The John J. Billings Memorial Lecture
Bioethical Considerations of Natural Family Planning
Dr Martin Tantaleán
27th May, 2018, Costa Rica
John J Billings Memorial Lecture
Dr Tantaleán is a surgeon and specialist in Integrated Medicine and Health Management with a special interest in Natural Fertility Regulation and natural conception assistance for couples with unexplained subfertility.
Dear Monsignors Salazar and Ramírez, esteemed Directors of WOOMB International, it is a great and undeserved honor to be able to deliver these words. However, when Marian Corkill, on behalf of the WOOMB Directors, asked me to deliver the John J Billings Memorial Lecture at this conference, I felt that it was a gift of providence and at the end of these reflections you will be able to understand why I could not refuse this invitation.
As most of us know, our beloved John Billings, who excelled in all areas as a doctor, sportsman and musician, left for the Father’s house in 2007, after a wonderful life’s work. Those of us who were able to attend in 2009 at the WOOMB International Conference in Australia, had the honor of listening to Bishop Peter J. Elliott’s wonderful paper, “Nature and Grace and the Billings Ovulation Method®”, at that first lecture dedicated to the memory of John Billings. It made sense, because in those days our beloved Evelyn was still with us. The Bible says: Jesus answered,
“Have you not read that the Creator from the beginning made them male and female and that he said: ‘This is why a man leaves his father and mother and becomes attached to his wife, and the two become one flesh? They are no longer two, therefore, but one flesh. So then, what God has united, human beings must not divide.” (Mt. 19:4-6)
This wonderful work, of which we have the privilege of being part, would not have been possible without Evelyn Billings, who was with John throughout his life and like him, had many awards at universities, and included the decoration of St. Gregory by St. John Paul II, which Dr. John Billings had previously received. Therefore, with the permission of the Directors of WOOMB International and the organizers of the meeting, let me make a change in the name of this conference, which I am sure Dr. John Billings would have approved to Bioethical Considerations of Natural Family Planning – Conference in memory of the Doctors John and Evelyn Billings, because it was a work done and even more, lived as husband and wife.
For the purpose of these short reflections, it is opportune first to remember our mission, the mission of man on earth. At a time when it is fashionable to talk about the vision and mission in companies, we will start by reviewing the mission of man on earth as instructors of the Billings Ovulation Method® and we will finish by reflecting on what our vision should be. We’ll refer to the Bible for this. In the book of Exodus we find the ten Commandments, because God wants man to be happy, knows what is good for us and gives us guidelines to achieve happiness and so return to the Father’s house. It is at the moment of creation, when God creates man in his image and likeness, that he gives man his mission “God blessed them, saying to them, ‘Be fruitful, multiply, fill the earth and subdue it’.” (Gen.1, 28a). Therefore, our mission and reason for being is to continue this work of God in the transmission of life.
Remember that although St. John XXIII convened the Vatican Council, it would fall to his successor, Blessed Paul VI, to continue the Council in the midst of a strong discussion about family planning, to the point that some councillors suggested closing the Council. It is through these difficult circumstances that he brought out this beautiful encyclical Humanae Vitae that centres us and summarizes the doctrine of the church when he tells us “If therefore there are well-grounded reasons for spacing births, arising from the physical or psychological condition of husband or wife, or from external circumstances, the Church teaches that married people may then take advantage of the natural cycles immanent in the reproductive system and engage in marital intercourse only during those times that are infertile, thus controlling birth in a way which does not in the least offend the moral principles which We have just explained”. [HV n.16]
This is sometimes not well understood, and we have both extremes. I remember when I was explaining this in a conference in a small room and suddenly one of the participants shouted at me “Dr Tantaleán, tell me one reason why you cannot have more children!” On the other hand, I received multiple emails from Catholic people telling me that “you have to modernize, times change and you have to accept contraceptives”. It should therefore be remembered that marriage is between three persons: the spouses and Christ and it is the only sacrament administered by the spouses, not the priest. Therefore, we are the spouses who in prayer must discover what God is asking us and we must make those decisions with an attitude of openness to life, seeing in the children a “gift” from God.
