Pope Francis during last week’s visit to the Philippines.

Being open to life meant being responsible, the Apostolic Administrator said, expanding upon the Pope’s remark that Catholics should not feel they had to breed like rabbits because of the Church’s ban on artificial contraception.

Mgr Charles Scicluna said Catholic teaching was very clear when it came to acceptable ways of regulating birth, meaning “condoms are out between married people”.

On Monday, Pope Francis said that Catholics need not breed “like rabbits” and should instead use Church-approved ways to regulate births and practise “responsible parenting”.

Mgr Scicluna said: “What the Pope referred to is an established principle of Catholic moral teaching concerning the gift of parenthood... It [sexual intercourse] has to be loving, it has to be faithful – but it has to be restrained and responsible,” he said.

Sexual intercourse, he said, has to bring couples together and be procreative.

The Pope, en route home from the Philippines on Monday, told reporters of a woman he had met who was pregnant with her eighth child after seven Caesarean sections.

“That is an irresponsibility... God gives you methods to be responsible,” he said.

The Pope argued that there were many “licit” ways of regulating births that were approved by the Church, a reference to the natural family planning method of monitoring a woman’s cycle to avoid intercourse in the days when she is ovulating.

Gynaecologist Marcelle Chircop said this natural or ‘safe method’ was adopted by some women in Malta.

“Given some thought, some women do very well – and with care and knowledge, it works.

“But if you do not give it enough attention you might get caught out.

“Many women in Malta use contraception. But some are happy to rely on natural methods,” Dr Chircop said.

A woman has a 22 per cent chance of pregnancy every month, she said, and these days people tend to rely on both natural and artificial methods of contraception – the pill, condoms and Mirena (a hormone-loaded intra-uterine device, referred to as ‘the coil’) – depending on their lifestyle.

Many women in Malta use contraception. But some are happy to rely on natural methods

Consultant obstetrician and gynaecologist Mark Brincat said Malta, much like Italy and Spain, has “one of the lowest take-ups of the contraceptive pill and yet the birth rate is low.

“Clearly people are finding their own solutions to responsible parenthood, which is not necessarily artificial birth control,” he said.

Dr Brincat said the key to responsible parenting was education. The UK, which has the highest uptake of the pill, has one of the highest teenage pregnancy rates.

“Without education, there cannot be any control of population growth,” he said.

Educating couples is in fact one of the tasks undertaken by Cana, which organises marriage courses for Catholic couples.

Director Fr Joe Mizzi said the course included a session on responsible parenthood based on four principles: the parent’s physical, psychological, financial and social conditions.

There is also a practical overview of natural family planning methods.

“Natural planning is a lifestyle; it’s getting to know your body and how to programme yourself,” Fr Mizzi said.

“We also mention condoms and pills during the meetings – we don’t live in a bubble; these are today’s realities.

“We inform couples what there is on the market and we point out that artificial contraception is abortive because we are always in favour of life.”

On the trip to the Philippines, Pope Francis gave his strongest defence yet of Pope Paul VI’s 1968 encyclical Humanae Vitae, which enshrined the Church’s opposition to artificial birth control.

The Pope’s comments, taken together with his defence of the Church’s ban on artificial contraception during the trip, show his more conservative side, so far not strongly projected in the media narrative surrounding him.

He is seen as less judgemental than his predecessor, Benedict XVI.