June 12, 2018
By Emily Krach, DO
Editor’s Note: We celebrate Men’s Health Week by highlighting a husband who recognizes a woman’s fertility is not a problem to be solved, but a gift to be appreciated, valued, and respected. The practice of natural or fertility awareness based methods (FABMs) of family planning brought this couple closer together, as noted below by Dr. Emily Krach, who interviewed them as part of a FABM elective during medical school.
James and Sarah are a married couple with two young daughters and another baby on the way. Before they married, their church required them to attend an introductory session about the various methods of natural family planning (NFP). Their teacher explained the different methods, and they determined the Creighton Model would be the best option for them. The Creighton Model seemed most convenient, since they preferred a method with only one marker of fertility (in this case, cervical mucus).
It took time for Sarah to become comfortable charting her cycles. At first, she was unsure whether she was charting correctly. She also found it difficult to talk about her biomarkers with James, but they have come a long way in terms of feeling more comfortable discussing her charting. Although she is much more confident in her observations now, she still has some difficulty during post-partum charting and distinguishing seminal fluid from cervical mucus.[i]
During the first four years of Sarah’s charting, her pregnancy care took place at a military base with a variety of doctors, residents, and nurse practitioners. She was always asked which form of contraception she wanted to use once her babies were born. After explaining to them that she charts her cycles with the Creighton Model, they usually told her she was choosing an ineffective method and would soon become pregnant again.
Although most of these healthcare professionals were fairly polite, one mocked her for choosing a natural method. This doctor tried to convince her to switch to an artificial form of contraception and told her she should at least use the withdrawal method, arguing this less effective but common approach is more effective than NFP. Although Sarah did not have great interactions with the military medical community regarding her use of the Creighton Model, she did not let that discourage her, and her husband’s engagement and support helped her persevere.
A Husband’s Perspective
“Fertility is not a woman’s problem,” said James to Dr. Krach. “It is not a problem at all. Men should not be asking their wives to eliminate their fertility before having sex. NFP gives us a way to embrace the fullness of masculinity and femininity in our marriage while offering a medically-sound technique for achieving and postponing pregnancy.”
A Couple Grows Closer Making Choices Together
James and Sarah agree that their two daughters (and their child on the way) are the most important benefits of using the Creighton Model. They acknowledge they communicate with each other more and have grown in respect for one another through the use of NFP. The couple feels their choice to use NFP is congruent with their religious beliefs, and they are proud to be using Creighton.
Since Sarah’s current physician is a Creighton Model medical consultant, she has also benefited from NaPro Technology, the medical diagnosis and treatment side of the Creighton Model. Overall, their experience using a natural method of family planning has been exceedingly positive, and they plan to continue using the Creighton Model as they expand their family!
Editor’s Note: Typical use of the withdrawal method alone (without a barrier method) is approximately 79% effective[ii] to avoid pregnancy, whereas FABMS are 86-98% effective with typical use to avoid pregnancy.[iii] This resource summarizes the effectiveness rates of the various fertility awareness based methods.
Author Bio: Dr. Emily Krach is a family medicine resident at Fort Wayne Medical Education Program. She completed medical school at Marian University College of Osteopathic Medicine in Indianapolis, IN. She participated in a FABM elective during her fourth year. Dr. Krach helped organize FABM workshops with FACTS speakers at her medical school during the clinical years. In April 2018, she completed the Creighton Model NFP medical consultant training. She looks forward to helping educate physicians, residents, and medical students by inviting trained FACTS speakers to her residency program.
[i] These common concerns can be managed and overcome effectively by working closely with a trained FABM instructor, especially during the first few months of use of a new method.
[ii] Marcus, Mary Brophy. “Many Young Women Use ‘Withdrawal’ for Birth Control.” WebMD, WebMD, 6 Aug. 2013, www.webmd.com/sex/birth-control/news/20130806/1-in-3-young-us-women-uses-withdrawal–for-birth-control#1.
[iii] Hilgers, T W, and J B Stanford. “Creighton Model NaProEducation Technology for Avoiding Pregnancy. Use Effectiveness.” The Journal of Reproductive Medicine, U.S. National Library of Medicine, June 1998, www.ncbi.nlm.nih.gov/pubmed/9653695.
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I had never even heard of the concepts this course covered despite being a 4th year medical student in my last semester at a prestigious medical school. This information about cervical mucus and the impact hormones have on it should be taught routinely in the pre-clinical years. (M.B.P.)
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