A different NaPro story: Leah Libresco Sargeant speaks on loss and kindness

Last week, during Infertility Awareness Week, I published an interview with a woman who was served very poorly by her NaPro doctor. He failed her medically and caused her unnecessary physical and psychological harm. 
 
Leah Libresco Sargeant had a very different experience. Sargeant, 31, was married in 2016 and has one living child, Beatrice, who is 15 months old. Before Beatrice was born, Sargeant lost six babies. 
 

Those children are named Robin, Ariel, Blaise, Casey, Camillian, and Luca. Her third pregnancy was a possible ectopic, after which she began seeing a NaPro doctor. She then had a very early loss, sometimes referred to clinically as a ‘chemical pregnancy,’ and two more ectopic pregnancies before conceiving and carrying Beatrice to term. 

These are not dueling interviews, and they are not mirror images of each other. I wanted to share both women’s stories to give the conversation around NaPro more depth and nuance, because it’s so often presented in Catholic circles as a miracle cure, and entirely different from what mainstream fertility doctors can offer. Sometimes it is, and sometimes it  isn’t.

As Sargeant says,”Both stories are true. It’s a reason for people to hold Catholic doctors to a high standard of charity, as well as ethics. It’s not an unreachable standard.” 
 
Here is our conversation, which has been edited for length and clarity:
 
A lot of people lose their first babies. When did you become aware that what you were dealing with was out of the ordinary?
 
 With our first baby, Robin. I didn’t care if it was out of the ordinary or not. People would say things like, “Your odds are good if you try again,” but who cares? Our baby just died. Nobody would say that if your baby got hit by a car. For each of our pregnancies, we focused on the risk to this baby, rather than thinking of it on some abstract level. 
 
After Blaise [the third loss] it was only partly that we were looking for a NaPro doctor. We were looking for a doctor who was a kind person, which wasn’t how we felt about the two doctors we had seen before. It felt like they didn’t see our babies as babies. They barely saw us as people.
 

When we came in for the last ultrasound, we suspected we had lost the baby by that point, and right before [the doctor] came into the room, I heard her say, “Okay, so there’s nothing there?” And they were brusque with us when we were crying in the waiting room. I’m sure it’s uncomfortable for people to see that, but what did they think was going to happen? It felt as though they had never delivered the news of a miscarriage before. You’re surprised by this? 

Even if it didn’t make any improvement in our medical treatment, [having a Catholic doctor] would mean someone who would take our losses seriously. 

How did you go about finding such a person?

We were in New York City, and we were in a Frassati Group for young married and engaged couples, and they said Dr. Nolte and the Gianna Center was really good. 
 
She took a very exhaustive NaPro history with a dozen blood tests, testing every possible hormone. She also asked about all our miscarriages, and when she took notes, she wrote down the babies’ names in the charts. I spoke to her recently, and she wanted to make sure she had accurately transferred all their names. 
 

So it sounds like this is one of those geographical things. Elizabeth had to drive four hours to get to a NaPro doctor, but you had a choice. 

 

Yes,  just walked across town. It was a 30 minute walk, and there was a park nearby. 
 
How did you first hear of NaPro? 
 
I had heard about in general. I took it with a grain of salt, the same as with people who say NFP is the best possible thing for your marriage, and whatever problem you have, NFP will solve it. 
 

It’s hard to make really strong promises, because women’s health is so under-researched. It’s important not to overpromise, not because the science is unsound, but because women’s health is always under-researched. Progesterone may be helpful. Depending on [your underlying condition] ,some studies have found yes, some have found no. It depends on what the nature of the fertility problem is. It’s certainly plausible it could save the life of some babies, but it’s not a given.

We talked about the side effects of medications, and whether it’s worth the chance to try it. I didn’t notice any side effects of taking progesterone, so there was very little down side of taking it. It might help, and it wasn’t difficult to take it. She said we could always come back and discuss how it was progressing. 

The thing that was most difficult was that it was a lot of different pills to take. It was depressing taking a little pill canister around, taking things at every meal, and having that be a reminder of how hard this was for us. 
 
Did you ever sit down and discuss what the parameters would be, how far you would go, what you would try? 
 
It would  have been something we would have evaluated if we had been [pursuing treatment] over a longer period of time. But we did keep getting pregnant. It was, “Is this baby going to make it?” It wasn’t this long, undifferentiated slog. 
 
You mentioned in an interview that, pre-conversion, you found some appeal in the gnostic idea that the “real you” is housed in the body; and in another essay that NFP did some work to heal that. I wonder if having struggles with your body not “functioning” right awoke that struggle at all. 
 