It is necessary that this attitude is also reflected in our way of speaking. I believe that it is partly influenced by the medical language that is very negative (when a laboratory result says that we are healthy, this is reported as “negative” and it is because doctors are thinking in illness and not in health). Often when we speak we do not use the appropriate words. Sometimes we have heard the saying “natural contraceptives”, which is an aberration, conception is “beginning of life” and nobody who is in favour of life can be against it (contraception = against conception). The correct thing is to talk about natural fertility recognition methods (NFR).
In the light of Humanae Vitae it is clear that we can teach and even practice natural fertility recognition methods and be in an attitude of sin. To illustrate this, I’ll share with you a real life case: A teacher married the daughter of the owner of the school where he worked. She was also a teacher. Everything seemed fine. But then his wife questioned whether he had married her for love or for her money and decided that she will not have children with her husband. Even though they would have used natural methods of fertility recognition, this attitude is not correct. The Church is not against contraceptive methods because they are artificial: it is not enough that the means are lawful (that is, they do not threaten life or disturb the conjugal act) but the motivation must also be lawful, remembering that our mission is be open to life. Drs. John and Evelyn Billings not only knew and taught this, but they lived it. Several years before Humanae Vitae was published, when Fr Maurice Catarinich in Melbourne asked Dr. John Billings to collaborate on research that would help many couples who had difficulties planning their family, John promised his help for 12 weeks! John himself always stated that they “had always wanted to have a large family, they were not worried about that.” At the time of his departure to the Father’s house, the Billings living family numbered 8 of their 9 children, 39 grandchildren and 31 great-grandchildren. It is a beautiful testament and gives us the courage to continue this work because they lived it.
Men and women have been created in the likeness of God, equal in dignity, but different, so as to complement each other. The sexual act, this intimate way of expressing the love of the spouses, has a double function: procreative as well as unitive or affective. If we change this, the conjugal act is de-natured and we run the risk of treating people as objects and not as persons.
We have the Christian family model in the Holy Family, with the Virgin Mary and Saint Joseph. He has no “important role”, he simply takes care of his wife and son, but it is Mary who “steals” Jesus to ask him to perform his first miracle at the wedding of Cana, in the context of marriage. She realizes that something is amiss and she tells Jesus “…they have no wine” to which Jesus replies “Woman what is it to me. My time has not yet come.” But Mary, with the love of a mother and the certainty that her son will not deny her anything, naturally says to the servants “Go with Him and do what He tells you.” Today our heavenly mother keeps telling us to follow Jesus and do what He tells us.
We must change our language to be positive. We now face the culture of death denounced by St. John Paul II. We must talk about methods of natural fertility regulation, or we could fall prey to the contraceptive mentality that has serious consequences.
About 15 years before Humanae Vitae was published and as part of the studies he carried out, Dr John Billings interviewed women who had experienced difficulties regulating their families for various reasons, and he found that several women had started the use of contraceptives. He realized then that this practice could have serious consequences in the future and we are witnessing it nowadays. To promote contraceptives, it is argued that “we should not have several children because there are no enough resources”, but that contraceptive mentality has led to a global decrease in the birth rate in the world and the ageing of the population worldwide. To maintain the population, there must be 2.1 children for each woman (Global Fertility Rate), that is, for every 100 women 210 children are needed to replace parents and those who will die due to accidents and illness. In some countries and cities, this global fertility rate has fallen below 1.8, thus running the risk of the disappearance of ethnic and cultural groups. In Europe and other parts of the world we see another effect in the raising of the retirement age to maintain an adequate workforce.
