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Catholicism and contraception


Katolicismus a antikoncepce

Cíl práce: Současná katolická církev představuje instituci čítající 1,3 miliardy lidí, kteří dodržují učení katolické církve, jež je jim předáváno prostřednictvím církevních dokumentů vyjadřujících se k jednotlivých otázkách, a to včetně rodiny a plánovaného rodičovství. Apoštolská exhortace z roku 2016, Amoris Laetitia, potvrdila předcházející dokumenty v tom smyslu, že schválila periodickou abstinenci jako jedinou možnou antikoncepční metodu pro katolické křesťany. Cílem tohoto článku je ukázat, analyzovat a diskutovat o důvodech katolické církve pro odmítání moderní antikoncepce.

Design: Původní práce.

Název a sídlo pracoviště: Centrum ambulantní gynekologie, Brno; Centrum prenatální diagnostiky, Brno; Katedra filozofie, Filozofická fakulta Masarykovy univerzity, Brno.

Metodika: Tento článek je založen na analýze poslední apoštolské exhortace Amoris Laetitia, předcházejících papežských encyklik a dalších náboženských dokumentů na toto téma.

Výsledky: Důvody, proč katolická církev odmítá moderní antikoncepci, jsou její údajná nepřirozenost a (poten­ciálně) abortivní charakter. Článek ukazuje neudržitelnost těchto tvrzení, protože moderní antikoncepce v žádné ze svých forem není ani nepřirozená, ani abortivní.

Závěr: Článek končí doporučením, aby katolická církev oficiálně schválila užívání moderní antikoncepce či tuto otázku nechala individuálnímu svědomí jednotlivých katolických párů.

Klíčová slova:

katolicismus – antikoncepce – plánované rodičovství – koncepce – potrat


Authors: J. Greguš
Authors‘ workplace: Centrum prenatální diagnostiky, Brno ;  Centrum ambulantní gynekologie, Brno
Published in: Ceska Gynekol 2019; 84(6): 468-474
Category: Original Article

Overview

Objective: The modern Catholic Church represents a body of 1.3 billion people who follow the Church’s teachings, given to them in the form of documents on different topics, including family issues, family planning, and many others. The latest 2016 Apostolic Exhortation, Amoris Laetitia, followed in the footsteps of previous documents on the topic in that it confirmed periodical abstinence is the only contraceptive method possible for Catholic Christians. The goal of this article is to show, analyze and discuss the Church’s reasons for its opposition to modern contraception.

Design: Original article.

Setting: Center for Outpatient Gynecology, Brno; Center for Prenatal Diagnosis, Brno; Department of Philosophy, Faculty of Arts, Masaryk University, Brno.

Methods: This article is based on the analysis of the latest 2016 Apostolic Exhortation Amoris Laetitia as well as the previous Papal Encyclicals and documents on the topic.

Results: The Church’s reasons for the opposition to modern contraception are primarily modern contraception’s supposed un-naturality and (potentially) abortive character. Nevertheless, this article shows the unsustainability of such claims because modern contraception in its various forms is neither unnatural nor abortive and thus this view does not stand up to robust criticism.

Conclusion: This article concludes with a call for the Catholic Church to officially give approval to contraceptive use or to at least officially leave it to the individual consciousness of Catholic Christian women and couples.

Keywords:

catholicism – contraception – family planning – conception – abortion

PART I: ON THE GOODNESS OF CONTRACEPTION

Introduction

The Catholic Church currently represents a body of 1.3 billion people worldwide (a total of 18% of the global population) [4], and as such, it is the largest Christian denomination. It issues documents on different topics including family issues, family planning, and so on. The goal of this work is to show the reader the current Church’s position on family planning, which is the opposition to modern contraception; analyze the Church’s reasons for it; and argue to the reader the unsustainability of these reasons in the light of consequences opposition to contraception brings. The work concludes with an appeal for the Catholic Church to officially give approval to contraceptive use or to at least officially leave it to the individual consciousness of Catholic Christian women and couples.

The Church against Contraception

In 2016, Pope Francis released Apostolic Exhortation Amoris Laetitia (The Joy of Love) [12], which followed the Synods on the Family held in 2014 and 2015, i.e., documents Relatio Synodi and Relatio Finalis. Here periodical abstinence was confirmed as the only contraceptive method possible for Catholic Christians. Other contraceptive methods including sterilization (and induced abortions) were rejected, called “unacceptable even in places with high birth rates” just as “a mentality often opposed to life […] promoted by the world politics of reproductive health” [12] was rejected. The document, however, does not explain the reasons for opposing modern contraception.

