Today in our series about sharing NFP we have a fantastic post from an NFP only doctor. Dr. Karen Poehailos, M.D. shares her opinion on talking to doctors about NFP from both sides of the exam table. Karen is also a certified Natural Family Planning Medical Consultant and NFP coordinator for her diocese in Richmond, VA.
One of the biggest challenges women face in using Natural Family Planning (NFP) is forging a working relationship with their physician—especially if the physician is not “NFP only.” I’d like to offer my thoughts, having been on both sides of the fence—as the physician and as the patient. I am a recently certified Natural Family Planning Medical Consultant (Creighton Model NaPro Technology) and also a SymptoThermal Instructor/Instructor Trainer for many years.
A quick look at the One More Soul website listing of NFP-only physicians will show that most of us do not have access to physicians who do not prescribe contraception in their offices. Or you may have a NFP-only family physician nearby who does not practice obstetrics. I’m going to focus my comments largely on how to approach the “average” physician who is skeptical about NFP (and honestly didn’t learn much about it in medical school if their experience was like mine.)
First, patience is a virtue. Your marching in with your chart and expecting him/her to respect your hard work (much less understand it!) won’t go over well, most likely. Expect comments about unplanned pregnancies. Bite your tongue from the reply you’d like to give.
If it makes you feel any better, I have been told that I should get my mammogram NOW because I won’t know when I’ll accidentally be pregnant later and not able to get it. Another doctor told me that my Creighton chart with its white and green baby stamps was “cute”, but wouldn’t trust that the pattern of mucus was consistent with a follicular ovarian cyst (which went on to rupture the following month.) If I have trouble getting respect as a physician talking to physicians, then your case is even harder. And oh yes, these were both Catholic physicians.
So give up? No. Be patient? Yes.
The best working relationships I’ve forged with my own care providers have been those in which I’ve tried to just acknowledge that our approaches are going to be different, but I promise to be responsible for my own behaviors (such as charting carefully to avoid pregnancy after having an endometrial ablation–when I refused the tubal ligation usually required when this is done.) They don’t have to agree with how you are handling your family planning just to do a Pap smear, or even deliver your baby.
I also have tried to accept as a sacrifice biting my tongue over comments made without much forethought. And I don’t scream (albeit tempting) when my chart is marked “rhythm method” for birth control by the nurse.
I don’t expect the doctor to understand my fertility charting. I have just asked that my decision be respected—and it usually is. I (like most doctors) take care of many patients with whom I may not agree on their health decisions—the morbidly obese, smokers, non-compliant diabetics, etc. I am NOT saying that using NFP is a poor health decision such as these other items are. I am saying that doctors are expected to treat these patients still with respect even if they don’t agree with their choices. You should expect no less as a patient.
If being polite with your requests doesn’t work, then move on if at all possible. Unless you’re in the middle of a very poorly served area, you usually can find more than one OB/GYN or FP within reasonable driving distance. If you want to have health care directed by what is found in a fertility chart (such as evaluation of abnormal bleeding, infertility, prolonged mucus cycles, etc), then you may be stuck driving further to find a physician who specializes in NFP applications.
And a request from one of the NFP-only physicians out there? If you’re in reasonable driving distance to us, and are using NFP, please use us! We lose more patients from not prescribing the Pill than we gain from being NFP only, if my experience is any indicator. If you want us around, we need to be supported, even if it does involve a slightly longer drive or higher copay. I’ve been touched by the patients who have driven hours to see me for my NaPro work—it keeps me going despite the challenges that being NFP-only present professionally (that would be another story!)
Good luck, and know that we NFP-only doctors appreciate your sacrifices and faithfulness.