In developing countries, covert birth control is being promoted, seeking to associate development with fewer children, but the reality is that the developed countries achieved their development when they had higher birth rates than the present. It is said that we
must have fewer children because there isn’t enough food. However, according to the Food and Agriculture Organization of the United Nations “one third of all food is spoiled or wasted before being consumed by people”. It is a problem not of resources, but of selfishness of man who does not distribute resources and imposes contraception and it has been accentuated since the Cairo Conference in 1994. https://datos.bancomundial.org/indicador/SP.DYN.TFRT.IN
For this reason, those of us who are spreading NFR methods that open our eyes, allowing us to see the wonder of God’s creative work, and recognize the gift of life and family, we are a barrier, an obstacle for the development of the culture of death and therefore it will try to exclude us. In Peru, until 1994 the population law and the code of ethics of the Medical College of Peru (CMP) prohibited sterilization as a method of Family Planning (FP) because it was not accepted that, with so many FP methods available, the body had to be mutilated. It was perceived as not rational. Imagine one of the best football players: the doctor detects a coronary problem and explains that he cannot play again, but since he knows that soccer is his passion, he says “we have to amputate your legs to make sure you won’t play.” This is what we mean when we say that “surgically sterilizing” a person is a disproportionate measure. After the Cairo conference, the Population Law of Peru and the CMP code of ethics were changed and a policy was developed that was later denounced as “The Green Plan”: … the most important problem in Peru is that its demographic trends after the Second World War have reached epidemic proportions … we must stop demographic growth as soon as possible. A treatment for existing surpluses is urgently needed. The generalized use of processes of sterilization of the culturally backward and economically pauperized groups is convenient. Without these unnecessary burdens, access to certain levels of well-being by weak family groups would be facilitated. Tubal ligation should be standard in any health center that attends childbirths, unless there is reliable proof of economic solvency.
- Rospigliosi “Control Natal: las Fuentes de Fujimori” Revista “Caretas ” 21/09/95
Between 1995 and 2000 more than 331,000 tubal ligations were conducted, many of them coercive and financed by international entities that promote the culture of death, gender Ideology and legalization of abortion. In an internet course of the World Bank, where the objectives of the millennium are stated, the 5th goal was abortion legalization worldwide, as a right. As there was resistance from several countries but the goal was included as a strategy to fight against maternal deaths – but the decriminalization of abortion has no great
impact on maternal deaths: In Poland, a developed country, one of the few in Europe where abortion is prohibited, maternal mortality ratios are around 8 per 100,000 while in India, a country in development and where abortion is decriminalized, the maternal mortality ratio is above 400 per 100,000 live births.
In the year 2002 I was in a meeting with ministers of several countries and the Minister of Bolivia was talking about “sterilization fairs” that we had already experienced in Peru which not only provided sterilizations, but also disguised abortions. I asked the speaker, thinking that he would be annoyed by my question: “What do we want, do we want to control poverty or control the poor?” To my surprise, he replied with the utmost naturalness “Dear young man, Bolivia is a poor country, I cannot control poverty, I have to control the poor.”
Blessed Paul VI, seeing what was happening, denounced it saying: “It is necessary, in effect, not to suppress the diners, but to multiply the bread.” [Paul VI, speech to the UN 4/10/1965]
Unfortunately, when the culture of death is imposed, NFR methods are a barrier and therefore there is no interest in their dissemination. It opens the doors to the “morning after” pill as a means of abortion. We must be vigilant.
As Dr. John Billings intuited, contraception would have serious consequences. According to official US statistics from 1955 to 2010 as seen in the graph, blue is the use of contraceptives and red divorce rates. They seem two curves mounted one on another, denoting a clear association and that brings dire consequences that affect family, spouses and society.
As instructors of the Billings Ovulation Method® we must keep in mind what the instruction Dignitas Personae tells us, which was promulgated on the 20th anniversary, of Donum Vitae. It has 3 chapters, but we will look only at the first one: Chapter 1 Anthropological, theological and ethical aspects of life and human procreation: number 6: “The human being must be respected and treated as a person from the moment of conception and, therefore, from that moment the rights of the person must be recognized, especially the inviolable right of every innocent human being to life.”
The human being must be respected and treated as a person from the moment of conception. It must be recognized that the first right of the person is the right to life. Given this, the NFR methods are the best and perhaps the only valid option. Professor Jérôme Lejeune, geneticist, currently in the process of beatification, told a United Nations meeting: “From the moment of fertilization, from the moment when all the information contained in the sperm comes to the female cell, there is a human being.” These words were spoken at a time when the United Nations was beginning to promote the decriminalization of abortion. After this conference he called his wife and said “I just lost the Nobel Prize” and that’s how it was – the geneticist who discovered Trisomy 21 as a cause of Down syndrome, is considered the father of modern genetics and deserved the Nobel Prize for Medicine.
