Can I prescribe birth control?

[livingwordunity]

Birth control is legal and people have a right to use it.

In Nazi Germany it was legal to kill Jews. Just because the State declares something to be legal doesn’t make it a right. Any law that goes against God’s natural law is not a valid law.

 

[Luigi_Daniele]

Short answer: no.

I would imagine that if you knew that it wasn’t for birth “control”, you could.

I am a pharmacist, and as I can never be sure, I don’t carry them.

Obviously MAPS and IUD’s are an easy no, as they are never used for anything other than BC. (Although I would argue that BC’s are rarely used for anything else, either. There are other ways to get estrogen and progestin in those cases where they are needed).

 

[grandfather]

Note: There are differing judgments among good orthodox Catholic voices on such (one the first part) due to the potential abortive nature of the pill -that is in the case of one who is sexually active.

Got any references?

 

[Bookcat]

Got any references?

One can look at various works of sound moral theology or indeed online on orthodox Catholic Q&A sites.

 

[TimothyH]

It’s not very realistic to change specialties. I have been working toward my NP for many years, in this field. I don’t have experience with other nursing fields and I can’t just “decide” to switch to dermatology and start looking for a job. It’s a long road and that would be a huge diversion that I cannot afford.

I do not work at a hospital. I work for a private practice OBGYN who is the only one in my town who does not perform or recommend abortions. He is also the only one in town willing to do VBACs. He is a lovely man and a caring, gentle practitioner. Unless you live in a heavily orthodox area, I am not sure there is a way to carry a practice if you do not prescribe any birth control, and I do not live in a Catholic-heavy area. There are several Catholic OBGYNS, but none that have a no-contraceptive practice, in our area. It’s simply part of the job, since very few people are opposed to it (even most of our Catholic clients use contraception.) It is kind of like being a pediatrician who doesn’t give vaccines. Not a huge number of people lining up for that in most areas! Right now, about 70% of our practice uses some sort of prescription birth control that was prescribed by us. That is not counting those who use over-the-counter varieties, or who get their contraceptives from their family practice doctor or a clinic.

The hospital that the OBGYN I work for admits to at is, in fact, owned by Catholic Healthcare West. Abortions cannot be performed on the premises, of course, but there are no rules about the OBGYNs who deliver/operate there not prescribing birth control in their private practices.

Right now we are waiting on some documentation and insurance stuff to be settled before I start seeing patients as a licensed NP. I am so torn about this, since I will NOT be doing obstetrics at all, but straight gynecology and clearly Rx family planning is a huge part of that for the majority of women. I do not want to sin or offend God, but this is a hard one.

Rachel, please reach out to Dr. Kathleen Raviele in Tucker, Georgia.

Dr. Raviele is Catholic and an OB GYN who runs an NFP only practice here in the Atlanta area. She was past president of the Catholic Medical Association. She has spoken at my Church and is highly respected. I’m sure she would be able to provide some direction.

Dr. Kathleen Raviele
2167 Northlake Parkway Suite 105
Tucker, GA 30084
Phone: (770) 491-0255
http://thecatholicsnextdoor.newevangelizers.com/2009/01/21/dr-kathleen-raviele-nfp-doctor/

You might also see if the American Association of Pro-Life OB GYN’s at aaplog.org/ has any resources for you.

-Tim-

 

[Holly3278]

I don’t have an authoritative answer for you but if I was a nurse practitioner specializing in gynecology, I would not prescribe birth control unless it was needed for therapeutic purposes. An example would be prescribing the birth control pill or the depo provera shot to someone who has very heavy and painful periods. The reason is because some pills can reduce the amount of bleeding and the cramping with periods. The depo provera shot can eliminate periods altogether. However, I would try other means first before prescribing any form of birth control. I would never prescribe birth control for contraceptive purposes because I would feel like I was participating in someone’s sin.

