One Catholic physician's journey to becoming a Natural Family Planning advocate

Amid the U.S. Conference of Catholic Bishops' Natural Family Planning Awareness Week, Dr. Marguerite Duane, a board-certified family physician, spoke with OSV News' Charlie Camosy about her work as co-founder and executive director of FACTS about Fertility, an organization dedicated to educating medical professionals and students about the scientific evidence supporting fertility awareness-based methods (FABMs).

--Charlie Camosy: "NFP Week" is here. Can you tell us a bit about your personal journey that led you to being such an important voice for natural family planning?

--Marguerite Duane: I first learned about NFP as a first-year family medicine resident in Lancaster, Pennsylvania. One night, as I was required to write birth control prescriptions for patients, my supervising resident, Dr. Pearl Huang, discussed the importance of considering the impact of conventional birth control methods, including side effects. To my surprise, she then told me about evidence-based natural methods that equip women to manage their fertility without any medical side effects. I was stunned. As a physician and a cradle Catholic, how had I graduated from medical school having never learned this?

That conversation would change the trajectory of my entire career, as I began learning more about NFP. I learned the Family of the Americas method to monitor my own cycle and address menstrual health concerns. Then, when my husband and I got married, we used the Sympto-Thermal Method to plan our family. Later exposure to the Creighton Model opened my eyes to the possibilities of charting not only for family planning, but also to address women’s health issues.

In 2010, I developed an elective on NFP to teach to a small group of medical students at Georgetown University. Since the course was so well received, I became determined to integrate this vital information into medical education. That same year, I collaborated with Dr. Bob Motley to found an initiative that has now grown into its own nonprofit organization, FACTS About Fertility. At FACTS, our mission is to educate both current and future medical professionals about the effectiveness and applications of natural and fertility awareness-based methods for family planning and women's health conditions.

--Camosy: I get the sense that there is tremendous interest in NFP when folks really take a chance to dig in and learn about it. This includes, for lack of a better way of saying it, more liberal or progressive folks who one might not expect to be interested. Is that your sense as well?

--Duane: Absolutely. There is tremendous interest in what we commonly refer to as FABMs. The term "fertility awareness-based methods" highlights the broad applications of these methods beyond family planning to management of myriad women's health concerns.

In 2016, the American College of OB-GYNs issued a statement recognizing the menstrual cycle as a vital sign of health and recommended young women track their cycles beginning in adolescence. Understanding the female cycle and learning to track the biomarkers is empowering, attracting people from various backgrounds due to the lack of side effects, synthetic hormones, and environmental effects.

One testimony stands out from a former FACTS elective student. Health-conscious, she exercised daily and ate organic, hormone-free foods but in her efforts to avoid hormones in her food, she had never considered the effects of daily consuming a pill full of synthetic hormones!

As a physician, it is important to promote the evidence for these methods to ensure widespread access to valuable information for women's health. FABMs should be accessible to all women of reproductive age, regardless of religion, race, language, economic or marital status.

--Camosy: Despite this level of interest, it doesn't appear that today's health care professionals have enough training or even basic knowledge of NFP. Would you also agree with this?

--Duane: Yes, medical professionals have limited knowledge about NFP, which is why we established FACTS -- to educate the medical community about the science behind these methods. A study in 2010 revealed that only 3-6% of family physicians and OBGYNs were familiar with modern NFP methods such as the Billings Ovulation and Sympto-Thermal Methods. This lack of knowledge is concerning, as professionals are responsible for providing family planning options to patients.

In a 2015 FACTS study, we identified less than 600 physicians in the U.S. and Canada with basic knowledge of NFP or FABMs, despite there being over 300 million people in the U.S. We are working to address this knowledge gap.

Since 2018, FACTS has educated nearly a thousand medical, nursing, and health professional students on evidence-based FABMs. Even the pandemic didn’t slow our progress -- our medical elective course was already online.

We also offer online continuing medical education courses and host conferences, both in-person and virtually, to further educate medical professionals, FABM educators, and the general community about the importance of FABMs in women's health care. Our next virtual conference will take place Oct. 18-19, 2024.

--Camosy: What can be done to address this problem? What can the church do? What about legislation?

--Duane: FACTS is devoted to bridging medical professionals' knowledge gap regarding the science supporting these methods, primarily through our elective, continuing medical education course and conferences. As of last year, we have partnered with several nursing schools to integrate fertility awareness education, and we are delighted to work with organizations such as Ascension Health and OSF to make this information more readily available to their clinicians.

We also collaborate with organizations that share similar goals of education and research in FABMs, such as the Institute of Restorative Reproductive Medicine of America. Additionally, we actively support programs that train health care professionals in the medical applications of FABMs, including Creighton, FEMM, NeoFertility and Marquette. The church can set the expectation that medical professionals working for faith-based institutions should be educated about the evidence-based effectiveness for NFP and the broader applications of FABMs.

Personally, I am also excited to share that as of July 1, I have the honor to serve as the director of the Center for Fertility Awareness Education and Research at Duquesne University's new College of Osteopathic Medicine. Through our research, our goal is to expand the evidence base for the effectiveness and versatility of natural methods, and this will be the first medical school to incorporate fertility awareness education at every level of the curriculum.

Medical schools from Australia to Europe also want this information, but since FACTS is a small nonprofit with a small team, it is challenging to expand our reach without financial support. We are grateful to the generous donors who make our work possible and made the launch of Duquesne's center a reality.

However, in addition to our donors, we need legislation that will allocate additional resources for this important field of medicine. The RESTORE Act, introduced in June 2024, aims to promote access to information, resources and medical training. The act will ensure that patients and doctors can receive and provide the care that they desire for women and couples struggling with reproductive health conditions and infertility. This is an exciting step toward proactive, authentic women's health care.

Supporting such legislation and organizations like FACTS and Duquesne University can help advance the field of restorative reproductive medicine.