U.S. Catholic dioceses are confronting a sharp drop-off between initial interest in natural family-planning education and completion of full courses, according to a 2025 survey by the U.S. Conference of Catholic Bishops.

Among 61 dioceses that responded, 18,211 people received some information or instruction on natural family planning, while 7,518 attended a complete course. The report says further research is needed to understand the gap and adapt programs accordingly.¹

The financial and staffing picture helps explain why dioceses may struggle to sustain more intensive instruction. Sixty-eight percent of surveyed dioceses budgeted under $5,000 for these programs, and 58% of instructors were unpaid volunteers. Steve Mattern of OSF HealthCare said the reliance on volunteers appears to meet much of the demand, but many dioceses may not have the capacity to require or provide more extensive training.¹

Catholic health leaders frame the courses as more than preparation to achieve or avoid pregnancy. Dr. Annevay Conlee said fertility-awareness-based methods can support health monitoring and the recognition of abnormalities, arguing that they avoid the side effects and possible long-term consequences she associates with artificial contraception. She urged providers to offer different course options that fit couples’ schedules and to emphasize health and well-being alongside family planning.¹

Others stress a longer-term cultural approach. Mattern suggested that dioceses consider vouchers or a choice of methods within marriage preparation, saying such models have worked in some places. Sister M. Mikela Meidl argued that education about the body should begin earlier, within families, so young people approach fertility awareness before marriage with greater openness.¹

A separate account of the findings similarly describes underfunding and limited access to professional instructors as barriers, while highlighting proposals for stronger links between dioceses and Catholic health providers.²