Levels of Training for NFP docs

Dr. Hilgers was kind enough to write me (some time ago, sorry for the delay) and let me know about the different levels of training Napro docs can get.  Many of you, especially fertilitycare practitioners yourself, already know this.  But others, like me, had no idea (thank you for those of you who did start to explain it to me under the comments section of previous posts and via email; the letter explained this in more detail).  This stemmed from the fact that at one time I saw a doc I thought was Napro (referred to by my former practitioner) and came to find out he only completed half the training once and never attended anything else to learn more.  While he was the nicest physician ever, it was frustrating.  Frustrating, but not disastrous because I am insanely fortunate to be on my second insurance that covers Dr. H as in network even though we are out of state (though I still curse them regularly, I am forever grateful)! Napro docs are listed on the fertilitycare.org site, but it doesn't distinguish the level of training, only that they've received it.  Here is what I learned.  First of all there are NFP only docs, and while arguably doing something noble and good and need our support and prayers, they have not received any training in Naprotechnology and therefore will not be qualified to just "wing it."  It is something that definitely requires specified training.  I have a wonderful ob/gyn that is NFP only at this time.  I go to him as "baby catcher" since Dr. H still manages my care.  I am excited to report to the locals that he will be attending the training in the fall, which is huge as he is the ONLY ob/gyn in this large metropolitan area that will be trained in Napro!  I digress...

The letter explained the levels of actual training available.  They are:
1. The medical consultant program, which is 16 days long and the basics are covered. There is a variety of physicians that come out of this, some good and some that just seek the certificate.
2. The next level is Certified Fertility Care Medical consultation. They do the same program but get additional certification through the organization that requires some peer review of cases and a three hr exam based on Hilger's textbook. I personally have found the good docs own and refer to this book regularly. Good is my own term, here being defined as "adhering closely to Dr. Hilgers' methods."  Dr. Hilgers himself  said this group "is the most enthusiastic and generally involved in their practice."
3. Finally, the most advanced program is the ob/gyn that has done the fellowship program to learn the surgical aspect of napro. They also know the medical components, but the surgery component allows them to be skilled at Hilgers' high tech methods of less adhesions/scar tissue and tube repair etc. In my opinion, these are the docs for sure well worth traveling several hours to go see for surgery if they are closer than Dr. H and/or Dr. H isn't covered by insurance. Personally, I would never trust another doc with even a lap again. Scarring is too big of a deal.

I am grateful for Dr. Hilgers, his methods, and his network of trained professionals.  I am sorry this information isn't more readily available, but now you have it.  Your personal experience and thoughts are welcome. 

Tying the Knot and If at First You Don't Conceive...

Our wedding was beautiful, picture perfect in my mind. I was so happy to be marrying such a wonderful man. There was no cloud over us, as we were excited to give of ourselves fully and completely as God intended. This time we were doing it right!  The readings came from Tobit, the prayer with Sarah, and Romans 12:1-2 about giving your body as a living sacrifice.  Good friend said she almost stood up and shouted Amen! at that part because we were really doing it!

