The Uses and Abuses of CycleBeads

The United Nations Population Fund (UNFPA), the world’s premier pusher of population control on Third World peoples, has recently cottoned onto a form of natural family planning (NFP). Long a global promoter of hormonal contraceptives such as the pill and the injectable Depo-Provera, not to mention the diaphragm and numerous other forms of artificial contraception including the ever-popular but unreliable condom, UNFPA and its bought-and-paid-for Third World government health division collaborators increasingly promote CycleBeads, a scientifi cally refined form of the old rhythm method.

Hundreds of thousands of women worldwide now use this technique, thanks primarily to the secular programs and governments distributing it. Why are these people now promoting a simple type of NFP, and is CycleBeads a good or bad method of “family planning”?

America’s own leading dispenser of condoms worldwide, the U.S. Agency for International Development (USAID), is a prime funder of Cycle-Beads’ growing global distribution. USAID has not been noted in the past for a healthy interest in NFP. One of CycleBeads’ advantages is its ease of use. Unlike sympto-thermal methods, CycleBeads uses timing alone.

CycleBeads literature says, “Cycle-Beads are a color-coded string of beads that represent a woman’s menstrual cycle. Each bead represents a day of the cycle and the color helps a woman to determine if she is likely to be fertile that day. The day a woman starts her period, she puts the rubber ring on the red bead. Each day she moves the ring one bead, always in the direction of the arrow. When the ring is on the red bead or a dark bead, there is very low likelihood of pregnancy, so she can have intercourse on these days without getting pregnant. When the ring is on a white bead—Days 8 through 19—there is a high likelihood of getting pregnant if a woman has unprotected intercourse.”

Not only does CycleBeads not require observations of symptoms or body temperature, it requires no calculations or charting. But it works for certain women only. “Please note [that] the Standard Days Method, on which CycleBeads are based, works best for women with regular menstrual cycles that are between 26 and 32 days long. Women with cycles outside this range should use a different method of family planning,” says CycleBeads literature.

“Most women have most of their cycles within that range,” says Cycle-Beads inventor Dr. Victoria Jennings, Director of the Institute for Reproductive Health (IRH) at Georgetown University Medical Center. But, she said, women’s cycles do vary and can be affected by many factors from breastfeeding to menopause.

However, she said, her studies have found that for women whose cycles conform, CycleBeads fails only 5% of the time with correct use and 12% of the time with typical use. That means that 5% of sexually active women using CycleBeads become pregnant within a year if they use CycleBeads with exactitude, and 12% using it the way it’s typically used in the real world become pregnant within a year.

THE DEBATE OVER EFFECTIVENESS

Other Catholic proponents of NFP say that there are far more effective natural methods to use. “It’s 5% failure rate is far higher than the Billings symptothermal method,” says Steve Mosher, President of Population Research Institute. “If the UNFPA is going to provide natural family planning, why doesn’t it promote more advanced natural family planning, more reliable natural family planning? For years, UNFPA has refused to accept any method of natural family planning as a ‘modern method of family planning.’”

Billings’ China study found a 1% failure rate for the Billings method, but only if the system, with its various measurements, is followed precisely. Yet if delaying childbirth is a necessary and justified goal, is starting at a 5% failure rate under optimal conditions acceptable when other NFP methods do so much better?

Jennings does not agree that other NFP methods necessarily have a lower failure rate in the real world, where people make mistakes, become busy, or simply get lazy. CycleBeads is relatively easy to follow, she points out. “It’s very visual,” she said. “It’s very easy to understand and use. It doesn’t require counseling over a long period. It can be used by people with a low literacy level.”

Proponents of more sophisticated methods say that it’s the Standard Days Method on which CycleBeads relies that does not take into account the real world. “A woman’s pre-ovulatory phase can vary significantly, even for the same woman,” wrote Dr. Ligaya B. Anacta-Acosta, Executive Director of Human Life International-Asia, in a paper she presented to the Philippines Catholic bishops’ conference urging them not to propagate the SDM. “Why is this? By the workings of many factors, such as stress due to pressures at home or on the job, fi nancial concerns, family discord, weight loss, even travel and other triggering factors; medication; illness; nutrition; menopause; breast-feeding; and when the woman is coming off previous hormonal contraception, among others. It must be emphasized that the cycle is not identical for all women. Even in the same woman, it can change from cycle to cycle. A woman never knows in advance how long her cycle will last.”

Dr. Acosta says that simply counting beads isn’t good enough. “Thus, should a woman with previously regular cycles have a delayed ovulation due to any of these factors, she will still be fertile when the SDM beads falsely indicate that she is in the post-ovulatory or infertile phase,” she wrote (emphasis in original). “On the other hand, if she has an unusually early ovulation, the same beads will indicate falsely that she is still in the pre-ovulatory or infertile phase when she has actually become fertile. In the case of pre-menopausal women, SDM is also bound to fail, becausecycle durations are bound to vary markedly.”