Many contraceptive methods attack life and therefore euphemisms are used to confuse, because there is a lucrative business that began in the last century towards the 60s with the introduction of hormonal contraceptives. The paradigm of the last century was “having sex without children”, now in this new century it is “having children without sex”, and all issues of assisted conception and invitro fertilization come into play.
Hormonal methods are postulated to have several mechanisms of action: they seek to prevent ovulation, they change the cervical mucus so that sperm do not pass and alter the motility of the tubes (which can be an abortive mechanism, because if the embryo arrives as a morula – 3-4 days after conception – it cannot be implanted) and can also affect implantation factors in the endometrium. If you read the inserts of the contraceptives you will see that “…taken before 8 days of the beginning of the menstrual cycle, there will be no pregnancy.” As we know, after 8 days a woman could have ovulated, how then can they guarantee that they will work in that cycle? It is because they know that it will also not allow implantation and that mechanism is also abortive. Intrauterine Devices (IUDs), particularly Copper T, also have an abortive effect. In fact, until a few years ago, PAHO recognized that “The IUD does not favour the implantation of a fertilized egg” (that is abortion), but WHO says that pregnancy starts after implantation (perhaps to favour the business of fertilization in vitro), giving two arguments: the first is that a high percentage of pregnancies is lost in the first trimester (which is true) and second, that “individuality has not been established.” In this regard, sometimes, at the time of implantation, the embryo can be divided, generating twins, or triplets and therefore it is argued that before implantation there is no “embryo” but a “pre-embryo”. To this we must respond that although what has not been established is the “singularity”, that is, whether they will be one or more, but what is established is that there are already one or more people. It is one thing that there are spontaneous abortions and another that we provoke them.
Of the origin of human life, Dignitas Personae tells us: “The origin of human life, on the other hand, has its authentic context in marriage and the family, where it is generated through an act that expresses the reciprocal love between man and woman.” A truly responsible procreation for those who are to be born “is the fruit of marriage”. John and Evelyn knew this. In a meeting with St. John Paul II they were told that “you always have to talk about these things in the context of marriage” adding “I know, you talk about marriage.”
John Billings has written “Marriage is a building that must be built continuously every day”.
Marriage must be a reflection of God’s love for his Church and Dr. John Billings had this very clear, when he said: “Man can advance in age and know that every time he looks at his wife he is seeing the most beautiful woman in the world.”
Dignitas Personae also alerts us about new problems related to procreation and new therapeutic proposals that involve the manipulation of the embryo or the human genetic heritage. On this, there are a couple of things that I would like to highlight: we must be alert, with regard to assisted conception and surrogate maternity, this includes what is known as a rental belly, which, some people believe could be “a new and more terrible form of slavery”. An NGO denounced not only human trafficking but also found women abducted, raped, enslaved and even involved in the business of harvesting the organs of their fetuses, which is why some countries have banned surrogate maternity. At the other extreme we have in-vitro fertilization (IVF), cloning and experimentation with embryos, where embryos are manipulated and eliminated. There have been several successful results in therapies with adult stem cells, particularly in post-myocardial infarction treatment, Parkinson’s, etc. but the investigations are oriented to obtaining and patenting new species for the production and sale of organs for transplant and for that purpose they are trying to mix human genetic material with animal genetic material.
We must be alert to these issues, for on many occasions a couple will resort to these procedures in order to have children but we must keep in mind that the end does not justify the means. In IVF some embryos are left frozen. They are not conceived as a result of the love of the spouses in a conjugal act, but through the laboratory, through a biopsy. If it is with a donor and this donor is the brother or father of the husband, then will a child be his son, his brother or his cousin?
