Family Planning, Naturally

Doctors who stop prescribing contraceptives and switch to a natural family planning practice can feel cut off from their medical colleagues and, at least initially, struggle to develop a new patient base.

Yet most doctors who make the change to NFP-only find a large new list of patients, including many who are willing to travel, if that’s what it takes to receive medical care in keeping with the moral teachings of the Catholic Church.

These doctors also experience a deep professional satisfaction in the moral aspects of their practice — and in providing care according to sound medical principles that treat fertility as a positive part of the patient.

“Fertility is not a disease; contraception is not health care,” says Dr. Mark Rollo, an obstetrician-gynecologist in a countywide medical group based in Fitchburg, Mass. “A doctor normally would not prescribe a medicine that has multiple side effects when there is a treatment just as effective that has no side effects. Yet when it comes to fertility, doctors give out the contraceptive pill, which has many proven negative side effects, when NFP is just as effective [in delaying pregnancy] and perfectly safe.”

The other doctors interviewed for this article express similar satisfaction with how NFP allows them to treat their patients as whole persons, rather than seeking to suppress naturally occurring fertility with pills or surgery. They also report having closer professional relationships with their female patients than they did previously.

In some cases, doctors have uncovered underlying illness by taking more time and paying more attention to a woman’s symptoms. They also have helped infertile couples have children, since NFP can be used not only to delay pregnancy but also to achieve it.

The doctors also express relief that they are no longer potential accomplices in abortion, pointing out that, in some cases, the contraceptive pill and the intrauterine device (IUD) may cause an early abortion of a newly conceived embryo.

The switch to an NFP practice does raise potential problems with other doctors, especially when an NFP doctor is asked to cover for a colleague and refuses to prescribe contraceptives to patients who are used to receiving them. But for the most part, the NFP physicians report, colleagues accept the decision and make accommodations.

“I enjoy what I do now because I work with patients instead of covering up their symptoms with the pill,” says Dr. Kathleen Raviele, who has a private ob-gyn practice in Atlanta. “I cannot say that I enjoyed medicine before my change of heart.”

“If there has been any side effect to NFP in my experience, it is joy,” says Rollo. “That includes the joy of being able to treat infertility naturally and see a couple hold their baby. I think that’s what all of us got into medicine for.”

The initial process of switching to NFP-only can be fraught with uncertainty about the future and fear over what colleagues and patients will say. Dr. Rollo admits that, when he switched to NFP almost 20 years ago, he was initially uncomfortable with the idea of patients asking for the birth control pill. “I struggled with a way to explain why I could not,” he says.

Raviele, who had a dramatic conversion after visiting the Medjugorge Marian shrine, says that, when she stopped prescribing contraceptives, her partners thought she was crazy. “My husband, who is also a doctor, sent me to a psychiatrist,” she recalls.

The psychiatrist’s diagnosis: “normal and happy.”

Dr. James Linn, chairman of the ob-gyn department at Columbia-St. Mary’s hospital in Milwaukee, stopped offering contraceptives in 1988, after four years of practice. Although he and his wife had met in a college pro-life group and did not use birth control in their marriage, Linn explains, he initially prescribed contraceptives because “I rationalized that my patients didn’t understand or accept the Church’s teachings. Probably, too, I was afraid of losing patients and my livelihood. If I didn’t prescribe contraception, they’d think I was a nutcase fanatic.”

When he made the change, some patients were annoyed and left, he says. But “many didn’t care. Some were happy that I wouldn’t prescribe contraception. Overall, I don’t think my number of patients changed.” The doctors he worked with “certainly respected my decision. One made the same decision soon afterward.”

Canning Contraception

“It can be quite traumatic for some doctors,” says Steve Koob, the head of One More Soul, an organization that provides education and support for NFP-only physicians and the public, and maintains an online directory of NFP health care providers and teachers (oms.org). “They’ve been trained in one way about the necessity of contraceptives for their patients, and now they’re trying to establish a practice based on a wholly different model that they know is not popular among their peers or their patients. It really takes a lot of courage, as you can see by the fact that so few physicians take up the NFP-only model.”

Koob’s group has distributed more than 1 million copies of audio and videotapes of a talk by Janet Smith, “Contraception: Why Not?” Some of the doctors contacted for this article said that program was instrumental in their conversion to NFP. One More Soul also sells the book Physicians Healed, which tells the stories of doctors who made the switch to an NFP-only practice.

Dr. Mary Davenport, an ob-gyn in Berkeley, Calif., wanted to provide NFP-only health care for many years, but did not think such a change was possible. After meeting other NFP doctors at a conference, she made the switch in 1998.

“My number of patients did not change much,” she says. “Since I am the only NFP-knowledgeable ob-gyn in my area, people come to me from all over. My partners were supportive, or at least tolerant.”

She has since moved to private practice.

“I really appreciate having a clear conscience in dealing with patients, and not colluding in the corruption of young women, mainly with birth control pills,” says Davenport.

After he became convinced three years ago that the contraceptive pill could also sometimes effect an early abortion, Dr. Robert Scanlon became an NFP physician. He works in a multi-specialty practice in Huntington, Long Island, and is one of the few NFP-only doctors in the New York City area. A long-time anti-abortion activist, he serves as a physician for the Life Center of Long Island, a crisis pregnancy center.

“My ob-gyn partners were quite accepting,” he says. “They had seen for years my activism with respect to defending the unborn. My medical group had a harder time initially, but came to see that my intentions were pure. When you see the truth, you can’t live any other way. It creates real peace. Medical care that acknowledges both our body and our soul will always lead to better outcomes.”

Speaking about the benefits of an NFP-only practice, Linn says he was “not doing the crazy thing of treating fertility like it’s a disease. And I know I’m not cooperating with evil and leading the others to do the same. I pray for those I hurt by prescribing contraception in the past. I also pray for my colleagues who prescribe contraception, that they may some day see the light. I thank God for those who prayed for me.”

Stephen Vincent writes from

Wallingford, Connecticut.