Learning About NFP in the ER

How do Natural Family Planning and working in the Emergency Department interact with each other? Well, at first glance, it doesn’t seem like there is a lot to relate Natural Family Planning and the Emergency Department. But there is more than meets the eye, for an ER staff alert to the needs of the patient.

Many women come into the Emergency Department looking for an answer to their question. They may be spotting or bleeding, with or without menstrual cramps. Are they pregnant? Or is this another trip to get more bad news? Some of the women are hoping for the news that they are indeed pregnant. That would be great news for them and for their spouse. Some are seeking confirmation that they are not in fact pregnant, and that would be great news for them.

I have had a number of women who are in fact looking to be pregnant and I have to let them know that they are not pregnant. There follows an immediate sadness or anger, or both, on their part and the part of their spouse. But when I get them back to a level of interacting with me, I can ask them if they have ever heard of Natural Family Planning. Almost all of them have never heard of Natural Family Planning. This is an opportunity to educate them that they can use their knowledge of her menstrual cycle to become pregnant. I can explain that the Natural Family Planning method requires no medications, no fancy positions, and no other procedures to achieve pregnancy. I further explain they would begin by charting their cycles for two to four months and see what is normal for them. They would then have intercourse on the days that they have now identified as most likely for them to achieve pregnancy. I would assure them, that while it seems a little too easy, that is how it works!

Here is a short story relating my experience in the ER, helping women try to become pregnant. It is a composite of women I have encountered in the ER, as opposed to a profile of an individual patient, to protect patient privacy.

The patient is 41 years old and has no children. She has been married for five years and trying to get pregnant, but without success. I listen to her, do an exam, and get the test results back. She is not pregnant. She expresses interest, when I tell her about Natural Family Planning, so I go into more detail, approaching it from a medical/practical perspective, appropriate for the public hospital environment we are in. As we talk about all the “maneuvers” she has been going through, without any success, she becomes hopeful as she learns of this option. So I proceed to tell her about her cycle, it’s ups and downs, and how to time intercourse. I inform her the success rate is about the same as what the infertility clinics are doing, and this program is much easier to access. If she wants to proceed, I get her set up with a referral to a Natural Family Planning program.

I prepare for such encounters, by having available information on how Natural Family Planning works, so I can share with the woman general information about her cycle, and the timing of having, or not having, coitus based on her goals. I also have available information on organizations and resources I can connect her with, to help her achieve her hopes and goals. In California, we are fortunate to have CANFP as such a resource.

The Emergency Department environment doesn’t normally allow the physician to see the patient again beyond this initial encounter. So I rely on the Holy Spirit. Just remember, you don’t have to be the one who picks the flower when it blooms. Planting the seed may be all that you get to do.