In the July-August issue of Crisis magazine, Marjorie Dannenfelser fills readers in on why so few Catholic obstetricians and gynecologists are able and willing to support women who practice Natural Family Planning (NFP).

“More than 1.5 million American women practice natural family planning (48% of them Catholic), according to the Natural Family Planning Center. But only 32 obstetrician-gynecologists nationwide serve them, according to Steve Koob, founder of One More Soul. For those women who seek family practice physicians for their ob-gyn needs, the pool of NFP-only physicians increases to around 157 nationwide. As a result, large pockets of faithful Christian women around the nation do not receive the proper medical care they both need and deserve.”

Changing this situation will prove difficult, Dannenfelser writes, because “medical schools, academic journals, health management organizations (HMOs), and pharmaceutical companies, along with the professional and social pressure of peers, control money and respect in the medical world.”

The difficulties start in medical school, where “With very few exceptions, NFP is not taught at all, or only barely and in a dismissive fashion as a ‘religious thing’ not necessary to medical training. Natural Family Planning Center ob-gyn associate professor Dr. Hannah Klaus explains that in medical schools, the female reproductive system, ovulation, and contraception are taught as a unit.… While Klaus praised an exception — Georgetown's inclusion of NFP in its ob-gyn curriculum — even there it is not given exclusive treatment.”

And, Dannenfelser reports, “When really tested, medical authorities do not even tolerate NFP-only obgyn practice. Baltimore's St. Agnes Hospital ob-gyn residency program lost its accreditation because it would not train students in contraception, sterilization, and abortion.”

For those who persist in opposition to contraception past med school, “‘Residency is set up a lot like the military,’ says Dr. [Marie] Anderson.… ‘If you cause problems, they can make your life miserable’… the tough reality is that 50[%] to 60% of most ob-gyn practice involves contraception or sterilization.”

Adding to the pressure on Catholic residents is the fact that “NFP-only residents miss out on some aspects of training. For example, Klaus's own training included only three cesarean section deliveries because so many of these procedures involve tubal ligation [sterilization] surgery immediately following delivery.”

Meanwhile, “the sheer quantity of cash pumped into the development and promotion of artificial contraception as compared with natural means is astounding. Well over $75 billion has been spent by American taxpayers on national and international population activities since 1968 … then consider the billions of dollars spent in the development and promotion of contraceptives by drug companies.… ‘NFP stands for Not For Profit.… You can't sell a woman her own mucus,’ says Klaus.”

And the spread of HMOs “does not bode well for the future for NFP-only ob-gyns: For-profit HMOs are too risk-averse to chance losing their contracepting clients. Dr. Lorna Cvetkovich, an ob-gyn in Wichita, Kan., says that not only is there ‘no place for Catholic physicians to go and be trained as Catholics,’ but ‘our own Catholic HMOs won't accept them.’”

Among the few bright spots for NFP-only physicians “is the supportive network of enterprising organizations like the Pope Paul VI Institute, the U.S. bishops' Human Life Foundation, the Family of the Americas, Human Life International, and several others.”

With such extraordinary pressure to conform, why do some doctors swim against the tide? Dr. John Bruchalski says, “‘This is not just about contraception; it's about children’.… Are they blessings or little self-fulfillment pills?” His own change of heart came after he saw “the destruction contraception inflicts upon women and their marriages.” Now, “he believes.…” God works with the simple.… ‘If you stepout an inch, God gives you back much more.’”

Ellen Wilson Fielding writes from Davidsonville, Maryland.

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