Friday, September 01, 2006

Doctors Why Deny Women Birth Control

The Washington Post ran an article yesterday entitled "Medical Practices Blend Health and Faith." You can read it at http://www.washingtonpost.com/wp-dyn/content/article/2006/08/30/AR2006083003290.html?nav=hcmodule

It described a trend that frankly had escaped me until I read the article -- obstetrician/gynecologist offices that "pray for and with" patients, refuse to offer or even refer for birth control, sterilizations, or abortions, and promote only natural family planning.

There are according to the article more than 500 such medical practices in the United States. They quote one doctor who says, "We're trying to get doctors to see that contraception is not good medical practice" and that natural family planning "builds a marriage."

Unfortunately, the article doesn't quote one religious leader who thinks this is a bad idea.

It is. What happened to informed consent in medicine? Natural family planning is the least effective method of contraception, and effective contraceptive use is not only "good medical practice" but a moral choice. What happens when a woman goes to one of these doctors who has a different religious point of view? What happens in a rural area where this might be the only obstetrician/gynecology offices? Although not addressed in the article, one shudders to think how a woman with a sexually transmitted disease is seen in one of these practices. Do they treat her or send her out with a lecture? Do these doctors refuse women vaccines against Hepatitis and HPV because they protect against such diseases? What is the end of their limiting their services to sexually active women?

To my mind, these medical practices neither support women's health or their faith. They're dangerous and they are immoral in their goal of limiting women's moral agency. What do you think?

***
I'll be on spiritual retreat in Maine next week. I'll be "back" next Friday. Have a good Labor Day weekend!

Rev. Debra W. Haffner

29 comments:

Anonymous said...

I attend this clinic and am grateful that it exists. I am morally opposed to abortion and cannot support an ObGyn that performs abortions. I am thankful that I have a choice to receive care from an ObGyn who shares my beliefs regarding medical ethics.

Tepeyac makes it very clear to patients and prospective patients that it does not give prescriptions for abortions and will not make abortion referrals. There are hundreds of doctors who do. It may not be your choice to go to Tepeyac, but it is my choice.

You may want to do some reading on modern Natural Family Planning methods. It is not the "Rhythm Method" of old which is ineffective for most woman. My husband and I as well as many of my friends use the Sympto-Thermal Method of NFP which is 98% effective with perfect use. No surprise babies, thank you! I love that the responsibility of birth control is not solely on my shoulders. I love being chemical free. I love that my husband is in tune with my body.

Anonymous said...

" Natural family planning is the least effective method of contraception"


sorry - your reference for this is from where?

Perhaps if you did your research correctly (or if you did *any* research at all, instead of merely spouting off your uninformed opinion) you would've found out that NFP has a method faliure rate of 2% at most (the vast majority of studies quote it as being 1% or less)

That is, as effective, if not *more* effective than many other methods of family planning.

Oh, and it doesn't involve destroying human life (unlike the pill & coil), AND it does not twist and distort the sexual act into something perverse and akin to the egotistical sterility of mutual mastrubation.

Anonymous said...

I am well-acquainted with many of the women who are attended by Dr. Lorna Cvetkovich, of the Caritas Women's Center in Ann Arbor, Michigan, an NFP-only practice. These women tend to be college-educated (at least!), thoughtful and well-informed about their reproductive health-care choices. Many seek out this practice because of their religious faith - they look forward to enjoying a pregnancy where prenatal testing is not shoved in their faces every 5 minutes, with the implication that they should abort the minute there is a possibility of a "defect." They appreciate a practice where cycle irregularities are actually studied and diagnosed rather than covered up with artificial hormones (possibly masking serious problems). They like learning about their ferility and having it treated as a healthy part of themselves rather than a disease. And many appreciate that their doctors do not personally perform or refer for abortions.

However, in addition to those who are religiously-motivated to seek out this practice, many non-religious women seek them out despite disagreeing with their moral views because they are the only practitioners who are able to counsel them on natural family planning. Many "crunchy granola" women (especially in liberal Ann Arbor!) use NFP they learned from secular sources because it is healthier and very effective. They have tried and failed to get respectful support from more mainstream practitioners.