To the Origins of Opposition

The following research shows that opposition to modern contraception and family planning has always existed. In 2008, the Congregation for the Doctrine of the Faith released the instruction Dignitas Personae (The Dignity of a Person), in which it gives doctrinal guidance on ethical issues concerning artificial reproduction. The document also confirms the Church’s opposition to contraception, while mentioning new contraceptive types, such as female condoms or emergency contraception. Earlier, in 1995, Pope John Paul II released the Encyclical Evangelium Vitae (The Gospel of Life), which condemns abortions, euthanasia, and artificial reproduction. The Encyclical also condemns modern contraception and sterilization in multiple paragraphs.

However, it is the Encyclical Humanae Vitae (On Human Life) [11] released in 1968 by Pope Paul VI that is the Church’s most explanatory work on the topic because it divulges the Catholic reasoning for opposing modern contraception.

The reason why periodical abstinence is accepted, while other contraceptive methods are rejected, is that “in the former the married couple rightly use a faculty provided them by nature,” while “in the later they obstruct the natural development of the generative process” [11].

This rejection is very vigorous, as when the document says that the Catholic Church “condemns as always unlawful the use of means which directly prevent conception, even when the reasons given for the latter practice (i.e. contraceptive methods other than periodical abstinence) may appear to be upright and serious” [3].

On the Evilness of Contraception

Some could argue that the Church’s teachings are set as a high standard, something (of God) to what a human can only aspire but never reach. Some even argue that the Church’s practice, in reality, is much more benevolent when it comes to the topic of family planning and contraception. It may be true that some priests have a more liberal view on this than others; nevertheless, the Pontifical Council for the Family is firm on the topic. In 1997, it released the document Vademecum for Confessors Concerning Some Aspects of the Morality of Conjugal Life [10], in which it gives priests a clear directive: “Priests, in their catechesis and in their preparation of couples for marriage, are asked to maintain uniform criteria with regard to the evil of the contraceptive act, both in their teaching and in the area of the sacrament of Reconciliation, in complete fidelity to the Magisterium of the Church. […] Bishops are to take particular care to be vigilant in this regard; for not infrequently the faithful are scandalized by this lack of unity, both in the area of catechesis as well as in the sacrament of Reconciliation” [10].

Un-natural, Hence Evil?

Whereas the document Humanae Vitae takes a stand against modern contraception because it “obstructs the natural development of the generative process”, the document Vademecum for Confessors goes further and calls modern contraception “evil”. So, what makes modern contraception evil? It seems the answer lies in its “un-naturality”. But here, it is necessary to raise two questions. First, is modern contraception really un-natural? And second, does un-natural mean evil?

Prominent gynecologist (and devout Christian) John Rock was convinced neither is true.

On the Naturality of Contraception

John Rock was an American Catholic Christian who witnessed the suffering women endured from unwanted pregnancies and their complications. He saw birth control as a means to curb poverty and prevent medical problems associated with pregnancies. As such, he came to support contraception (despite his faithful Catholicism and the Church’s opposition to contraception) within the confines of marriage. After the Catholic Church approved periodical abstinence, he became the first doctor to open a rhythm clinic where he taught Catholic women how to use the only permitted contraceptive method by the Catholic Church. Later on, Rock participated in the creation of oral contraception, or the Pill. When it received U.S. Food & Drug Administration approval, he launched a one-man campaign to gain the Catholic Church’s approval. He argued that the Pill was a more precise way of following the rhythm method [13].

In 1963, he published the book The Time Has Come: A Catholic Doctor’s Proposals to End the Battle over Birth Control where he took a stand against the view of the Catholic Church that holds modern contraception as something un-natural. He argued that the Church should consider modern contraception a natural, and therefore acceptable, form of birth control because it contains the same hormones already present in every woman’s reproductive system [13].

Nevertheless, the Church did not endorse his ideas, and a few years later, Pope Paul VI issued the aforementioned Humanae Vitae that officially banned modern contraception. This led to Rock losing his faith in the Church, whereby the man who once attended mass daily stopped going to church altogether [13]. Despite the Church’s continued opposition to modern contraception, a profound change had taken root among the Catholics, and millions of Catholics around the world have chosen to follow their own consciences on the matter of birth control.

But John Rock was not the only John who greatly contributed to the debate on birth control.