There is no solid or scientific evidence to say that pregnancy begins after implantation: these are arguments to allow this trade and the decriminalization of abortion promoted by the United Nations. The WHO says that before implantation it is a pre-embryo, however, we speak of “embryo bank”, when biologically it is the same human being. Why if biologically it is the same, in the laboratory is it an embryo and in the womb of his mother a pre-embryo? That is the worst discrimination for the place of residence. On the other hand, there is a substance that researchers have called the Early Pregnancy Factor that begins to occur between 12 to 16 hours after conception and which serves to prevent the mother’s defenses attacking the baby who could be immunologically incompatible to her. The interest in research is whether this substance could help prevent rejection in organ transplantation. If the pregnancy started after implantation, as the WHO argues, why is this substance that occurs within 24 hours of conception, long before implantation, called the Early Pregnancy Factor? On the other hand, all embryology books show and describe human life from conception day by day.
To conclude these reflections, I would like to propose a Vision for instructors of the Billings Ovulation Method® and for that we have our models in John and Evelyn Billings. I do not know about you, but for us they are the only people we have met who had friendships with 3 popes (Paul VI, John Paul II and Benedict XVI), they have shared with 2 saints, St Mother Teresa of Calcutta (whom they met late in the 70s in Australia), St John Paul II, and with Blessed Paul VI. The Billings, husband and wife, have taught us with their lives that our vision is to “live holiness in the ordinary.” The Billings Ovulation Method® should not be seen as an end, but as a means to carry out our apostolate.
Benedict XVI said that although we Catholics should interact with non-believers and we must in many cases give in on some things, there are 3 non-negotiable principles that we should take care to defend which John and Lyn Billings had very clear:
- Respect for life, from conception to natural death. John Billings once said “Abortion and euthanasia are crimes that no human law can legitimize. There is no obligation in conscience to obey such laws; on the contrary, there is a serious and clear obligation to oppose them by conscientious objection. You have to love your neighbour as yourself (Lk 10:27): Promote life. Thus, when we teach the Billings Ovulation Method®, we teach truth and love, two of the foundations of marriage and the expression of the natural law for all people.”
- That marriage is between man and woman. In this regard, Dr. Evelyn Billings in an interview I found in COMPASS said “This is what marriage is about. Living together in peace and cooperating harmoniously.”
- The right of parents to educate their children on issues of values and faith. It is timely to remember what Dr. John Billings said while spreading the Ovulation Method in Europe “The spouses, cooperating with what the Creator has designed in nature, are at peace with their consciences and live in an atmosphere of love, joy, security and peace that is best for the development of the children, each of whom has experienced the beauty of having a father and a mother who love them and who love each other.” Something that is now no longer possible in some countries, such as Spain or Germany, a “secular education” is being imposed, complete with gender ideology that, under the pretext of “equity and equality”, seeks the “deconstruction” (destruction) of sexuality and family.
In view of this, we must bear in mind that the State has a duty to perform three functions to ensure common welfare:
- Promote what benefits society as a whole. For example, in Peru, the government promotes education and health and, in doing so, is not discriminating against anyone, since it benefits everyone.
- Allow those things that do not affect others.
- Prohibit things that affect the common welfare. For example, paedophilia.
When the natural order is left aside, you enter a field where everything can be valid and there are no points of reference. In the Netherlands, to cite a case in 2006, a political party with a very nice name that speaks of “love of neighbour” was legalized but what they propose is the decriminalization of paedophilia. The commitment that we must have, as instructors of the Billings Ovulation Method® which is a means to evangelize and approach the model that the Drs Billings have left us, is summarized in the Prayer for Life in
the encyclical Evangelium Vitae of St. John Paul II: Oh Mary, bright dawn of the new world, Mother of the living, to you we entrust the cause of life. Look down O Mother upon the vast numbers of babies who are prevented from being born (referring to the scourge of abortion), of poor people whose lives are made difficult, (while elsewhere food is thrown away), of men and women who are victims of brutal violence (in many countries Christians and others are persecuted), of the elderly and sick killed by indifference or out of misguided and presumed mercy (euthanasia).