The bottom line is that NFP-only practices are in no way "dangerous." In fact, they enhance the "choice" of women who too often face ridicule for sincerely-held religious beliefs opposing abortion and contraception, or even for secular health-related preferences for natural, holistic care.

Anonymous said...

Risks are justified when treating pathology. But since when is fertility a disease, so that eliminating it from the body justifies taking ANY risks?

All that is needed to manage one's procreative choice is the use of one's head to learn one of the modern NFP methods, and a cooperative partner. it is not difficult.

Debra W. Haffner said...

I've posted these four comments in the interest of dialog...I am not opposed to NFP for women who choose it; I object to the idea that it is the ONLY method that is made available. According to Contraceptive Technology, yes perfect use of the sympto-thermal method is 98%, but typical use -- 25% of women who use NFP are pregnant in a year.

As for the several hateful comments I've received, well, they won't be posted. After all this is MY space, and as a minister, I take very seriously "Love thy neighbor."

Sparki said...

Considering the fact that many couples use NFP to actually GET pregnant, the success rate of NFP is far, far, higher. It is truly family planning in that the data collected can be used to either acheive or avoid pregnancy.

Bonus: NFP education also teaches a woman to understand her body to the point where serious medical conditions can be detected far, far earlier, resulting in easier and more effective treatment. Many women have no idea that certain pains, bowel behavior and secretions can indicate ovarian cancer, but the NFP-using woman would see and track the change and be able to seek out medical assistence much earlier.

IMHO, even women who insist on using artificial contraception should take the time to learn NFP in order to protect her own health.

Anonymous said...

The medical licensing boards in the states where physicians refuse to counsel or prescribe birth control should cancel the individuals' licenses.

A physician's religious and moral beliefs don't trump the rights, needs and wishes of patients.

I not only support the clear and distinct separation of church and state, but equally feel a physician's religious beliefs belong at home, or in the church,but not in a medical office or hospital.

Anonymous said...

Rev. Haffner,

As the lesser half of an NFP teaching couple, I commend you having the intellectual honesty to post the comments below.

I believe you find yourself the victim of a great deception in this culture, and those of us who teach and promote fertility awareness instead of fertility distortion have to deal with this wide-spread cultural deception every day.

For centuries mankind knew that sexual intercourse was intimately connected with making babies, and sexual constraints on the misuse and abuse of women were arranged beside or around that basic fact of human physiology.

Why else would men make use of he "oldest profession in the world" instead of "risking" the evidence of their dalliances showing up on their doorstep?

As it is today, and man can "use" a woman for his own sexual gratification INSIDE marriage as well. IF a woman on contraception is always available for him, and she can't really say "no", then what does her yes really mean?

Contraception has reduced the intricate and delicate dance of human sexuality to a contract arrangement, with the "consequence" of children becoming an afterthought. This deep shift in the marital dynamic has ripped the soul out the family, and left strewn across the world dissolate women with children, and irresponsible men blithly moving on to another "sexual contract".

I urge you to REALLY LOOK at the effect contraception has had at the REAL lives of women, and how their sexual needs have been subjegated to the convenience of men, and how children have become not a "blessing", but a burden and liability that must be avoided.

Anonymous said...

Rev. Debra,

Do you not respect the beliefs of some doctors who do not prescribe the birth control pill or refer for abortions for religious reasons? For some, they cannot be complicit in a prescription for a birth control pill that can be an abortifacient. If a doctor feels strongly to make that choice, they should be respected, not told they have to go against their religious beliefs in what they prescribe.

I don't understand the uproar. There are plenty of doctors who will prescribe the pill. None of the doctors are luring in patients with false information and then surprising them that they won't be getting any birth control that day. There is no separation of church and medicine. If someone wants to practice medicine as a Christian Catholic and use prayer and morality as part of his/her practice, what's the big deal. If that's not what you want, you find another doctor.

