Elizabeth Dye never got an apology.
She and her husband had gone to a NaPro fertility care doctor looking for help. She’d had a honeymoon baby, then a second trimester loss, then an ectopic pregnancy. Everyone told them that NaPro doctors are the ethical, humane answer to fertility problems, so they drove four hours to see what help there was.
Dozens of tests, drugs, shots, and procedures later, she got pregnant again: A second ectopic pregnancy, in the same disfigured tube her doctor chose to leave intact despite her request to remove it.
Fifteen years and seven surgeries later, Dye finally got a medically necessary hysterectomy this year for a condition her NaPro doctor missed. He not only didn’t heal her infertility, he caused her and her husband unspeakable sorrow, stress, and pain.
She agreed to share her story during Infertility Awareness Week because it’s so common for Catholics to tell anyone suffering from infertility, “Try NaPro!”
Sometimes that’s good advice. For many women, NaPro technology is literally an answer to prayer. NaPro touts itself as a cheaper, more effective, morally sound alternative to IVF, and some NaPro sites boast a success rate of “up to 80%.” Sometimes the care women receive allows them to conceive and sustain a pregnancy when nothing else worked; and many women say that, after IVF failed them, they felt treated as a whole person for the first time.
But there are other stories.
Couples with stories like Elizabeth’s often keep quiet, because they’re afraid of discouraging hopeful couples, or because they’re leery of damaging the reputation of a fertility system that presents itself as the medical face of the Catholic church — or because people simply don’t want to hear stories without happy endings.
But it serves no one — and often leads to greater heartache — to paint an overly rosy picture of what couples should expect when they try NaPro.
Here is our conversation.
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How did you first become aware you had fertility issues, and how did you address them?
I didn’t think I would have any trouble because my daughter was conceived on our honeymoon. She was a textbook pregnancy and textbook delivery, a four-hour labor. We thought we were good to go, and we were going to have a bunch of babies. I got pregnant when she was about fifteen months old, and that ended up to be a second trimester loss, a little girl. Pathology said they couldn’t find any anomalies, and it was just a fluke.
We weren’t trying to get pregnant, but we were using the stupid sympto-thermal method that never works for anybody. And that turned out to be an ectopic pregnancy, which was really mismanaged by my traditional doctor and by a hospital. My tube wasn’t removed. I was treated with a chemo drug. The baby was already dead, so it’s a folate antagonist so it shrivels the fetus. She didn’t follow the protocol with the drug, so I had to have several doses, which you’re not supposed to have, and it left the tube really disfigured.
We were hesitant to try to have any more children. My doctor thought maybe I had endometriosis, and we didn’t want to try for another baby if it was going to happen again. So everybody kind of steered me toward NaPro medicine.
So we went to NaPro and told [the doctor] everything. He scheduled me for exploratory surgery. He’s about four hours away. Everything looked really great. There was no endometriosis, no sign of PCOS. But I told him if anything looks like a liability for a future ectopic pregnancy, please take it out.
The right tube was horribly disfigured. It looked like sausages when they’re in a link, where it’s twisted. He told me he left it in because he felt he could resection it if something were to happen with my left tube. I wasn’t happy with that.
So we went ahead with the charting, and everything that was required. I had to go to the hospital every day for an entire cycle and have my blood drawn and have it spun out and returned to me. I had a freezer full of blood. At the end of the cycle, it would get shipped to NaPro on dry ice, and he would look at my hormones. It was time-consuming and expensive. My insurance company didn’t want to pay to have my blood drawn and spun out and given back to me.
We also had to do a sperm analysis, but you can only do it with perforated condoms, and they have to have it at the lab within thirty minutes of doing the deed, so that was a great experience to have to run that to the lab.
They never really found anything major. My periovulatory estrogen could be a little higher, but there was no smoking gun. So they put me on fertility drugs to try to conceive.
When we started fertility treatment, they don’t tell you how badly they’re going to make you feel. The debilitating anxiety; all the stuff you can imagine when you start messing with stuff on a fundamental level. So I did fertility drugs, I did Clomid, I did HCG shots to trick my body into thinking it was pregnant, to make more estrogen and progesterone. I did intramuscular injections. And I did get pregnant.
Because I had had a previous ectopic pregnancy, I needed to have labs sent every 48 hours to make sure the HCG doubled, and it did. Everything looked great. And when I went in for my ultrasound, there was a perfect baby, in my right tube. The tube the doctor swore nothing could get through, that was completely sealed off and nothing could get in.