Although John and Lyn Billings have departed from us, they left us their witness and many teachings that we should cultivate and that should distinguish us in our apostolate in order to approach our Vision:
- Unity with the church and its pastors. Although the religious have vows of obedience, the laity do not, but we must remain in unity with our Church and our pastors. Remember as the Bible says: “If the branch is not attached to the trunk it cannot bear fruit.” In a 1953 interview, Dr. John Billings confirmed that he and his wife were convinced that contraceptives were going to be very bad. It was 15 years before Humanae Vitae, John said: “We do not know what our pastors will say, and we will keep aligned with them, but we will not stop teaching the Billings Ovulation Method®”.
- Much prayer. Prayer was the source that fuelled the work of the Drs Billings and must also be ours.
- Openness to life. The Drs Billings, as we have already mentioned, not only preached but lived it intensely.
- Be persistent. When they started their work they did not have much support and rather they often foundndistrust. But they were persevering in their research and teachings and currently the Billing Ovulation Method® is the most widespread method of Natural Recognition of Fertility in the world.
- Not be intimidated by adversity. They commented, on a visit to Guatemala, that they had faced a lot of opposition from their medical colleagues who received with skepticism the new knowledge that they tried to share. But John and Lyn patiently answering their questions and today we see right in the front row, this beautiful delegation of instructors from Guatemala, the fruit of that work.
- Know how to listen. Dr. John Billings always stressed that he learned a lot by listening to the women he sought to help.
- Act with joy. To paraphrase St. Teresa of Calcutta we can say that “a sad instructor is a bad instructor…” Joy is something that stood out and is testified by all those who knew the Billings. Dr. John Billings commented how seeing Lyn for the first time in the anatomy dissection room at the university he fell in love with her – love at first sight. When he later told Lyn, she answered “well, there … I did not have much competition.”
- Humility and knowing how to recognize our limitations. When Dr. John Billings began his research with the women in Melbourne and they asked him if he could guarantee that it would work, he humbly and honestly acknowledged “I cannot guarantee the results, but I will do my best.” Despite all their merits, academic degrees and distinctions, John and Lyn Billings were always very simple and humble.
- Always ready for cooperative work. The Drs Billings throughout the years have known how to open their doors to work in a cooperative way. We all know of the collaborations and friendships with the Professors James Brown and Erik Odeblad whose independent investigations gave the scientific explanation and validation to the rules of the Billings Ovulation Method®.
- Have a missionary spirit. Successful professionals, with multiple recognitions and a large family, they had the detachment to go around the world spreading their knowledge. We must also be willing to respond to God’s call to continue this wonderful work.
Finally, I would like to share with you a little testimony of our family. Our children had often accompanied us as small children when we went through the cities of Peru teaching the Method and one day we discovered that they learned more than we imagined. Our oldest son, who is now 23 years old, was then 10 years old and in school. In his science and environment course he had been taught about the beginning of life and pregnancy. In an exam he was asked: “what is required so that a pregnancy occurs?” All children answered “a sperm and an egg” as that was what they had been taught, while our son answered “sperm, an ovule and the helpful mucus” (in Spanish we say cervical mucus and he thought it was helpful mucus as helpful in Spanish is “servicial” and sounds like cervical).
I want to thank the WOOMB Directors for the providential invitation to share with you these reflections. There is one detail that you probably did not know: my wife Yanina and I met the Billings in March 1993 at a Congress we had in Peru. When I heard John’s lectures I realized that I did not know anything about the Billings Method and was captivated. One night we were able to share with John and Evelyn in the house of the founders of CEPROFARENA, the Giusti couple, just a few months before we got married (we got married 20 August 1993) and in the middle of all the stress that comes with the preparations for the wedding and the natural fears for such an important decision that is going to be undertaken, the sight of that marriage gave us the confidence to move forward. Seeing them, he playing the piano, she singing, marked our lives, reaffirmed us in our decision and today we feel that this is a beautiful gift from God and thus why, as I mentioned at the beginning, I could not refuse this invitation to speak, because since then our apostolate began and with it the commitment to the spread the teaching of the Billings Ovulation Method® and with God’s help, it is going to be our apostolate for the rest of our lives.
“It’s not so important how much we do, but the love with which we do it.”
Credidimus Caritati : We have put our Faith in Love