Medical Practices Blend Health and Faith

"It's not enough for someone to advertise 'We provide natural family planning' or have a sign up in the waiting room that says 'Only natural family planning available here,' " said Jeffrey L. Ecker, an obstetrician-gynecologist at Harvard Medical School. "The assumption shouldn't be that patients understand exactly what that means. The doctor has an obligation to fully explain all options to their patients."

Some experts also criticize doctors who represent natural family planning as being as effective as birth-control pills, patches and other medical approaches.

"To suggest they are equivalent to modern methods is simply incorrect," said David A. Grimes of the University of North Carolina School of Medicine in Chapel Hill. "These methods do not compare favorably in terms of effectiveness, acceptability and continuation rates."

And many doctors and advocates argue it is wrong to imply that pills and other contraceptive devices are equivalent to abortion.

"By saying they won't offer pills because 'I'm a good Christian and don't believe in abortion' basically is saying the pill causes abortion, and that's not accurate," Nelson said.

Tepeyac, named after a shrine in Mexico City that inspired Bruchalski, is one of the largest NFP-only practices in the country, with three full-time obstetricians in Fairfax and an office in Silver Spring, serving about 15,000 patients.

The practice makes it clear what services it offers, and Bruchalski said doctors fully explain all options, including natural family planning.

"I think the approach rests on its own," Bruchalski said. "I believe it promotes excellent communication and understanding between the husband and wife, and the woman knows she's not putting something plastic or hormonal into her body."

Many patients who come to the practice are religious, drawn to it because the care conforms to Roman Catholic teaching but also because it is a nonprofit clinic that takes uninsured patients.

"I really like their whole approach," said JoEllen Murphy, 37, of Falls Church, who started going to Tepeyac after she got fed up with her previous doctor repeatedly asking her what kind of contraception she was using.

"It got annoying, so I decided to switch to Tepeyac," said Murphy, who is Catholic. "They share the same beliefs. You go there and know no one is going to try to talk me into something that I'm not morally comfortable with. I feel understood and not judged for my views."

While the doctors routinely pray for and with patients, the practice serves women of any faith, and some women seek it out not for religious reasons but because they like the doctors' natural and comprehensive approach.

"We approach the person from a very holistic perspective -- body, soul and spirit," Bruchalski said. "We tell patients you have to take care of your body. You have to be able to communicate and develop a relationship. You have to meditate and pray to God or a higher power. We bring this to people of all backgrounds."