by Cristina Bolling
For years, Dr. Stephen Blaha felt conflicted about the two lives he was living.
On weekdays, he’d put on his white coat and perform his job as an OB/GYN with Atrium Health, which included prescribing birth control pills, tying fallopian tubes and placing IUDs to prevent pregnancy.
But he was having a hard time reconciling his work life with his spiritual life as a devout Catholic, husband and father of six children who believed contraception was a violation of God’s will.
He says he prayed about it for years, until one day in 2022 when on a Zoom call with a men’s Catholic spirituality group, the leader posed a question: What are you willing to give up for the truth?
“I just knew at that moment that I had to change,” Blaha said.
Blaha (pronounced blah-ha) wasn’t just any physician at Atrium — he was the chief of obstetrics at Carolinas Medical Center, the network’s flagship hospital.
He called a meeting with his Atrium medical practice, Eastover OB/GYN, and told the physicians and staff that he would no longer be prescribing contraceptives.
And then he had to tell his patients.
“I sort of looked at it as my penance — I have to explain this to every single patient who I’ve been giving pills to all these years … why I’m not going to do it anymore. That it’s not you, it’s me,” Blaha said during a recent interview with The Ledger in his office.
Patients who wanted contraceptives would have to see one of the practice’s other providers for that service. Many understood, he said. Some didn’t.
After several months, Blaha, 44, said he realized the situation was “not a great long-term solution,” so he decided to look into whether a practice that specializes in Natural Family Planning, or NFP, would be sustainable.
He had been developing a following among Catholic women who were seeking a doctor supportive and knowledgeable in Natural Family Planning, during which women monitor body signs to determine when they’re fertile each month, and avoid intercourse during those days.
So Blaha began to research the region’s Catholic population, and the general market for Natural Family Planning.
Meanwhile, Atrium was planning to shuffle its Eastover OB/GYN offices, sending the physicians and staff from the Indian Trail office where Blaha had been working to a new larger office in Plaza Midwood.
Blaha put together a proposal and delivered it via Zoom to a group of high-level Atrium administrators: with the Indian Trail office scheduled to be vacated, he could open a new Natural Family Planning OB/GYN office there.
They approved, and in December, Atrium Health Women’s Care Natural Family Planning opened — the first practice of its kind at Atrium Health. Blaha says he’s the only physician he knows of in Charlotte who specializes in Natural Family Planning contraception.
He shares hospital call duties with OB/GYN doctors at nearby Atrium Health Women’s Care Creek Pointe. (They deliver babies at the new Atrium Health Union West Hospital.)
The niche practice falls in line with other recent Atrium program expansions, Atrium executives say, such as the opening of a sexual health clinic in SouthPark and a service with special emphasis on hormone replacement therapy for menopausal women spearheaded by Dr. Aviva Stein.
“Our philosophy as a service line is that we want to meet the unique needs of patients — whether that’s physical, mental, emotional — and we design service offerings around that. So we know that a one-size-fits-all [approach] is not going to work,” said Meghan Clithero, vice president of Atrium’s Enterprise Women’s Service Line.
“In this case, Dr. Blaha approached us because he felt passionately about this particular niche, and it just worked, because we happened to have available OB/GYN office space and a brand-new hospital,” Clithero said. “So it was one of those things where it was like the perfect storm of three things coming together: a physician who wanted to do the work, who had a patient following who was seeing that type of care already, and the space for us to offer it. So that made it easy to say ‘yes.’”
Less popular, less effective: Even among Catholics, Natural Family Planning is one of the lesser-used forms of birth control.
The American College of Obstetrics and Gynecology considers fertility awareness-based methods to be among the “least effective” forms of birth control. It estimates that among 100 women practicing fertility awareness-based methods, 24 will get pregnant in a year. By contrast, the ACOG estimates that among 100 women taking birth control pills, 9 will become pregnant in a year, while among 100 women relying on the male condom for birth control, 18 will become pregnant.
When practiced perfectly, using one of the three methods Blaha counsels his patients on, Blaha says the efficacy rate is over 90%. (The methods require women to measure their cervical mucus, take their temperature daily and/or use a urine test to monitor for fertile times of the month when they would need to avoid sex.)
