Catholic couples struggle through an infertility care desert

By Zoey Maraist/OSV News

VIRGINIA. Serenity Quesnelle saw six fertility doctors, went through multiple procedures and braved surgery in the hopes of conceiving a child. After four years, one of her doctors felt that nothing more could be done and asked Quesnelle to write down the number of a nearby in vitro fertilization clinic. But Quesnelle and her husband didn’t want to go through IVF, a process that often results in the destruction of unborn lives. She wanted to find out what was going on in her body.

Quesnelle is one of many Catholic women who spend years seeking out medical professionals who will ethically and effectively treat the underlying conditions leading to their infertility. Secular doctors often turn to artificial reproductive technology, while Catholics OB-GYNS who are trained to seek out the root cause of infertility are few and far between.

“There’s a huge demand and we don’t have enough doctors right now,” said Dr. Teresa Hilgers, an OB-GYN at the St. Paul VI Institute in Omaha, Nebraska. The institute has pioneered a restorative health care technique called NaProTechnology, which treats women by supporting rather than suppressing their reproductive systems. Patients have traveled from all 50 states to receive treatment there. “So many are looking for more help and we can’t train people fast enough to help them.”

Quesnelle, who lives outside Detroit in St. Clair Shores, Michigan, found it difficult to find providers who respected her Catholic beliefs. “At one time I was told just to go on birth control because once I went off of it, it would help me get pregnant,” she said. With another non-Catholic doctor, Quesnelle asked about the possibility of going on progesterone supplements, as her blood work had shown low levels of the hormone. “(The doctor’s) exact words to me were, ‘After your first miscarriage we can talk about it,’ “ recalls Quesnelle. “So I never went back to see her.”

But seeing Catholic doctors wasn’t an easy fix, either. “We found a Catholic NaPro doctor a couple of miles away and she was very unkind, her bedside manner was awful,” said Quesnelle. They waited months to see a different Catholic NaPro doctor, but within three days of their appointment, the doctor went on medical leave.

Eventually, one doctor found and removed a polyp that was carpeting Quesnelle’s uterus, preventing the implantation of an embryo. She also found Dr. Lydia Rayes, a family doctor in the midst of receiving NaPro training, who was able to prescribe Quesnelle progesterone. Quesnelle attributes those factors, the Mira fertility monitor and God with the gift of her son.

Quesnelle co-founded The Fruitful Hollow as a resource for those experiencing infertility as it’s not always easy to find answers or support within the church, she said. “It really comes down to women on the internet who have had to walk this path (and) are now helping other women to educate themselves.”

Stephanie Koch realized something wasn’t right after she and her husband spent a year trying to conceive their third child. But her OB-GYN and two different reproductive endocrinologists couldn’t explain why. Worse yet, the miscarriage she experienced was seen as just part of the process. “It never even occurred to the doctor that this was a profound loss for our family,” said Koch. “It didn’t even occur to her that my then four-year-old was sobbing at home because he’s been begging God for a little sister every night.”

Eventually, Koch was able to see her nearest NaPro doctor, located two and a half hours away from her home in Chesapeake, Virginia. Dr. Karen D. Poehailos suspected Koch had endometriosis, an often painful condition where tissue similar to the lining of the uterus grows outside of the uterus. One of the closest NaPro surgeons who could treat her was in Harrisburg, Pennsylvania — Dr. Naomi Whittaker.

“That consultation (with Whittaker) completely changed my life,” said Koch. “She spent about two hours with me just going over a thorough history. She asked questions that nobody had asked before. To feel heard and not totally dismissed meant everything.” During Koch’s 10-hour surgery, Whittaker found Stage IV endometriosis. Two months later, Koch naturally conceived twins.

Koch says the whole process made her lose faith in much of the medical system. “Infertility is a symptom — something causes it. It was such a foreign concept for some of these doctors,” she said. “If the experts seem to only be interested in helping me if I’m willing to pay $30,000 for IVF, who can help me?”

Maria Ranck from Lancaster, Pennsylvania, sought out treatment from Whittaker because she hoped to preserve her fertility while treating her endometriosis. Oftentimes, surgeons will simply remove a diseased ovary or fallopian tube. “I wanted to have a surgeon look at me and say, ‘I’m going to do my best to save every organ because that’s how God created your body to function,’ “ she said.

Whittaker removed the endometriosis growth and fibroids around Ranck’s abdomen and helped her find a cardiac surgeon willing to operate on her thoracic endometriosis, which affects the lungs and heart. Before treatment, Ranck had a myriad of crippling symptoms, including coughing up blood. She’s grateful she feels better and has a chance of having children one day. “I know so many women that had endo and had surgery because they heard my story,” she said. “Now they’re going to have a child even though they were told they needed to have all their (reproductive) organs removed.”

For Whittaker, providing quality, compassionate care is personal. During the birth of her first child, she had what she considers an avoidable cesarean section, made all the more traumatic by the fact that her grandmother died during a C-section.

Sadly, many of the patients she sees are victims of callous care. She recently saw one patient who was nearing 40 and hoping to conceive. For years, the patient wanted to treat her polycystic ovary syndrome (PCOS), but doctors kept prescribing birth control to manage her symptoms instead. “If you don’t treat PCOS then you can get endometrial cancer. We found her cancer instead of being able to help her conceive,” said Whittaker. “That’s just every day. Your heart bleeds for these people.”

Because of the current climate, Catholics and other pro-life medical students often are afraid to go into gynecology, said Hilgers. “The concentration in women’s health care really is on contraception, abortion, sterilization and IVF,” she said. “So, in many ways, medical professionals are not well trained in understanding the menstrual cycle and how to diagnose these underlying conditions and treat them.”

While many doctors and medical professionals are trained in NaProTechnology, far fewer OB-GYNS have gone through the yearlong training the institute offers. “We have about 30 doctors around the country actively practicing, who are doing the surgeries that we do,” said Hilgers. “(The scarcity) is a problem.”

There are challenges even within the restorative fertility world, such as a good, standard set of medical protocols, said Whittaker. “The American College of Obstetricians and Gynecologists has practice bulletins updated by a huge panel of doctors. It takes hours and hours to revise these things and lots of minds that need to come together,” she said. “We just don’t have the manpower or the money.”

But the number of restorative fertility-focused providers is slowly growing. For example, Reproductive Health Medicine & Gynecology has an office near Atlanta, another near Birmingham, Alabama, telemedicine patients from six states and plans to open another physical location in Northern Virginia.

“There are so many Catholics who are struggling with infertility,” said Katie Morris, an RHM Gynecology nurse practitioner trained in Fertility Education and Medical Management (FEMM), another root-cause focused health philosophy. “They need a place to land that’s not just going to educate but uphold the teachings of the church, so you’re not just getting this teaching from the catechism, you’re not just getting it from the priest, but you’re also getting it reinforced in your doctor’s office, when it matters a lot.”

Until the number of restorative health care providers increases, many Catholic couples will devote heartbreaking years searching for competent care. Some may even turn to artificial reproductive technology. “If we’re not going to offer IVF, we have to be able to research the medical conditions that are impacting (couples) and develop ways of helping them,” said Hilgers. “We just have to keep pushing forward.”

More about The Fruitful Hollow, a resource for those experiencing infertility, can be found at www.thefruitfulhollow.com.