Can I use a barrier for medical reasons?

[TxDeeDee1028]

I have rheumatoid arthritis and my doctor wants me on Methotrexate. This medicine can cause horrible birth defects should I get pregnant. I’m currently using NFP as my birth control, however, I’m wanting to have extra protection, such as a condom. I’m so afraid I’ll make an error and then conceive a child that will have defects or not even make it to birth. My doctor said I’d have to have an abortion, but I know I wouldn’t do it. I’m wondering if there is some way to get a sort of approval from the church to do this. I would still chart my cycles and not have intercourse on unsafe days. I just want the safe days safer. I cannot be a good mother to my 2 small children if I am in pain. There are apparently no other safe RA medicines besides Plaquenil which I’ve tried, and it doesn’t work. I plan to call the church, but thought I’d ask y’all too.

 

[Evania]

I’m in a similar situation. I’m praying for you!

 

[annb]

NFP (you can use the most conservative rules) and abstinence are allowed.

If you should become pregnant while on the drug, you can stop the drug and still have a good chance of a positive pregnancy outcome.
Your doctor saying you’d have to have an abortion is absurd.

 

[Rau]

I have rheumatoid arthritis and my doctor wants me on Methotrexate. This medicine can cause horrible birth defects should I get pregnant. I’m currently using NFP as my birth control, however, I’m wanting to have extra protection, such as a condom. I’m so afraid I’ll make an error and then conceive a child that will have defects or not even make it to birth. My doctor said I’d have to have an abortion, but I know I wouldn’t do it. I’m wondering if there is some way to get a sort of approval from the church to do this. I would still chart my cycles and not have intercourse on unsafe days. I just want the safe days safer. I cannot be a good mother to my 2 small children if I am in pain. There are apparently no other safe RA medicines besides Plaquenil which I’ve tried, and it doesn’t work. I plan to call the church, but thought I’d ask y’all too.

I don’t believe there is any precedent to declare an “exception” to the ban on contraception. Assuming there is no alternative medical treatment, you would need to adopt very conservative NFP rules, which would limit you to a fairly short “safe” window for sex.

 

[Starrsmother]

I have rheumatoid arthritis and my doctor wants me on Methotrexate. This medicine can cause horrible birth defects should I get pregnant. I’m currently using NFP as my birth control, however, I’m wanting to have extra protection, such as a condom. I’m so afraid I’ll make an error and then conceive a child that will have defects or not even make it to birth. My doctor said I’d have to have an abortion, but I know I wouldn’t do it. I’m wondering if there is some way to get a sort of approval from the church to do this. I would still chart my cycles and not have intercourse on unsafe days. I just want the safe days safer. I cannot be a good mother to my 2 small children if I am in pain. There are apparently no other safe RA medicines besides Plaquenil which I’ve tried, and it doesn’t work. I plan to call the church, but thought I’d ask y’all too.

I think you should absolutely speak to your priest–but I do know as a Catholic health care provider, that dispensations to allow condom use have been granted in a number of cases–even in such cases as where where one of the parties is HIV positive and thus unprotected intercourse could result in the other party being exposed to a nearly fatal illness.

Methotrexate is an older generation chemotherapeutic drug. As such, it destroys “fast growing tissue”–which is why it works to kill tumors–as they are very, very vascular and grow more rapidly than most surrounding human tissue. It also has a use in obstetrics that many people don’t realize–but that I feel is equally valuable! We use a shot of methotrexate to dissolve an ectopic or “tubal” pregnancy if said pregnancy is discovered before it is so far along that it bursts the tube. Since the advent of early pregnancy tests and the use of methotrexate to dissolve these early extra-uterine pregnancies, many women’s very lives have been saved. If a fallopian tube bursts, the woman almost always dies rapidly as she bleeds out internally. I had an aunt–much older than even my own parents–who died, leaving a husband and 6 or 7 kids motherless, because of just such an ectopic pregnancy that burst! In the not-so-distant past, such things happened frequently. Moreover, methotrexate use can actually SAVE a woman’s fertility, as if you simply dissolve a doomed tubal pregnancy, you are able to not remove the entire tube on whichever side the pregnancy occurs–which once was be the only treatment and only way to save the mother, if you discovered a tubal pregnancy early enough to save her life at all. Back then, the BEST outcome that could even be hoped for was that a woman would lose a tube and half of her future fertility–but at least continue to live!

