The John J. Billings Memorial Lecture
The ‘Billings Revolution’ 70 years later: an intuition that changed history
Paola Pellicanò MD, PHD
28-29th April 2023, Università Cattolica del Sacro Cuore, Roma
WOOMB International Congress
In the introduction to the famous novel “I Promessi Sposi” (The Betrothed),1 , Alessandro Manzoni defines history as “an illustrious war against time”; in fact, history frees the years – because the time has made them prisoners and made them die – and brings them back to life. But history generally brings back to life the stories of great people or heroes, these stories the author does not feel worthy of narrating; therefore, he begins to describe the events of ordinary people. The result will be one of the greatest books of all time!
It is one limitation to turn the spotlight exclusively on major events; to think that, in order to write history, it is necessary to immediately achieve great results, skipping small stages, discarding small details or secondary protagonists … Pope Francis is instead teaching the law, valid both in the scientific and in the socio-educational fields, of triggering processes, patiently inhabiting time, rather than occupying spaces, especially spaces of power 2. Triggering it is like lighting the small flame of a fire, which will then flare up, or throwing a seed destined to grow on the ground. And the “Billings Revolution” is a process triggered 70 years ago, starting from an “intuition” which, like a seed on the ground, has blossomed in history and has changed it.
The First Intuitions
The history of the mid-twentieth century was the story of an awakening. Coming out of the Second World War, and of the horrors that had marred it more than any other conflict, humanity seemed to react, albeit with difficulty. While an economic and demographic renaissance was making its way in many countries and the world was witnessing the solemn proclamation of human rights – although with the new threat of totalitarian regimes and the struggle between opposing ideologies – science was making unbelievable progresses: the trials on penicillin and the advent of antibiotic therapy date back to those years, as well as studies on the structure of proteins and on the double helix of DNA, discovered in 1953.
Also in 1953, in Melbourne, Australia, a seed was planted in the field of medical science, the flowering modalities of which no one could ever have imagined. The priest Maurice Catarinich asked Dr. John Billings for help, in order to be able to direct some couples, who desired to naturally regulate their fertility, in a simpler and more effective way compared to the scientific knowledge of the time. It was the first of many “intuitions” that punctuated the path of the “Billings Revolution”: someone in fact wrote that, by choosing Dr. Billings, Father Catarinich was certain that he would face the problem with “a scientific mind, moulded by an intuitive understanding of conjugal love and responsible parenthood”3 .
To intuit, ‘Intuire’ means, literally (from Latin ‘in tueri), ‘go inside with the look’. It means getting started, observing and penetrating the secret of things, which hides deep questions and reveals exciting news.
Dr. Billings and Father Catarinich heard the profound questions of many couples, their need to space births naturally, their desire to cultivate conjugal intimacy avoiding procreation when it becomes a cause for anxiety. Starting from those years, many people would offer the “solution” of eliminating fertility, the possibility and – gradually – the idea of procreation from the horizon of human sexuality; in fact, it was in the same 1950s that the anti-ovulation pill was tested, later spread in market as a contraceptive.
Together with the priest who involved him in the mission – for which he initially felt inadequate – Billings instead began to intuit that the Creator himself must have placed the answer they were looking for in the woman’s body and made it accessible to every woman. In other words, he intuited that it was the same biological law that made the body an instrument of the language of love, which could also be read through sexual desire, that wrote the language of procreation inside it. That was a language that every woman, regardless of her cultural or social status, should be able to understand, through the knowledge of the times of fertility and infertility of the cycle which determine the rhythms of the couple’s fertility.
From Intuition to Discovery
The initial intuition therefore opens the door to a new discovery in the field of human fertility.
Yes, the Billings Method was a discovery!
Not a simple elaboration, reproduction, measurement… a real discovery, which has led researchers to reach ‘inside’ the biological mechanism of female fertility, without manipulating or destroying it. Actually it is one of those scientific discoveries that directs the path of research and validates the hypothesis, in pursuing the goal to which the scientist has addressed himself, from the beginning, enlightened, supported and pushed by the light of his/her own conscience.
John Billings deepens his studies; he spends whole days in the library, surprisingly discovering the many references to cervical mucus present in medical literature since the mid-nineteenth century, when the English scholars Smith and Sims spoke of vaginal discharge reported by some women in the fertile phase of the cycle4. He begins to listen carefully to the women and, with the help of some diagrams prepared by Father Catarinich, teaches them to record their own self-observations daily.