It actually ruptured just prior to surgery. I had an abdomen full of blood. I had the right tube removed, finally.
He told me I could try again next cycle. I tried again, I got pregnant, and I miscarried at about seven weeks naturally.
Through all of it, I don’t think my experience was any different than most women who go so a secular, mainstream fertility doctor. They are pushing a product. Their endgame is to get you a baby. They don’t talk about things like how it’s going to affect you, and I think [the NaPro doctor] was willing to continue treatments after that second miscarriage, after such a short period of time. I lost so much blood, and I still had to go have blood draws to make sure my HCG was going down. At one blood draw, I just flat out hit the floor, passed out. I was put through the wringer, and he was like, “Just have one period and we’ll try again.”
When you’re on that rollercoaster, it’s really hard to get off. You’re basically hormonally not culpable, almost. You make decisions you wouldn’t make if you weren’t jacked on all these hormones. It’s like crack. You might as well be on a totally illicit drug, they are so powerful.
I wish my husband and I had sat down and set really clear parameters for how far we would go, because once you’re started, it’s so hard to get off. I’d be on an intramuscular progesterone that would jack me up to third trimester hormones, and then tank after that. It was like having a baby every month .
They did so many different things to me, it was just throwing stuff up against the wall to see what would stick. They couldn’t find a smoking gun. I felt like a guinea pig. He did say, “We’re still learning, this is still new, we’ve had success with a few patients” with this and that. I felt like I was learned on.
I was very resentful he didn’t remove the tube when I asked him to, if there was something wrong with it. I had a major depressive episode after having been on and off and on and off progesterone so much in such a short period of time. My husband said we would never go there again. Even if I were to get pregnant again, I would never supplement with progesterone. They had never proved there was a deficiency, and my mental health couldn’t handle it. No on asked me if I was prone to depression and anxiety. He just pushed, “This is what I need you to do if you’re going to try to have a baby.” [Using] licit methods doesn’t make them appropriate. They’re pushers.
I imagine it to be the same exact experience with [traditional mainstream] fertility doctors. They would have just kept going.
The last time I saw him was when I went into the OR, and he was so shocked [the tubal pregnancy] had happened. He said over and over that in 23 years, he’s never seen anything like it. My numbers had risen perfectly. He was so sure. He never apologized. He never said, “I should have taken that tube out.” He never said he was sorry.
It was horrible. I remember the ultrasound like I was not in my body. I can see myself sitting in the chair, and them showing me the heartbeat, and knowing the pregnancy had to be terminated. I’m grateful it ruptured, because the baby died naturally.
It happened because he knew better. He knew better than I did. And it was my body. I asked him to take out the tube if it was a liability, but he knew better. He thought possibly he could fix it.
[NaPro] was presented as medically superior. They say they try to get to the root cause and really find out what’s going on, instead of just throwing people on Clomid. They did try to get to the root cause, but they still threw me on Clomid. You have to learn the Creighton method for them to see you, and that wasn’t cheap, to go through an instructor. A lot of this was out of pocket, especially to travel four hours away. My husband works for our hospital, and they’re basically self-insured. If you need surgery, they want you to have it there. They only paid a small portion. I ended up having to have two surgeries out of state.
A few months after that, because of all the hormones I had been on, my gall bladder went kaput, and I had to have gall bladder surgery. I had three major abdominal surgeries in a year.
When did it occur to you that NaPro wasn’t matching up to the hype?
After I got away from it. There was a part of me that knew from the get-go that someone who’s willing to schedule me for surgery without even seeing me first is kind of strange. They scheduled me for surgery and I had my first visit with him 48 hours before. That’s the standard practice.
I used to be in a Yahoo group with a NaPro Catholic group, and it was full of really desperate women. it was so sad. They just kept going on with the next surgery and the next round and ovarian resections and endo removed from their bowels in an attempt to try to have a baby. If this is supposed to be so ethical, I don’t understand why these doctors don’t say, “Maybe you should think about adoption. Do you really want to go forward?” People are going to Omaha and shelling out thousands and thousands of dollars, that could be better spent on an adoption agency.
