Learning Prudence from Miscarriage, Post-Partum Depression, and NaPro

Two and a half years ago after my last miscarriage, I decided to stop and visit a priest friend of mine who had recently been re-located from our parish. During our visit, he told me something that I had not even considered, nor wanted to consider. It was simply: “Constance, God may only want you to have one child.” He had been our parish priest through two of my miscarriages and he had been the priest to come see me when, unbeknownst to a great many people, I wound up an in-patient at a psychiatric hospital just weeks after having my daughter because I had severe post-partum depression and anxiety. My anxiety was crippling and I could barely function. My priest friend was seeing something that I just didn’t want to see at the time and that is, God has given me a Cross and I need to decide how to live with it and that means making prudent decisions while also trusting in His love and plan for my life.

A couple of months after that visit, a Natural Procreative Technologies (NaPro) physician introduced herself to me. She had heard through the grapevine that I had experienced repeated miscarriage and she was confident that she could help me. I was stunned and had a bit of hope after 2.5 years of devastating losses. She ran an extensive battery of blood tests on me and discovered that I have very low estrogen and progesterone levels. In fact, she told me she was shocked that I had even gotten pregnant to begin with. She prescribed me HCG shots to give myself four times a month in the second half of my cycle. The progesterone corrected immediately, but the estrogen did not and she wanted me to go on estrogen. I wasn’t comfortable with that at the time. We were not actively trying to get pregnant because I was battling post-partum from my recent miscarriage in which I had hemorrhaged and required emergency surgery. Estrogen comes with a one page warning of cancer risks. While that may mainly mean women in menopausal years, it gave me serious pause. My doctor and I decided to wait to use it until we were looking to get pregnant.

My doctor is pretty confident that she can help us have more children through HCG injections, progesterone injections, and estrogen. Yes, I have to do multiple shots and take pills in order to even have a chance of another child. What none of this does is prevent post-partum depression and anxiety. I still struggle to this day, even with my current treatments. Anti-depressants are not a magic cure, and neither are the natural hormone shots that I take each month. As I have gone through this often painful experience with NaPro, people keep on asking me the same thing Father mentioned to me after my last miscarriage. Perhaps I am supposed to have only one child. If enough people are telling you something, it is time to start listening because God is up to something. I began to understand Humanae Vitae 16:

If therefore there are well-grounded reasons for spacing births, arising from the physical or psychological condition of husband or wife, or from external circumstances, the Church teaches that married people may then take advantage of the natural cycles immanent in the reproductive system and engage in marital intercourse only during those times that are infertile, thus controlling birth in a way which does not in the least offend the moral principles which We have just explained.

I was living with guilt. I felt like a failure and I was trying to force myself into treatments to have another child even though I had just spent three years fighting hormone issues, grief from three miscarriages, and serious depression. Whether intended or not, we Catholics can make others who have very serious struggles that limit or keep them from having children, feel like grave sinners and utter failures. I had to stop reading articles debating NFP versus the always open crowd.  It was devastating to read these arguments, many of which were not founded on Church teaching. I have learned not only through my theological studies, but through experience, that it is best to read Church documents and teachings ourselves and then seek guidance from an orthodox priest. Too many people mistakenly transmit their own brand of teaching to the detriment and pain of others. If you struggle with infertility or secondary infertility, do yourself a favor, do not read these debates. They will only reduce you to tears.

My post-partum anxiety after my last miscarriage was also debilitating. It is not something that our family can go through again. There is no prevention or complete cure for post-partum and as I know from experience, medication does not fix all of it. Post-partum is complex due to its hormonal factors and its impact on the rest of the body. I have learned throughout this experience that just because I can do something, does not mean that I should. Having another child is imprudent if it will hurt the one that I have in the process. Her mother developing another severe case of post-partum would be damaging. That is not to say that I don’t think NaPro can really help families. NaPro can also treat gynecological issues and is not just for having children. It can and it does help, but we need to truly discern if God is calling us to more children when serious matters persist in our lives. We need to look at our individual families to make those decisions and not compare ourselves to others.

