web 20170524T0958-9787-CNS-INDIA-REMIND-APP-HEALTH.jpg Sunita Prajapati, right, an accredited social health activist, counsels village women on maternal health at her village in Uttar Pradesh, India. (CNS/Catholic Relief Services/Jen Hardy)

It's a strange church that would see the anniversary of its ban on contraceptives as a cause for celebration. But in perhaps one of the more curious displays of Catholic exceptionalism, Catholic institutions and organizations around the world are presenting Masses, symposiums, documentary films and other kinds of jamborees to fete the 50 years that have passed since the publication of Humanae Vitae, Pope Paul VI's encyclical that forbade the use of artificial contraception. Reactions to Humanae Vitae, it often seems, can be categorized in two extremes: the natural family planning fanatics who extol the document as prophetic and courageous; and the vast majority of lay Catholics who have rejected the teaching, finding it so unreasonable that it isn't worth another thought. A 2016 Pew Research Center study reported that 89 percent of American Catholics believe that contraception is either morally acceptable or not a moral issue at all, making an almost irrefutable case that Humanae Vitae's descent into irrelevance has only deepened with time.

But what gets lost in the Catholic laity's dismissal of the church's directives on contraception is the fact that for countless people around the world, the doctrine has been profoundly consequential. Those who believe that that church's ban on artificial contraceptives does not matter need to hear this wake-up call: Untold numbers of women and children have died, will die and are dying right now as a direct consequence of Humanae Vitae. According to a 2016 report by the United Nations Population Fund titled "Religion, Women's Health and Rights," each year globally there are 290,000 maternal deaths, 74 million unintended pregnancies and 3 million newborn deaths. Adding to this catastrophic suffering, a 2016 study published in the Lancet found that nearly one in four pregnancies ends in abortion worldwide, with 90 percent of abortions occurring in developing countries where people have limited access to family planning services and contraceptives. One would think that these grim statistics would be enough for the Catholic hierarchy to reconsider its position or, at the very least, initiate an honest assessment of the ways in which its doctrine might be exacerbating this human tragedy. But the bishops have only dug in their heels, using their health care facilities, financial resources and political influence to make the church perhaps the most powerful force in the world driving the movement to restrict access to birth control. When Catholic theologians and ethicists argue against Humanae Vitae, they ultimately appeal to the church's teaching on individual conscience as the final arbiter in moral decision-making. The problem with this argument is the fact that the Catholic hierarchy is making it increasingly difficult for individuals to exercise their consciences. Realizing long ago that it had lost its authority over the faithful regarding contraception use, the bishops changed their strategy, investing their energy in promoting laws and policies that force individuals, Catholic or not, to obey their doctrine on conception. And they have been remarkably successful in their campaigns worldwide.

'Humanae Vitae': The maturing of church teaching To mark the 50th anniversary of Humanae Vitae, NCR has been publishing a multipart series of essays examining Humanae Vitae through the lens of time. The series is intended to map the influence of Humanae Vitae, the impact this teaching on birth control has had in the Catholic community and where it might be pointing us in the future. Catch up at NCRonline.org/feature-series/humanae-vitae-at-50/stories.

For decades, the Holy See, which has permanent observer status at the United Nations, has used its influence at the U.N. to object to declarations, charters and sustainable goals that make reference to sexual and reproductive health and contraception. The Vatican routinely uses its U.N. status to create coalitions with conservative Christian organizations and hardline Islamic governments to derail consensus on actions on family planning and HIV/AIDS prevention. In the Philippines, the bishops spent 15 years in the courts blocking the passage and implementation of a reproductive health care bill, even though 72 percent of Filipinos believe the government should provide free supply or service to the poor who wish to use any family planning method. Like most families around the world, Filipinos long to be able to choose the timing and number of their children so that they can adequately feed and educate their families. More than a quarter of Filipino people live on the equivalent of 62 cents a day, and some families are forced to abandon their children to the streets because they cannot provide for them. In African countries with large Catholic populations, the bishops refuse to acknowledge the impact that contraceptives could have on reducing Africa's high maternal mortality rate. Instead, they concoct far-fetched claims that birth control is part of a culture of death that leads to the "hypersexualization" of youth and the destruction of human society. Even in the United States, the U.S. Catholic bishops have exerted enormous influence in rolling back the contraceptive mandate in the 2014 Affordable Care Act. The intensity of their lobbying and their high-powered legal teams, supported by well-oiled groups like the Becket Fund for Religious Liberty, not only led to success in the courts, but also built up enormous political capital that paid off with the election of Donald Trump, who fulfilled his promise to extreme religious leaders by signing an executive order that allows any employer, religious or secular, to opt out of the contraceptive benefit on the basis of any vague moral objection. That benefit allowed 55 million women access to contraception at no cost. So, as is the case with restrictions on contraception around the world, it is the poor, the sick, the suffering, the sexually violated and the most vulnerable who are most impacted by the bishops' ideological battle.

