A report by the United States Conference of Catholic Bishops (USCCB) found diocesan natural family planning (NFP) programs across the country are experiencing continued low course completion among couples.
In January 2025, 196 dioceses were invited to take part in the annual Diocesan Natural Family Planning Ministry National 2025 Profile Report by the USCCB. Of the dioceses, 61 completed the questionnaire.
Similarly to past years, there is a wide gap between the numbers of couples who enroll in an introductory NFP education program and those who follow up with a full course.
The report found that a total of 18,211 individuals received some information or instruction on NFP across dioceses in 2025. In comparison, there were only 7,518 individuals who attended a full course in NFP.
The report noted that further research must be done among dioceses to understand the disparities and adjust NFP efforts to combat them.
It is important to strengthen NFP programs for many reasons but especially for the overall health of women, according to Dr. Annevay Conlee, vice president of the Women’s Health Service Line at OSF HealthCare, an integrated health system founded by the Sisters of the Third Order of St. Francis.
“When looking at the overall health of the couple, but also the woman in particular, fertility awareness-based methods (FABMs) are better than artificial contraceptive methods when looking at the wellness aspect and monitoring health, recognizing abnormalities, and being able to help in a restorative way sustain and support health,” Conlee told EWTN News.
“It does not cause the side effects and long-term potential consequences that contraception does,” she said.
To best ensure that couples continue the NFP learning process, Conlee suggested dioceses and other NFP providers ensure that they offer different types of options to “fit the needs and time commitment of the couple,” she said.
Also, they should be “making sure that there is awareness of not only the ability to achieve and avoid pregnancy with this but also monitor health and wellness,” she said.
Report reveals few employees and low budget
The 2025 report also found that employment for NFP programs differs among dioceses.
Of the 2025 respondents, 30% reported they rely on paid part-time staff and volunteers, and 16% have a full-time paid NFP coordinator.
Most instructors are volunteers (58%) who do not receive any stipend, while some are volunteers who do receive a stipend (16%) to cover expenses.
Steve Mattern, senior vice president of mission services at OSF HealthCare, noted high levels of volunteers may contribute to some of the low numbers.
“It seems like volunteers staff much of the demands of this work and while some … pre-marriage work does involve expectation of education and training, many dioceses do not expect this nor have the ability to serve it if they did expect it,” Mattern said.
“Still, there are some wonderful things happening where the next generations of Catholics are stepping up to give witness talks, to help give orientation, and to support education,” he said.
Along with employees, the survey also found that limited funding continues to be a significant issue for NFP programs. Of dioceses surveyed, 68% budgeted less than $5,000 for NFP programs.
Most diocesan NFP programs rely on indirect funding from other sources including donations from parishes, grants from local Knights of Columbus councils, a fee for course instruction, and follow-up fees, according to the report.
Next steps for the Church
“We hear anecdotally in healthcare that fewer couples are coming to seek marriage in the Catholic Church,” Mattern said.
As “more people are living together and may be seeking marriage outside the Church when they do marry,” there is more of a question around what “needs to be in the required marriage prep pathway,” he said.
“Should the couple go through a course of their choosing within a range of offered methodologies for NFP, and should the diocese offer a coupon or resource for them to do this?”
“This has been tried and it does work; many do go on to take a course offering,” he said. “However, other dioceses may seek to do a very basic course … and may not really get to NFP or may make only a brief mention of it.”
“It seems like a strong and effective communication approach and partnership across both the diocese and the Catholic healthcare ministry, and its professionals can bring a stronger approach for life and for the good of these couples and their family life,” Mattern said.
Overall, “people still need basic awareness of what the fertility awareness-based methodologies offer and provide and so this work is ongoing and invites our creativity, hope, and imagination,” he said.
While discussion around NFP is usually in regard to pregnancy, “it is so much more important to start forming our minds and hearts when we are young and in the context of our families,” Sister M. Mikela Meidl, FSGM, president of OSF HealthCare, said.
“Learning about modesty, purity, and the beauty of our bodies as we grow and develop helps create an openness to understand ourselves long before we marry,” she said.
“Supporting and helping parents to hold these conversations without embarrassment and full of confidence and attentive listening will go a long way in making people desire what is true and good,” she said.
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