The Intuition of Intuitions
It was precisely here the ‘intuition of intuitions’ that, despite the relatively rich scientific literature, no one before had hypothesized: understanding how it was the woman herself who had the perception – we could say the intuition – of the mucus: in a word, look at the mucus as a ‘symptom’!
By tuning into their own symptom and learning to interpret it, women were able to grasp the fertility pattern of mucus, to determine the ‘fertility Peak’ correlated with the ovulatory event, and to identify post-ovulatory infertility, with a precision which was soon confirmed by the studies of James Brown, biochemist and endocrinologist. Arriving in Melbourne from Edinburgh in the 60s, this brilliant scientist, originally from New Zealand, correlated women’s observations on the mucus pattern in the cycle, with blood and urinary assays of ovarian and pituitary hormones and enriched the clinical research of the Billings Method with laboratory research, supporting the first scientific publications on the Ovulation Method5. The codification of the rules of use completed the development of the Method, later called the Billings Ovulation Method®.
The Female Intuition
The contribution of a woman was missing. And the subsequent interest in the research by Dr. Evelyn Billings, John’s wife, was decisive, particularly in the interpretation of cases defined as difficult, as it made it possible to perfect the concept of pre-ovulatory infertility – the Basic Infertile Pattern -, by extending the applicability of the Method to all situations of a woman’s fertile life, even circumstances in which ovulation is delayed. A fundamental discovery, linked to a better understanding of the sensation at the vulva, produced by the mucus, the perception of which only female intuition was able to explain, demonstrating that women are the ideal teachers of the Billings Method.
Starting in the 1970s, the importance of sensation had a strong boost by the fascinating studies of Erik Odeblad, gynaecologist and biophysicist at the University of Umea in Sweden, on the physiology of the uterine cervix and vagina and on the biophysical properties of cervical mucus, whose variations in composition, induced by ovarian hormones, explain the changes in the woman’s symptom6.
If it is true that the Billings Method is an extraordinary scientific discovery, it is also true that it represents, we still see it today, a discovery for women, invited by science to humbly and amazingly listen to themselves, to understand their own fertility and, in turn, return to science a further understanding of the events of the cycle.
Yes, even today, in order to carry out research, we need women, who are not unwitting providers of clinical data but aware collaborators, in the certainty that, as Professor Brown used to say and as we constantly verify in our clinical experience, women can be more precise than the laboratory in detecting and interpreting their mucus symptom.
So how can we not see in the Billings Method almost an anticipation of modern ‘personalized medicine’, whose link with the ‘knowledge of fertility’ we wanted to reaffirm in this Congress? It leads to acquiring awareness of a ‘symptom’ that assumes specific characteristics in each woman, to knowing how to value and interpret it, both as a physiological indicator, i.e. of health, and as an alarm bell for possible pathological conditions; last but not least, as a detector of senses and meanings, in decoding the language of fertility that the mucus symptom helps to explain.
The Intuition of a Meaning
Fertility is a mystery of otherness: it refers to the complementarity of the sexes, to the dimensions of relationality and fertility constitutive of the person. And the “personalized medicine” is not simply individualized medicine. It is medicine “of the person”. The Billings began and continued their research and their teaching service for love. John had at first
promised Father Catarinich only three months of help; what kept him going was the goodness of the couples he met, their motivation in making every effort to follow the path of respect for fertility and procreation, in their married life7.
The Billings Method is therefore also a discovery for the couple, who intuit new aspects of the relationship, learning to decode a language which, if not taught, leaves everyone, especially young people, at the mercy of false teachers. It is the language of knowledge and respect, collaboration and sharing, freedom and responsibility, beauty and self-giving. It is the joyful language of the fullness of love!
When the Method began to spread, many people were sceptical about its value, even on an ethical level, thinking, for example, that the Catholic Church itself would have approved the use of the pill. John and Lyn, on the other hand, were convinced of the opposite because, they said, “we had before our eyes both the negative effects of contraception and sterilization – destroyed marriages, growth of marital infidelity and deterioration of sexuality to levels of absolute banality and perversion – and above all the positive effects of the natural method”8 even in difficult conjugal situations, when it becomes a sort of therapy for the couple relationship.