The Catholic-Orthodox Polemic

John Meyendorff was an American Orthodox Christian theologian and author who wrote in Marriage: An Orthodox View [9] in 1971. In his book, he confronts the official position of the Catholic Church: “recent Roman Catholic teaching recommends periodical abstinence, but forbids the “artificial” means, such as the “Pill”. But is there a real difference between the means called “artificial” and those considered “natural”? Is abstinence really “natural”? Is not any medical control of human functions “artificial”? Should it, therefore, be condemned as sinful? And finally, a serious theological question: is anything “natural” necessarily “good”? Is not science able to render childbirth more humane, by controlling it, just as it controls food, habitat and health?” [9].

Meyendorff makes a great point because then the Church should consider any human (medical) intervention as un-natural, and hence forbidden, including therapy of diseases such as diabetes, hypothyroidism, and so on (i.e. diseases easily treated by human-made hormones), or infectious diseases that are well-managed by artificially- or human-made antibiotics or prevented by vaccinations. Not to mention that other therapies, such as radiotherapy or chemotherapy, are much less likely to be considered natural, yet are not forbidden. This presents a great challenge and problem for those who base their opposition to contraception on its “un-naturality”.

But Meyendorff continues: „Straight condemnation of birth-control fails to give satisfactory answers to all these questions. It has never been endorsed by the Orthodox Church as a whole, even if, at times, local Church authorities may have issued statements on the matter identical to that of the Pope. In any case, it has never been the Church‘s practice to give moral guidance by issuing standard formulas claiming universal validity on questions which actually require a personal act of conscience. There are forms of birth control which will be acceptable, and even unavoidable, for certain couples, while others will prefer avoiding them. This is particularly true of the “Pill”. The question of birth control and its acceptable forms can only be solved by individual Christian couples. They can make the right decision” [9].

Meyendorff concludes by saying that “the issue of family planning has also aspects. For example, if the “life” given by parents to their children is to be a fully human life, it cannot involve only physical existence, but also parental care, education and decent living. When they beget children, parents must be ready to fulfill all these responsibilities. There obviously are economic, social or psychological situations where no guarantees can be given in this respect. And there is sometimes even a near certainty that the newly born children will live in hunger and psychological misery” [9].

On the Non-Abortiveness of Contraception

As has been argued, a ban on modern contraception based on the claim that it is un-natural, fails to give satisfactory answers to other questions that, as John Meyendorff points out, naturally arise. But more than that, it is also a very problematic view, because a ban on the contraception that prevents unwanted pregnancy and its often dangerous medical or socioeconomic complications could – if taken seriously – lead to a ban of the cures for hypertension, epilepsy, depression, and so on.

But is this really the only reason why the Church stands opposes it? It is not.

Another reason for opposing modern contraception (even though this is not directly mentioned in the previous Church’s documents) is the misconception that contraception is abortive, or potentially abortive, i.e., it causes or can cause (induced) abortion. This is, however, not true.

Contraception either blocks ovulation, or disables the penetration of sperm into the uterus, or both, thus preventing fertilization. Prevention of implantation is the third mechanism of contraception, in case blocking ovulation and fertilization fails. Nevertheless, such a thing is rare and limited only to some forms of contraception (intrauterine device, emergency contraception). However, the use of the word “abortion” in this situation is misleading because abortion means ending an established pregnancy, i.e. after implantation – based on the mainstream scientific, as well as legal, definition. No contraception has been shown to disrupt an existing pregnancy. From this, it is evident that contraception prevents, not ends, pregnancies.

Simple explanation and public demonstration of this difference is crucial because it provides the chance for the representatives of the groups opposing contraceptive use based on the aforementioned faulty line of thinking, could rethink their position and instead give their approval for contraceptive use. But what is a theist’s view of this?

Since John Rock and John Meyendorff have already been named, it is necessary now to mention the third John.

A Theist’s Thoughts for Theists

Another devout Christian as well as gynecologist, Professor of Family Planning and Reproductive Health John Guillebaud speaks persuasively on this topic. He, just as other theists, is convinced that “life begins at conception.” But he explains the misconception of conception as being synonymous with fertilization alone [7] – which it is not.

Con-ception (a word whose etymology means “being with child”) is a process initiated by fertilization but not completed until implantation. Until implantation, a fertilized egg has no proper two-way relationship with the mother. Guillebaud states: Before implantation, there is no true “carriage”, so how can it be “procuring a miscarriage” (i.e. abortion)? [7]

To restate, implantation is the biological event that completes conception and thus separates conception from abortion. In other words, implantation is what separates family planning from abortion. For this reason, Guillebaud is convinced that “theists whether providers or users of contraceptives, should be comfortable with the view that contraceptive mechanisms up to the time of implantation are not abortifacient” [6].