web 20170720T1620-0336-CNS-FAMILY-PLANNING-APPS.jpg Natural Cycles' contraception device and smartphone app are seen in this photo. (CNS/Natural Cycles)

The bishops also exert control by reigning over Catholic health systems. An estimated 25 percent of health care facilities in developing countries are operated by Catholic institutions, making the church the world's largest non-governmental provider of health care services. Even in the United States, one out of six hospital beds is in a Catholic facility. For women living in rural areas with no transportation, sometimes the only option is a Catholic health facility. For women languishing in refugee camps or on migrant pathways where incidences of rape are high, or for those being trafficked, sometimes the only charity that can help them is a Catholic relief agency. In all of these cases, none of these women are able to receive contraceptives, reproductive health care befitting their dignity and their needs. And this is really the heart of the matter. We have a church that sponsors so many excellent services for the marginalized, a social justice tradition that promotes care of the poor and sustainability for the Earth and a pope who has won the world's affection with his radical message of love for the destitute, the sick and the refugee, and, yet, this same institutional church staunchly enforces a teaching that only exacerbates the plight of those who already suffer disproportionately. Some have argued that the hierarchy's ongoing fight against contraception is a sign of how little they understand modern family life. But priests and bishops cannot possibly be so isolated from human experience that they do not understand the necessity of using birth control to maintain a manageable family size. There is something bizarre and unseemly about a group of celibate men who have such a preoccupation with controlling women's fertility. One cannot help but wonder to what extent this obsession relates back to the hierarchy's own training for the priesthood. When most of these men were in formation, few had any meaningful interactions with adult women. For heterosexual men in seminary, a woman was seen as a temptation, and her sexuality something to be regarded with fear or loathing, since it could lead to a fall from grace. Gay seminarians, on the other hand, likely had little interest in female sexuality at all. In fact, some may have joined the priesthood to escape it. Most priests were taught three models of female sexuality: the pure and holy virgin, the chaste mother who only engages in sex for the sake of conceiving a child, or the wanton woman who is in need of repentance and the directive to "sin no more." These men were never expected to imagine what a women's real life was like, what kinds of complexity she faces in her decision-making and what capacity she has to make judgments about her own sexuality.

There are many repercussions from the hierarchy's refusal to listen to women and to involve women in decision-making and the development of doctrine, but the ban on contraception may be the most tragic one of all, since it has caused and continues to cause immeasurable suffering. Tweet this

It is little wonder that the hierarchy compulsively acts as if they have been charged as guardians of women's purity; the ongoing exultation of the ban on contraception positions the church as a bastion of "old-fashioned values." Some who argue against contraception claim it has enabled men to use women for their own sexual gratification and therefore hurts women physically, emotionally and spiritually. This suggests women are so feeble of mind that they can be easily seduced by men or conned by culture. Either way, women are not trusted to make decisions about their own bodies, and the thought of women willingly engaging in sexual activity in an equitable partnership remains the great unmentionable. There are many repercussions from the hierarchy's refusal to listen to women and to involve women in decision-making and the development of doctrine, but the ban on contraception may be the most tragic one of all, since it has caused and continues to cause immeasurable suffering. On this anniversary of Humane Vitae, let us not forget what a luxury it is to have the freedom to disregard the church's teaching and to have the resources to access contraception. Even though, for many of us, this doctrine does not impact our daily lives, for so many of our sisters and brothers, the need to dismantle it is an urgent matter of life or death. To remain indifferent to the issue is allow the Vatican to continue to do great harm and terrible injustice. [Jamie L. Manson is NCR books editor. Her email address is jmanson@ncronline.org.] Editor's note: We can send you an email alert every time Jamie Manson's column, "Grace on the Margins," is posted to NCRonline.org. Go to this page and follow directions: Email alert sign-up.