There is a lot of fighting and arguing between those who read Humanae Vitae as always being open to a ton of children and those who practice Natural Family Planning (NFP) to naturally space out their children. What the former ignores is that God does not call each family to the same size. There are couples who carry the great pain of no children and those like mine who have one. While these people are telling all of us to have big families, they are ignoring that God’s will differs for each person. They also forget that some of us cry very real and painful tears for the children that we will not be able to have for one reason or another. For those of us with medical issues or other reasons, Natural Family Planning is the tool God has given us to live as faithful Catholics in accordance with His will for our lives. Prudence is an essential element of the Christian life and that includes within our family structures.

Much of the confusion related to a clear understanding of child spacing in Humanae Vitae boils down to translation errors. The text most often quoted was translated from Italian, while the text used by the Vatican is translated into English from the Latin, as it should be. Angela D. Bonilla writing for CatholicCulture.org, wrote an extensive article explaining these issues. Based on the translations, she concluded that:

According to HV, the Church calls the faithful to examine their situations and be prudent, generous, serious, and, ultimately, just when putting responsible parenthood into practice. Because this particular set of good qualities and the way they can be manifested are so complex, it is unreasonable to reduce the question to moralistic formulas that focus only on how problematic a situation must be to excuse periodic abstinence. It is also out of place to form opinions about others based solely on how many or few children they have, since these virtues and the lack of them are oftentimes hidden from outsiders. The Church is a Mother who lovingly guides her children and exhorts them to fulfill their manifold responsibilities correctly and with the right priorities. These include embracing children as the supreme gift of marriage and having a generous disposition towards accepting more children than what is merely comfortable. At the same time, the Church does not require or sanction unwise behavior, especially because every child brings about additional, important obligations. When responsible parenthood is understood well and applied virtuously, with God’s help and to the best of one’s abilities, the criteria can and should be both heroically and judiciously integrated into concrete circumstances.         

This is the great Cross of my life. I don’t understand it at times and there are moments the weight is unbearable and I sob in agony. It hurts especially when I sit up at night with my daughter who I know would love to have a sibling. It stings when she asks me when we will have a baby. I hold back tears when a baby is baptized at Mass. Christ has His reasons for giving this Cross to us. I don’t get to know all of the reasons on this side of Eternity. I do know that He is working for my good, if anything, He is teaching me prudence. He is telling me, My will not yours.

It is important for us to remember that God is still in charge of our fertility. He has a plan for each one of our families and it is not identical to the family next to us. There are great medical advances in line with Church teaching that are helping couples today. That doesn’t mean that it is prudent for all of us to use them to have more children. Just because a licit means is available, does not mean it is what we are called to do. Each husband and wife have to very seriously consider their situation. God wants us to discern His will for our lives. Sometimes the answer is the very one we do not want to hear. I never wanted to hear that I should only have one child. I have been running from that thought for a while now, but when I seriously consider what we have been through in the past few years, it is playing with fire to have another child. I know that it could be devastating for my family when the severe post-partum hits again. Someday I will explain all of that to my daughter when she is old enough. For now, I have to ask Christ to help me carry this very heavy Cross.

If, like me, you have battled unbelievable grief, guilt, and embarrassment because life has not turned out the way you expected, give it over to God. Let Him be the one to make these decisions for you. He will tell you if you should continue down one path or another. Do not let guilt be the reason you make decisions. Prudence must be our guide. You are no less a member of the Church because you have no children, one child, or fifteen children. Your family size does not dictate your orthodoxy or devotion to Christ.


Constance T. Hull is a wife, mother, homeschooler, and a graduate with an M.A. in Theology with an emphasis in philosophy.  Her desire is to live the wonder so passionately preached in the works of G.K. Chesterton and to share that with her daughter and others. While you can frequently find her head inside of a great work of theology or philosophy, she considers her husband and daughter to be her greatest teachers. She is passionate about beauty, working towards holiness, the Sacraments, and all things Catholic. She is also published at The Federalist, Public Discourse, and blogs frequently at Swimming the Depths (www.swimmingthedepths.com).

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  • Jane Ellen Hautanen

    Thank you, Constance. I am also in pain as to which direction God wants me to take. I wish you and your family the best.

  • Lee

    I wish you healing.