Yet even for those, who hold the absolutist ethical position that blocking implantation is a form of abortion, there is a list of methods that are entirely secure (that is, to ensure no escape ovulations ever occur). Guillebaud gives us an example: instead of “outdated 21/7 regimen”, he recommends “the 21st century way”, i.e., taking the Pill continuously 365/365 [6].

Guillebaud concludes: “Some in Faith communities who do not share my views [on this] have nevertheless felt free to use such a method long term, when backed by prayer to their God that in their case it would in fact always (rather than very nearly always) operate before fertilization” [7].

On the Goodness of Contraception

A good or evil nature of contraception, as well as all things generally, cannot be based on their naturality or un-naturality, not even in philosophical (or theological) disputes. On the contrary, it can – and should – be based on the effects, or consequences, the things bear.

If we respect the health of women and contraindications of different kinds of contraception, and if we prescribe contraception only to women who freely ask for it (after being given enough information on how contraception works, what its positive or potential negative side effects is, what its reliability is, etc.), then the positive effects hugely outnumber the possible negative effects. In this case, we can – and ought to – speak of the goodness of contraception.

To a non-gynecological reader, it is vital give a reminder – however briefly – of all the positive effects related to the use of contraception such as a global decrease in unintended and adolescent pregnancies, a decrease in induced abortions, a decrease in maternal and infant mortality and morbidity, a decrease in the spread of sexually transmitted infections and AIDS/HIV pandemic (only some kinds of contraception), and a general improvement in women’s societal position and emancipation, not to mention the individual benefits for women using contraception, such as protection from some kinds of cancer, ovarian cysts, relief from painful periods, and so on.

The First Conclusion

The reader has been shown the Church’s reasons for opposing contraception with its supposed un-naturality and (potentially) abortive character; that viewing modern contraception as something un-natural cannot stand a robust critic; and also that modern contraception in its various forms is neither unnatural nor abortive. Hence there should not be a problem for the Catholic Church to accept it as have some other Christian Churches or at least officially leave it to the individual consciousness of Catholic Christian women and couples.

However, there are more reasons for the Church’s opposition, namely God’s direct Order to fill the Earth and multiply.

PART II: ON THE EVILNESS OF OVERPOPULATION

On the “Fill the Earth” Commandment

As the Bible says: “God blessed them and said to them: Be fruitful and increase in number; fill the Earth and subdue it. Rule over the fish in the sea and the birds in the sky and over every living creature that moves on the ground (Gen 1:28) and As for you, be fruitful and increase in number; multiply on the Earth and increase upon it.” (Gen 9:7) [1].

This is one of the commandments that humanity took seriously and is still more than willing to fulfill. Nevertheless, this commandment was issued in a time when there were very few people on the planet, and thus when such a commandment was rational. Given the United Nations demographic data (and projections) it is evident that this is not the case anymore.

But God in his wisdom had never said we should overfill the Earth and destroy it with our numbers which is precisely what we are doing right now, while ignoring this very fact. Hence one more last but definitely not least positive effect of contraception (and thus one more argument for its being good) is that it helps to curb human overpopulation – a problem that is neglected in the Church’s documents, or even contradicted. As showed above, Amoris Laetitia speaks of “a mentality opposed to life […] promoted by the world politics of reproductive health” [12].

But is a plan to limit rapid population growth that threatens life itself really “a mentality opposed to life”? This paper argues it is not. For as British diplomat and environmentalist Sir Chrispin Tickell wrote: “Unlimited growth is the doctrine of the cancer cell.” [8]. A stubborn demand on multiplying is a mental position that leads to human overpopulation with all its vast consequences (i.e., environmental, healthcare, political, economic, and social) [5] and thus leads humanity down the path to its (as well as the planet’s) destruction. Christians may cite the aforementioned Bible quotations to support their position, but here is another one that is – for some reason – not cited so often.

The Bible also says: “Yet he [God] does not leave the guilty unpunished; he punishes the children and their children for the sin of the parents to the third and fourth generation.” (Ex 34:7). It also states: “The Lord is slow to anger and abounding in steadfast love, forgiving iniquity and transgression, but he will by no means clear the guilty, visiting the iniquity of the fathers on the children, to the third and the fourth generation.” (Num 14:18) [1]. While in some verses the bolded line is followed by an explanation that this applies to those who hate God, it can be adapted to the case of human overpopulation. If we, as parents, destroy this planet (with our numbers), it will be our sons and daughters and their sons and daughters who will pay the price (for our ignorance or arrogance). And if not God, the planet Earth will be the one that will be punishing them for our sins committed on the face of Earth.

