February 9, 2023

National Marriage Week

FABMs help couples make well-informed decisions about their Family Planning Goals

By: Savannah Maddox

Editor’s Note: This week marks National Marriage Week, and we are featuring an interview with Lilly, an emergency medicine physician assistant, who used both the Sympto-Thermal Method and the Marquette Method when growing her family. Savannah Maddox, a former FACTS elective participant, interviewed Lilly about her story and why she’s grateful that more physicians are becoming educated in fertility awareness-based methods.

Lilly* and her husband were married in 2015 and have since grown their family to include three beautiful children. In addition to caring for her family, Lilly works as an emergency medicine physician assistant. She and her husband desired to plan their family in a way that was compatible with their faith and would also allow Lilly to observe her natural cycle without the interference of exogenous hormones. Her familiarity with fertility awareness-based methods (FABMs) allowed the couple to make a well-informed decision about their family-planning choices.

“Her familiarity with fertility awareness-based methods (FABMs) allowed the couple to make a well-informed decision about their family-planning choices.”

As a newlywed, Lilly started charting with the Sympto-Thermal Method (STM). She found the observations required by the method straightforward, but her charts were complicated by “runner’s amenorrhea.” Lilly would go several weeks to months without a period due to hormonal changes caused by overexercise, making it challenging to identify her fertile days. Despite this, Lilly and her husband became pregnant on their honeymoon. This first pregnancy ended in miscarriage, but Lilly experienced regular cycles from then on. One year later, they conceived their oldest daughter using the STM to time intercourse in the fertile window. Lilly reports that the postpartum transition following the birth of her first daughter was a “confusing” time to use the method, as she was amenorrheic and then oligomenorrheic for several months.

Lilly and her husband then conceived their second child when their first daughter was only eight months old. The couple was happy to learn of this “surprise blessing” but after the birth of their second child, they desired a method that would facilitate more accurate tracking of her cycle and fertile days. Lilly switched to the Marquette Model. After almost five years of using FABMs, Lilly was familiar with her cervical fluid cycle and able to cross-check the readings on her monitor with her body’s mucus biomarkers. The Marquette Model allowed her to stay in tune with her body and cycle, and she appreciates the heightened awareness of any problems or abnormalities present during her cycle. The Marquette Model also allowed Lilly and her husband to successfully plan and conceive their third child, a daughter born in January.

Lilly’s story highlights the importance of regular evaluation and counseling for patients with irregular menses. The postpartum period presents a particular challenge for many women, and women may need to switch methods to meet their family-planning goals, investigate cycle changes, or try something different if they so choose.

“The postpartum period presents a particular challenge for many women, and women may need to switch methods to meet their family-planning goals.”

Overall, Lilly has found the Marquette Model works very well for her body and her family. She appreciates being able to read the indicators of her cycle to identify and even manage any health concerns without hormonal birth control, which sometimes masks problems. Additionally, she has found the method easy to incorporate into her daily life. On potentially fertile days, she collects and tests her urine specimen immediately upon rising and then simply “gets on with her day” as usual. However, she did allude to the difficulty of abstaining from intimacy during her fertile window, especially as hormonal changes during this time often increase her desire. Lilly shared that she and her husband understood that abstinence would be required with the method, and so they have found other ways to be intimate during that time. Despite the challenges, it allows them to “look forward to” the times in her cycle in which they can have intercourse. Lilly’s story showcases the open discussions between a woman and her partner that are fostered by FABMs. Finding an arrangement that works for both of them can bring a couple closer together.

Lilly’s experience with the Marquette Model inspired her to become certified to teach it to others. There were few Marquette educators nearby in Southern California, and she felt that her church did not provide sufficient resources to couples looking for natural methods of family planning. She has now been teaching the method for one year and has already taught 34 couples.

Lilly said: it is “good to have OB-GYNs who are open to NFP.” Her message is ultimately one of gratitude; she is so grateful that medical students and physicians are educating themselves on FABMs and that there will be more physicians equipped to offer these methods to their patients. In her experience, physicians tend not to be receptive to FABMs, forcing patients who desire FABMs to seek them out themselves or find a different clinician. Medical professionals educated in all family-planning methods can better meet the needs of women trying to achieve their family-planning goals.

“She is so grateful that medical students and physicians are educating themselves on FABMs and that there will be more physicians equipped to offer these methods to their patients.”

*Name has been changed to respect the privacy of the interviewee, and all information is shared with permission.