Friday, November 22, 2013

OB/GYN: The Hard Questions

So, this rotation makes me ask all kinds of questions. The first one is the most fundamental. When does life begin? And related to that...
  • Should we be mourning miscarriages? Ectopic pregnancies? Vanishing twins? Partial molar pregnancies? Degenerated IVF blastocysts? What about blighted ova?
  • Is hormonal contraception ever useable in sexually active women? In any woman of reproductive age?
  • Are barriers licit to prevent STD transmission between spouses?
  • Is emergency contraception ever useable in victims of rape? Which forms? (Paraguard? Which isn't currently to be given to victims of rape?)
  • Is ovarian hyperstimulation licit?
  • Is IVF licit?
  • When is sterilization okay?
  • What should we do for women who shouldn't have more children?
  • What is parenthood? Genes, gestational carriers/surrogates, adoptive parents? How should men and women licitly become parents?
I need to read Dignitas Personae and Donum Vitae. Just as soon as I have some free time.


  1. Parents naturally mourn all human life which dies. An Ob/Gyn I shadowed told all couples who suffered a miscarriage etc., regardless of age and religion, that "they really are parents, and that they will know their child in heaven". All of them seemed comforted, and not the least bit offended, by this.

    Hormonal contraception is used for all sorts of things in Gyn practice. If doctors understood the endocrinologic reasons for anovulation, menorrhagia, etc. (very often mild insulin resistance undetected by GTT, mild prolacinemia, mild hypothyroidim, cortisol elevations) they would only very rarely need to use supplemental estrogen/progesterone to suppress the HPA axis. Dr. Pilar Vigil (Chilean Ob/Gyn) and Dr. Mary Martin (Oklahoma) are international experts in this field.

    STD transmission is not effectively prevented by condoms. It is better to treat the underlying cause than to suggest this practice.

    Emergency contraception is always a form of early abortion. It is never morally licit, according to Catholic teaching.

    Ovarian stimulation, using clomid, is licit, if the intention is to achieve ovulation, and not to extract an egg for the purpose of IVF. Intentional hyperstimulation is illicit in that it poses a medical danger tot he mother.

    IVF is not licit. Embryos are killed in this process. The woman experiences trauma. Dr. Mary Martin can get most people pregnant without having any recourse to this, simply by understanding the underlying cause of anovulation. It only takes one sperm to achieve pregnancy, and even when the count is low, there are many. There's only one egg (in most cases) for the sperm to penetrate.

    Sterilization is not okay, ever.

    Teach NFP to women who "should not" have more children for psychological or medical reasons. It works when taught well, and well understood. Despite the practice of many American physicians who use Creigton, I would contend that Billings Ovulation Method is the most scientific method out there and the simplest by far and the most hygienic: the guy who did the hormonal work behind this method, Dr. James Brown, was the same guy who helped to invent the oral contraceptive pill in the 60's (and then saw that it was ridiculous to give women exogenous estrogen for 30 years of their life).

    Parents are those who image the Trinity to their offspring.

    -Your Canadian medical student colleague

    1. Thanks for reading and for such a detailed reply! I love how you ended it. God bless you on this feast of St. Paul's conversion!