For most couples, Blaha said, the efficacy rate is in the 80s. Both members of a couple must be supportive to use it as a method of birth control, Blaha said, and success does not come without sacrifice.
“The time of the month when a woman might be most interested in having intercourse is going to be when she’s the most fertile,” he said. “It just depends on each couple’s circumstances … how much do you not want to be pregnant right now, which determines how diligent they are.”
Blaha doesn’t know exactly what percentage of his patients are Catholic — religion only comes up if the patient brings it up, he says. But he said he believes Catholic women make up at least half of his patients, with some driving an hour or more for appointments. The Catholic News Herald, which covers the Diocese of Charlotte, wrote about Blaha in an article last month.
He said he makes it a point to inform patients that his approach is sometimes “different than what 99% of OB/GYNs would do in this same circumstance,” and that he’s “very upfront, saying, ‘I might be the only person who will tell you this from this perspective. So please get a second opinion.’ … I’m not opposed to that — ever.”
There are 240,000 Catholics in the Charlotte region (Mecklenburg and contiguous counties of Union, Cabarrus, Iredell, Gaston, Stanly and Lincoln), according to the Catholic Diocese of Charlotte. That number has more than doubled since 2000, a spokesperson for the diocese told The Ledger.
One day last week, Amy Smith drove from her Gaston County home in Belmont to see Blaha, bringing her 2-month-old daughter Mae (short for Mary Elizabeth). Mae was one of the first babies Blaha delivered under his new practice.
Smith, who converted to Catholicism in 2021 while engaged to her husband, Christopher, said she was looking for a Catholic OB/GYN who could help her abide by the Catholic Church’s moral teaching when it comes to family planning.
She also wanted a doctor who would deliver babies in a hospital and have access to all the modern medical interventions she might need for a healthy pregnancy and delivery.
Her sister-in-law recommended Blaha, and she said she now keeps hearing his name pop up in Catholic mom circles.
“Moms keep saying, ‘Where do you go?’ Dr. Blaha! Dr. Blaha!” Smith said.
A move toward a more natural approach: There’s a market for natural forms of contraceptive beyond Catholics, said Michael Thompson, associate professor and associate chair of the Department of Public Health Sciences at UNC Charlotte.
Across the U.S., the “growing trend of everything natural is a buzz, so that’s part of the holistic, patient-centered perspective for people who would like that.”
Medical systems that have Natural Family Planning practices tend to be in Catholic hospital systems, Thompson said, but he said Atrium’s decision to open one near the new Union West hospital, which it is marketed to have a wellness focus, makes sense. (Union West is billed to have “extra amenities to restore your body and mind.”)
“The message around Natural Family Planning fits in, which is probably why from a business perspective Atrium does this,” he said.
It’s not unheard of for a large secular hospital system to offer a Natural Family Planning OB/GYN practice. Charlotte-based Novant Health has one, for example, called Novant Health Triad OB/GYN in Winston-Salem.
Blaha said he perceives that since Covid, “people are super skeptical — way more than they’ve ever been, I think, of the medical industry. So, and I think contraceptives goes along with that.”
But a move toward a more natural way of living started happening before Covid, he said, with women asking, “Should we be doing all these artificial things for our body? Is that the right thing to do, or not?”
Cristina Bolling is managing editor of The Ledger: cristina@cltledger.com
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I believe that doctors practices should drop any religious alignment because it invariably becomes isolating and an opportunity for a doctor of a different alignment to minimize your diagnosis. I speak from first hand experience. A doctor asked for both an explanation of my Native American beliefs and an explanation of my academic and occupational history. Why would the fact that I am working on a full dissertation or a GED test affect my treatment in any way other than communication of diagnosis but doctors are educated in that also. I have unimpeachable witness to the differences that a doctor can be obtuse,dismissive, and indifferent. Just because they can be call Doctor they are also people with human judgements and prejudices. My dark skin long black hair and chiseled features defined me and then I spoke and blew his mind.