Trading birth control for prayer and the rhythm method

OB-GYN practices offering "natural family planning" have surfaced as an alternative to "unnatural" practices like birth control.

Published August 31, 2006 7:25PM (EDT)

Practices in natural family planning -- kindred in spirit to crisis pregnancy centers -- are sprouting up throughout the country, the Washington Post reports today. These practices often refuse to write birth control prescriptions, and provide skewed information about contraceptives, sterilization, in vitro fertilization and abortion. Instead, the doctors often pray with their patients and provide information about following a woman's bodily rhythms to properly time intercourse.

Supporters say these centers allow doctors and nurses a way to practice medicine without compromising their religious objections to "unnatural" family-planning techniques. But representing oneself as an OB-GYN when you're in truth practicing something more akin to folk medicine or faith healing, is awfully misleading. Of course, there's room for all sorts of traditional and nontraditional medical practices, and more than enough demand for both. But critics rightly worry that natural-family-planning practices will draw in unsuspecting patients through misleading advertising, à la crisis pregnancy centers.

"If women know before selecting them, then it's quite a legitimate thing to do and might meet the needs of many women and doctors," said Anita L. Nelson of the University of California at Los Angeles and acting spokeswoman for the American College of Obstetricians and Gynecologists. "But if you hang out your shingle that says 'All-purpose OB-GYN' and don't offer certain services, that's false advertising." Jeffrey L. Ecker, an OB-GYN at Harvard Medical School, took that argument a step further: "It's not enough for someone to advertise 'We provide natural family planning' or have a sign up in the waiting room that says 'Only natural family planning available here. The assumption shouldn't be that patients understand exactly what that means. The doctor has an obligation to fully explain all options to their patients."

And that's why some natural-family-planning clinics are so troublesome; for a doctor to misrepresent medical fact seems truly criminal. David A. Grimes of the University of North Carolina School of Medicine in Chapel Hill told the Post that comparing the effectiveness of natural family planning with that of birth control is, hello, "simply incorrect." "These methods do not compare favorably in terms of effectiveness, acceptability and continuation rates," he said. Sometimes, the medical misinformation is dealt through deceptive religious rhetoric, as Nelson points out: "By saying they won't offer pills because 'I'm a good Christian and don't believe in abortion' basically is saying the pill causes abortion, and that's not accurate."

Most frightening is the idea that this trend is growing and that ferreting out real medical information amid the misinformation will become more and more difficult, particularly for poor and undereducated women. (Many of these centers offer services to uninsured women.) R. Alta Charo, a bioethicist at the University of Wisconsin at Madison, told the Post that this is part of a new "era of balkanized medicine." "We've had this for years with religious hospitals. What's happening now is it's drifting down to the level of individual practitioners and small group practices. It essentially creates a parallel world of medicine."

By Tracy Clark-Flory

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