Naturopathic Doctor Specializing in Fertility
I had the wonderful pleasure of sitting down to chat with Dr. Rosia Parrish - a naturopathic doctor who specializes in women's health, and more specifically, fertility! The following is a brief recap on our conversation (because, let's face it, I can TALK):
What is the name of your practice:
Naturopathic Wellness Center of Boulder
What drew you to the path you're on:
I wanted to work in a profession that had some overlap with conventional medicine but also incorporated some of the best that nature can provide with the least amount of side effects. I initially wanted to be a medical doctor and do integrative medicine, but didn't think I could survive being in school for four years doing conventional medicine, so I just wanted to immerse myself - I had done pre-med and graduated in 2004, and then graduated in 2016 from Vassar. No one could treat my psoriasis and eczema, and I read a book called healing psoriasis and ended up healing myself! I had a lot of patients experiencing the complications of conventional care, and wanted to have a more gentle approach.
What is the main focus of your practice:
Fertility! I treat women from pre-conception to infertility and those experiencing failed IVF. I treat pregnancy through post-partum. I see other things as well - thyroid, autoimmune disease, etc. My patients who are pregnant do have to have a midwife or OBGyn, but I treat many of the ill-effects of pregnancy in addition to the care they receive from their other practitioners. I have a big tool-kit: I think that when you start incorporating homeopathy, botanical herbs, and lifestyle interventions, the tool-kt gets a lot bigger - a lot of this is European-based, things that are more widely known in other countries, and I can integrate a lot of that here in the United States.
What are things your patients can do to create a healthy environment for that pre-conception or conception:
I always start with functional lab testing to see if there is anything that might be overlooked from a regular visit: nutritional depletions all the way up to hormone imbalances. I ask extensive questions about medical history. In naturopathic medicine, we don't think that anything is unrelated. Anything they have grappled with in their past is probably going to impact their fertility.
How does your care overlap with their other practitioners:
Most of the overlap is with pregnancy. If they're dealing with recurrent pregnancy loss, sometimes I integrate care right away, but once they establish care with an OB or midwife, some labs go through them. If they need managed care for chronic conditions, I can fill in gaps within their other care providers too. Women often get overlooked because there is a focus on the pregnancy rather than the underlying conditions that may be impacting them, so there is a more balanced approach with naturopathic doctors.
Do you treat men:
Yes! A lot of times I see them because they haven't been to a doc in a long time and want a comprehensive lab workup. I treat male factor infertility as well. The majority of fertility patients I see are female but sometimes I see their partner too. I start by ordering a semen analysis, and if there are any concerns, I will see them as a more comprehensive patient and get them more care than they have been getting. Fertility is just as much a male concern as a female. I do lots of work reversing infertility. One of the things we see is that a lot of clinics will use poor sperm for IUI (intrauterine insemination) or IVF, so my work will allow them to have better odds if they use fertility assistance. A lot of my patients get pregnant naturally though, so the work we do can make a huge difference.
Do you follow the same guidelines as most conventional doctors of waiting a year during attempted pregnancy:
No, I think that can be time that gets wasted by just waiting. I believe them when they're struggling or when there's a delay in pregnancy. I don't have a timeframe associated with age. I don't have them wait a certain amount of time to see me, or start treatment. I do have patients that are under 35 and I just hop to it. I don't ever use a delay as an approach to pregnancy. I feel like it's a place in conventional medicine that can cause a lot of mental health concerns and added stress. They could have had that time to treat an underlying cause of infertility where they could have addressed those concerns.
Outside of fertility, do you think a lot of your patients see you in conjunction with other providers:
I have both kinds of patients. I can order labs, imaging, and referrals. I am not a primary care doctor, but I can serve as one. I prefer if people have a primary care or specialist that they see just so that I can have some form of backup so I am not working in a vacuum. Colorado is a very limited scope state. I can't prescribe anything - like with thyroid meds so I can refer out. I have had a number of fertility patients where I refer out for imaging to find they have a prolactinoma, which is a tumor, and that is a super easy and quick referral to an Endochronologist where they can be treated quickly. Often people are working in conjunction with other practitioners. Or like with a UTI, I can do a home remedy, but without improvement, they need a referral quickly so that we don't end up dealing with something more serious.
Do you work full-time?
I work part-time! I typically see patients for two or three days a week.
Are you taking new patients:
What does your intake and patient process look like:
Patients will either find me from referral or word of mouth, or on the internet. Some people book outright or they take a fifteen minute consult to hear what my strategy and approach would be. The first visit is up to 90 minutes and they fill out an extensive intake form and then they can share with me any recent labs or medications, and then I just have them share a narrative about what is going on - birth control history, pregnancy history, hormone history. Then we go through their diet, stress, and sleep, some of the basics and we go over all the systems - breathing, digestion, etc. After that, I come up with a plan and take a short break to order labs and imaging if necessary, and I create a treatment plan. We usually have follow ups every four weeks after that.