In the time of the ’sexual revolution’, the meek and silent ‘Billings Revolution’ had intuited what Paul VI was to confirm in 1968, with the Encyclical Humanae Vitae. Subsequently, it was the Pope himself who expressed his gratitude to the Doctors Billings and the certainty, renewed by John Paul II and Benedict XVI – and today by Francis!9– of the educational mission entrusted to the Method.
The verb ‘Educare’– To educate – means ‘going inside’, but to bring to light what the person is; to find the truth.
Understand and Join
“The truth is symphonic”, writes Von Balthasar10; it is the harmonic synthesis of different voices.
The Billings Method is a synthetic discipline, above all because it is based on the recognition of ovulation, a biological phenomenon that represents the crossroads of women’s global health, since ovulation is affected by endocrine-metabolic and infectious, emotional and behavioural components, lifestyles and risk factors.
It is then a Method and, as such, it makes a synthesis with life; it represents an indication of behaviour and a possibility of influencing an experience, changing personal history and more. As a method it triggers processes, entrusted to human freedom.
In a cultural situation divided between the liberalization of sexuality advocated in the West, and the demographic colonization imposed in many developing countries, John and Evelyn Billings were able to spread a simple and effective way of knowledge and freedom throughout the world, transmitting a style of teaching that does not impose, does not respond by attacking, does not fail to place trust in the person whatever their origin or previous experience. They have always reaffirmed the duty to teach the Method to everyone, even to those who, theoretically, could “not make good use of it”; although this question was initially reason for discussion, even with theologians and pastors. The Method has an “intrinsic goodness,” Lyn loved to repeat. It is simply authentic knowledge, which enables the person to “intuit”, to grasp within themselves the truth that liberates; a truth to which no one has exclusive rights
but whose understanding grows with the harmony of collaboration.
The collaboration network between competent, motivated, enthusiastic operators, that the Billings Method has been able to gather, in all the countries of the world is extraordinary: it is sufficient to have a look at this wonderful assembly to have just a very small example!
It is a horizon of peculiar unity. As happened among the three great scientists who studied it – Billings, a Catholic; Brown, Protestant; Odeblad, Lutheran – as demonstrated by its diffusion in countries with different races and languages, cultures and faiths, the Method continues to represent not only an important element of dialogue between religions, but a concrete tool to realize that ‘practical ecumenism’ which ‘appears as a providential area’ for collaboration also ‘with all people of good will’11 and can give strength to the message of defence of life, procreation, human love and peace.
Intuition and Prophecy
So much light was shed on the link between life and peace by Mother Teresa. Like all prophets, she was able to intuit the long road that the Billings Method would make in the world: ‘it is a secret that is with God’, she told John and Lyn who, already torn between work and family, asked her how the spreading of the Method, as she envisaged, would be possible. The Saint of the poor of Calcutta had intuited the prophecy entrusted to the testimony of the Billings spouses by their holiness of life and had grasped the value of their message to promote women, teaching them the knowledge of fertility as an education to their own dignity and acceptance of life, first steps on the path to peace. It was precisely during the awarding of the Nobel Peace Prize that she reported what one of her poor Indians said she had intuited: “You people who have vowed chastity you are the best people to teach us family planning. Because it is
nothing more than self-control out of love for each other”12.
In many realities, the promotion of the Billings Method is due to the intuition of consecrated women, capable of discovering, in chastity, the beauty of love fully lived in the gift of self. And to the intuition of a consecrated woman, Dr Sr Anna Cappella, we owe the beginning of all the work and diffusion of the Billings Ovulation Method® in Italy, starting from our Study and Research Centre for the Natural Regulation of Fertility of the Catholic University of the Sacred Heart, up to all the regions where the Method has spread. We owe everything to her – I would say it loudly, opening this 70th anniversary and thanks to the University that called her in 1976.
As a passionate gynaecologist and missionary in Pakistan, she did not want to abandon the poor women she was assisting, but she discovered in the Method an answer to prevent the many deaths in childbirth they were facing, as well as to educate them through the knowledge of what is in nature; she did not want to leave the clinical job she loved so much, but she discovered in the Billings a concrete and innovative way of doing medicine.