On the Number That Is Power

Is it just an unreasonable demand on the “Fill the Earth” Commandment? Or might it not be about something else, such as the number of adherents to different religions? The Catholic Herald gives us a hint. In November 2018, it published the article Martyrs and Tomorrow’s Church: “But despite this bewildering violence, the Church’s prospects in Africa are actually far from bleak. By 2050, a quarter of the world’s Catholics are projected to live in Africa.“

The Church’s growth has been nothing short of astonishing. As the historian Philip Jenkins puts it: In 1900, the whole of Africa had just a couple of million Catholics, but that number grew to 130 million by the end of the century, and today it approached 200 million. If current trends continue, as they show every sign of doing, then by the 2040s there will be some 460 million African Catholics. Incredibly, that number would be greater than the total world population of Catholics as it stood in 1950.

It is, perversely, a mark of Catholicism’s success that it is being targeted in Africa. Catholics are now present in significant numbers where once they were a minority. This attracts the unwelcome attentions of militant groups. It is impossible to deny that the majority of the Church’ persecutors are Islamists. While they are by no means a unified or ideologically consistent group, they consider Christians an obstacle to Islamization and seek to drive them out of disputed areas. The violence, it is sad to report, is not always one way.” [2].

On the Evilness of Overpopulation

Given the problems human overpopulation causes, it can be called evil. Thus, we should not be talking about the evilness of contraception, but of the evilness of overpopulation. Furthermore, attempts to address this problem should not be considered “a mentality opposed to life” nor can it be called anti-natalist position (anti-natalism is a philosophical position which attributes a life or a birth negative value) – given the fact that there has never been so many people on the planet as there is right now. Lastly, this demand to multiply could be viewed not as a mentality for life, but a mentality for having more adherents, and thus greater influence and power.

How else can a state when an increased number of people causes a destruction of the planet and wildlife and poses a threat to the people themselves, other non-human beings, the planetary ecosystem and life itself be called, if not evil? A sixth major extinction is under way and for the first time in history it is caused by human behavior (to be more precise, by overpopulation and overconsumption – more on that later). As was pointed out: “Of the total land mammalian biomass, 98.5% is now the flesh of humankind or our cows, sheep, goats… leaving just 1.5% for all wild mammals put together…” [8]. If this is not genocide, and thus evil, what is?

One cannot un-notice that the Church’s documents on family issues, family planning and contraception which support “the culture of life” never mention the rights of other species. These are not discussed, philosophically or theologically. But the use of contraception is a win-win situation because it helps both women – their health, emancipation, limiting the size of their families – and the environment, and as such, the use of contraception should become, philosophically speaking, a moral imperative. This is especially true once we realize what this, what could be called “pro-natalism,” is really about. It is about the numbers because “numbers give power” [8].

The Future Happens in Africa

Given the overpopulation happening in (Sub-Saharan) Africa and the threat it poses to global biodiversity, it is not a strong statement to say that future happens in Africa. And as such, it must be kept in mind that Africa mustn’t become a battlefield of religions. Admittedly, it is not up to Catholics alone, but also up to other Christian denominations and Muslims, in particular, as well. For this reason, more effort must be put into international cooperation, agreements and laws that will help to transcend religious fighting for control over the continent. Also, more effort must be put into promoting women’s rights and empowerment and undoing barriers to women, which have been caused mainly by men.

As this work is being addressed to a Christian Nation, the Bible will conclude this section: “I will punish the world for its evil, the wicked for their sins. I will put an end to the arrogance of the haughty and will humble the pride of the ruthless.” (Isa 13:11) [1].

The Second Conclusion

We, as well as the Church, must be reminded that contraception is not un-natural (unless all medicine and all technological advancements are and should be banned), that it is not abortive, and that God had never spoken about overfilling the Earth which is precisely what we are doing. On the contrary, He warned us about “our children paying for our sins”.

This punishment could be ever more severe natural disasters, wars over water and drastically reduced resources, but also draconic, coercive, restrictive means against continuing population growth in the future. Here, once again, voluntary family planning and voluntary use of contraception is and must be viewed as a good means of solving this problem (and the most humane way).

