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Relations with Husband
Question from SEE on 3/17/2013:

My husband and I have agreed to stop having sexual relations to avoid pregnancy. My husband is in his 50s and I am in my 40s. We have 5 children, and our 5th child will be turning 1 this month. The reason we have decided this is because I am the only one working right now, and it is physically hard on me to work while pregnant. I also have c-sections (I've had 6 - we lost one child), which is physically hard on my body, too. We use the creighton model of NFP, but neither I nor my husband are reliable on this method (hence, the 5th child). What brought us to this decision is about 3 months ago, I thought I was pregnant...even though, according to my chart, I shouldn't be and my menses cycles range anywhere from 27 to 32 days...very, very irregular, so I couldn't even say I was late. That didn't stop me from going into a tailspin of anxiety. (I believe I might have a hormone imbalance since my last pregnancy because I often feel anxious for no apparent reason.) I couldn't eat or sleep due to my extreme anxiety, and one night I was railing against God, saying I would have an abortion, then crying that I had no where to go if I left God...it was just an awful night. Scared the bejeezus out of my husband, too. I remember waking up the next morning, deciding that I had no choice but to tell my boss I was pregnant (in less than 9 months). I realized my period had started right after that moment. At any rate, that whole experience scared me so badly that I do not want to have sex unless I feel confident that I could handle another pregnancy. (It's really all about the pregnancy...especially with me being the only one working.) This will be for a couple of years.

The problem is that I'm not sure this is "fair" to my husband, and it doesn't show a trust in God. I admit it, I'm having a hard time trusting God. I feel like I've been on an emotional rollercoaster. My husband losses his job...panic...I get a job...elation...I get pregnant in less than a year on the job...panic...I get through the pregnancy and 1st 6 months and start feeling better again...relief...I think I'm pregnant again...panic. I just want some stability until I can get on my feet, but am I thwarting the will of God?

Answer by Judie Brown on 3/20/2013:

Dear SEE

I sent your question to Catholic physician Anthony Dardano and here is his response:

I will start by saying that you are certainly not alone with this problem. Having been a gynecologist some 44 years I have seen and treated thousands of patients with these same problems and frustrations. Therefore I answer you with the compassion and genuine concern these years of experience have given me. It is also important to state that although our lives, circumstances, etc., may change over the years, moral principles do not. Simply put, artificial birth control or sterilization can never be the answer. I certainly agree that following NFP in the peri menopausal era can be difficult due to the physiologic irregularity of the menstrual cycle during this time. There are however a few solutions which are morally acceptable. As a starter, the day flow starts is day 1. A progesterone tablet taken from day 16 thru 25 each cycle can over a period of a few months regularize a cycle enough to make NFP more effective. This is not a birth control pill. It is a "progestational" agent as the name suggests and is morally permissible. It simply puts progesterone in the cycle where it belongs and replaces the declining level. Should fertilization take place, it is the natural hormone which makes implantation possible and again as the name implies is the "pro-pregnancy" hormone. Should fertilization not occur, then the normal menstrual pattern follows in a more regular time frame. A favorite preparation of mine is "Prometrium" which is a naturally occurring progesterone. There is a wonderful aid available called an ovulation predictor kit. This simply tests a morning urine sample and the fertile versus the infertile days are clearly delineated. Again this is an aid to NFP which of course allows intercourse on the infertile days and calls for abstinence on the fertile days. This is available over the counter and its use is morally permissible. Years back, we Catholic physicians advised couples facing this problem to limit intercourse to the days of menstruation. This is totally safe and very effective and certainly is a far better and emotionally healthier alternative to total abstinence. This practice too is morally permissible. In reading your question, I sense that your anxiety is a factor leading to less "trust in God". There are numerous safe medications which can help you cope during these difficult years and your primary care physician can be a great resource in this area. Above all, don't forget prayer. God knows your good intentions and if you place your trust in Him totally, He will see you through this. This is a difficult time in your life, but only a phase, and a natural one at that. Women today live a third of their life in menopause. Wait and see what great joy God has in store for you, your husband and children just down the road a bit. May God bless you and your family this Easter Season.

Anthony N Dardano, MD, FACS, FACOG

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