It’s been a long and continuing conversion of heart. There’s a difference between teaching women that their cycle has a structure, versus teaching as though there is no cycle, there’s just periods, and it’s a problem, and here’s how to manage it. That bodies are basically bad, but you can stay ahead of them if you work hard.  [Although, with some situations with NFP,] it can feel like your body is sending you signals from a distance, and it’s foggy. It’s not as though NFP is a magic bullet. 
 
A lot of women struggling with fertility problems talk about feeling like their bodies are broken, or that they betrayed them. 
 
I didn’t feel that way. Although a lot of medical terminology pushes in that direction. “Miscarried” sounds like you were carrying the baby, but you screwed up. “Losing the baby” makes you feel like, “Did I take my eye off the baby? Somehow I lost him.” A lot of language circles around blame. I didn’t have this [particular] problem, but “incompetent cervix” [is another example]. It’s not like you personally went cervix shopping and picked out one with a bad expiration date. 
 
A lot of medical language ticks me off. It sounds like it’s a woman’s fault. [My doctor wrote on my chart] “early loss,” rather than “chemical pregnancy.” Part of what happened was I felt like my body was doing the best job it could.
 

It was personally comforting for me [that I didn’t have to have a DNC]. I got take care of my baby till the end. It could be in my family without involving aggressive medical attention. 

With Camillian, it was an ectopic pregnancy. The blood tests started getting bad, and when we went in for the ultrasound, we were steeling ourselves to hear that the baby had died. But we got told the baby was in the wrong spot and had probably already died, based on the lack of heartbeat and how far along we should be. That really changed things. We were in the doctor’s office in New York, and they said, “You need to go to the hospital.” We took a train to New Jersey [so as to avoid] a surgeon who had been unkind to us. 
 
It was one thing to lose the baby, and for the baby to leave on their own time, but the idea that they were going to take the baby really upset me. The sense of peace I had with the other babies, I couldn’t feel with Camillian. It didn’t feel like it was happening on God’s time table or on the baby’s time table. 
 
Dr. Beiter had just met us. He hadn’t know us before. But he also stopped and talked through all our options. It was a Catholic hospital. Because the baby had already died, we had more options than is sometimes the case. We wanted to know how can we take care of the baby, even if the baby has died?
 

We didn’t like methotrexate very much as an idea. It would have been licit, but I didn’t like the idea of dissolving the baby. You have to wait longer, and it doesn’t always work. 

[The doctor said,] “You could avoid surgery; isn’t that better? You can go home today, and possibly just be done.” We talked it through, and he definitely had a preference for the drug, but he talked through what we preferred. Both options were morally fine and medically effective, and we made the call, and he took good care of us. 

Surgery is a harder recovery. It was locking in a harder recovery, but we wouldn’t expect to go back for another treatment. [With methotrexate, the symptoms of the drug can be similar to those of a tubal rupture, so you may have to go back to the ER.] I just wanted to go home and be done with everything, even if I’m recovering from abdominal surgery.  
 

That’s a tough thing with not just fertility medicine, but with medicine generally. Sometimes things are black and white, but sometimes there are different degrees of benefit and side effects, and there isn’t a single right decision. 

Did you ever receive any specific medical treatment from NaPro doctors that a mainstream fertility doctor would never have offered?

 

It’s hard to know for sure. Some mainstream doctors won’t consider progesterone at all, but my original doctor tested and had me supplement. There were tests that a doctor might have done later that our NaPro doctor didn’t need to wait for many many losses to do. None of them came through, but if I’d had a clotting disorder, I would have been very grateful for her being up to check.

The big (evidence not fully in) treatments we had were metformin for PCOS, and antibiotics for endometritis (which is different from endometriosis). Both of which, from my review of the literature, don’t have enough evidence behind them to make them an obvious right choice. But they have plausible mechanisms of action and (for me) mild to no side effects.

Did you ever have to deal with Catholics judging you for family size or for not having a honeymoon baby? 
 
We’ve been pretty open about our losses. Anyone who knew us enough to ask would know. Sometimes strangers will see Beatrice and say, “Is she your first?” I usually say “She’s our first to make it to birth.” Just because it’s true. 
 
Despite your good experience with Catholic doctors, is there anything you would like to see changed about the culture around NaPro or the conversation around Catholic fertility issues in general?
 

It’s good to remember that there’s not necessarily anything there to be fixed. [Sometimes people speak] in terms of something secretly wrong with you, and NaPro can fix it. We still don’t know for sure. We really don’t know if there was an underlying problem, or if we were just unlucky. 

