By PATRICIA COLL FREEMAN
The phones are ringing more these days for a particular doctor at Capstone Family Medicine clinic in Wasilla. The 34-year-old Dr. Sarah Hennemann is a general family practitioner who provides pregnancy, pediatric and geriatric care. But many of her new patients are calling because of what she doesn’t offer – contraception.
NATURAL FAMILY PLANNING
Opposed to contraceptives and sterilizations, Hennemann instead dispenses information on Natural Family Planning (NFP), a natural method for managing fertility. Hennemann, who has just relocated to the Mat-Su Valley from North Pole, is one of a few self-identified “NFP-only” physicians in Alaska.
Based on a woman’s day-to-day observations of naturally occurring fertility signs, NFP methods are numerous and backed by decades of medical research. They enable couples to recognize fertile and infertile times – and sometimes help to identify underlying reproductive problems – from progesterone deficiency to cancer – that often go undiagnosed in doctors’ offices.
Hennemann is certified in the Marquette Model of NFP, a variation developed by physicians and nurses at Marquette University in the late 1990s. The method involves charting fertility signs, including fluctuations in a woman’s basal body temperature. Besides a thermometer, the only equipment is a fertility monitor used at home to measure hormone levels in urine.
Otherwise, NFP involves no chemicals, devices or surgical procedures. And it is highly effective – “better than what most people are doing with the Pill,” Hennemann told the Catholic Anchor in a recent interview.
A 2007 study published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing showed the Marquette Model of NFP to be 98 percent effective when correctly applied.
Lower efficacy rates aside, contraceptives are bad medicine – physiologically and morally, Henneman said.
Taking drugs like the Pill that contain hyper doses of hormones, she explained, is a “medically unnecessary and dangerous practice.” In fact, according to various research studies, hormone-based contraceptives increase the risk of certain serious conditions, from breast cancer to blood clots.
Dr. John Tappel, 53, a Catholic pediatrician at a private practice in Anchorage is another physician who does not dispense birth control. Given he treats adolescents as well as children, the issue comes up.
Like most doctors, at the beginning of his career, Tappel dispensed contraceptives. But that changed when he began to better understand God’s design for the relationship between men and women, he said.
Moreover, unlike other medications, he explained, contraceptives don’t act to restore a woman or girl to health.
“It’s about the only time I know when you’re taking a pill on purpose to decrease the normal function of some part of your body,” Tappel observed. “You’re working perfectly well, and now you’re taking this medication that makes you less functional than you normally would be … it’s taking away from your biology, your physiology.”
Hennemann noted also that some contraception methods, including the Pill, can cause early abortions.
There is “a small risk of conception or union of the egg and sperm,” she explained, but since the Pill thins the uterine lining, it can prevent the implantation of the living, embryonic baby.
Across 10 years, Hennemann has seen about a dozen patients who were on birth control stop taking it when they learned of the possibility. They didn’t know, she said, and “that was very upsetting to them.”
BARRIER TO LOVE
But even the non-abortifacient contraceptives are morally problematic.
Because the marital act has two, inherent purposes – procreation and the unity of the couple – the Catholic Church opposes contraception, which acts as a barrier between the couple. Most Protestant denominations opposed contraception until around the 1930s.
Embracing one good of the marital act, however, but refusing the other causes a spouse to be treated as a means to an end, Tappel explained.
“The idea that I would use my best friend as an object, you can’t think about that too much without developing some level of horror.”
Divorcing the two integral parts of marital intimacy means it is no longer “free, total, faithful and fruitful” love, he said, referencing “The Theology of the Body” — Pope John Paul II’s teachings on human sexuality.
To respect the integrity of God’s design, “Each and every marriage act must remain open to the transmission of life,” explained Pope Paul VI in the 1968 encyclical “Humanae Vitae.”
At the same time, couples should exercise “responsible parenthood,” the pope added.
“With regard to physical, economic, psychological and social conditions, responsible parenthood is exercised by those who prudently and generously decide to have more children, and by those who, for serious reasons and with due respect to moral precepts, decide not to have additional children for either a certain or an indefinite period of time,” he explained.
Utilizing NFP, a husband and wife with serious reason can delay conceiving while protecting the nature of every marital act – as open to life and unitive for the couple.
Still, contraceptives are ubiquitous. According to a 2010 study published by the Center for Disease Control, during 2006-2008, 10.7 million American women took the Pill and another 10.3 million women used sterilization as contraception.
So, what is it like to be in the minority when contraception is practically universally accepted?
“I don’t wear my NFP-only t-shirt with a cape every time I go in and see a patient,” Hennemann said with a laugh.
When the issue of contraception comes up, patients who don’t already know her stance are mostly curious.
“Generally, it’s very well received, and people have a lot of questions,” Henneman said. For many, it’s the first time they learn there’s any controversy about contraception.
Those conversations are critical, Hennemann and Tappel believe, in helping patients make fully-informed health decisions.
“A lot of people are happy to have the information,” Hennemann said.
“You know when we put anybody on a medication, we always give them the risks, the benefits, the side effects, the alternatives,” she added, “and I don’t think that in general, people get a good enough education about the oral contraceptives and the shots and the IUDs … and sometimes they are just devastated by what they’ve found out they’ve been doing.”
When contraception comes up in Tappel’s clinic, he talks with teens about the negative physical and emotional effects of sexual activity on the young.
“When you get involved in sexual intimacy as a teenager outside of marriage, you are generally getting into areas of feeling and thinking that you don’t fully understand … it’s my job to get them thinking,” Tappel said, and to show them “there is an alternative, that is, not being sexually active.”
MEDICINE & CONSCIENCE
Among their contraceptive-prescribing colleagues, Hennemann and Tappel both said they have freely practiced medicine according to their conscience. But both are concerned about the threats to conscience rights of medical personnel.
Similarly minded health care providers and others came out en masse when in 2009, the Obama Administration announced a plan to rescind Bush-era regulations enacted to uphold federal conscience protection laws. Nevertheless, in February, the Administration abolished key parts of regulations.
“I wanted to become a physician to take care of people and to give them the best that I could … to have them be the healthiest they could be,” the cheerful Hennemann explained.
Turning somber, she added, “If someone’s going to tell me that I must refer for abortions or I must prescribe birth control, then I will do something else.”