It’s really rough on a marriage, too. This was thirteen, fourteen years ago. It took a lot of healing. It took a long time for my husband to be at peace with us not having more children. They can never really understand what we go through in having babies, in carrying a person, in having that connection. They can never really understand. There’s a part of me that feels sad or sort of resentful, because he really doesn’t get the way I suffered to try to give him another baby, to have another baby. That lingers. Sometimes I felt like he thought I didn’t really give it the old college try. I almost died twice, and I had all these surgeries. When you die, I tell him, you’re gonna know, and then you’re gonna feel like shit.
They should be counseling couples, maybe asking them, “How’s your marriage doing?” If your marriage is shit by the time you get this baby, what good is it? I know there are plenty of women in this forum who probably did get their baby, but their marriage was destroyed.
Have you felt pressure from Catholics to be positive about your experience?
For a little while. The further I got away from it, the more realistic I was with people. Every experience is different. They might get a good NaPro doctor. I can’t speak universally. Some women have had a super easy fix and have gone on to have all these babies. Those are the poster children they use. Most women do not, and they are on the same rollercoaster and the same drugs as the women who do IVF or IUI are on.
It’s almost like an unspoken attitude that since you’re doing it God’s way, you’re gonna get a baby. I kind of felt like that. We’re going to such great lengths, surely He’ll bless us with a child. And He did bless me with two more children. They’re just not here.
Have you been made to feel like a second rate Catholic because you don’t have a giant family?
I struggle with this weekly, being part of the Catholic homeschool community where four kids is a small family. I’m sure everybody thinks we’re contracepting so we can can have a fabulous vacation every summer. People have told me, “You don’t even actually have a real family; you only have one kid.” It’s really hard to see a lot of pregnant women in our co-op. I don’t want another baby, but it’s like women doesn’t realize how amazing it is that your body just does what it’s supposed to do. Your body can grow people so easily. It’s just a miracle, when I see it with other people. I wish I had cherished my pregnancy with my daughter more. I would have relished it more if I had known.
And you’re still using NFP now?
We use Marquette now, a sort of abbreviated Marquette using mostly Lh strips.
Do you notice a difference in culture between Creighton and Marquette?
It seems less judgmental. It’s being used to avoid more than to achieve, and there’s more support for that. It seems more open to the reasons people would need to avoid, versus the idea that you should just keep having babies until your uterus falls out. Serious reasons are mental health, physical health, my marriage. I need to be a wife and a mom. I need to be alive.
I do have difficulty finding an OB/GYN who will take me as a patient, because I had two ectopic pregnancies and I won’t contracept. That’s another “gift” that’s been given to me by NaPro. It’s forced me back to NaPro. Last summer, I was under so much stress that my period stopped, so I needed to go on progesterone. The NaPro doctor gave me twice as much as was necessary, twice as much as they even give pregnant women. It spurred a big depressive episode.
They kept me on HCG shots for a year after I stopped fertility treatment, because they said it would continue to raise my progesterone and estrogen naturally. I had terrible heartburn. I had to have an endoscopy, and the meds weren’t working. I finally thought that maybe tricking my body into thinking it’s pregnant every blessed month maybe isn’t the best thing to do for my body. I stopped, and the heartburn went away. There were a lot of things like that.
And I cannot get life insurance, unless I get my tubes tied.
What kind of changes would you like to see?
If they looked at us like people, and not just a hormone profile. It was so very clinical. I don’t feel we were looked at like people.
Do you still believe in NFP?
I do believe in NFP, in general. It has made my marriage stronger. We’ve had to grow as people. It has made us less selfish. We’ve had so much more abstinence than the average couple, because we haven’t had any pregnancies. I would say it’s hard, but worth it.
I don’t feel conflicted. After my experience with hormones, I do believe hormonal contraception is bad. [Women on hormonal contraception] are probably feeling crazier than they need to. I’m pretty open about the fact that we use NFP and it works well for us.
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POSTSCRIPT:
This interview is from 2019. Dye has since undergone a medically necessary hysterectomy — her seventh surgery. The condition that necessitated surgery was not diagnosed by her NaPro doctor.
Dye said:
“Not gonna lie, the absence of NFP has been a game changer. The amount of space it takes up in your head is phenomenal — especially if your cycles go off in the weeds, like mine. It’s not that we’re really having more sex or better sex, it’s just the mental burden was so tremendous and I didn’t realize how tremendous.”
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NOTE: I’m in the process of preparing an interview with a Catholic woman who had a very different experience with NaPro.
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