If you feel like every person’s story ends by finding and fixing a problem, you can get emotionally blackmailed, by yourself, even. “I must have a really secret, obscure problem!” I saw that a bit in the miscarriage support group I was in. For the most part, it was really helpful, but [people would go to extreme lengths like] really aggressive elimination diets. I think people do that because they’ve tried everything, and it hasn’t happened, so they have to look harder for what’s wrong. 

God does make people who don’t have children, because that’s His really exhausting will for them, and not because His will is that they find and fix anything. It’s not comfortable, but it is true. That means people who do fertility care have to talk about the theology of suffering, not just aspirational fixing. 
 

One thing that helped me is that I have a friend who’s a Dominican sister who cares for people who are fatally ill with cancer. That’s their charism: They care for indigent people who cancer who wouldn’t otherwise have anyone to care for them. Not to cure them, but to care for them. That’s what my job was as a mother. 

Can you say more about that?
 
Some moms get to take care of their babies for the mom’s whole life. That’s not what I got to do. Instead, I got to take care of them for their whole lives. 

To care for them without the hope of curing them: That could be my work as a mother. 

Hopefully it’s because He trusts me with them. “I’m going to give you this baby who’s going to die. I’m entrusting you to love this baby in the way that baby needs to be loved, not the way you want to love that baby.”
 
And I worried, what if I get really good at this and God only wants me to do that? 
 
Is there anything we didn’t cover that you’d like people to know about your experience, or about infertility in general?
 
Sometimes people weren’t sure what to say to us. Trying to get us not to be sad is a lousy approach, but a common one. They didn’t say “Don’t be sad” out loud, but that is what they were saying quietly. If you could say quietly “Don’t be sad” in front of what you’re going to say, don’t say it. It’s better if you could say “I’m sad, too” quietly. 
 
What I wanted to hear was, “I’m sorry I won’t get to meet your baby. I would have liked to meet your baby.” 
 
 
***
 
Leah Libresco Sargeant is the author of two books, Arriving At Amen and Building the Benedict Option, and she runs a Substack called Other Feminisms: Creating a culture that values interdependence over autonomy
 

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8 thoughts on “A different NaPro story: Leah Libresco Sargeant speaks on loss and kindness”

  1. I’ve thought about this post for a couple of days now, and I am still troubled by one part of it: the treatment of ectopic pregnancies as actual babies. Ectopic pregnancies never produce children. If the mother doesn’t get it — I am quite deliberately using this pronoun — removed, she dies. It is functionally a tumor that will grow and kill her. The Catholic ‘treatment’ of removal of the fallopian tube is extremely invasive and destructive of the woman’s potential fertility for absolutely no benefit. I could give the specific risks of surgery, but I think all the readers here are familiar enough with them. Methotrexate allows the woman to avoid surgery and preserve her life and her fertility.

    I understand that Ms. Libresco-Sargeant endured truly soul-killing heartbreak. I understand her desire to name the babies she lost to miscarriage. I understand that she regards the ectopic pregnancies as the same as the other miscarriages and wants to mourn them as well. I have known several women who have had ectopic pregnancies. Most of their families were supportive, but in a few cases people blamed the women for saving their own lives. Women in general get the blame for anything that goes wrong with reproduction. Ms. L-S’s actions in naming something that is not and cannot ever be a person adds to that culture of blame by suggesting that an ectopic pregnancy is somehow equal in status to the woman suffering through it.

    I will be open about something: I am strongly pro-choice and loudly in favor of all forms of birth control that are exclusively controlled by women. NFP gives husbands the veto over their wives’ health in fact, regardless of what the books say should happen. That said, I also know that the history of birth control advocacy is poisoned by the worst kind of racism. Further, real choice means supporting the decision to have babies as much as not. (I have two kids. I remember going back to work when they were three months old and trying cases on two hours’ sleep. It’s not something I treasure.) If we’re really going to solve this problem, we have to at least try to talk to each other. In the spirit of respectful communication, I ask you both to acknowledge and support women who do not want to treat ectopic pregnancies as anything but a dangerous illness, and to encourage them to seek effective treatment. Do not shame them for choosing something different from Ms. L-S. This specific and narrow topic merits a lot longer discussion. If it’s done right, the parties might learn something from each other.

    1. You are asking for a spirit of respectful communication yet you tell a grieving Catholic woman that her ectopic pregnancy resulted in an “it” and not a loss to be named? And then you tell her that by naming the unique DNA she conceived (and that she fully believes is a child with a soul) that she is perpetuating a culture of blame? Is that a good start for respectful communication?

