March 27, 2009

Natural family planning-only doctors find peace in integrating faith and science

Dr. Thomas Brown, an obstetrician and gynecologist, speaks on March 19 with medical assistant Emily Linville at his office in Greensburg. Brown, a member of St. Louis Parish in Batesville, is a natural family planning-only doctor who has chosen not to prescribe hormonal birth control for the purpose of preventing pregnancy. Linville is a member of St. Nicholas Parish in Ripley County. (Photo by Sean Gallagher)

Dr. Thomas Brown, an obstetrician and gynecologist, speaks on March 19 with medical assistant Emily Linville at his office in Greensburg. Brown, a member of St. Louis Parish in Batesville, is a natural family planning-only doctor who has chosen not to prescribe hormonal birth control for the purpose of preventing pregnancy. Linville is a member of St. Nicholas Parish in Ripley County. (Photo by Sean Gallagher)

By Sean Gallagher

Second of two parts

GREENSBURG—Prescribing hormonal birth control to women who want to avoid pregnancy has been commonplace in American medicine for more than a generation.

It has become so routine that the medicine has simply become known as “the pill.”

So when physicians refuse to prescribe the pill for both medical and religious reasons, it can cause turmoil in their practice, with patients leaving for other doctors. It can also lead their medical colleagues to question their decision.

But for four such doctors in the archdiocese, the choice has given them peace of mind and, ultimately, has had a positive influence on their practice and the patients they treat.

These physicians have sought to integrate their professional competence with their faith, and thus have chosen to become what are sometimes called “NFP-only doctors,” a reference to natural family planning, a Church-sanctioned way of regulating conception that is in harmony with the natural cycle of a woman’s fertility.

‘Taking care of the whole person’

When Dr. Thomas Brown was studying obstetrics and gynecology in the late 1980s in medical school in Ohio, it was a given assumption that hormonal birth control was “a gift” that women could use to avoid pregnancy.

“Anyone who thought otherwise was an alien, basically, according to the way we were trained,” said Brown, a member of St. Louis Parish in Batesville who practices medicine in Batesville and Greensburg.

For his first eight years of practicing medicine in southeastern Indiana, Brown worked according to that assumption.

But in 2000, after a powerful spiritual experience in Rome, he began his return to the Catholic Church, in which he had been raised, but which he left after marrying his wife, Lisa, who was Episcopalian at the time of their wedding.

His return to the faith led him to question and, eventually, end his practice of prescribing the pill for the purpose of preventing pregnancy, which, he said, caused “a total ruckus” in his office.

“My entire staff melted down,” he said. “Patients were mad. I had people yelling, hanging up because they wanted a refill on birth control and [I wouldn’t do it]. It was ugly.”

But his choice to stop prescribing the pill wasn’t related solely to his re-discovered faith. Brown also studied its side effects and spoke about them with his patients.

“I couldn’t [persuade] people from a religious basis because they don’t care, and half of my patients are Protestant,” he said. “I needed to [tell them] how the pill was bad for you medically—the risk of breast cancer, the risk of cervical cancer.”

Although Brown persuaded some of his older patients to stay with him and welcomed new patients who appreciated his stance, it took three or four years before he was again treating enough patients to make his practice sustainable.

Through it all, he has had no regrets, seeing his choice as a means to fully harmonize all spheres of his life, including his life of faith and his life as a medical professional.

“By understanding my faith and being able to integrate that with the way I treat my patients medically, [using] faith and reason, it’s just made such a big difference because I feel like I’m taking care of the whole person now,” Brown said. “I’m not just taking care of a part of a person.”

‘A big leap of faith’

For her first 18 years as a physician, Dr. Melanie Margiotta spent a lot of time teaching residents in family medicine at Methodist Hospital and the Community Hospital network, both in Indianapolis.

As a Catholic, she accepted the Church’s teaching on natural family planning, but was hesitant to talk about this approach to fertility with her students.

“I avoided trying to teach about NFP because I was never in a Catholic hospital, and didn’t feel supported and actually was a little discriminated against,” said Margiotta, a member of Christ the King Parish in Indianapolis. “I myself practiced it on my own, but I never went to the next step of teaching it.”