  • Lisa

    Constance, thank you for sharing your story and please know that you are not alone. Like you, my husband and I always thought we’d have more than one child (I have 6 siblings). We, too, met with a doctor about NaPro when we hadn’t been able to conceive a second child, but decided it wasn’t the right path for us. I had also felt guilt about not giving my child a sibling. However, a couple of good friends reminded me that even if we were able to have another child, there’s no guarantee that the children would even get along. In addition, I felt so thankful for the beautiful child God HAD given me, that I didn’t want to spend any time while he was young yearning for another child. I’ve always explained to my son and to others who seem to question the size of our family that, “God makes families of all different sizes, and he knows what the perfect size is for each family.” You are right to trust in God. I am at peace with God’s plan for my life and have been pleasantly surprised at the path God had led me down. I think you may be surprised at what wonderful, unexpected things God has planned for your life, too. May God continue to bless you!

  • Holly

    I have found post- partum depression often linked to rejection by birth mothers own mother. Essentially a spiritual link that goes unlooked/unacknowledged. For me the internal work of forgiveness was very powerful in my own healing. Just wanted to share.

  • Kelli

    Constance, thank you for being a voice for all those who suffer infertility. Even though you don’t desire pregnancy, please continue with the Creighton model to get your body functioning at its best capacity. You owe that to your family and most importantly to your own health. The Creighton model of NFP is challenging. It requires that we document and become part of a “study.” It can be very frustrating and may require lots of efforts for very little visible results but, you could greatly improve life for future generations by offering your suffering for a greater good. I am convinced that hormone issues are plaguing society. I experienced a miscarriage, like what you are describing , and the tears would not stop:( I did opt to take the estrogen because I had 6 other children that needed their mom and a husband that needed to work. I was only on it for 6 months and it worked. I had to learn to give my health over to a physician (a very devout Catholic physician), and submit to his authority over me. Surrender, God is at work in us always. I now have 3 more children for a total of 9 living and 4 in heaven. We never know what God has in store for us. My last births I experienced no hormonal shifts, and my last miscarriage was filled with “normal” emotion. I smile when I think of the Grace that God exhibited to me. But known of this would have been possible without the help of a dynamic gal teaching me the Creighton model NFP method and guiding me to seek medical interventions numerous times along the way. Sometimes, God allows these struggles so that we can help others. I desire to become a instructor for this method when God gives me the the time away from my family for proper training… it could be in 2 years:) I would recommend that you come see the physician that began this wonderful teaching in Omaha NE , his name is Dr. Hilgers. However, it sounds like God already placed a physician in your path. I will pray for you and all women. Don’t give up, study your body, and make it a part of daily life, and you will little by little grow in prudence, patience, and joy.

  • filiaecclesia

    Constance, thank you for your honesty in sharing your thoughts and experiences of pain and grief. I’m sure you have addressed this in other posts, and I do not at all mean to minimize your experience, but perhaps you are being called to be an adoptive mother? My other comment is based on my own experience as a slightly older woman (I suppose): all our expectations for our lives will undergo extensive renovation by the time we’re done. Whether we have one, five, or no children, whether we marry or don’t, whether we have money or are struggling, on and on there is no guarantee that anything will turn out as we desire. This is wisdom gained from the experience of living and every single person will endure more than enough difficulties in life. Those families you see with their seven smiling children have sorrows and trials you may not be aware of. Your daughter and husband need you and you have each day to do the duties Our God has given you to do. Take heart, dear one: our Blessed Mother had ‘only’ one Child, too.

  • NJ

    I had an extremely loving mother (who is my best friend) and still suffered a great deal with postpartum. It is very much a scientifically proven, hormone related issue. Perhaps a spiritual component can exacerbate it to a degree.

  • nancyveronica

    all I can say is “wow”. This beautiful, gutwrenchingly honest account of how you are learning to carry your cross will be a great blessing to many. Thank you for sharing. I am going to forward this to my daughter who has lost 3 children to miscarriage….and my dear friends who do not have children. Thank you and God bless!

  • Constance

    You are most welcome! I truly hope it helps. Psychiatric illness can be absolutely grave. I didn’t share in the article, but I also have service-connected PTSD from being a 9-11 relief worker when I was in the Navy. My history is complex and PPD was what broke the camel’s back, so to speak. My husband and I have to take into consideration my history and the 3 years I suffered from PPD while also trying to be open to children and experiencing 3 miscarriages. Each miscarriage made the PPD worse.