 

[littlenothing]

Hi all,

I am an RN who has recently completed studies to become a nurse practitioner. I work for an OBGYN who is pro-life, but not Catholic. I have carried this question in my heart for many months. Can I prescribe birth control? To be perfectly honest, there is no job for me in OBGYN if I can’t prescribe at least birth control pills and diaphragms. Most of our patients are not opposed to birth control and are not Catholic. I would not be responsible for inserting IUDs, but the OBGYN does. I also would not prescribe the “morning after” pill. I am really torn because I know I cannot force my beliefs on others (my husband and I used NFP), and I do need to work. On the other hand, I do not want to commit a grave sin.

Thanks for your (name removed by moderator)ut.

Rachel

Nice to have you on board, OBNurseRachel! I am an NP too, though not in OB. I don’t write for OCP’s and the like, but my collaborator will at times. Maybe it seems chicken, but I just don’t see people who are using it. I refer them or they can see my collaborator. Is it possible for you to specialize? I love treating PCO, for instance, is that a niche you could fill? Or stick to pregnancy or nonchildbearing women? This is a really tough spot you’re in and I completely sympathize.

 

[littlenothing]

Three!

Otherwise, have you thought about changing specialties or checking out working at a Catholic hospital?

Unfortunately, working for a Catholic hospital doesn’t guarantee freedom from ethical dilemmas such as this.

 

[Echolynn]

It’s not very realistic to change specialties. I have been working toward my NP for many years, in this field. I don’t have experience with other nursing fields and I can’t just “decide” to switch to dermatology and start looking for a job. It’s a long road and that would be a huge diversion that I cannot afford.

I do not work at a hospital. I work for a private practice OBGYN who is the only one in my town who does not perform or recommend abortions. He is also the only one in town willing to do VBACs. He is a lovely man and a caring, gentle practitioner. Unless you live in a heavily orthodox area, I am not sure there is a way to carry a practice if you do not prescribe any birth control, and I do not live in a Catholic-heavy area. There are several Catholic OBGYNS, but none that have a no-contraceptive practice, in our area. It’s simply part of the job, since very few people are opposed to it (even most of our Catholic clients use contraception.) It is kind of like being a pediatrician who doesn’t give vaccines. Not a huge number of people lining up for that in most areas! Right now, about 70% of our practice uses some sort of prescription birth control that was prescribed by us. That is not counting those who use over-the-counter varieties, or who get their contraceptives from their family practice doctor or a clinic.

The hospital that the OBGYN I work for admits to at is, in fact, owned by Catholic Healthcare West. Abortions cannot be performed on the premises, of course, but there are no rules about the OBGYNs who deliver/operate there not prescribing birth control in their private practices.

Right now we are waiting on some documentation and insurance stuff to be settled before I start seeing patients as a licensed NP. I am so torn about this, since I will NOT be doing obstetrics at all, but straight gynecology and clearly Rx family planning is a huge part of that for the majority of women. I do not want to sin or offend God, but this is a hard one.

Dear Rachel,

First of all, God bless you for even bringing up the question.

I understand that the first question in OBGYN to a woman in a relationship is “so what kind of birth control can we get you on?”

We need more Catholic women who will reframe the question. “Congratulations on your relationship. Here are some resources on relationship statistics and chastity. Here are some resources on relationship statistics and marriage. Here are some pamphlets on what the pill really does.”

As a Catholic, and a health care provider, I am horrified at the “oh you’re in a relationship - what kind of birth control can we get you on?” mentality. Birth control is not health care.

Fortunately I A) own my business and B) am in alternative health care so that I can present these crazy ideas to women without fear of my job (directly – there is always the “word of mouth/ if they don’t like me” pressure).

That being said – though it is hard to switch now, it is easier to switch now than it is 10 years from now when suddenly you realize you’ve slowly been led down a road where you wake up and see blood on your hands, under your nails, in your walls . . . I didn’t realize when I first started what IVF was. 7 years into practice after putting the pieces together I had to try to educate potential mothers on why I could no longer be part of a machine I didn’t even realize was creating babies just to destroy them. Get out now!

It is hard to switch fields now. It is harder to switch the longer you don’t.