The value of this way of carrying out medicine is also demonstrated by the many awards entrusted to John and Lyn Billings – among them we recall the ‘Honorary Degree in Medicine’ offered in 2005 by the University of Tor Vergata, within an initiative promoted by the five Faculties of Medicine and Surgery of Rome.
And this way of doing medicine, which today we can call ‘personalized medicine’, is alive within the Faculty of Medicine and Surgery of the Catholic University of the Sacred Heart, a university which carries the female intuition of another great consecrated, Blessed Armida Barelli in the DNA of its foundation. Certainly, she would rejoice in our Congress. And it is significant – and it impressed me greatly – that a week ago, during the ‘Thanksgiving Audience’ for her Beatification, the Pope asked this University to be
«generative» like she was13.
The ‘Billings Revolution’ is a generative revolution!
A generativity intuited, welcomed, loved. A generativity that allows this anniversary to be celebrated not only as a memory of the past but as a bridge to the future.
Intuition: “Going Beyond”
What does such a simple message have to say to the post-modern era, which some call post-human, while in this nation the Italian Drug Agency is wondering whether to propose free contraceptives and, in many parts of the globe, the debate rages on so-called ‘surrogate motherhood’? What can we say today about great scientific progress in which the “technocratic paradigm”14 – as the Pope calls it – can bridle freedom of thought, even of scientific thought, and intuition itself?
There are many different publications on the Billings Method, starting from the first book published by John15 up to the latest Italian translation of Lyn’s text, published just yesterday16. It will be good, during this Congress, to revisit the scientific studies and see again how new technologies confirm them, shedding further light on the world of delicate hormonal mechanisms or on the wonders of cervical mucus.
But the centre of everything is always the woman’s self-knowledge. Whether it is recorded with stamps or symbols, whether it is noted in the chart or in modern applications
(apps), whether it is simplified by tying dry or green twigs on a thread to designate the fertility rhythms of the cycle, the knowledge of the self, the self-intuition, is like a golden thread that unites the woman and the couple with the privilege of giving life, developing the responsibility of cultivating the flower of fertility, germinated by love, and of recognizing and preserving its unique perfume, in the body and beyond the body.
The body is gift and task; and the body is also “pedagogy”, said John Paul II17. It is the same gift which, in order to become a task, must be lived as a method. And the method, learned through the body, is none other than that pedagogy which makes the body a gift, within the gift of love. The Billings Method leads to a broader horizon. Indeed, if it is true that ’to intuit’ means ‘to go inside’, ‘to look inside’ it is equally true that the term, starting from ancient philosophy up to the great Christian authors, has traditionally designated a knowledge in which it is not only the reason to be involved but the spirit of the person, which comes into contact with the Transcendent, with the Absolute, with God. Going inside, deep inside, therefore, the altitude of a wonderful value is illuminated, as when one enjoys the panorama from a peak to which everyone has the right to reach. But, as in the mountains, the road is not always easy and it is necessary to accompany the journey; and this – taught a great professor of our University and great pastor, Cardinal Elio Sgreccia – does not mean lowering the summit but helping the other, and helping each other, to reach it, thus opening wide a “beyond”.
You who are here today from all over the world – and we welcome you with great gratitude, joy and emotion – have taken this task and this challenge seriously, aware that, in order to reach the “summit” and the “beyond” to which the teaching of the Billings Method can lead, we need scientific intuition, personal guidance and collaboration in a network. This network unites all the countries of the world, brings us on earth closer to our friends in Heaven, links the past and the future like a bridge. Because, as John and Lyn had intuited, «we are not saying that everything will be easy, we will still have to fight for a long time», but the natural regulation of fertility is destined to be “the method of the future”18. May the story of the small seed which has flourished in these 70 years remind us!
