Phone apps help couples practice NFP

To mark Natural Family Planning (NFP) Awareness Week, July 19-25, the Catholic Voice examined how couples are using technology to facilitate using NFP to monitor their fertility. NFP Awareness Week is a national educational campaign conducted by the U.S. Conference of Catholic Bishops to focus attention on the use of NFP in marriage and Church teaching on the beauty of human sexuality, which NFP upholds. The week is timed to the anniversary of St. Pope Paul VI’s encyclical, “Humanae Vitae,” which was promulgated July 25, 1968 and expresses that teaching.

Digital technology has found its way into just about every aspect of daily life – including the very personal realm of family planning. Over 100 phone apps are now available to help women monitor their fertility to achieve or postpone pregnancy.

Using the principles of NFP, several of these apps help couples increase their awareness of the woman’s fertility cycles, respect the dignity of their bodies and remain true to the teachings of the Catholic Church on human sexuality and reproduction.

One such app, The FertilityCare app, was developed just last year by the Saint Paul VI Institute for the Study of Human Reproduction in Omaha. Others, like the Marquette Fertility app developed by Marquette University in Milwaukee, have been around a bit longer.

Religious motivations have sparked the creation of some of these apps, while many others have been developed simply to meet the growing demand for tools to track fertility markers, the outward physical signs of the changes in a woman’s body during her monthly cycle.

Since most women carry their phones with them, apps make it simple for them to compile a record of those markers, an activity known as “charting.” It’s this record that gives her the ability to approximate as closely as possible when she has ovulated, her “fertility window.”

PRACTITIONERS REQUIRED

The FertilityCare app is web-based and available to Creighton Model FertilityCare clients through staff members, called practitioners, who train women and couples in fertility awareness using the FertilityCare program and often support couples in the practice throughout their marriages.

“Our app is not on the marketplace because our clients have to have proper teaching as far as what they are observing. It demands teacher involvement,” said Sue Hilgers, co-founder of the Saint Paul VI Institute.

She and her husband, Dr. Thomas Hilgers, founded the institute in 1985 and developed the Creighton Model FertilityCare System. Their efforts were a response to St. Pope Paul VI’s 1968 encyclical “Humanae Vitae,” which encouraged scientists to develop methods to help couples plan their families in line with Catholic Church teaching. That teaching affirms that the beauty and integrity of the marital act must always be respected.

“Our system is the only one of its kind,” she said. “It is a communication vehicle. Clients can send their chart to their practitioner, who can use the information to make a referral to the client’s physician.”

“The role of the practitioner is not just about charting, but setting the couple up for success in choosing how they want to plan their family,” said Jenny Barrett, a Creighton Model practitioner.

COMMUNICATION AID

She believes it was essential for the program to develop an app.

“Women in our culture keep so many things on their phone; they are very connected … It is nice to access your chart from anywhere,” she said.

Andrea Mack, a Creighton Model practitioner in Grand Island, sees the FertilityCare app’s ability to facilitate married couples’ communication as a big benefit.

The husband, who can access his wife’s chart at any time, “can know before he comes home from work if his wife is expecting her period and may need more encouragement, or it may be a peak fertility time and it helps him to know if his attention needs to be in other areas of intimacy,” she said.

“A wife feels so loved when her spouse is able to be attentive in that way[D1] .”

Unlike the FertilityCare app, most fertility apps are available on the open market and lack a foundation in Church teaching. In 2018, Natural Cycles became the first FDA-approved direct-to-consumer NFP app for use to prevent pregnancy.

CONTRASTING APPROACHES

Richard Fehring, director of the Marquette University Institute for Natural Family Planning and one of the creators of the Marquette Model of NFP, said Natural Cycles encourages couples to use artificial contraception, so its approach is incompatible with Church teaching.

The Marquette Fertility app, by contrast, was created to enhance and simplify an NFP program for couples, Fehring said. Though it’s free for download, he said, “we prefer that it is used as the couple works with a Marquette Model teacher.”

Ferhing and his team are also working with Premom and Mira, two companies with their own innovative fertility tracking apps, to integrate their functionality with the Marquette Model.

Premom’s ovulation tracker reads the darkness of urine test strips, which reveal the presence of hormones, then charts the results.

“We are working with Premom to develop an app that will read the client’s quantitative hormone levels,” said Fehring.

Mira has a small appliance that analyzes its urine testing instrument and uploads the results to the client’s cellphone through a wireless Bluetooth connection.

Fehring hopes these apps will be available within a year.

MIXED RESPONSES

Bekah Knoblich, a member of St. Joseph Parish in Lincoln and Marquette Method practitioner, is eager to see Fehring’s studies of the Premom and Mira apps concerning how well they support the Marquette Model and help women identify their fertility window.

 She has clients who like to utilize apps, but found Marquette’s app difficult to use. So she uses other apps in conjunction with the Marquette Model.

“I tried the different apps, because people ask me which ones I like best,” Knoblich said. “I didn’t really find a favorite because they all have positives and negatives. I encourage people to try different apps to see which works best for them.”

To do that, Knoblich suggests using the apps during their free trial periods, as well as visiting Facebook pages where women and couples discuss fertility monitoring[D2] . Some of the more popular apps include FEMM, FLO, Fertility Friend, Kindara, Apple Health and Ovuview.

Marisa and Nicolas Fredrickson, members of Christ the King Parish in Omaha and parents of Ignatius, 4, and Shepherd, 2, said they strive to make each marriage and family planning decision in the light of their Catholic faith.

The couple began using the Marquette Model after Ignatius was born. They have found the Marquette Model very simple to use postpartum, since its primary tool is urine testing rather than mucus testing. But the associated app was difficult to use, Marisa said.

“I tried the Marquette Fertility app and the problem is it didn’t save any information (to the web), so Ignatius was messing with my phone and deleted the app and that was it,” she said.

The advantage of privacy in keeping personal data off the web can be eclipsed by the disadvantage of not having it saved in a safe place. Knoblich related a similar story.

“There was a situation where client’s phone fell in lake. There was no separate login, so all data was on the phone. All the client’s data was gone,” said Knoblich.

Fortunately, Knoblich was able to help the client piece her data together based on the information she had shared with her before losing the phone. 

REALISTIC ASSESSMENT

Developers and practitioners of both the Creighton and Marquette models are concerned that some women are led to believe that the corresponding apps can tell them more than they actually can. While most apps are good at fertility marker tracking, few reliably predict fertile windows.

Although apps enhance the ability of women to document fertility markers and share information, they are generally poor substitutes for counseling by practitioners, who can guide women and couples to more accurately interpret their data.

“Women are buying apps because they have never been taught about their body,” said Hilgers, but ministries such as the Saint Paul VI Institute “have taken the mystery out of the menstrual cycle.”