Finally, let it be said that religions and churches such as the Catholic Church that encourage “love for one’s neighbor” should take into consideration our future neighbors, namely those who can greatly suffer from the consequences of our overpopulation and overconsumption.

The Great Reconciliation, or on the Evilness of Overconsumption

Though Amoris Laetitia neglects the problem of human overpopulation, it acknowledges the problem of overconsumption. It is important because as John Guillebaud puts it: “Reducing overpopulation and overconsumption are two sides of the same coin. […] contraception is as important as bicycles.” [8]. Amoris Laetitia’s passages, on which great cooperation can be built, are those critical to consumption, extreme individualism, current stressful lifestyle and “the individualistic culture of possession and enjoyment” [12]. Pope Francis’ Christmas homily also warned us: “In our day, for many people, life’s meaning is found in possessing, in having an excess of material objects. An insatiable greed marks all human history, even today. […] Let us ask ourselves: Do I really need all these material objects and complicated recipes for living? Can I manage without all these unnecessary extras and live a life of greater simplicity?” [3].

Though some would do their best do consider this work as an attack on the Church, on conjugal love, on family, on relationships, or on life itself, none of that is correct.

There are other important Exhortation’ passages calling for the support of families and relationships, as well as passages concerning women’s rights and their promotion. This gives a promise that the Church will not artificially place support of women’s rights and emancipation in the opposition with the “culture of life” which is a man-made strife, just as it will not put the “pro-women approach” in the opposition with the “pro-family approach,” because one cannot be without the other – especially if we realize that healthier women create healthier families.

MUDr. Bc. Jan Greguš

Centrum ambulantní gynekologie

Orlí 10

602 22 Brno

e-mail: jangregus@seznam.cz


Sources

1. Biblehub. [online] https://biblehub.com.

2. Catholic Herald. Martyrs and tomorrow’s Church. Catholic Herald. 2018. Available from: https://catholicherald.co.uk/magazine/martyrs-and-tomorrows-church/.

3. Catholic Herald. Pope Francis: Invite God to dwell in your heart this Christmas. Catholic Herald. 2018. Available from: https://catholicherald.co.uk/news/2018/12/24/pope-francis-invite-god-to-dwell-in-your-heart-this-christmas/.

4. Central Office of Church Statistics of the Secretariat of State. The Pontifical Yearbook 2017 and the Annuarium Statisticum Ecclesiae 2015. Summary of Bulletin. Holy See Press Office. 2017. Available from: http://press.vatican.va/content/salastampa/en/bollettino/pubblico/2017/04/06/170406e.html.

5. Greguš, J. Prolegomena to any future discussions on overpopulation. Praha, 2017, p. 6–8. In press 2019.

6. Guillebaud, J. How do contraceptives work? Ecotimecapsule. 2018. Available from: http://www.ecotimecapsule.com/pagecontents/pdfs/contraception/article4a.pdf.

7. Guillebaud, J. Is implantation the biological event which completes conception, and so separates conception from induced abortion? Ecotimecapsule. 2018. Available from: http://www.ecotimecapsule.com/pagecontents/pdfs/contraception/article3a.pdf.

8. Guillebaud, J. Perfect storm. Ecotimecapsule. 2018. Available from: http://www.ecotimecapsule.com/pagecontents/pdfs/perfect-storm.pdf.

9. Meyendorff, J. Marriage: An orthodox perspective. New York: St Vladimir‘s Seminary Press, Crestwood, 2000. p. 58–63.

10. Pontifical Council for the Family. Vademecum for Confessors Concerning Some Aspects of the Morality of Conjugal Life. Vatican: Libreria Vatican. 1997. Available from: http://www.vatican.va/roman_curia/pontifical_councils/family/documents/rc_pc_family_doc_12021997_vademecum_en.html.

11. Pope Paul VI. Encyclical Letter Humanae Vitae. Vatican: Libreria Editrice Vaticana. 1968. Available from: http://w2.vatican.va/content/paul-vi/en/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae.html.

12. Pope Francis. Post-Synodal Apostolic Exhortation Amoris Laetitia. Vatican: Libreria Editrice Vaticana. 2016. Available from: https://w2.vatican.va/content/francesco/en/apost_exhortations/documents/papa-francesco_esortazione-ap_20160319_amoris-laetitia.html.

13. Public Broadcasting Service. People & Events: Dr. John Rock. PBS. 2018. Available from: http://www.pbs.org/wgbh/amex/pill/peopleevents/p_rock.html.

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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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