Anonymous said...

Consider this: a patient comes to see a doctor. The doctor recognizes a health condition and knows of 3 treatment options. Would you consider it ethical for the doctor to exclude any option from the patient for any reason? Remember, the doctor’s opinion is considered authoritative – if they did not present an option, it is reasonable for the patient to assume that the option was omitted for a good reason.

Suppose the patient knows of an alternative treatment, but the doctor is opposed to it. Is it ethical for the doctor to refuse to provide that option, to discuss it or refer the patient to another doctor that might provide that treatment?

When would you consider it ethical for a doctor to behave this way? What if the patient effectively has no alternative? What if the treatment increases the patient’s risk without providing any benefit?

Anonymous said...

Wow, this article and these responses have deeply saddened me. I am saddened to think that women who are struggling with a very difficult decision are met with physicians who inflict their morals on their patients. I am saddened to think that there is a medical student (and probably more out there) who think that the pill "destroys human life" and will someday be in the position to offer medical advice to a patient.

Although I agree that NFP can be very effective, I know of a number of women who have gotten pregnant while using it during a stressful time or illness in their life which altered their cycle. It can be a good method, but thankfully, we have many other options available to us. And for those times when NFP or any other method does not work, I am thankful that women can safely obtain an abortion in our country, hopefully free of judgement, shame and guilt.

Renee said...

I hate to be another to chime in on how I love NFP, but I hope to direct you to a secular site on the subject of NFP run by an American non-Catholic at www.tcoyf.com "Taking Charge of Your Fertility" also, www.woomb.org for the Billings Ovulation Method. The founders of Billings are Catholic, but there are no direct refernces to Catholic theology there just education materials and peer review medical papers online.

I understand with all the financial investment in research and marketing of contraception, the average person is skeptical and hestitant of the idea. I believe it is wrong to jump down people's throats who currently use or promote contraception. For those who been using NFP for years after being on contraception thinking there are no other option, I learned the concepts behind NFP are very basic. Every young adult, girl and boy should have this knowledge when going through puberty. The most common question asked after learning is "Why don't they teach this in sex ed?"

I'm sorry for the "hate mail", been a victim of that too on a different issue on my blog. When it comes to such sensitive topics, patience and listening is key before speaking.

Anonymous said...

There's another benefit to seeing NFP-only doctors that hasn't been mentioned. They understand endocrinology (hormones) far better than the average OB-GYN. The first time I saw Dr. Bruchalski, after moving here 13 years ago, he immediately guessed I might have hypothyroidism, based on our hour-long discussion of my general health issues. The tests he ordered confirmed that condition and also showed that I am gluten intolerant. To that point, I had suffered 6 years of discomfort, pain, exhaustion and many, many misdiagnoses; all that ended within 2 weeks of my first visit to Tepeyac. I also am the envy of friends my age because I never suffered a hot flash or any other symptoms of menopause. He carefully had me take just the right amount of whatever hormones were deficient and later gradually weaned me off them. When I compare their "whole person" approach to health care, really listening to patients' concerns, to the care my family gets from other MDs who are tied to insurance company mandated 10-minute-per-patient visits, I only wish all our MDs followed the model of patient care practiced at Tepeyac. Susan

Anonymous said...

As a religious woman, what has been happening to my health service options lately are terrifying. I have morals! I have boundaries! I deserve respect from my doctor! I require my doctor to provide me with any and all options related to all aspects of my health care!
Requiring this of my doctor does not mean that I will choose an option I am opposed to. My knowledge of what's available to me encourages me even more so to do what I believe is correct for ME! The only time that I would expect my doctor to tell me what the correct decision for me is, would be if all other options would permanently harm me or my chances of performing "normally."
What should be the "moral" thing for a doctor to do is to provide health care! To care for my health no matter what my views are and no matter what her/his views are.
As a peer health educator, my job is to inform anyone who comes to me of ALL their options. I would expect the same treatment-- especially from my doctor!
I am not opposed to NFP as an option. For the women who choose NFP, it is the correct option. I AM opposed to NFP as the ONLY option that women are told about by their doctors/heal care providers. Options mean freedom and wellness. To be able to decide what is done to our bodies is sacred and fundamental to health care services.