“Definitely SDM is seriously flawed and meant to tell people that NFP does not work,” said Dr. Acosta in an e-mail to CWR. She believes that people who try an SDM method will fi nd it ineffective and then conclude that NFP is ineffective, possibly prompting them to switch to artifi cial contraception.

Another possible impetus toward artificial contraception is CycleBeads’ long abstinence period of 12 days. “Technically, a woman is fertile only up to 24 hours of the cycle because the egg can survive only up to a maximum of 24 hours,” says Dr. Acosta. “Without the egg, no pregnancy can take place. However, researchers have shown that ovulation can happen either on the peak day or one to two days before or after the peak day—thus an abstinence [period] of only about five days” is necessary.

A METHOD PROMOTED WITH CONDOM USE

Beyond the question of CycleBeads’ efficacy is the question of how it is being promoted. Dr. Acosta, a former Philippines Department of Health employee, quoted the manual that the government distributes: “Emphasize to your client that if she does not want to get pregnant, then she should abstain from sexual intercourse when the marker is on the white beads. Otherwise, she should resort to a back-up method like asking her husband to use a condom.”

Acosta reported, “From my personal experience at DOH, condoms have always been part of SDM training, particularly when there are no participants from the Catholic Church. Abstinence in fact is not encouraged.”

The U.S. government is the major financier of CycleBeads. A September 10, 2007 press release from USAID and IRH says, “Building upon two decades of developing highly effective, easy-to-use fertility awareness-based methods of family planning and introducing them worldwide, the Institute for Reproductive Health (IRH) at Georgetown University Medical Center has been awarded a five-year, $38 million grant by the U.S. Agency for International Development (USAID) to expand access to these methods and ensure their sustainability in developing countries. USAID has been funding the Institute since 1985. IRH is an international leader in the development of fertility awareness-based methods of family planning, also known as natural family planning.”

SDM and another method invented by IRH, the Two-Day Method, have received the official stamp of approval from the World Health Organization, and it hardly gets more establishment than that. “The recently released Family Planning: A Global Handbook for Providers includes a chapter on fertility awareness based methods of family planning highlighting the Standard Days Method and the Two-Day Method…,” says a July 10, 2007 press release.

“The publication, developed by the World Health Organization, Johns Hopkins University, and the United States Agency for International Development, is used by family planning providers worldwide, especially in developing countries. ‘With the inclusion of the Standard Days and Two-Day Methods in the WHO family planning handbook for providers, we anticipate that many more providers around the world will offer fertility awareness methods, thereby increasing women’s access to these effective, easy-to-use, low-cost options,’ said Victoria Jennings, PhD….”

In her May 13, 2008 (a spiritually significant date for a method that looks like a set of rosary beads) article talking up CycleBeads called “Happily Strung Along: In Senegal, Women Count Beads as Contraception,” UNFPA writer Kathleen S. White said, “For a woman with a regular menstrual cycle that falls between 26 and 32 days in length, Cycle-Beads can identify when she is most likely to conceive. During that time, she and her partner either abstain from sex or use another form of protection.” Later in the article, White paraphrased an expert who specifi cally discusses “the periodic abstinence or condom use necessary with CycleBeads.”

Clearly, UNFPA is not promoting CycleBeads as a purely natural form of family planning, but is rather linking NFP with condoms in at least some Third World women’s minds.

Jennings herself does not promote condoms for use with CycleBeads, and notes that abstinence during the fertile period is a far more effective method of family planning. But she and Georgetown do not manufacture and distribute CycleBeads; instead, it is licensed and sold to others. USAID and UNFPA- funded programs, as well as others willing to pay to distribute CycleBeads, can package it as they see fi t. Asked if some people were promoting condoms for use with CycleBeads, Jennings replied, “They may be. I don’t know.”

She also says that though few do so, some women use CycleBeads as an easy way to increase their chances of having a child by identifying their fertile periods.

THE CATHOLIC RESPONSE

Said Fr. Thomas Euteneuer, President of Human Life International, in an e-mail to CWR, “Why would the antilife organizations all of a sudden be so in favor of an NFP method? Simple, it is a counterfeit. The CycleBeads mimic the form of the rosary (it is also promoted heavily in Catholic countries for that reason) and offers the condom back-up as a way to step them into condom-dependence. Furthermore, the ‘method’ is nothing more than the outdated ‘rhythm’ method and therefore is bound to fail. ‘Unwanted pregnancies’ and condom dependency will undoubtedly result through massive promotion.”

The U.S. Conference of Catholic Bishops (USCCB) provides information about CycleBeads to those who ask. “We’re not officially involved with it, but we know about it and talk to diocesan officials and answer questions about it,” says Theresa Notare, Assistant Director of the Natural Family Planning Program division of the Secretariat for the Laity, Marriage, Family Life, and Youth. “I encourage them to consider using it with other forms of natural family planning.” She acknowledges that the instructions that come from CycleBeads’ manufacturer are not used by Church programs that promote CycleBeads. “They do not say ‘use condoms,’” she says. But “they say ‘partner’ and ‘unprotected sex.’” So other documents were created “that are more appropriate for Church sponsored natural family planning programs,” she says.