The one saving Grace: If you are in a position to council women away from abortion and abortive procedures into truly contra-ceptive methods, then you may discern if that is where you are supposed to be. There is great good in counseling people away from abortifacients into true contraceptives (for example - from abortions / oral contraceptives / IUDs into condoms / spermacides / other barrier methods) and thus it is not a sin. It IS a sin to council people toward those methods and away from the greater good and ultimate goal of learning the power and rhythm of our bodies as women, and going with the flow that God gave us. This does not mean BC is ok – it means we can counsel from a greater evil to a lesser evil - always with the goal of lesser and lesser evil and greater and greater good.

Please talk to your priest, as I had to do. It’s tough, but we are where we are for a reason. And if you want to join a Catholic-friendly inter-disciplinary practice - contact me.

<3

 

[OBNurseRachel]

Dear Rachel,

First of all, God bless you for even bringing up the question.

I understand that the first question in OBGYN to a woman in a relationship is “so what kind of birth control can we get you on?”

No, that is not the first question we ask our patients. We’d be out of work if we treated women so disrespectfully. If women want to use birth control, they usually ask about it. We would never push a woman into using any medication or device that she did not want to use. If anything, we ask, “Are you interested in talking about contraception or natural family planning?” If the answer is no, it’s no!

We need more Catholic women who will reframe the question. “Congratulations on your relationship. Here are some resources on relationship statistics and chastity. Here are some resources on relationship statistics and marriage. Here are some pamphlets on what the pill really does.”

We’d also be out of work if we approached our patients with that. Most are not Catholic and do not want their annual well-woman exams to be a “surprise” evangelization/morality seminar. Even though I support chaste relationships and NFP, I would be pretty horrified if I were greeted like that at my OB’s office.

As a Catholic, and a health care provider, I am horrified at the “oh you’re in a relationship - what kind of birth control can we get you on?” mentality. Birth control is not health care.

That is not the mentality we have, at all. Birth control is an option for women who feel comfortable using it. That is all. We 100% respect the rights of women to not use birth control. Having said that, yes, if we know a patient is engaging in risky sexual behaviors, we’d rather that women use condoms to protect herself, others and not bring an unwanted baby into the world than to continue to engage in risky AND unprotected sexual behavior. The truth is, we can not change the fact that most women do have premarital sex, and that some women are downright promiscuous and foolish. That is for God, their pastors and their families and friends to deal with. What we can change is if these women become sick or impregnated from their behavior.

Fortunately I A) own my business and B) am in alternative health care so that I can present these crazy ideas to women without fear of my job (directly – there is always the “word of mouth/ if they don’t like me” pressure).

That being said – though it is hard to switch now, it is easier to switch now than it is 10 years from now when suddenly you realize you’ve slowly been led down a road where you wake up and see blood on your hands, under your nails, in your walls . . . I didn’t realize when I first started what IVF was. 7 years into practice after putting the pieces together I had to try to educate potential mothers on why I could no longer be part of a machine I didn’t even realize was creating babies just to destroy them. Get out now!

It is hard to switch fields now. It is harder to switch the longer you don’t.

The one saving Grace: If you are in a position to council women away from abortion and abortive procedures into truly contra-ceptive methods, then you may discern if that is where you are supposed to be. There is great good in counseling people away from abortifacients into true contraceptives (for example - from abortions / oral contraceptives / IUDs into condoms / spermacides / other barrier methods) and thus it is not a sin. It IS a sin to council people toward those methods and away from the greater good and ultimate goal of learning the power and rhythm of our bodies as women, and going with the flow that God gave us. This does not mean BC is ok – it means we can counsel from a greater evil to a lesser evil - always with the goal of lesser and lesser evil and greater and greater good.

This is where I am at right now. I know I cannot maintain a no-contraceptive practice in my area, but I think I can maintain a pro-life practice. I will not be doing obstetrical work, usually, but if I can support the OBGYN in his mission to help women accept the babies they have been given or consider adoption - I think there is good to be done there. I was at a seminar not too long ago, and I asked another OBGYN in our town, “Ten women come into the office on a Monday, and all ten are told that their 16-week-old fetus has Down Syndrome. How many of those mothers schedule an abortion?” Do you know what she said?? “9 or 10.” That makes me sick. Can I help women consider that it might be worthwhile to continue an “imperfect” pregnancy, or even an unplanned one? I think that by supporting the OBGYN in our office, and maintaining a “baby positive” attitude at work, that I can.