Bill T said...

Reverend Haffner,

Thanks for posting such a common sense approach. The whole debate reminds me of watching the 700 Club. A mother called in, desperately worried about her young child who had a fever, and the hosts' response was to pray together.

Now, there's nothing wrong at all with praying, but never once, even in passing, did they suggest Tylenol, a doctor's visit, or any other pragmatic, health-promoting advice.

Religious faith plays an important role in the lives of so many people, but social health policy needs to be directed by science.

Thanks, Reverend Haffner, for simultaneously being a voice of faith and reason.

Christine Robinson said...

The forgoing comments have focused on Natural Family Planning, but I'm interested in your implication, Debra, that a physician who follows her church's teaching against artificial birth control and the meaning of sexuality in human life should not be allowed to follow those teachings in her medical practice but must, by virture of being a physician, counsel and prescripbe all available legal options, even if patients have been informed in advance of the physician's practices.

I don't agree with those practices and I would not be a patient in such a practice. And that might be inconvenient for me and mean I have to travel to get medical care. But as a believer in the sacred right of individual conscience, I could hardly ask this physician to do something she considers immoral.

The price of living in a pluralistic society is that we must respect each other's consciences. If I say, "against abortion, don't have one!", a Catholic physician has to be able to say, "want birth control pills? Go elsewhere."

Anonymous said...

The problem I have with a doctor who puts their own morality ahead of the welfare of their patient is that it interferes with the practice of medicine. Suppose a child were to have some concerns about a potential problem or wanted to know how to limit the risks of venereal diseases? If it were me I would hesitate before asking a doctor whose clearly stated position was to refuse to prescribe contraceptives. But a doctor is exactly the person who is most qualified to answer such questions! A kid in that situation is going to have enough problems just asking without having to worry about additional issues because the doctor holds certain beliefs.

I could easily see the same scenario with a wife who was nervous that her husband was having an affair. Perhaps she is having an affair and wants to limit the risk of exposing her husband to diseases. Maybe it’s a single woman who has been raped and did not report it, but is worried about diseases or becoming pregnant.

Is it really ethical for a doctor to refuse to refer a patient to another doctor whose work they have confidence in and to let the person end up finding someone who may not be as experienced? This is playing with someone’s health, maybe even life! Shouldn’t a doctor put the patient before their own morals?

Anonymous said...

Rev. Haffner

Thank you for posting comments reflecting such a diversity of viewpoints on this issue.

I would like to add to my comment above that those who advocate outlawing NFP-only practices or preventing physicians from practicing in accord with their consciences may not realize how severely such actions would restrict the choice of women who seek them out.

It undermines the position of proponents of reproductive choice when they propose restricting choices they disagree with or would not seek out themselves.

Detractors of NFP-only practices argue that in rural areas, an NFP-only physician might be the only one available. This is not the fault of the physician (who if she is foregoing the revenue of contraception and abortion is not making that much money). Organizations like Planned Parenthood could also take the financial hit to locate a factility in such underserved locations in the service of enhancing "choice".

As long as the practice is public and clear about what it does and does not offer, it has a right to exist. The few women who accidentally stumble upon it and find it not to their liking are no worse off than I was when I sought NFP instruction at the secular University of Michigan Health System. I was not at all religious at the time. My mother had just been diagnosed with estrogen-receptor-positive breast cancer, and I had decided to forego hormonal birth control. I wanted to learn NFP NOT from a church group. When I asked my physician, she laughed and compared it to snake oil. I left with an unwanted Pill prescription in hand and a government brochure on "periodic abstinence." It was not helpful. In my view, I was denied legitimate health care information.

My reaction was not to claim that U-M has no right to practice according to its beliefs (i.e,, that NFP doesn't work, is the province of religious fanatics and that hormonal contraception carries no risks to women's health.). My reaction was to look for another doctor.