      I am very sorry that you know women who’ve suffered ectopic pregnancy and were further wounded by their families. There are always going to be jerks in this world. We can’t stop people from being jerks, and we can’t stop feelings from being hurt. So isn’t it best if we don’t tell people how to grieve even if we might not like or agree with their particular way of grieving?

      You talk about wanting to solve this problem. What problem are we trying to solve exactly? The problem outlined in this article is infertility and its various treatments for Catholic women. You seem to want to talk about other things.

    2. I don’t see how the location where implantation occurs determines personhood…nor does the amount of time a person is going to be alive. An embryo implanting in the uterus is a person, an embryo implanting in the Fallopian tube is a person, an embryo that’s going to die four weeks after conception is a person, and an embryo that’s going to die four years after conception is a person.

  2. I love your description of mothering miscarried babies. So beautiful!
    And I definitely agree on the language used: “hostile uterus” is another example of terminology that tends to “blame” the woman’s body.

  3. I have three living children but I have lost several more babies to miscarriage. Unlike Leah, I do not wish to share my miscarriages and health issues stories with many people. My close friends and family know, but I have no desire to share with the random judgemental Catholic at my parish or especially at work (I work for a Catholic institution). I get judged for my family size all the time but I refuse to “use” my miscarried babies as a ticket into the “true Catholic club” and chose to let everyone at work think that we contracept if that’s what make them feel good about themselves.

  4. I guess I’m having trouble seeing what the benefit is to NaPro versus traditional non-IVF fertility treatments?

    I mean, I know tons of women who use progesterone to maintain a pregnancy after losing one baby. And that’s prescribed by their regular OB’s and midwives.

    I don’t know that I’ve given a second of thought over to NaPro but I’m pretty sure I assumed it was functional medicine, i.e. MD’s and Osteopaths dedicated to finding root causes rather than treating symptoms. But the other article mentioned the woman “tricking [her] body into thinking it was pregnant.” I’m not going to judge other people, especially those who are desperate for a baby. To me, “tricking my body” with massive hormones is everything I detest about the traditional medical community. I get why somebody would resort to it, but I’ll never think that approach is good for a woman’s physical health.

    I guess I’m asking what’s the benefit to NaPro? I know five women (three in my own family so this may be peculiar to our genetic makeup) whose PCOS was significantly improved or cured with low carb paleo style diets. But jumping to metformin before prescribing an extreme low carb diet seems like regular old “take a pill” medicine to me. What’s the difference?

    1. “Tricking your body to be pregnant” is a necessary treatment for many things.

      I have PCOS – if i don’t have a period for over 3 or 4 months, I get progesterone to “trick my body” so it cycles. I also had a period that lasted over 3 months – same treatment – progesterone for 10 days then 3 months of Birth control pills. It was good medicine. I stopped the birth control pills and was okay for the past 2 years.

    2. Just my personal take, I don’t think I would have ever been prescribed progesterone. I have a “standard” 28 day cycle (hence my doctors never took my concerns seriously), but through NaPro, was able to discover that I ovulate a full week later than “normal”, and thus have a very short luteal phase. I doubt I would have ever had anything except chemical pregnancies/missed miscarriages. My NaPro started with progesterone, which lengthened my luteal phase a little but not enough, and eventually prescribed hCG, which I don’t think is common outside of NaPro. Turns out that has been the trick for me – both to conceive and carry babies, as well as to alleviate menstrual pain form endometriosis. And that is a whole separate issue – the ability to diagnosis and treat endometriosis among standard OBs was sorely lacking, at least 15 years ago. I think it has gotten better, but I saw numerous doctors about my severe menstrual pain – no one ever suggested endometriosis. And when I did bring it up, they told me they would only prescribe birth control, and surgery would only happen after a year of failing to conceive or two miscarriages. Not what my not-married self wanted to hear. Furthermore, endometriosis groups (NaPro or not) all agree that seeing your local surgeon for endometriosis treatment is likely going to be a failure. There are certainly non-NaPro surgeons who are quite capable at endometriosis excision, but they are few and far between.

      For me, at least, I read about NaPro prior to becoming Catholic, and it gave me hope about my health care I hadn’t had in years. That the Church is seen as so anti-science and anti-women, when I was getting terrible advice/treatment form secular doctors, yet comprehensive, informed treatment from NaPro doctors, has been quite the testimony to my close friends and family (almost all of whom are not Catholic) who have followed my story. Having worked with five different NaPro doctors/surgeons now, I have been so impressed with every single one of them.

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