CycleBeads is not USCCB’s NFP method of choice, Notare says, because women’s menstrual cycles can vary so much. With sympto-thermal methods, “ a woman watches every day for the signs she’s going to be fertile,” she explains. “So if she has emotional stress or other kinds of stress in her life, she knows if her cycle changes…. CycleBeads doesn’t allow for that, so it only works for a certain percentage of women.”

Notare says that though there is a danger that CycleBeads could lead users who become pregnant to decide that NFP in general does not work, its ease means that it “might open the door to learning about basal body temperature” and other, more sophisticated methods of NFP. “It’s a first step for some people…,” she says. “I suggested to Victoria Jennings that they put into their material a paragraph saying that there are other methods of natural family planning. They haven’t done that.” She, too, said that she’s not sure Cycle-Beads isn’t often promoted with condoms outside of Church-organized programs. “I wouldn’t know exactly how it plays out in reality,” she concedes.

Notare commended IRH and Georgetown for trying to make NFP accessible to more people. Most scientists don’t bother, she says. “That’s the problem with most people who do research on family planning and contraception,” she says. “They have lost the complete vision of the human person.”

Not to mention journalists. “A few weeks ago, when I was interviewed by a reporter for Ms. magazine about natural family planning, he asked if I believed the world was overpopulated, and I said, ‘No,’” she says. “He was shocked.”

THE UNFPA’S MOTIVATION

UNFPA celebrates the fact that CycleBeads is reducing birthrates among people who otherwise would not use family planning, even as the world’s birthrate plummets.

CycleBeads is “particularly suited to West Africa, where the influence of religion is high and contraceptive prevalence is low,” White wrote in her May article. “Though the beads do not protect against HIV or other sexually transmitted infections, a major appeal is that they are entirely natural and without any side effects. CycleBeads offer an additional contraceptive option for women who have religious or health concerns about other methods, or for whom cost or supplies may be an issue. For this reason, the beads may expand the number of women who choose to manage their fertility.” In Senegal, she wrote, “religious and cultural beliefs put women at risk for early and frequent pregnancies and inadequate obstetric care.”

Jennings said that CycleBeads users by and large have not switched from other forms of family planning. “I can say almost unequivocally that it’s a new group of people,” she says. IRH’s website reports, “More than half the women who selected the Standard Days Method had never previously used family planning and on average, contraceptive use increased by 8% in communities where the method was introduced, according to an article published in the March 2008 issue of the journal Contraception.”

UNFPA also expresses its condemnatory attitude toward anyone who doesn’t celebrate condoms even in its CycleBeads article, suggesting that men who won’t use condoms are sexist pigs. “Dame Gueye, co-coordinator of the CycleBeads program at [UNFPA-funded group] Tostan, explains that some husbands were resistant to the periodic abstinence or condom use necessary with CycleBeads,” says UNFPA. “Almost exclusively, they were those who work in major cities during the week and return to their villages on the weekends, he says. ‘Some men say, “Why would I use a condom with you when you are my wife?”’ Gueye explains. ‘Unfortunately, there are men who don’t make women’s health a priority.’”

Jennings insists that most women who use CycleBeads in Africa use abstinence during their fertile periods. “We say people should avoid unprotected sexual intercourse, and that abstinence is the most effective method…. Other methods are not only against Catholic teaching, but can fail,” she says.

Jennings says that CycleBeads is “available in 25 countries around the world.” In Africa, it is currently being distributed in Benin, Senegal, Rwanda, Kenya, the Congo, Mali, Madagascar, Guinea, Malawi, Tanzania, Nigeria, and Burkina Faso. In some of these countries, she says, Catholic bishops are supporting the distribution of Cycle- Beads. She estimates that approximately 300,000 African women currently use CycleBeads and she hopes two million will be using it within fi ve years.

“In India, there are quite a few people using it,” perhaps another 300,000, she says. “The Philippines is another setting where they have really caught on. In Latin America, it varies by country.” USAID does not focus on Mexico or Brazil, so some of the smaller countries such as Guatemala, Peru, and Bolivia are the ones with distribution programs.

CycleBeads is also easily available in the United States. It recently was available on Amazon for the very reasonable one-time cost of $10.37 plus shipping. And CycleBeads’ manufacturer now makes a version for the more discerning woman: “I am pleased to tell you that in response to customers’ requests, Deluxe CycleBeads are now available. This upscale version of CycleBeads is made of man-made cat’s eye, and comes in three beautiful colors—aqua, copper, and mauve.”

CycleBeads is not illegitimate in itself, and it may work well as an easy-to-use option for those exceptional women with very regular cycles that fall into CycleBeads’ window. But considering the availability of NFP methods that watch for the changes in women’s cycles, and especially given the common association of CycleBeads with condom use, it’s something Catholics should avoid promoting.