I found an NFP-only doctor in practice with a pro-life physician who does prescribe contraception. The practice more than met my needs.

For those who embrace reproductive choice, I don't understand why the ethic of "let a thousand flowers bloom" doesn't apply. I hate to think that it reflects a basic prejudice or lack of concern for the sensibilities of those whose views are different or even abhorrent.

As a lifelong political liberal (a pro-life Democrat, actually), I don't see how this squares with our concepts of freedom of conscience and the value of diversity.

Anonymous said...

Now, there's nothing wrong at all with praying, but never once, even in passing, did they suggest Tylenol, a doctor's visit, or any other pragmatic, health-promoting advice.
*************
Prayer does not replace real medical care at the Tepeyac Center-it's a complement to it. When my labor was not progressing and my son's heartrate was dropping, my doctor and I didn't pray for him to come out. I had a C-section. I did, however, receive a wonderful talk from my doctor at my last office visit about being accepting of my labor and delivery if it didn't go the way I hoped ( I wanted to go natural, but ended up with a C-section) which really helped me recover from a difficult L & D. I would never have received this help and support from a secular practice.

Anonymous said...

I not only support the clear and distinct separation of church and state, but equally feel a physician's religious beliefs belong at home, or in the church,but not in a medical office or hospital.
************************
In a private practice, this would be an imposition of the State upon the Church.

Bill T said...

Ms. Robinson argues that a doctor should have the right to let her/his conscience guide her/his practice. But imagine if this premise were extended to other professions.

Imagine, for example, the Scientologist pharmacist who refuses to provide psychiatric medications because of moral objections, and preferences for behavioral treatments.

Or the emergency room doctor who refuses to perform a blood transfusion because of moral objections stemming from the Jehovah's Witness faith.

Or the Islamic elected official who refuses to have any official duty performed during the holy month of Rammadan.

Or the Catholic butcher who refuses to sell meat to his or her customers on Fridays during Lent.

Or the fast food worker who refuses to serve anything that is not prepared in accordance with the rules of preparing Kosher meals.


All these scenarios are, of course, absurd. People should not seek out jobs that are fundamentally in conflict with their religious beliefs. Likewise, a medical doctor should be prepared to provide the full range of services expected of the profession, without imposing her/her sense of subjective morality. Otherwise, s/he should consider looking into another profession.

Sparki said...

I agree -- I don't understand why the patients are free to have whatever religious beliefs they want, but the doctors aren't?

It's their private practice. They openly state their philosophy. They don't MAKE anybody come to see them -- patients are free to choose their services or go elsewhere. So where it the travesty? Where is the injustice?

To me, the injustice would be forcing a person of ANY profession to do something that is entirely opposed to their personal religious beliefs. I don't want to force Jewish doctors to work on Saturday because it would be nice for me to be able to have appointments on Saturdays instead of during the work week. I don't want to force. Why do some of you want to force Catholic doctors to prescribe contraception?

Aren't they human beings with a right to the same freedom of religion that you and I enjoy?

Sparki said...

Bill, you seem to think that all OB/GYNs do is hand out contraception. There is a lot more invovled in this profession. Some people who get degrees in this kind of medicine only do fertility treatments -- they don't offer a full range of services. Do you condemn them for not offering everything? Soem OB/GYNs won't perform abortions because it violates their conscious, but they do everything else. Would you force them to do something they honestly believe is murder? Some OB/GYNs won't deliver breech babies because their insurance won't let them -- do you want them to get out of the business too, because they don't offer a full range of services?

Fact is, the medical profession has gotten so specialized, hardly any doctor offers a "full range of services." So why get all bent out of shape that these particular doctors openly advertise that they don't offer contraception, leaving women free to choose to work with them or not?

Why do you think that people who have earned medical degrees are no longer entitled to the same freedom of religion that you have? Nobody is dying because they don't write Rxs for contraception. And no woman is denied the contraception she wants, because plenty of other physicians will give her the Rx.

