One of a series of six special columns written by Catholic women on family planning issues.
As a practicing general pediatrician, I occasionally get asked to prescribe contraceptives. The reasons are varied: from contraceptive desires to abnormal bleeding, and even for acne.
People ask very casually for "the pill" and are often surprised when I tell them I do not prescribe them. Generally, after explaining that I have theological and medical concerns about the pill and sharing some of the medical reasons, the patients are satisfied. If there are medical concerns that need addressing, then I work to find a solution for them or I help them find a gynecologist I trust to address their needs.
I entered medical school as a convert to the Catholic faith, dedicated to the message of natural family planning and the Theology of the Body, and I quickly found that this was too countercultural. Oral contraceptives are the norm. They are so prevalent that people often overlook their side effects. Thus, we forget to question their safety or why the Church objects to their use in marriage.
People often point out that there are medical conditions which require women to be prescribed hormonal contraceptives. While there are conditions that warrant the use of hormonal treatments (and women should discuss these with their doctor), the most common reason is for contraception. A woman may take hormones for one, five or even 10-plus years to prevent pregnancy, which is a medical condition, not a disease.
As Catholics, we believe pregnancy begins at conception. This leads to one of the first objections to hormonal contraceptives: they can be abortifacients. While the goal is to prevent ovulation, this doesn't always happen. In cases where an egg is fertilized, most pills also work by thinning the lining of the uterus, making it uninhabitable to the fertilized egg. By doing this, the embryo will not implant, or it may be sloughed off after implantation because the uterus cannot sustain the life. The medical community and drug companies will say that these drugs are not abortifacients because the definition of pregnancy begins at implantation. As Catholics, however, we believe that a life is created at fertilization -- the moment when there is a unique set of DNA.
My other concerns with oral contraceptives are their medical side effects. Hormonal contraceptives are often accompanied by side effects, such as mood changes, irregular bleeding, nausea, weight gain, decreased libido and breast tenderness. These types of side effects might be tolerable to some women, but what about side effects such as increased blood pressure, blood clots, heart disease or stroke? While these might be tolerable for a medication treating infection or cancer, is it worth it to treat a normally functioning body?
In today's world, where natural diets are popularized and people will go to lengths to buy organic food grown without hormones or antibiotics, it is surprising how easily we will put hormones into our own bodies when they are well. The Church encourages a different approach. It's radical. It's healthy. It's free. Natural family planning allows us to understand our bodies' normal functioning and helps us to interpret our patterns of fertility -- without any unnecessary side effects. NFP allows me to understand and work with my own fertility naturally, without compromising my embrace of the fullness of Catholicism.
Dr. Anna Ostrom lives in Little Rock with her husband Brad and their two children. They attend the Cathedral of St. Andrew in Little Rock.
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