Imagine this scenario; you have recently been introduced to the idea of using natural family planning to avoid pregnancy. You are taking a class with a qualified instructor, and you have begun to observe your fertility signs and chart your cycle. You feel like you are really getting in touch with your own internal rhythms, and you understand what your body is telling you about your hormones. You are even gaining confidence at your ability to determine if and when you are fertile!
Since it’s been a while, you schedule your regular female exam with your doctor. When the date arrives, you pack your fertility charts, excited to share what you’ve been learning. However, when your doctor gets to the part of the exam when she asks about your birth control, the conversation goes something like this:
“According to this you are due to renew your birth control prescription. Any problems or questions?”
“Actually yes. I got sick of the side effects, so I stopped taking the pills several months ago. I use NFP now.”
“Pardon me? What are you using?”
“NFP. Natural family planning.”
“Oh.” Pause. “So you don’t mind getting pregnant then?”
“Well… I’d rather not at the moment actually. That’s why I’m using NFP to prevent pregnancy.”
Another pause. “Well. Natural family planning is notoriously ineffective. If you continue using this method you will likely fall pregnant in the next year. Are you using condoms?”
“No,” you say, growing uncomfortable. “I don’t need condoms. I use abstinence when I’m fertile. I took a class.”
“Okay,” says your doctor, looking unimpressed. "But how would you feel about an unplanned pregnancy right now?"
“Not great, but okay I guess…”
“Then you should really think about going back on the pill. We can try a different prescription if the last one didn’t sit well with you.”
You leave your appointment feeling deflated, disempowered, and even a bit embarrassed. You start to question what you’ve learned about NFP. If it’s supposedly so effective, why is my doctor certain that I’m going to get pregnant?
Now, I’m sure there are plenty of medical providers who support the use fertility awareness-based methods of family planning. However, they're pretty hard to find. The above scenario seems to match the experience of the majority of NFP users. By why? Why do intelligent, caring, well-meaning doctors immediately poo-poo the idea of NFP as a viable form of family planning? I believe that there are three major reasons that this happens.
Despite the fact that research on fertility awareness based methods of family planning is abundant and clearly shows high levels of effectiveness, many medical providers are simply unaware of it. Fertility awareness and natural family planning are not taught in medical school. In fact, when most doctors hear the term ‘natural family planning’, they probably think of the Rhythm Method. The Rhythm Method calculates the fertile time based on the length of past cycles, rather than observing physical signs. It has been shown to be rather ineffective over time. True natural family planning however, has been shown to be 99.4% effective at preventing pregnancy. This is comparable to other popular forms of birth control on the market, only without the risks and side effects! Sadly, your doctor probably has no idea of this fact.
Chances are, your medical provider became a doctor because he/she really cares about people, their health, and their overall well-being. If you say you want to prevent pregnancy, they assume you have good reasons for that. They want you to succeed. They may fear any disappointment and struggles you may face if you get pregnant unintentionally. And because of the aforementioned ignorance, they may conclude that using NFP means that you certainly will become pregnant. They assume this scares you, so it scares them too. They may feel the need to save you from yourself.
Doctors are in the business of helping people. It’s what they do. If you come to see them with an ache, pain, injury or illness, they are trained to provide treatment to make you feel better and to relieve the symptoms. That’s why doctors love hormonal birth control. If you want to avoid pregnancy, regulate your cycle, lessen your menstrual cramps or bleeding, or improve your skin, there’s a magic pill to take care of all that. And while it’s true that hormonal contraception can provide temporary symptom relief for many ailments, it works by artificially shutting down your natural hormonal cycle, not actually curing your problem. Stop taking the pill, and the problem remains. And often, the hormonal contraception itself carries significant risk and side effects.
But when you tell your doctor you aren’t interested in artificial hormones, you may be declining the only form of ‘treatment’ that they are familiar with. They may not be used to investigating the true origins of menstrual maladies (hormonal, pathological, structural, nutritional, etc). And because they don’t know much about natural family planning, they won’t know how to support you in preventing pregnancy, either. It’s up to you to chart your cycles, identify your fertile times, and modify your sexual behavior. They can’t control any of that, meaning they can’t help you, and that may make them uncomfortable.
So what’s the solution? Well, solving the first problem can go a long way to solving all three. Don’t be afraid to come to your doctor armed with studies, research, and reading materials that accurately describe fertility awareness methods, how they work, and their effectiveness. FACTS is an excellent resource. Do your own research, or talk to specialists and/or alternative healthcare providers if you are struggling with reproductive health problems. Demand real treatment, not just an artificial band-aid. Connect with other experienced NFP users to exchange information, ideas and strategies. Believe that your doctor just wants what’s best for you, and help them to understand the merits of NFP – not just for family planning, but as a powerful healthcare tool. Not only will you be doing yourself a favor, but you’ll be helping future patients too.
photo credit: freedigitalphotos.net/everydayplus