Earthbound Spirit said...

sparki notes:
"I agree -- I don't understand why the patients are free to have whatever religious beliefs they want, but the doctors aren't?

It's their private practice. They openly state their philosophy. They don't MAKE anybody come to see them -- patients are free to choose their services or go elsewhere. So where it the travesty? Where is the injustice?"


This assumes that a woman lives in an area where more than one medical practice is available, and has the resources (money and/or adequate health insurance) to 'go elsewhere.'

There are states where only one abortion provider exists. There are large rural areas in this country that are served by one or two health care providers. And speaking of health insurance - some 'preferred provider' plans are pretty limiting of patients' choices, too.

Sure - offer NFP as an alternative. From what little I understand of it, it works for couples who are super-dedicated to making it work for them. OTOH, don't deny an alternative choice to the other couples, who may not have a choice of health care provider.

Anonymous said...

Let's reverse this scenario. Suppose I'm in a small town where the only ObGyn available is one who also performs abortions. I'm morally opposed to abortion and feel I cannot support this ObGyn with my money. What do I do? This more often seems to be the case these days.

Bill T said...

Sparki, I appreciate your thoughtful comment, but we disagree. Again, imagine the pharmacist who refuses to fill a psychiatric medication because it sincerely violates his/her Scientologist beliefs. We could argue that there are plenty of pharmacies to choose from, but what gives a medical professional of any type the right to say, “No, MY personal religious beliefs outweigh the treatment YOU need”?

Where is the line to be drawn? At what point do we say it is NOT ok for a medical professional’s personal religious beliefs to infringe on the treatment process?

And if we DO say such infringement is ok, how do we go about choosing which religious beliefs are worth upholding? You argue that it’s ok for a doctor to say, “No birth control for you” but how about a doctor who decides, “No, I’m not going to treat your genital warts because I don’t approve of your having sex outside marriage.”? Or what about a doctor who has a religious or moral objection to war? Is s/he within her/his rights to decline treating a patient who is a soldier? (“I just can’t condone the way you got your Post Traumatic Stress Disorder…”) just as long as they make an announcement, "NO SOLDIERS TREATED HERE!"

Several years ago, my then 4-year old son fell and split open his chin when he fell while we were at a “family day” at the racetrack. Imagine if, at the emergency room, the doctor said, “I can’t stitch him up…you might go back to the track and I oppose gambling.”

If a person decides to become an MD, pharmacist, or whatever medical profession, patients have a legitimate right to expect that need whatever appropriate medication --- from valium to the contraceptive patch --- they need to treat their medical needs are not going to be dictated by what the doctor or pharmacist prays about in church.

Sparki said...

Again, imagine the pharmacist who refuses to fill a psychiatric medication because it sincerely violates his/her Scientologist beliefs. We could argue that there are plenty of pharmacies to choose from, but what gives a medical professional of any type the right to say, “No, MY personal religious beliefs outweigh the treatment YOU need”?

What give society the right to tell the pharmacist that his/her religious beliefs don't matter? It's the USA, dude. You vote with your money and your feet. If Pharmacist A doesn't give you what you want, you go to Pharmacist B. And maybe Pharmacist A winds up going out of business, but that's his problem.

And I live in Nebraska, where there are a TON of small towns. Even the folks who live in very remote areas have more than one option for pharmacists.

Where is the line to be drawn? At what point do we say it is NOT ok for a medical professional’s personal religious beliefs to infringe on the treatment process?

As long as there are many other medical professionals who don't have a religious impediment, it's not an infringement. Our medical professionals are people, too, and they have the same rights as we do, the same freedom of religion that enables them to just step aside and not participate in something they believe is immoral. This is why Amish men don't have to fight in wars if they are drafted, and why Jewish shopkeepers don't have to be open on the Sabbath and Muslim workers can't be fired for taking a day off on one of their holidays, etc., etc., etc.

If you really want freedom of religion, you have to let EVERY person be free to operate on their religious convictions. Even if that means a person has to go someone else for the services they want.

And if we DO say such infringement is ok, how do we go about choosing which religious beliefs are worth upholding?

