John F. Kippley's Couple to Couple League, in addition to providing instruction in the natural family planning (NFP) method, conducts a series of 4 classes for couples who want to learn about health care, breastfeeding, prepared childbirth, and continence. The parents learn the philosophy and practice of the "ecology of natural mothering". Like prepared childbirth, NFP is based on scientific principles and is an art which must be mastered through study and practice. "Ecological mothering" means total breastfeeding and physical closeness between mother and infant. The basic principle is that the baby's frequent sucking will provide the mother with a period of natural infertility. The concept of total breastfeeding is radically different from the cultural nursing as is often seen in this society. "Ecological mothering" means: no solid foods for the 1st 6 months of the baby's life, no artificial pacifiers or nipples, no schedules, and mother baby closeness day and night. The vast majority of women will have extended natural infertility with ecological breastfeeding, and there will be a menstrual period after childbirth before ovulation occurs again. After the 1st menstrual period postpartum, a couple should assume that fertility has returned. Then it is time for them to use their awareness of a woman's body signals to determine fertility. The Couple to Couple League maintains that a woman can "read" her body through the symptothermal changes that are observed and then recorded. Actually, interpreting these bodily changes accurately allows a couple to detect ovulation before the 1st menstrual period postpartum. A chart outlines the theory of the symptothermal system. The observations of body changes can help a couple either to planor avoid conception. The symptoms and temperature changes are charted and intercourse is avoided during peak fertility if the couple wants to avoid conception. Kippley notes that the philosophy behind NFP has brought many couples closer together.
The experiences of natural family planning (NFP) counselors around the US indicate a growing interest in NFP methods in recent years, on the part of low parity non-Catholics as well as of higher parity Catholics. Fears of side effects of artificial methodss and interest in ecology and natural things are cited as the main reasons for the growing popularity of NFP. The calendar rhythm method has been largely replaced by the symptothermic methods, that combine observation of general physical symptoms such as mucus, abdominal pain, breast fullness, skin eruption, and mood changes with recording of basal body temperature (BBT), and the ovulation or Billings method, which records in great detail the presence and consistency of vaginal mucus during the menstural cycle. The Billings method identifies safe, relatively safe, and fertile days according to mucus signs alone. Both methods require keeping of chars. The BBT method has been rated as highly effective when intercourse is confined to the postovulatory phase, but it has the disadvantage of not being able to predict ovulation and of not being useful during menopause, after childbirth, and during nursing. Advocates of the ovulation method claim it can reliably predict ovulation at any time, but recognition of the mucus signs can be difficult and no intercourse is allowed during the menstrual period. Most NFP clinics in the US now offer a choice of methods. The majority of couples are able to assume responsibility for interpretation of their charts after a few months, but counseling is necessary at the beginning for success with the method. All NFP methods requre varied periods of abstinence during the fertile days of the cycle, a major hurdle in acceptance of NFP. Success depends on motivation, and most failures are believed attributable to "taking a chance." Cooperation of both spouses is more essential in NFP than in other methods. Couples who persevere in NFP accept the period of abstinence as a challenge and find it a source of enrichment for their marriages.
Much research in the past few years has been devoted to assessing the reliability of natural family planning (NFP). Partly as a result of a 1974 complaint by the Human Life Foundation, and independent nonprofit corporation originally formed by the American Catholic Bishops in 1968 to promote scientific research into natural methods of fertility regulation, the US Department of Health, Education, and Welfare in 1974 set up a special project to include natural methods in federal family planning programs. The Human Life Foundation was awarded a contract to compile a list of clinics offering natural methods. The majority of such clinics were found to be under Catholic auspices but to make services available to all denominations. HEW's lack of attention to NFP was largely explained by the religious affiliation and the poor reputation of "rhythm" as a method. The Human Life Foundation researched the existing literature on NFP and prepared a compendium on the various NFP methods for distribution to federal clinics as well as a curricular outline for establishment of a training program for instructors. At present most Human Life Foundation funding is from the US governmetn. The foundation acts as a catalyst in funding and coordinating research in the US and abroad and in disseminating the results. The Natural Family Planning Federation of America (NFPFA) was created in 1973 to develop standards for NFP teaching and clinic operation. Goals are to encourage teaching of both the ovulation and symptothermal methods and to ensure medical backup for all clinics, to promote collection of statistical data, and to help NFP providers obtain funding. HEW policy is that all family planning methods should be made available in all publicly funded clinics, which creates difficulties for NFP clinics whose organization and requirements are very different from those of other types of family planning. The scientific and family planning extablishments have generally preferred other forms of contraception to NFP, because of the time required to counsel patients, the need for relatively long periods of abstinence, possible reluctance to place control in the hands of the couple rather than the doctor, doubts abouth the efficacy of NFP, and other factors. Limited studies thus far have suggested that highly motivated couples can achieve excellent success with NFP, although failure rates among users as a whole may be high.
What was the role of the Catholic colleges in urban social mobility? Why has Pennsylvania a mediocre record in the development of community colleges? What has been the history of Pennsylvania State University's relations with the state legislature and with the University of Pennsylvania? What has been the career of academic freedom in Pennsylvania? How did the changing economic and social life of the commonwealth shape the higher learning, and vice versa? What does the record of higher education in Pennsylvania tell about democracy in Pennsylvania? To what extent were the colleges and universities significantly influenced not by conscious administrative decision but by student action? Who taught in these institutions and what did they teach? How did the struggle between piety and intellect go in Pennsylvania? At this moment in the historiography of higher education the answers to these questions should not remain a mystery at the end of a book that runs to more than 800 pages.