How has the pandemic changed the scope of your business:
It actually completely pivoted me into a place where people have access to my practice that wouldn't have before. I can create a really awesome care team for someone who might not live here. I have patients in places in the US that I never thought I would be practicing and sharing this medicine in a lot of different places. It's been a really great thing to come out of all of this.
With Colorado being so limited in how you practice, do you accept insurance:
I am licensed in Washington and Colorado, and the scope of what I can do in Washington is much broader than it is in Colorado. Naturopathic doctors are out of network in Colorado - I am a self-pay practice, so patients have to pay at the time of service and submit to their insurance. If they are in CO or WA I can order labs through LabCorp or Lab Quest and usually those are covered through insurance. But the majority of my patients require specialty labs and those are usually not covered by insurance. It really varies.
Do you feel like a lot of practitioners are supportive of what you do:
Yes, but the problem in Colorado is that there aren't a lot of naturopathic doctors so there is some misunderstanding about what we do. There is a difference between a traditional naturopath and a naturopathic doctor, you know, we are regulated by DORA, and go through rigorous training and education. But, there are only about 200 naturopathic doctors in the state of Colorado whereas there are about 4,000 in Washington by comparison, so there is a general misunderstanding here. There are many traditional naturopaths but they don't have a doctorate, and there is a much less formal training and they are unregulated. Because of that, I think there is a lot of misunderstanding about our profession. But the doctors I refer to and work with understand. We are able to get referrals and get people into hospitals and such. On occasion I have had to educate people on naturopathic care, but mostly I think people are grateful that someone is noticing something obscure with their patient's health and that we are referring them to the appropriate care. I do sometimes attract patients who have had poor medical care or haven't been listened to, and so when referring them back to their primary care, the feedback I have received is that they will be doing more screening for certain fertility concerns.
How have you seen infertility shift over the past few years, maybe ten years:
Were seeing more. And I think a lot of it is there is much more industrial chemicals, and plastics in our environment. I have a lot of patients who work in industrial settings, and with Covid, were seeing some hormone imbalances. When Covid had just kind of started to be treated, we didn't know the pattern that after getting Covid it can take up to three months to re-regulate our bodies. That has changed the fertility world and I think there is more acceptance of talking about it. And I think there is a lot more support. I have connections with all the fertility clinics in the area. There are still gaps in their care, just finding the root causes and why they keep pursuing certain fertility treatments when they know they'll have another IVF failure. That is a huge change with clinics- incorporating things like keto diets (which doesn't work for everyone, but just a shift in treating as a whole...) there have been a lot of cool changes and more acknowledgement of autoimmune issues and immunology, etc. It can be hard for patients to pay for all of those services and even to figure out that that is their problem to begin with, so being able to piece it all together is a huge part of what I do. A lot of patients come to me frustrated, and my role is to pull all of the pieces together and creating a strategy, and a lot of patients get pregnant just because they're able to get rid of some of the stress of it all. Stress has the capacity to shut of our pathway to pregnancy. I have had the majority of my patients get pregnant pretty quickly, and then I am often taking on the first part of their care in pregnancy until they get settled with another care provider like a midwife or an OB-Gyn.
What do you want people to know about your practice:
I think people have misconceptions about naturopathic care - but some people want my care to avoid conventional medicine altogether. A lot of my patients are people who are actively avoiding fertility clinics or have been through the ringer and had multiple failed IVF cycles or recurrent pregnancy loss. I know that is such a heavy and profound place to find a patient, but I find that I have really comprehensive information about my patients, and am able to treat them successfully. Sometimes I am the last thing they try, and many of them are surprised by a natural pregnancy at that point. I have had a few patients who decide pregnancy isn't for them at this point or at their age, but they come to me to get healthier overall.
What do you love about what you do:
I am uniquely useful. I have adequate training and resources to really help people. It took me a long time to get pregnant. My story with fertility is I didn't have a period for 10 years because I had PCOS. I had conventional doctors tell me it wasn't reversable. I went to an acupuncturist who would push a period for me every month. But it took me quite a few years. My approach is a lot faster than what I did. But when we decided that we wanted kids again, I got pregnant pretty quickly because of what I did and had been doing. I have a lot of pregnancies right now and I just get so much joy and happiness from my kids, and the fertility world is so results based. I get to see the results because I see the babies and the pregnancies! I know I am making such a profound change in people's lives.
**This is a recap of our conversation. I transcribed, paraphrased, and edited for length. Dr. Parris is a joy, and I would recommend her to anyone working to get and stay pregnant!! The journey to parenthood is not often linear. We struggled with infertility, and I so wish we had found this gem of a human while we were in the thick of it. If you're on an infertility journey, just know that you're not alone. It's okay to reach out. It's okay to get a second, third, seventeenth opinion! It's your body, and your journey. Please check out my Local Resources page to access more information about some of the pregnancy support!