Any sensible person can answer that one. If Dr. Smith's religion tells him he can't perform abortions, then he doesn't have to. But if Dr. Jones' religion tells him to molest children, he can't be allowed to do that.

You argue that it’s ok for a doctor to say, “No birth control for you” ...

Not at ALL! And that's not what's happening and I'm rather appalled that you would try to pull that over on people.

What these doctors are saying is, "We do the NFP thing, not the contraception thing here." Patients are NOT being denied contraception because they can go just about anywhere else to get it. The patients who ARE seeing these doctors are people who have ELECTED to operate with the NFP system instead of artificial contraception. Everybody's freedom of religion is protected -- these docs, their patients, and the people who choose to reject these doctors and seek healthcare elsewhere.

...but how about a doctor who decides, “No, I’m not going to treat your genital warts because I don’t approve of your having sex outside marriage.”?

Nobody's doing that or condoning that. Same goes for your soldier and racetrack examples.

These doctors have never said they won't treat any illness. All they've said is that they don't prescribe contraception. And they say so openly. So the people who want it know they can go elswhere. Heck, you can usually get prescriptions for contraception at any Planned Parenthood clinic without anybody looking over your medical history to see if it would endanger your very life (due to smoking, family histories of blood clots and heart disease, liver problems, etc.)

Getting contraception is really, really easy. So what's the big deal if a few small practices of doctors here and there skip that part because of their personal religious beliefs?

If a person decides to become an MD, pharmacist, or whatever medical profession, patients have a legitimate right to expect that need whatever appropriate medication --- from valium to the contraceptive patch --- they need to treat their medical needs are not going to be dictated by what the doctor or pharmacist prays about in church.


No, that's not true. If a doctor is a urologist, I can't expect him to do a good job operating on my torn ligaments. If a doctor is a pediatrician, I can't expect her to know exactly how to take care of my mother's Alzheimer's disease. If a doctor is a dermitologist, I can't expect him to be able to do neurosurgery. Nobody expects every single doctor to know how to do every single thing.

As I said previously, even among OB/GYNs who are okay with contraception, not all of them offer every single OB/GYN service there is to be offered. So there's no need to get bent out of shape by these guys. Give them the freedom to practice their religion, same as you have the freedom to practice yours. If that means you won't use them for health services, fine. And if it means they can't get enough patients to stay in business, fine.

The most important thing is that we are all free to believe what we believe, and nobody is required to park their convictions at the door when they go to work.

Sat Sep 09, 03:12:21 PM PDT

Debra W. Haffner said...

This has been a fascinating dialog...but I'm going to cut off what has become a two or three person discussion. Please do not post anything else to this entry...why don't you go see what I posted today, and share your comments on that?

Rev. Debra

Carla Schmidt Holloway said...

I agree this is bad medical practice.

NFP isn't actually the least effective method; I believe withdrawal is. I'm told that NFP is as effective as it is important for you to not get pregnant. If pregnancy would kill you, then you'll be very dedicated to following all the rules to a T and abstaining when you're supposed to. If pregnancy would simply not be a part of your plans, but wouldn't devastate you financially or endanger your health, you're going to be more lenient on following the instructions. My problem with NFP is that it is not as "cooperative" as they make it sound. It's the woman who has to check her mucus several times a day, and when she's ovulating is when she has to abstain. The woman carries the burden of not getting to have sex when she naturally wants it the most. But then of course, there's are other ways of having sex ...

Which brings me to MEDICAL STUDENT: just because you have a problem with mutual masturbation doesn't mean everybody does. There's more than one way to have sex with your spouse and enjoy it. Just shows you don't know much about female sexuality; less than 25% of women can climax with plain old vaginal sex. They need either oral or manual stimulation of the clitoris to climax, and a loving partner will probably be willing to participate in order to give his partner pleasure. To imply that any such sexual activities are "perverse" and "egotistical sterility" is ignorant and prejudiced in the extreme. What kind of doctor will you be if you judge your patients like this?