By: Catherine Cahill
Editor’s Note: This thought-provoking summary tells the story of how three different fertility awareness-based methods (FABMs) — the Sympto-Thermal Method , the Lactational Amenorrhea Method, and the Marquette Model — met the needs of two couples. Having interviewed them, future physician Catherine Cahill noted, “While each couple discusses their individual journeys, the thread woven among them is the utility, accessibility, and beauty of FABMs.”
Introduction
Meet two couples, Jane and John,* and Paige and Peter,* each navigating the world of family planning to either achieve or avoid pregnancy. I had the pleasure of interviewing them while taking the Fertility Appreciation Collaborative to Teach the Science (FACTS) course in fertility awareness as a medical school elective. Jane and Peter are also medical students. Beyond the insights from each of the four individual spouses as personal users of FABMs, these medical students provide a unique perspective as future Ob-Gyn physicians. Their stories comprise education, health improvement, empowerment, resolved challenges, and growing intimacy.
When did you first discover FABMs, and what led you to begin using one?
For Jane, it was all about “wanting to take back control over my fertility.” Previously, she had used a hormonal implant followed by an intrauterine device (IUD) that coincided with painful, irregular cycles. Jane and John had discovered fertility awareness charting through a book recommended by a friend. They decided to give it a try after a second IUD “fell out.” Jane turned to charting with the Sympto-Thermal Method (STM), tracking cervical fluid observations and daily basal body temperature (BBT). Her cycles became regular, and the pain she’d experienced with the IUD did not recur. John affirmed the decision to use this method, and explained how “the educational aspect was an eye opener for both of us; it was extremely empowering.” It has now been six years of successful charting with “no regrets.”
Paige and Peter discovered FABMs through his family. They started out by charting with the Sympto-Thermal Method after the birth of their first child. Within the year, they had abandoned it, as Paige felt it was “just too hard to do postpartum.” They became pregnant with their second child and Paige decided to try the Lactational Amenorrhea Method (LAM). Since LAM can only be used while the mother is breastfeeding exclusively throughout the day and night until 6 months postpartum, she subsequently switched to the Marquette Model due to its “easy accessibility.” This method involves cervical fluid observations, the use of a urinary hormone monitor, and other biological markers of fertility such as BBT. For Paige and Peter, it has now been over two years of successful use of the Marquette Model to avoid another pregnancy.
Having done this successfully for years now, what are the benefits of FABMs, in your opinion?
Jane feels “empowered and extremely knowledgeable. I can often tell why I am feeling, thinking, or behaving a certain way any time of the month, depending on where I am in my cycle. Plus, I don’t have to deal with any side effects.” John chimed in that he is “more than happy to be supportive” on their journey with FABMs.
Paige and Peter emphasized how using the Marquette Model helps “keeps sex intentional.” When they compared their intimacy now to a prior time when they used condoms to avoid pregnancy, Peter explained how “the abstinence period is really so special. Before, the accessibility [of sex] made it feel watered down. Once the thrill died down, it was no longer as special as before.” Jane echoed that it requires good communication to “ask for attention and romance during times of abstinence.” She added, “We now also have more control over our family planning.”
How have FABMs affected communication in your relationship?
John endorsed that he is now “more aware of what is happening with my wife, which I appreciate.” Jane values the shared responsibility that using FABMs make possible. She recalled how “Before tracking, fertility was my problem, my burden to bear. Now, it is our collective fertility, and it has greatly improved our communication. We feel much closer.”
Peter and Paige agree. “The communication over her cycle backed by the information we know has brought a lot more confidence,” added Peter. “We are no longer afraid but have also grown to take it more seriously.” Paige acknowledged that, “Our communication is better because we have to be more intentional about flirting and pursuing each other actively, especially during periods of abstinence.” They emphasized that while the spontaneity of intimacy is not the same as before using Marquette, the depth of their emotional connection is beautifully deeper.
If you could counsel a younger couple seeking alternative methods of family planning, what would you say regarding FABMs?
John wishes every husband would be educated on the fertile window and that couples would be made aware of charting. He was surprised to learn about female fertility and noted that, from his knowledge, many couples are unaware of this biology, which he believes is incredibly eye opening. Jane, a future Ob-Gyn physician, wants to “empower women to know and understand their cycle.”
Paige and Peter emphasized that, “If willing to take (FABMs) seriously, it is one hundred percent worth it. FABMs encourage communication and teamwork because, as opposed to contraceptive methods, you both have to be fully committed.” For Paige, fertility awareness is something she wishes every woman had access to, including adolescents. With two young daughters, she hopes to pass on this knowledge to them when the time comes.
Interview Insights
The takeaway from these stories is that FABMs are not only enlightening and empowering, but also restorative. Whether considering a woman’s cycle, the postpartum phase, a couple’s understanding of each other, or the intimacy of their communication, FABMs are the future of women’s health and family planning.
Editor’s Note: Studies show only 3-6% of medical professionals are familiar with or knowledgeable about fertility awareness-based methods. The mission of FACTS is to educate future and current medical and health professionals about the evidence supporting FABMs, so they may empower and engage patients to value their fertility and care for their reproductive health. Follow the link to learn more about all we offer physicians in training and in practice as well as other health professionals interested in learning about the benefits of charting the female cycle and incorporating FABMs into practice.
* Names have been changed to protect privacy, and all quotes are included with permission.
ABOUT THE AUTHOR
Catherine Cahill
Catherine Cahill is a fourth-year medical student at the University of the Incarnate Word School of Osteopathic Medicine in San Antonio, Texas. Her goal is to become a general pediatrician and utilize fertility awareness-based methods in her practice to educate and empower adolescents and girls in regards to their health. Catherine also plans to utilize FABMs in her own life and is grateful for the transformative and foundational knowledge of the FACTS elective.
