Cathryn Sprynczynatyk
Dr. Laura Archuleta

Dr. Louise Murphy

Concern for what we put in our bodies -- from nutritional content in food to mercury in fish -- is a long-growing trend. For some women, that concern extends to the area of family planning.

Dr. Laura Archuleta, a family physician with St. Alexius Medical Center, and Dr. Louise Murphy, a family physician at Mid Dakota Clinic, are two doctors who, for reasons grounded in faith and science, no longer prescribe hormonal contraceptives. For patients seeking to avoid pregnancy, they recommend another way -- natural family planning, also known as fertility awareness methods of birth control.

"As it does for many people, it started as a religious thing," Archuleta said. "Natural family planning is the only form of pregnancy regulation that the Catholic Church endorses. It started in my own life from a religious foundation, but as I learned more about it, I found that it was very scientifically based, and medically it is a safer option for women as well.

"There are no artificial chemicals. There are no hormones involved, no procedures to do. It's very natural. I've found almost equal interest in non-Catholics who are interested in the natural side of things. It's a very green way of planning pregnancies."

Methods of natural family planning do not rely on any form of contraception. Instead, the methods are based on observing and recording a woman's biological markers of fertility. The Creighton Model Fertility Care System and the Billings Ovulation Method use observations in cervical mucus. The Sympto-Thermal Method incorporates basal body temperature and cervical mucus with the option of including observable changes to the cervix. A newer method that has been developed by Marquette University is the Marquette Model, which uses the ClearBlue Easy Fertility Monitor to track hormone levels in urine in addition to optional observation of cervical mucus and temperature.

"Basically on any given day, a woman can tell whether she's fertile or not," Archuleta said. "She can plan her activities accordingly. If she is trying to get pregnant, she can plan to achieve pregnancy. And if she is trying to avoid pregnancy, she can plan accordingly."

Couples planning to avoid pregnancy will avoid sexual intercourse during periods of fertility.

"Natural family planning is not considered a contraceptive as it doesn't inhibit ovulation or conception," Murphy said, "but it does allow the couple to avoid pregnancy, when discerned as necessary, by abstaining during the fertile period."

Murphy used to prescribe contraceptives in her practice, but it became morally troubling to her a few years ago.

"I am a Catholic, but prior to 2010, I was prescribing oral contraceptive pills," Murphy said. "It was through a troubling time that I became aware of the (Catholic) Church's teaching and philosophy on contraception. It made sense to me and enlightened my science background. I quickly changed my practice to embrace this beautiful teaching of natural family planning."

Both physicians said the transition went smoothly. Archuleta said her patients know they can get the pill almost anywhere, and they know she won't be prescribing it.

"It's gone much smoother than I expected," Archuleta said. "It's not that different than a doctor saying 'I'm not comfortable prescribing chronic pain medication.'"

Instead, Archuleta has found patients will seek her out because they want an alternative to the pill.

"Many choose (natural family planning) because they have medical reasons that hormones are not safe, such as history of blood clotting that can cause strokes," Archuleta said. "Many choose it for the green option. Society is very environmentally conscious. We worry about artificial chemicals in the food chain and in the water supply. In the same way, women are starting to become very aware of what's going into their bodies."

Alicia Wohl is among those who chose to start using a fertility awareness method of birth control, not for reasons based in faith, but for reasons in her own medical history. When Wohl was in college, she was diagnosed with polycystic ovarian syndrome. At that time, she was put on hormonal birth control, which she said only masked the symptoms. The problem resurfaced in a different way after she got married.

"When we wanted to start a family, I couldn't get pregnant because I have PCOS," Wohl said.

Even though Wohl and her husband had been trying to conceive for a year and a half, they were not interested in diving into fertility treatments.

"I wanted to do (things) as naturally as possible," Wohl said. "I didn't want to go through drugs. I wanted to give my body a chance."

A friend recommended that Wohl talk to Archuleta about natural family planning. Wohl had been concerned about her menstrual cycles, since with PCOS her cycles were far from regular.

"It was awesome; for the first time in my cycling life I actually could see that I did have cycle," Wohl said. "I often went two months, six months without a cycle being normal." A woman's familiarity with her own body and her cycle is a major benefit of natural family planning according to both Archuleta and Murphy.

"It's ... a good way for women to know what's going on with their health," Archuleta said. "I have women bringing in their charts saying, 'I think I have this thing or that thing going.' I used to laugh at that, but I have found they are often right, because they know their bodies so well."

Once Wohl started tracking her cycle through the Creighton Model Fertility Care System, she was able to achieve pregnancy within five months. After their daughter was born, Wohl and her husband used the method to avoid pregnancy for three years. Wohl said both partners have to be committed to the use of natural family planning.

"It's not something you do by yourself," Wohl said, "it's something you do with your husband. If you see things changing, he can ask you, 'Have you had extra stress? Is something going on?' The Creighton Model is not just the physical aspect, it's spiritual and emotional."

When Wohl and her husband wanted to add another child to the family, they were able to achieve their second pregnancy in one month. They now have a 3-year-old daughter and a 2-month-old son.

Archuleta said she has seen how natural family planning benefits relationships. "It brings couples together," Archuleta said. "They both have to be on board with this, and it can strengthen the relationship."

Cathryn Sprynczynatyk is a lifelong resident of Bismarck, a proud Ukranian and a news junkie. She is wife to Jason and mother to Sigurdor and Henrik.