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The Catholic Church prohibits the use of any form of artificial or hormonal contraception; however, only two percent of American Catholics use the church-approved method, Natural Family Planning (Jones and Dreweke 2011). Drawing on the empirical case of Catholic women who use contraception for pregnancy prevention, this project poses the general sociological question: How do individuals manage and negotiate engaging in personal practices that contradict the ethical teachings of an institution with which they identify? Analysis of eighteen interviews with married women who self-identify as practicing Catholic but use contraception for pregnancy prevention revealed, a religious identity construction where problematic feature were strategically minimized while other features of their identity were maximized. However choosing to use non-church-approved methods of pregnancy prevention while remaining a practicing Catholic led to tension. These women enact coping strategies of justifying, legitimizing, normalizing, and boundary making to manage their “Catholic guilt.” These aspects identity construction and negotiation are further complicated by lack of institutional communication and medicalization of contraception. This negotiation process demonstrates the burdens and resources provided by religion as well as individual management of religious and secular influences in daily life, with implications for healthcare professionals, sex educators, and the Catholic Church.