That changed when she established her own practice called the Kolbe Center in Indianapolis in 2006. She had originally planned on specializing in addiction medicine, but was persuaded to be open to treating Catholic couples practicing NFP by Daniel Sarell, then the director of the archdiocesan Office of Family Ministries.

She had never heard of the term “NFP-only doctor.” But when Margiotta saw the great desire in many Catholic couples for a physician with such principles, she felt called to go that route.

Now she is receiving training at the Pope Paul VI Institute in Omaha, Neb., in its Creighton method of NFP, and in ways of treating infertility that are in accord with the Church’s moral teachings.

Margiotta is amazed by the amount of scientific research behind the institute’s treatment methods, and thinks that it goes into far more depth in treating infertility than the way it is done conventionally in the medical community today.

“The amount of data that I collect for each patient is just incredible,” she said. “[The institute] has volumes of patient data sitting there just waiting for whoever wants to research more.”

But when she started learning about the many treatments that the institute and its founder, Dr. Thomas Hilger, pioneered, Margiotta was actually angry.

“I’ve become more and more angry the more [that] I learn,” she said. “I’ve had a hysterectomy, and the main reason why was because I had fibroid tumors.

“And now I’m learning that, all along, I could have been most likely treated with the progesterone-estrogen balance and been able to preserve my own fertility … ”

As much as Margiotta personally regrets not knowing about these treatments earlier, she is happy to be an NFP-only doctor and using the science behind it to benefit the infertile couples that she treats.

“It was the right thing to do because, from the moment I said ‘Yes,’ couples have been just so incredibly grateful,” Margiotta said. “It’s absolutely amazing how grateful they are.”

Bringing faith and medicine together

When Margiotta taught residents at non-Catholic hospitals in Indianapolis, she didn’t feel free to teach her students about NFP and other bioethical issues.

Bringing the faith and medicine together in his practice and while mentoring residents hasn’t been a problem for Dr. Brooks Bolton, who is an associate director of St. Francis Family Medicine in Beech Grove.

Even before entering the full communion of the Church in 1998 when he was finishing his residency, Bolton was convinced while still in medical school that he wanted to work at a Catholic hospital.

“I only interviewed at Catholic hospitals … precisely because of their role in putting life first at both ends of the spectrum, be they the elderly and infirmed or the very young,” said Bolton, a member of Our Lady of Lourdes Parish in Indianapolis.

Bolton, an NFP-only doctor, had the chance to help a resident apply her faith to her medical practice in a way similar to his own in 2004 when Dr. Maria Bajuyo came to his office in the middle of a crisis of conscience.

A lifelong member of St. Barnabas Parish in Indianapolis, Bajuyo hadn’t given serious consideration to the Church’s teachings on natural family planning until she got married during her final year in medical school.

As a new resident physician, she was finding it difficult to honor her patients’ request for hormonal birth control, but found little time to reflect on the question due to the typically long work hours of a resident.

Bajuyo was finally able to consider the role of her faith in her medical practice while on vacation.

“It was when I came back from that [trip] that I found myself in Dr. Bolton’s office, teary-eyed and pretty beside myself,” she said. “But he was like, ‘No worries. No worries. It’s going to be all right. We’ll be fine.’ ”

Her choice to become an NFP-only physician was supported by Bolton and the rest of the faculty at St. Francis Family Medicine.

But Bajuyo is especially grateful for having had the chance to learn from Bolton.

“I definitely think that God put me there and wanted me to get to know him,” she said. “It’s absolutely had a huge impact on me and on my formation as a physician.”

Since completing her residency, Bajuyo has found that being an NFP-only doctor has limited her employment opportunities. But she eventually was hired at Honey Grove Family Medicine in Greenwood, which is owned by the Sisters of St. Francis Health System.

“I just have a great deal of peace now, knowing that there’s no inconsistency,” Bajuyo said. “Whether at home or at work, there’s no question of who I am.”

(For more information on the Kolbe Center, log on to

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