is by no means unique.
It is of vital necessity that further research be undertaken on this method, a view which I, amongst others, have expressed in the columns of the CATHOT ir HERALD as far back as 1955, as some of its readers will no doubt remember.
At that time we advocated the establishment of a medical research centre in one of our big cities, such as London, where a team of medical men could work together under one roof on all problems associated with fertility and infertility.
As Dr. John Rock. a world authority on the subject of fertility, is reported to have said in an interview given to Life in June this year, when speaking of the staff of such a centre: ". . . To obtain these men, perhaps we may have to steal from cancer and heart centres or wherever we can get .them at whatever cost, for whether it be improving our health, increasing our food supply or our industrial capacity, it is not going to matter if we do not solve the population problem . . ."
To quote further from this
interview, he said: ". . The aim of research into planned parenthood should be to obtain a method suitable to every religious and physical need . . we are attempting to perfect the rhythm method so that one day a woman, by daily tests, can say on Monday '1 know I shall ovulate next Thursday' . . ." We are, of course, at this juncture, a long way from that !
Research Those who are interested in this problem cannot but be slightly envious when they read, for instance, in the Journal of the National Federation of the Catholic Physicians Guild of America (Linacre, May 1963), that such sums as $150.000 have been donated to a University to sponsor a population problem study related to Rhythm.
In Mauritius, a small island with a population of 700,000 (230,000 Catholics), very prac
tical efforts are being made to instruct married couples in this method with the full co-operation of Bishop Liston, the Government, the Anglicans and certain sections of the }lindu and Moslem population. Bishop Liston is reported in a Catholic newspaper to have said : "We cannot sit on the side lines and do nothing about the problems of over-population."
It is regrettable that in a city such as London we have not had a Medical Research Centre under Catholic auspices which today would have contributed much to our present knowledge and be in a position to play its part in solving the population problem.
Press comment This Centre could have given some authoritative comments on articles which appear from time to time in the national press such as the one by Paul Johnson in the Evening Standard of September 11, entitled "The Pill—and the sign from Rome".
Among other controversial issues raised in this article, he states as follows with reference to certain "natural" methods of birth control :
". . . Statistical surveys show that these methods are the least effective of all birth control techniques, producing three times as many unwanted pregnancies as other procedures."
Mr. Paul Johnson does not, however, inform us as to what proportion of these unwanted pregnancies were the result of inadequate instructions in the use of the method or, alternatively, what percentage of failures were due to the couple not following the instructions given. Again, the Centre could have had great influence in checking the extravagant claims sometimes made on the success of this method when advice has been given often with insufficient clinical data, and also in refuting quite unjustified socalled contra-indications for its use.
Centre Yet again, it would have rendered a tremendous service to so many members of the medical profession and auxiliary personnel from abroad who come here to study medical and social developments.
This is not a question of denominational medicine, but a realistic acknowledgement of the fact that, so long as the. Church and other religious communities disagree on the moral principles involved in the methods of family planning, a Catholic Research Centre is essential.
We must face the fact that there is no 100% method of preventing conception except abstinence, It is known that even some women who have undergone operations for sterilisation have become pregnant, The taking of the contraceptive pill is the easiest approach to a period of absolute sterility in any cycle and, at least, is not an irreversible procedure as are most cases of sterilisation; in fact many authorities believe that a woman may become even more fertile than she was previously, on ceasing to take the pill.
To quote again from Mr.
Johnson's article : "British Catholics with their strong Irish traditions, have always formed a conservative body within the Church, and are notoriously reluctant to discuss, let alone challenge, official policy . . ."
It would be interesting to know from an official authoritative Catholic source what the clergy's views are on this opin toms Efficient In the light of our present medical knowledge, if we exclude approximately 10% of cases where it is unsuitable for a variety of reasons to advise the use of the safe period, there is a mass of medical references to support the view that this method of family planning is as efficient .as any contraceptive measure.
There are, however, certain important reservations before this conclusion can be justified. The doctor must have the time (and a good deal of time is required) to deal with the case; sufficient clinical data must be before him; he must have sufficient experience in interpreting the temperature charts; a full knowledge of the clinical history of the patient, both physical and psychological. The woman must be carefully checked up medically, particularly gynaecologically, and the doctor must he prepared to check the instructions given from Lime to time.
Essential There are two further factors essential to the success of the method—that the couple have sufficient intelligence to understand the instructions and a willingness on their part to co-operate. The result of giving instructions to a wife without explaining to the husband the exact meaning of the advice and what co-operation is required of him may be disastrous.
Time It is probably true that there are not many family doctors who have the time to deal with the problems of planned parenthood, but surely if this is so, all the more reason why a research centre should be established among the objects of which would he to make expert advice easily obtainable.
/-inance, of course, is a necessary consideration in the establishment of such a Centre, but I feel sure that this could be obtained, not only from the Catholic community but also from some non-Catholic and even non-Christian sources who deplore the necessity for contraceptive methods on religious or aesthetic grounds or both.