Frankly, if you got pregnant while on methotrexate–which is a bonafide treatment for RA by the way and which is usually tried before using Humira, Enbrel or any such injectible medication–I’d bet you wouldn’t carry the pregnancy anyway, and that’s again if it even occurred and wasn’t spontaneously lost. Most likely, the methotrxate would dissolve the embryo–and you’d never even know you’d been pregnant. IF, however, in the one in a million chance that somehow a pregnancy occurred on methotrexate and then actually continued–you’re right–the fetus would have some of the most horrible deformities you can ever imagine–and I DO MEAN HORRIBLE!!! I’d explain all this to your priest and I bet you’ll be dispensed–as you are truly only wanting to use condoms due to a medical treatment, and one which is certainly needed and warranted.

 

[TxDeeDee1028]

Thank you StarrsMother for your very helpful reply. I would be taking 10-15 mg of the methotrexate so it’s not as strong as chemo but still causes concern. I’m currently following the Creighton Model of NFP bc I’ve had irregular cycles in the past, so I feel that is pretty conservative. I will set up a meeting with my priest and see what he says. I don’t feel abstinence is an answer because I could be on this for 10+ years if it works. Pretty sure my husband won’t be on board with that!

Thanks to all that replied!

 

[webmiesterph]

Hi,

I sympathize with your situation, and your intentions are good.

Although you are taking Methotrexate for a medical reason, the purpose of using a condom is contraceptive rather than a medical one. Since your concern, of course, is fear that the child will develop birth abnormalities, we are concluding that the best way to avoid the child to have such abnormalities is to contracept him from ever being conceived.

Although RA is debilitating, it isn’t necessarily life-threatening. Our conclusions that it will lead to horrible birth defects is based on fear rather than faith, Let’s have faith that if God has a beautiful plan for you and the baby which may have been conceived despite your best efforts using NFP, His plan for you and the child will be a beautiful one. This is a beautiful plan even if the child is born with abnormalities. If God wills that the baby will not have birth abnormalities, He will prevent this and ensure that the child will not have abnormalities despite Methotrexate intake. If his plan is for you not to have a baby, He will ensure that you will not have one as you use NFP. If His plan is for you to have a baby with birth defects, let us trust that this plan is meant to further strengthen our faith. It may seem hard to accept, but many parents of children with abnormalities claim that the child has made them more loving.

There is much fear that we might not become a good mother, if we get pregnant, etc. This fear is common among those who want to use contraceptives. Some fear this because of economic reasons, or medical reasons. I am not to judge which reasons are valid or not. Just that the difficulties which you may encounter, like the pain if you stop taking methotrexate for the benefit of the baby, may be an opportunity to strengthen your faith.

A previous post gave an example where their patient was allowed to use a condom because the partner was HIV positive. In that case, we are trying to prevent the spread of a deadly disease and the contraceptive effect is only a “side effect” of that prevention. However, in your case, we are preventing a birth defect not as a “side effect” of the contraceptive action of the condom but rather as a primary or direct effect of the device. In essence, the use of the condom is not at all to prevent spread of a disease but rather as contraceptive. A child with birth defects, if ever conceived, is a beautiful gift needing much of your love and attention.

This is a very difficult situation, and I will include you in my prayer intentions.

 

[Starrsmother]

Thank you StarrsMother for your very helpful reply. I would be taking 10-15 mg of the methotrexate so it’s not as strong as chemo but still causes concern. I’m currently following the Creighton Model of NFP bc I’ve had irregular cycles in the past, so I feel that is pretty conservative. I will set up a meeting with my priest and see what he says. I don’t feel abstinence is an answer because I could be on this for 10+ years if it works. Pretty sure my husband won’t be on board with that!

Thanks to all that replied!

I honestly think if you lay it out to your priest totally and reasonably–much as I did in my post to you–or even to your bishop if your priest somehow feels unsure himself—that a dispensation will be granted! As a Catholic provider, I do run into these things. Your treatment plan is perfectly reasonable and right on target with current medical management. I know my post was lengthy (sorry for that!), but I just wanted to give you some factual information to use to explain to your priest. Remember, he isn’t a doctor obviously and quite probably is unfamiliar with RA, women’s healthcare and many medications etc. I’m not saying that he is dumb or “only a priest”–I’m simply stating the obvious–that the part of you that a priest is expert in is your soul and not your joints or a pregnancy or teratogenic medications! I have NEVER yet found the Catholic church to be unreasonable or to deny anyone sincere medical care. I don’t know your rheumatologist obviously–but what I do know is that if he or she isn’t Catholic, he or she might explain very well to YOU why you need to be on something like methotrexate but fail to explain why you need to be using a secondary method of contraception other than NFP while on it–which is the actual information which you will need in order to talk intelligently to your priest and allow him to make a rationale decision!