Please talk to your priest, as I had to do. It’s tough, but we are where we are for a reason. And if you want to join a Catholic-friendly inter-disciplinary practice - contact me.

<3

 

[Ron_Conte]

I don’t have an authoritative answer for you but if I was a nurse practitioner specializing in gynecology, I would not prescribe birth control unless it was needed for therapeutic purposes. An example would be prescribing the birth control pill or the depo provera shot to someone who has very heavy and painful periods. The reason is because some pills can reduce the amount of bleeding and the cramping with periods. The depo provera shot can eliminate periods altogether. However, I would try other means first before prescribing any form of birth control. I would never prescribe birth control for contraceptive purposes because I would feel like I was participating in someone’s sin.

Contraception is immoral because it is intrinsically evil, and intrinsically evil acts are immoral due to the nature of the act itself (determined by the moral object). The purpose or intention for which the act is chosen does not change the moral object, nor can a good purpose transform an intrinsically evil act into a good act.

So contraception remains immoral, even if it is done for a good purpose, or without a contraceptive intention.

Pope John Paul II: “No circumstance, no purpose, no law whatsoever can ever make licit an act which is intrinsically illicit, since it is contrary to the Law of God which is written in every human heart, knowable by reason itself, and proclaimed by the Church.” (Evangelium Vitae, n. 62.)

Pope John Paul II: “Consequently, circumstances or intentions can never transform an act intrinsically evil by virtue of its object into an act “subjectively” good or defensible as a choice.” (Veritatis Splendor, n. 81).

CCC: “Legitimate intentions on the part of the spouses do not justify recourse to morally unacceptable means (for example, direct sterilization or contraception).” (CCC 2399)

If a woman is not sexually active, then the medication would not be contraceptive, since no sexual acts would be deprived of the procreative meaning. But if she chooses to be sexually active, and chooses to use contraceptives, the chosen act is inherently immoral.

 

[Ron_Conte]

The physician or nurse practitioner who prescribes contraception sins gravely. In the case of abortifacient contraception, I consider that the physician or NP is not merely formally cooperating with grave sin, but is actually procuring a direct abortion. He or she is authorizing a medication that is an abortifacient. In any case, whether the physician or NP is an accomplice without whose help the crime of abortion could not be committed, or a co-perpetrator, the sentence of automatic excommunication applies to all direct abortions:

Pope John Paul II: “The excommunication affects all those who commit this crime with knowledge of the penalty attached, and thus includes those accomplices without whose help the crime would not have been committed.” (Evangelium Vitae, n. 62)

That excommunication for abortion applies even to non-surgical abortions, to any means of procurement of direct abortion, is clear from this decision of the Holy See:

"D. [doubt] Whether the abortion, to which Canon 1398 [refers], is to be understood [1] only concerning the expulsion of the immature fetus, or [2] also to the killing of the same fetus being procured in any manner, and at any time, from the moment of conception.

“R. [response] Negative to the first part; affirmative to the second [part].” Source]

 

[Elizium23]

This is not true. Contraceptive pills are a hormonal treatment which happens to have a contraceptive effect. It can indeed be used for treating medical conditions, as long as the user refrains from sexual relations while she is taking it, in order to avoid the contraceptive and abortifacient effects it can have.

all.org/nav/index/heading/OQ/cat/Mzc/id/NjgyMg/

Many other types of contraceptives, such as barrier methods, are intrinsically evil and can never be used, because their use cannot be separated from a genuine medical purpose. But your argument does not provide an exception for the pill and it clearly exists in Catholic morality.

I also seriously question your allegation that prescribing drugs with an abortifacient effect will incur latae sententiae excommunication. If the user does not have sexual relations, there is no abortion. If the user has sexual relations and there is no conception, there is no abortion. There is no direct participation in an abortion that I can see.