- «L’Historia si può veramente deffinire una guerra illustre contro il Tempo, perché togliendoli di mano gl’anni suoi prigionieri, anzi già fatti cadaueri, li richiama in vita, li passa in rassegna, e li schiera di nuovo in battaglia. Ma gl’illustri Campioni che in tal Arringo fanno messe di Palme e
d’Allori, rapiscono solo che le sole spoglie più sfarzose e brillanti, imbalsamando co’ loro inchiostri le Imprese de Prencipi e Potentati, e qualificati Personaggj, e trapontando coll’ago finissimo dell’ingegno i fili d’oro e di seta, che formano un perpetuo ricamo di Attioni gloriose. Però alla mia
debolezza non è lecito solleuarsi a tal’argomenti, e sublimità pericolose, con aggirarsi tra Labirinti de’ Politici maneggj, et il rimbombo de’ bellici Oricalchi: solo che hauendo hauuto notitia di fatti memorabili, se ben capitorno a gente meccaniche, e di piccol affare, mi accingo di lasciarne
memoria a Posteri, con far di tutto schietta e genuinamente il Racconto, ouuero sia Relatione». Alessandro Manzoni, I Promessi Sposi (The Betrothed), Introduction
- «God manifests himself in historical revelation, in history. Time initiates processes, and space crystallizes them. God is in history, in the processes. We must not focus on occupying the spaces where power is exercised, but rather on starting long-run historical processes. We must initiate
processes rather than occupy spaces. God manifests himself in time and is present in the processes of history. This gives priority to actions that give birth to new historical dynamics. And it requires patience, waiting». Pope Francis, Interview given to father Antonio Spadaro, La Civiltà Cattolica, 19 September 2013
- «Dr. Santamaria believed Father Catharinich chose John because he understood the Teaching of the Church and would tackle the problem with “a scientific mind, moulded by an intuitive understanding of conjugal love and responsible parenthood”». Tess Livingstone, The Billings Enigma. Connor Court Publishing Pty Ltd, Melbourne 2017, p. 32
- W. T. Smith, The pathology and treatment of leucorrhea. Edit. Churchill, London 1855; J. M. Sims, Illustration of the values of the microscope in the treatment of the sterile condition. Brit. J. Med, 465-466, and 492-494, 1868.
- E.L. Billings, J.B. Brown, J.J. Billings, H.G. Burger, Symptoms and hormonal changes accompanying ovulation, The Lancet, 1972, 299,282-4
- E. Odeblad, Physical Properties of cervical mucus. In”Mucus in Health and Disease.” Adv. Exp. Med. Biol. 1977, 89, 217-225. E. Odeblad, Cervical factors In “Female Infertility.” Ed. P.J. Keller 1978 [Karger: Basel, Switzerland.] [Contrib. Gynecol. Obstet. 4,134 – 7.]
- Lyn e John. Billings, Due vite per la vita. Intervista di Angelo Montonati. San Paolo, Cinisello Balsamo (MI) 1998, pp. 38-39
- Lyn e John. Billings, Due vite per la vita. Intervista di Angelo Montonati. San Paolo, Cinisello Balsamo (MI) 1998, p. 42
- Pope Francis, Message to participants of the WOOMB International Congress «The “Billings Revolution” 70 years Later: From Fertility Knowledge to Personalized Medicine». Rome, Università Cattolica del Sacro Cuore, 28-29th April 2023
- Cfr. Hans Urs Von Balthasar, La verità è sinfonica (“The truth is symphonic”), Jaca Book, Milano 1979
- Giovani Paolo II, Encyclical Letter Evangelium Vitae, n. 91
- We are teaching our beggars, our leprosy patients, our slum dwellers, our people of the street, natural family planning. […] And you know what they have told me? Our family is healthy, our family is united, and we can have a baby whenever we want. So clear – those people in the street,
those beggars – and I think that if our people can do like that how much more you and all the others who can know the ways and means without destroying the life that God has created in us. The poor people are very great people. They can teach us so many beautiful things. The other day
one of them came to thank and said: “You people who have vowed chastity you are the best people to teach us family planning. Because it is nothing more than self-control out of love for each other” Mother Teresa of Calcutta, Acceptance Speech of the Nobel Prize for Peace, Oslo, 11
- Pope Francis, Address to the participants in the Pilgrimage of thanksgiving for the Beatification of Armida Barelli, Saint Peter’s Square, 22 April 2023
- Francesco, Lettera Enciclica Laudatosi’, nn. 101 – 114
- John Billings, The Ovulation Method, Advocate Press, Melbourne 1964
- Evelyn Billings, Ann Westmore, Il Metodo Billings. Usare il segnale di fertilità del corpo per ottenere o evitare una gravidanza. CISU, Roma 2023
- John Paul II, General Audience, 2 January 1980; General Audience, 8 April 1981
- Lyn e John Billings, Due vite per la vita. Intervista di Angelo Montonati. San Paolo, Cinisello Balsamo (MI) 1998, p. 99