    Based on some of the comments, some folks have missed my point. It is not miscarriage that is the more serious issue, it is psychiatric illness. Should I run the risk of a third inpatient (yes my PTSD resulted in a lengthy stay 10 years ago) stay to meet the approval of people who think they have a right to read Church documents in a manner that is counter to the Church? Take heart. You are not alone and psychiatric illness is just as serious as other health issues. We have an obligation to our children, our husbands, and Christ calls some of us to completely different crosses. Not having anymore biological children is deeply painful, but being courageous and sacrificial means giving up our own desires for God’s. For now I serve God as the mom of my one beautiful daughter, I am a writer, and a high school theology teacher. In them I share in the job of each woman to be a spiritual mother to all as put forth in St. JPII’s Mulieris Dignitatem. If we are called to adoption in the future, God will open that door for us. God bless you.

  • Elizabeth

    My husband and I have nine children, and while we have used the Crieghton method for spacing and to fix some minor health problems, our childbearing years have been relatively healthy. We teach about NFP and the problems of contraception several times a year at Marriage Preparation courses in our diocese and have related conversations constantly in social settings. Your article will really help us to be more sensitive to other peoples’ struggles, and has strengthened us in our resolve to try to not fall into the crowd that assumes that everyone should have a “full quiver.” Thank you for your honesty. I’m sure this article will help a lot of people.

  • Andy

    That is great insight, Elizabeth. I know with most people it’s not intentional, but I think there is a definitely (and probably often well placed) mind sent that people who don’t have children or only a couple must be using ABC and are not open to life.

  • Jennifer

    Very insightful, I join the other posting faithful here saying thank you. I will ask the question – how does adoption factor in? I know it’s a long, complicated process. Thanks again.

  • Constance

    I actually have 4 nephews who are adopted. Yes, it is a possibility. We do not have the money for the traditional route. It is prohibitively expensive about $20,000-45,000. My brother and sister-in-law did have the money to do that for their son, but they were manipulated out of their money to make it happen. It was awful. My other 3 nephews were adopted through foster care, which is a lot less expensive, in my area about $5000, but emotionally exhausting and taxing with no guarantee. So, we’ll see what God has in store. The adoption system in this country is appalling. There are good families who would be happy to take children, but just cannot afford the cost.

  • Gallibus

    I am sorry to come in on a purely technical basis to what was seemingly a theological and spiritual debate but I would like to suggest to persons with a fertility issue to visit http://www.drclark.com and obtain and study the book ‘The Cure to all Diseases’ by Dr Hulda Clark because her protocols have something very positive to offer people with these issues. The protocols are basically to clean up your bodies and free them of parasites and pollution so that they can perform as they were designed to do. This is done by cleaning the bowel, eliminating parasites and performing kidney and liver cleanses in that order. Removal of metal from teeth is a very important aspect to the cure as well because the parasites feed on the metals from them. You can also get a free e-book download off the site, viz. : ‘Clarke Therapy’ but I recommend reading the ‘Cure To All Diseases’ thoroughly because the case histories are extremely instructive. So I would by no means give up hope, Dear. Study these resources, apply the protocols and get well soon. God bless.

  • I just wanted to say that I’ve had this topic on my heart lately, and that I think you have done a raw and solid treatment of it in your beautiful post.

    A reader from my blog read your post this week and sent me over. I prayed for you tonight after I read this article. I know your crosses are heavy, and my heart goes out to you. I had a miscarriage last fall, and have experienced unexpected secondary infertility/subfertility, and have been through post-partum depression as well. I believe I have been through just a little taste of what you have been through, though. I can’t imagine how hard it’s been.

    I actually have a recent blog post and also an episode of my podcast on these topics. I wanted to share them in my comment not to promote myself, but rather to give any readers who connect with your beautiful post another resource to encourage and inspire them.

    “3 Social Habits that Can Make or Break a Culture of Life” – http://humblehandmaid.com/3-social-habits-that-can-make-or-break-a-culture-of-life/

    “Episode 9: Miscarriage” (Guest Molly Walter of Molly Makes Do) – TheRightHeartPodcast.com

    God bless, Constance!

  • Constance

    Thank you for your prayers and comment! I have read your blog quite a few times. I am so sorry for your loss and struggles with PPD. Thank you for sharing your own experiences. I hope that they minister to many. God bless.