 

[Bookcat]

Regarding excommunication: ewtn.com/expert/answers/abortio2.htm

 

[Elizium23]

The physician or nurse practitioner who prescribes contraception sins gravely. In the case of abortifacient contraception, I consider that the physician or NP is not merely formally cooperating with grave sin, but is actually procuring a direct abortion. He or she is authorizing a medication that is an abortifacient. In any case, whether the physician or NP is an accomplice without whose help the crime of abortion could not be committed, or a co-perpetrator, the sentence of automatic excommunication applies to all direct abortions:

Pope John Paul II: “The excommunication affects all those who commit this crime with knowledge of the penalty attached, and thus includes those accomplices without whose help the crime would not have been committed.” (Evangelium Vitae, n. 62)

That excommunication for abortion applies even to non-surgical abortions, to any means of procurement of direct abortion, is clear from this decision of the Holy See:

"D. [doubt] Whether the abortion, to which Canon 1398 [refers], is to be understood [1] only concerning the expulsion of the immature fetus, or [2] also to the killing of the same fetus being procured in any manner, and at any time, from the moment of conception.

“R. [response] Negative to the first part; affirmative to the second [part].” Source]

Sorry, I do not believe any of this is true for Catholics.

all.org/nav/index/heading/OQ/cat/Mzc/id/NjgyMg/

The so-called “birth control pill” is merely a hormonal drug treatment that has the effect of preventing ovulation, and sometimes an abortifacient effect which prevents implantation of a growing embryo. It has other uses. It is not intrinsically evil.

Hormone pills can morally be prescribed for treatment of irregular periods and the like, if certain conditions are observed. The woman must abstain from sexual relations while she is undergoing treatment with this drug. This rules out the contraceptive and abortifacient effects of the pill.

The prescriber, acting in good faith, when prescribing the pill for non-contraceptive use, and believing that the recipient will abstain from sexual relations while using it, is not committing any sin.

However, looking at the rest of the article I cited, it seems there is good medical evidence against the use of hormone pills for regulating periods, so that is also something to consider when asked to prescribe them.

Furthermore, I do not believe that merely prescribing drugs for birth control will incur latae sententiae excommunication. The prescriber cannot predict or know when or if the recipient will engage in sexual relations, nor whether those relations will result in the conception of an embryo. It is only in rare cases of conception that the ordinary “birth control pill” has an abortifacient effect, its normal effect is to prevent ovulation. Yes, it is a grave sin to prescribe contraceptives, but honestly I would check with a priest or canon lawyer as to the application of an automatic excommunication.

 

[MaryHelene]

Sorry, I do not believe any of this is true for Catholics.

all.org/nav/index/heading/OQ/cat/Mzc/id/NjgyMg/

The prescriber, acting in good faith, when prescribing the pill for non-contraceptive use, and believing that the recipient will abstain from sexual relations while using it, is not committing any sin.

My understanding is that, when using birth control pills for non-contraceptive purposes (i.e. hormonal problems), a couple need not abstain from intercourse. The intent is to treat or cure a medical condition, not prevent a pregnancy, so the use is licit, and the couple need not abstain.

 

[Elizium23]

My understanding is that, when using birth control pills for non-contraceptive purposes (i.e. hormonal problems), a couple need not abstain from intercourse. The intent is to treat or cure a medical condition, not prevent a pregnancy, so the use is licit, and the couple need not abstain.

Regardless of the intent, the reality is that the drug can induce an abortion, and that cannot be permitted to happen at any cost.

 

[Bookcat]

Regardless of the intent, the reality is that the drug can induce an abortion, and that cannot be permitted to happen at any cost.

forums.catholic-questions.org/showpost.php?p=9256899&postcount=16

 

[Bookcat]

ncbcenter.org/ (call number at bottom ask to speak with an ethicist --they can goto detail with you)

fertilitycare.org/massachusetts-medical-consulta/

popepaulvi.com/

 

[MaryHelene]

Regardless of the intent, the reality is that the drug can induce an abortion, and that cannot be permitted to happen at any cost.

The theory that oral contraceptives cause abortions is totally theoretical. As far as I know, there are no legitimate studies that indicate oral contraceptives cause an increase in zygote loss.

I think it weakens the argument against contraception when we mislead people with “proof” that simply does not exist because we think it will bolster our point.