What I’ll pray is that in the future, you’ll be well enough at some point to come off the meds at least long enough to have at least one or even two more children to love and enjoy! They are SUCH a blessing–and as a woman now in my 60’s with 5 kids–my only regret is not having had 10!! LOL! Good luck and God bless and heal you!

 

[St_Francis]

Starrsmother,
I fear you have been misled–there was a huge reaction against Humane Vitae and unfortunately, some of the rebellious and sinful teachings are still in circulation.

I think you should absolutely speak to your priest–but I do know as a Catholic health care provider, that dispensations to allow condom use have been granted in a number of cases–even in such cases as where where one of the parties is HIV positive and thus unprotected intercourse could result in the other party being exposed to a nearly fatal illness.

In the case of AIDS or HIV+ condom use, what Pope Benedict said was that, for example, an HIV+ male prostitute who used a condom to protect his customers from getting the disease would be “making a first step towards a different way, a more human way, of living sexuality.”

No one is permitted to give some sort of “dispensation” for committing an intrinsically evil act.

Methotrexate is an older generation chemotherapeutic drug. As such, it destroys “fast growing tissue”–which is why it works to kill tumors–as they are very, very vascular and grow more rapidly than most surrounding human tissue. It also has a use in obstetrics that many people don’t realize–but that I feel is equally valuable! We use a shot of methotrexate to dissolve an ectopic or “tubal” pregnancy if said pregnancy is discovered before it is so far along that it bursts the tube. Since the advent of early pregnancy tests and the use of methotrexate to dissolve these early extra-uterine pregnancies, many women’s very lives have been saved. If a fallopian tube bursts, the woman almost always dies rapidly as she bleeds out internally. I had an aunt–much older than even my own parents–who died, leaving a husband and 6 or 7 kids motherless, because of just such an ectopic pregnancy that burst! In the not-so-distant past, such things happened frequently. Moreover, methotrexate use can actually SAVE a woman’s fertility, as if you simply dissolve a doomed tubal pregnancy, you are able to not remove the entire tube on whichever side the pregnancy occurs–which once was be the only treatment and only way to save the mother, if you discovered a tubal pregnancy early enough to save her life at all. Back then, the BEST outcome that could even be hoped for was that a woman would lose a tube and half of her future fertility–but at least continue to live!

Using methotrexate to kill a baby in the Fallopian tube so end an etopic pregnancy is still abortion, and is still sinful. It is an immoral way of dealing with this type of pregnancy. The Fallopian tube can be removed, as before, but the methtrexate may not be used.

Frankly, if you got pregnant while on methotrexate–which is a bonafide treatment for RA by the way and which is usually tried before using Humira, Enbrel or any such injectible medication–I’d bet you wouldn’t carry the pregnancy anyway, and that’s again if it even occurred and wasn’t spontaneously lost. Most likely, the methotrxate would dissolve the embryo–and you’d never even know you’d been pregnant. IF, however, in the one in a million chance that somehow a pregnancy occurred on methotrexate and then actually continued–you’re right–the fetus would have some of the most horrible deformities you can ever imagine–and I DO MEAN HORRIBLE!!! I’d explain all this to your priest and I bet you’ll be dispensed–as you are truly only wanting to use condoms due to a medical treatment, and one which is certainly needed and warranted.

The priest is not permittted to give this kind of “permission.”

 

[on_the_hill]

Let’s have faith that if God has a beautiful plan for you and the baby which may have been conceived despite your best efforts using NFP, His plan for you and the child will be a beautiful one.

If I were in this situation, I would not put the Lord my God to the test.

 

[St_Francis]

Thank you StarrsMother for your very helpful reply. I would be taking 10-15 mg of the methotrexate so it’s not as strong as chemo but still causes concern. I’m currently following the Creighton Model of NFP bc I’ve had irregular cycles in the past, so I feel that is pretty conservative. I will set up a meeting with my priest and see what he says. I don’t feel abstinence is an answer because I could be on this for 10+ years if it works. Pretty sure my husband won’t be on board with that!

Thanks to all that replied!

DeeDee,
Unfortunately, Starrsmother has had bad information. A priest cannot “give permission” to perform an act which is in and of itself wrong. There are various forms of NFP, perhaps you could look into using two kinds as a back-up, or perhaps you could get one of those sensors which allows the investigations to be more accurate?

If your husband were to decide to use condoms *over your objections *(which you just need to make clear to him, not fight over or bring up every time), then he would be culpable for the sin, and you could still fulfill the marital act–you would not be required to abstain if he were using a condom.

But this would still be a sin on his part, so you would want to be praying for him to be more open to what the Church is teaching in this respect, and keeping yourself in Church teaching as well.

