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.

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