I remember some things I said in those early days. I was insightful enough to say “how do you prepare to have a baby this cycle and also know you might not ever have one?” I knew it was impossible to stay impartial that way. I vowed to both be excited to have a baby and also to make the most of our time being without children. Something else I said in those early days, “I am not going to let this take over our lives!” Little did I know the fears, the emotions, the learning and physical requirements of it all would very much make their way into every crevice of our lives. I was naïve, yet I am not complaining because, as you will see, we were so very fortunate.
Already we knew we were blessed. We knew that we had more diagnosis than some get in a lifetime (I was pained for the women who had “undiagnosed fertility”). I knew we had hit the ground running when time was so precious. I knew God had rewarded our giving up premarital relations and giving everything over to Him without holding back. The direct result of this was giving up the pill, turning to charging for health reasons, getting a referral for the creator of the charting system (Dr. Hilger’s in Omaha) and coming away from my trip with a handful of diagnosis and another one of treatments-yes, things that could be done about what I had. It wasn't that we were special, quite the opposite; it was that God wants to do these things for everyone, but we had seen our error early and were now changing our ways and letting give us these precious gifts.
So we were hopeful and we were blessed. And yet I was more than a little jealous when friend said that after she got married, they weren’t going to try and they weren’t go to avoid and they would see what would happen. With pcos, endometriosis, low progesterone and estrogen post ovulation, complete lack of ovulation on my own, thyroid and clotting issues, DH and I would never be able to “just see what happens.” You see, because I don’t ovulate without a pill, I either take it or I don’t. And if I don’t do my post-ovulatory shots, I would doom a baby to be miscarried. Yes, a lot of responsibility, but we had a sound moral method to achieve or avoid and so we made our choice to try to achieve.
We tried for two cycles with no results. My sis JB was also trying during that time I believe and one day we had a funny conversation. She was asking me if I put my legs up on the wall afterwards. Of course not, I said. I refused to be caught up in silly wives tales. (and there are a lot of them that come with infertility). I was placing my hope in hard science, and of course faith, and only do treatments that were called for by my diagnoses. I figured this was “function-based” which is similar to what I do in my job (function-based interventions for children with behavior problems). I knew how much it helped in my job, to narrow things down, and I refused to be like so many women doing treatments of this and that without knowing if that was even their problem. I wasn’t judging, but I didn’t want to be desperate like that. With my faith came peace that many with IF don't have. I was grateful to God for the diagnosis we already had.
But even though I wasn’t going to engage in silly wives’ tales, one thing sis JB said stuck in my head; it was about waiting to pee. I had seminal fluid instructions to follow post intercourse as part of CrMS. I had learned these in my sessions. I had asked my fertility care provider at the last appt, did we still do them when we are trying to achieve? Yes, she said, they are about hygiene and avoiding observation confusion. And so each time we had intercourse, I promptly got up and urinated. Silly me. I asked sis JB to return my NFP book I left at her house when I lived there and looked up seminal fluid instructions. I learned that while you still do them within an hour after intercourse, you wait 30 minutes at least when you are trying to achieve. So, validating the wives’ tale with science, I was excited! There was a reason we weren’t getting pregnant. I could do something about it! And so next time, not only did I not urinate for 59 minutes (haha!) but I had my legs up on the wall for good measure.

The beginning of Physical Healing and Authentic Treatment

Well, obviously future DH didn't leave me (or I wouldn't be calling him future dear husband, lol). It wasn't easy, he was full of questions and I answered them as best I could. He was confused, hurting, struggling, and everything else you'd expect. But to his credit, he hung in there. With the help of the Holy Spirit, he survived and our relationship with God, and each other, was strengthened.
Because I knew I had endometriosis since I was 16, and that previously the pill had been used to treat this, I knew I needed something else. Because I had great faith filled married friends in my life using Natural Family Planning (NFP), I knew it was an option for health reasons. It took this conversion to realize that the pill as the only option was an opinion, not a fact. Not only that it came from doctors who do not respect life. For them, it is an easy way out, a band-aid that covered up symptoms. It is not an authentic treatment. Seeking authentic treatment for endometriosis brought me to NFP, specifically the Creighton Model (CrMS), which only involves observation.
I learned to chart on my own, without future DH. He was not against it, and was minimally supportive, but he did not really know his role his since we weren’t even engaged at the time. He went to the intro session with me, but not the follow ups. He understood why I was doing this, and didn’t disagree.
I used the charts to consult locally with a primary care physician trained in NFP (unfortunately there are no ob/gyns in our area). From him I got a surgery referral to Dr. Hilger’s of Omaha, the creator of the Creighton model. He was "the best of the best" to do the surgery, I was told. Through another act of God, while on the phone with the office scheduling the surgery, I became aware that he was also willing to review charts sent in the mail for a small fee and make recommendations, so I decided to do this as well. This was in Dec. 2005.
By the time the letter came back with recommendations, in Feb 2006, future DH has just proposed to me. We chose to fully pursue the testing that was recommended based off red flags Dr. Hilger’s found in my charting. Future DH became more actively involved in my treatment and decisions.