 

[St_Francis]

If I were in this situation, I would not put the Lord my God to the test.

One does not “put the Lord to the test” by obeying His commandments…

 

[on_the_hill]

One does not “put the Lord to the test” by obeying His commandments…

Then what do you call taking that risk?

 

[Usige]

No one is permitted to give some sort of “dispensation” for committing an intrinsically evil act.

…

The priest is not permitted to give this kind of “permission.”

Yes, yes, 1000 times yes. In the catechism section 2370 it is made very clear that contraceptive acts are intrinsically evil. This is the oft repeated teaching of the Church and there is never any ambiguity on this issue. Intrinsic evil cannot be situationally dispensed. Unfortunately too many (presumably) well meaning priest will tell people it’s okay when it is not in their power to “authorize” evil acts. I pray for ever priest when I hear them give people the “okay” to do this.

Using methotrexate to kill a baby in the Fallopian tube so end an etopic pregnancy is still abortion, and is still sinful. It is an immoral way of dealing with this type of pregnancy. The Fallopian tube can be removed, as before, but the methtrexate may not be used.

Thank you for pointing that out. You cannot “dissolve” a pregnancy; in reality this is killing a child one cell at a time. The whole concept of dissolving a child turns my stomach. If it offends me that way I can only imagine the reaction of God to such an act.

 

[Rau]

Then what do you call taking that risk?

That risk would likely be sufficient motivation to abstain from sex when pregnancy is possible. Sadly, I know of no other moral approach.

 

[St_Francis]

Then what do you call taking that risk?

I suggest that you find out what is meant by putting the Lord to the test; you don’t seem to understand what it means.

 

[maryjk]

TxDeeDee1028

I am in a very similar situation. Only up the amount of the medication.

You, like me, have two choices. Total abstinence or periodic abstinence. I have chosen periodic. Yes, it can be a long row to hoe. But I think total abstinence would be even more difficult.

And, no, a priest can’t give you permission to sin. So, yes, you could talk to a priest. But he can’t tell you to use a condom. And no, in doing that, he isn’t denying you your medication.

Honestly, if you are afraid that NFP won’t work, why would you trust condoms?

 

[Evania]

I honestly think if you lay it out to your priest totally and reasonably–much as I did in my post to you–or even to your bishop if your priest somehow feels unsure himself—that a dispensation will be granted! As a Catholic provider, I do run into these things. Your treatment plan is perfectly reasonable and right on target with current medical management. I know my post was lengthy (sorry for that!), but I just wanted to give you some factual information to use to explain to your priest. Remember, he isn’t a doctor obviously and quite probably is unfamiliar with RA, women’s healthcare and many medications etc. I’m not saying that he is dumb or “only a priest”–I’m simply stating the obvious–that the part of you that a priest is expert in is your soul and not your joints or a pregnancy or teratogenic medications! I have NEVER yet found the Catholic church to be unreasonable or to deny anyone sincere medical care. I don’t know your rheumatologist obviously–but what I do know is that if he or she isn’t Catholic, ****he or she might explain very well to YOU why you need to be on something like methotrexate but fail to explain why you need to be using a secondary method of contraception other than NFP while on it–****which is the actual information which you will need in order to talk intelligently to your priest and allow him to make a rationale decision!

What I’ll pray is that in the future, you’ll be well enough at some point to come off the meds at least long enough to have at least one or even two more children to love and enjoy! They are SUCH a blessing–and as a woman now in my 60’s with 5 kids–my only regret is not having had 10!! LOL! Good luck and God bless and heal you!

If used correctly, you wouldn’t need anything other than NFP. You can’t get pregnant if there is no egg to fertilize. The whole purpose of NFP is to know your body and chart your fertility. With birth control, whether condoms or the pill, there could still be a chance where a conception takes place due to that egg being present. You may have longer abstaining periods than the typical NFP couple, but it can also be an invitation to be creative with non-sexual romance.

 

[on_the_hill]

I suggest that you find out what is meant by putting the Lord to the test; you don’t seem to understand what it means.

Well, when Jesus stood on the…whatever he was standing on…and Satan told him to jump, Jesus said don’t put God to the test.

Isn’t that substantially the same as risking a horrible outcome while having faith God will make it good?

I’m not meaning to be argumentative.

 

[TxDeeDee1028]

I would use the condom in addition to NFP. I would not have sex on my unsafe days. I would just have the condom as extra protection. I am 36, total abstinence is NOT an answer. I’m trying so hard to live a Catholic life, but ya know, sometimes it’s a real pain. I’ll talk to my priest anyways.