December 9, 2021
By Ellen Gaudet Urrutia, MS
A Woman’s Journey with the Marquette and Creighton Model
Editor’s Note: This interview with a user of two different fertility awareness-based methods (FABMs) of family planning provides insight into their classification as true family planning methods, since many of them can be used to both avoid and achieve pregnancy. As such, accurate teaching about FABMs should be integrated into all educational endeavors about family planning.
While on the FACTS elective, Ellen Gaudet Urrutia interviewed an enthusiastic user of FABMs. For this woman, learning to chart her cycle hastened the diagnosis and treatment of a luteal phase defect, and using different methods in new seasons of life has provided a natural and effective way to not only plan their family but also manage her health.
During the FACTS elective, I spoke with Gianna* about her experience with two different fertility awareness-based methods of family planning: the Creighton Model FertilityCare SystemTM and the Marquette Model. She provided great insight into the utility of each method during different stages of her life.
Gianna was first introduced to FABMs by family members. Her mother and sister were users of the Creighton Model, and her sister-in-law used a sympto-thermal method. She was grateful to know about natural options for family planning even before she was ready to start her own family, and always knew she would eventually use an FABM. While engaged to be married, she chose to learn the Creighton Model to begin to understand her menstrual cycles and fertility.
Basics of the Creighton Model
The Creighton Model allows women to identify phases of fertility and infertility based on observations of cervical mucus. A woman charts her cycle by using the method’s standardized system of classifying the cervical mucus observations, dry days with no cervical mucus, and patterns of bleeding.
Gianna liked that she could turn to her Creighton FertilityCare practitioner (FCP) and her family members with any questions or concerns about the method. She also sought out an Ob-Gyn physician who had trained in Natural Procreative (NaPro) TechnologyTM, which is the medical application of the Creighton Model. Gianna noted she “really liked having a standard form of communication” to use with her doctor.
Learning to Chart the Female Cycle
As Gianna began learning the method, she was surprised to learn for the first time about her body’s cycle of cervical mucus changes. She encountered some challenges with charting at the beginning, needing help from her FCP to identify fertile vs. infertile mucus as well as her peak days of fertility. She also began to recognize bleeding abnormalities, and her charting led to the diagnosis of a luteal phase defect and the recognition of her need for progesterone supplementation.
“I thought it was so interesting that my doctor knew exactly what was going on with me just by looking at my charts.” She also appreciated that having knowledge of her charts allowed her to be treated as a unique individual.
True Family Planning
After getting married, Gianna and her husband felt confident using the Creighton Model to avoid pregnancy for a couple of years. She loved that the method involved her husband daily and how they were always in communication about their mutual goals for family planning. Once they were ready to start a family together, they then used the Creighton Model to successfully achieve pregnancy. They now have a 5-month-old son!
Gianna recalled that during the postpartum period, the Creighton Model proved difficult for confident family planning. Her observations of cervical mucus became confusing and harder to follow, and since she was breastfeeding her baby, she was not yet cycling regularly. Her sister recommended she look into another FABM called the Marquette Model, as she had found it helpful during her own postpartum time.
Basics of the Marquette Model
The Marquette Model is a sympto-hormonal method of family planning which requires a woman to observe cervical mucus and test urinary hormones to detect her days of fertility. The method uses a hand-held electronic fertility monitor (ClearBlue Easy) to measure estradiol and luteinizing hormone (LH) urinary metabolites at home. Different protocols for certain phases of life can be learned with an instructor, and Gianna used a special breastfeeding protocol of the Marquette Model.
While she admits it was challenging to learn a new FABM while also learning how to take care of a newborn baby, Gianna was grateful to have another natural method to monitor her fertility during the postpartum period. She encourages new parents to consider learning the method before the baby is born to help ease the transition. The Marquette Model has been relatively easy for her to use, since it can involve a one-time urine check each morning instead of cervical mucus checks multiple times a day, as with the Creighton Model. Gianna’s husband appreciates that he can still be involved in her charting with this method and that they are always in communication about their family planning goals.
Gianna reports one downside of the Marquette Model is needing to purchase a fertility monitor and single-use hormone strips, which has become costly after months of daily use. She also feels less “in tune” with what is going on with her cycles, since she is no longer using cervical mucus as a guide to her changes in fertility.* For this reason, she plans to go back to using the Creighton Model once her menses returns.
The Gift of Knowing Yourself
Gianna is an advocate for FABMs and feels grateful for the knowledge they provide about her body and fertility. She summarized her experience by stating, “It is so pro-woman and feminist to educate women about their bodies.” Prior to learning how to chart, she had never focused on her cycles as being part of her general health. She now knows so much more about herself, thanks to the Creighton and Marquette methods.
I am thankful for Gianna’s willingness to share her experiences with me. I was especially inspired by her confidence about using FABMs throughout different life circumstances, and I learned more about the ways women can tailor certain methods to fit their needs.
I was also encouraged to hear that Gianna’s Ob-Gyn physician was able to support her through those changes, having been trained to use her charts as practical tools to apply in her medical care. Anecdotally, I have heard many stories of women being discouraged by their healthcare providers to use FABMs for family planning since they did not understand their efficacy and/or never learned how to incorporate these methods into practice.
Knowing that, I am grateful I was able to take the FACTS elective during medical school to learn about the many forms of FABMs and their medical applications. I am also glad that so many other medical students across the U.S. also sought out this information. It is exciting to see that knowledge about FABMs is reaching so many medical students going into the fields of obstetrics and gynecology, family medicine, pediatrics, and more.
*Editor’s Note: With the Marquette Model, a woman tracks her cervical mucus observations and utilizes a fertility monitor to measure her urinary hormone levels. Yet, this method also offers various combined approaches to estimate the fertile window. Follow the links below to learn more about the Marquette Model and its applications in the postpartum period and during breastfeeding.
- The Marquette Model Empowers a Couple: An Interview
- Computerized Fertility Monitors: A Review of Research
- An Online NFP Program for Breastfeeding Women: A Research Review
*Names were changed to protect privacy, and the interview is published with permission.
ABOUT THE AUTHOR
Ellen Gaudet Urrutia
Ellen Gaudet Urrutia, MS is a fourth-year medical student at the Texas College of Osteopathic Medicine in Fort Worth, TX who plans to pursue family medicine. Prior to medical school, she earned a Master’s degree in anatomy. She is excited to use FABMs in her future practice to aid patients who are learning about their menstrual cycles, planning their families, dealing with fertility concerns, and more.