For years, the form Anne Olek had to fill out at her annual obstetrician/gynecologist check-up asked whether she took "birth control" or used "the rhythm method."
She would always cross out "rhythm method" and write "natural family planning" — a term she said is more reflective of the practices she teaches her own patients. One year she was happy to see that the form finally had been revised to say "natural family planning."
Olek is a nurse practitioner who teaches patients the Creighton Model FertilityCare System, a system for observing and charting cervical mucus secretions to track fertility and predict times when sexual relations are likely to lead to conception. And she is on a mission to educate others about natural family planning.
Now Olek, who first heard of the Creighton Model during a 1997 Catholic Medical Ethics Conference in Buffalo, has reinforcements for her mission.
Two local doctors traveled to Omaha, Neb., in February 2012 and April 2013 to be trained in the Creighton Model at the Pope Paul VI Institute for the Study of Human Reproduction. Through this training, they will be able to treat many fertility problems in women who have abnormal cycles. Additionally, work has begun to set up a fertility care center in the Syracuse area.
The doctors — Dr. Elissa Sanchez-Speach, who is president of the Finger Lakes Guild of the Catholic Medical Association, and Dr. Karen Dalton, a convert to Catholicism who learned about natural family planning through Catholic media — said they returned from Nebraska energized by the new outlook they had received on women’s health.
They say they hope to dispel some of the many myths people believe regarding natural family planning. One of the most common, Olek said, is that NFP is the same as the rhythm method, an older form of natural family planning that relied on calendars and women’s cyclic histories to predict their most fertile times. Such newer NFP systems as the Creighton Model, the Symptothermal method, the Marquette Method and the Billings Ovulation method offer various evidence-based ways for women to track their fertility, she said.
Olek said another myth is that natural family planning is only for couples who are trying to achieve or avoid pregnancy.
Any woman can use the Creighton Model of charting to help doctors diagnose cycle and fertility problems so that any underlying problems can be treated with medicine, surgery or nutritional changes, Olek said. Pioneered by the Creighton Model’s developer, Dr. Thomas W. Hilgers of the Pope Paul VI Institute, this diagnostic process has been named NaPro Technology, which is short for Natural Procreation Technology.
"Through his research (Dr. Hilgers) discovered that certain patterns of women’s cycle way may be indicative of disease processes," Olek noted.
NaPro Technology can detect and treat infertility, abnormal bleeding, ovarian cysts, polycystic ovarian syndrome, repetitive miscarriages, premenstrual syndrome, postpartum depression, hormonal abnormalities, premature birth and cancers. It can chart the approach of menopause as well as irregularities that might be an early indication of cancerous growths.
"It’s a method not just to achieve or avoid pregnancy, but also to find out what’s happening with a woman’s cycle," Olek said.
A final myth is that natural family planning is not effective, she said. A use-effectiveness study of the Creighton Model published in the June 1998 issue of the Journal of Reproductive Medicine revealed that over a year’s time, the method was 99.5 percent effective in avoiding pregnancy with perfect use and 96.8 percent effective with typical use. Olek pointed out that these effectiveness rates rival those of many forms of artificial birth control.
Additionally, Olek noted that natural family planning does not have the side effects associated with some forms of artificial birth control, including an increased risk of blood clots, weight gain and high blood pressure. According to the National Cancer Institute at the National Institutes of Health, some studies have linked birth control pills to an increased risk of breast, cervical and liver cancers; however, researchers have documented reduced risks of endometrial and ovarian cancers among users of the pill.
When used to achieve pregnancy in couples with normal fertility, studies have shown the Creighton Model to be 76 percent effective during the first cycle of use and 98 percent effective by the sixth cycle of use, according to the Pope Paul VI Institute.
From a doctor’s perspective, Dalton said NaPro Technology represents a new approach that looks for root causes of fertility problems, rather than suppressing symptoms with birth control pills or other medications.
"I was trained in standard medicine," she said. "Everybody was on the pill and that was what you did."
Sanchez-Speach and Dalton are both family-practice/internal medicine doctors, and noted that the greater Rochester area lacks an obstetrician/gynecologist who is trained in the Creighton Model and would be able to perform surgeries to correct fertility problems among local women.
Surgeries that remove obstacles to natural fertilization are considered morally licit, according to the 2008 bioethical instruction Dignitas Personae from the Vatican’s Congregation for the Doctrine of the Faith. This instruction rejects in-vitro fertilization, which often produces numerous embryos that are frozen indefinitely or thrown away.
Dalton and Speach pointed out that in-vitro fertilization has many drawbacks that natural family planning does not; in-vitro fertilization can cost thousands of dollars and has high failure rates.
According to the National Centers for Disease Control and Prevention, the use of in-vitro fertilization has doubled over the past decade, yet in 2011 only 29 percent of in-vitro fertilization cycles in the United States resulted in live births of one or more living infants.
Speach said Hilgers — the doctor who began developing the Creighton Model in 1976 and currently is clinical professor of obstetrics and gynecology at Creighton University School of Medicine — was inspired by Humanae Vitae, Pope Paul VI’s 1968 papal encyclical on married love and procreation. That encyclical reaffirmed church teaching that the transmission of human life is a duty of married couples and that artificial contraception is morally wrong.
"If therefore there are well-grounded reasons for spacing births, arising from the physical or psychological condition of husband or wife, or from external circumstances, the Church teaches that married people may then take advantage of the natural cycles immanent in the reproductive system and engage in marital intercourse only during those times that are infertile, thus controlling birth in a way which does not in the least offend the moral principles," the encyclical states.
"The ethical value of biomedical science is gauged in reference to both the unconditional respect owed to every human being at every moment of his or her existence, and the defense of the specific character of the personal act which transmits life," Dignitas Personae states.
Speach said she hopes more doctors will realize that not only does natural family planning respect the human person, but it has many medical advantages.
"They may think it’s a Catholic thing without looking at the fact that it’s effective and safe, and has so many advantages over using artificial hormones," Speach said.
Olek pointed out that the Creighton Model already has garnered interest beyond Catholic circles. For instance, a group of local Mennonite women have shown high interest in presentations about the method.
"One of them said to me, ‘It’s so wonderful to know there are doctors out there who practice how we believe,’" Olek said.
And, because NFP respects the potential to create life within sexual relations, couples who practice natural family planning often experience enhanced communication and shared responsibility for family planning, she added.
"(Natural family planning) respects the way we are created," Olek said.
