January 23, 2019
Editor’s Note: This interview with a practicing OB/Gyn physician was conducted by a second-year medical student as part of a course taught by FACTS Executive Director, Dr. Marguerite Duane, at Georgetown University School of Medicine. During this online selective, students are encouraged to interview users of fertility awareness based methods (FABMs) or physicians who utilize FABMs when treating patients with various medical conditions in which these methods provide additional options for diagnosis and/or treatment. In this case, the interview was with a physician who not only offers patients the option of using FABMs but is also a user of FABMs for family planning. Her personal and professional experience with FABMs provides a unique perspective for medical professionals in training and in practice as well as patients.
An Interview with Dr. Sarah Bascle
I had the opportunity to interview Dr. Sarah Bascle, an OB/Gyn physician who uses the Creighton Model personally and in her medical practice. I was excited to hear her insights about the method as a user as well as its advantages and usefulness in her practice.
Dr. Bascle started using the Creighton Model as a medical student in 2010. She was not using any other method of family planning at that time, but after learning about the method from Dr. Duane and doing some research on her own, she began to chart. She chose the Creighton Model because it is a mucus-only method and she felt that would be easiest for her. She also liked that this method would be useful throughout the different stages of life: postpartum, peri-menopause, and more.
Dr. Bascle and her husband used the Creighton Model to avoid pregnancy for the first few years, and when they decided they wanted to become pregnant, they used it to help them conceive. Using this method, they were able to get pregnant within one cycle! After giving birth, she used the Lactational Amenorrhea Method but found that challenging as a second-year resident in an OB/Gyn residency program. She wasn’t able to nurse exclusively so she began using the Creighton Model again.
As a student and now, Dr. Bascle felt it was easy to learn to chart and read her own signs of fertility and simple enough to incorporate into her everyday life, although she acknowledges the process of charting can be somewhat tedious.
FABMs Enhance the Practice of Medicine
Dr. Bascle works in a private practice setting with a midwife and a Creighton Model instructor. If a woman is trying to avoid pregnancy, she counsels her patients on the various FABMs. She has patients chart with the Creighton Model specifically if they have gynecologic issues or difficulty conceiving. She then uses hormonal support and pharmacologic interventions to help support conception and instructs patients to use timed intercourse during their fertile window.
The Patient Perspective
When asked if her patients took to the methods well and what seemed most challenging for her patients, Dr. Bascle said reading signs of fertility was sometimes a challenge for women, particularly in women with gynecologic conditions like polycystic ovarian syndrome (PCOS). She noted that women who initially struggle at interpreting their otherwise normal fertility often benefit from multiple counseling sessions, which often resolves this issue. She also mentioned remaining abstinent during fertile times is a challenge for many couples.
It is also important to counsel your patients that when using NFP methods to avoid pregnancy, if they choose to have intercourse with a barrier method during a fertile window and end up getting pregnant, this is not due to a failure in the NFP method but a failure in the barrier method.
Reflections from a Future Physician
I initially signed up for this selective by accident, misreading the title and thinking it would emphasize infertility and available treatment methods. Once I realized the selective was about natural family planning, I was afraid I wouldn’t enjoy it because I consider myself very liberal when it comes to women’s rights regarding their body and health. However, this selective ended up being really interesting and I am very thankful I took it. Although some of the articles and videos had a religious component that I felt weakened them as scientific sources, I recognize that knowing these different options of natural family planning is necessary to serve women well.*
I enrolled in this selective thinking there was no way natural family planning could be effective. Now I realize it is another option that is just as relevant to know about as IUDs and oral contraceptive pills so you can best serve women and help them have control and understanding of their reproductive health. I also was shocked to see the utility of FABMs in diagnosing hormonal problems, helping to manage different ovulatory dysfunctions, and helping women conceive.
Coming into this selective, I had an interest in reproductive endocrinology and infertility. I now can’t help but wonder how many women receiving infertility treatment have even attempted to chart first, and if this is ever recommended, especially in women who are in their early thirties and thus have “time” to try different methods. Overall, I really enjoyed this selective and I am confident I will be able to use this information in the future and be a better physician for it.
* Editor’s Note: At FACTS, we aim to be known as the source of evidence-based research about fertility awareness and FABMs. This worthy goal is contingent upon the ongoing availability of solid scientific research in this field as well as funding for our work to disseminate this information. Quality, well-funded research in fertility awareness will impact women’s health in terms of prevention, family planning, reproductive health, health monitoring, and diagnosis, treatment, and management of common conditions like endometriosis, PCOS, and infertility. We urge the medical community as well as interested couples and patients to support such research and our efforts by spreading the word about FACTS and helping fund our groundbreaking work to educate future physicians and physicians in practice in what we know is the future of women’s health.
Author Bio: S.C. is a second-year medical student at Georgetown University School of Medicine who plans to specialize in reproductive endocrinology and infertility. Taking the 6-week fertility elective in her second year solidified many of the concepts she learned in pre-clinical coursework and provided the knowledge to start applying what she learned to women’s health. The elective also furthered her interest in reproductive endocrinology and infertility and, specifically, how fertility awareness based methods can be utilized in the treatment of infertility.
FACTS 2019 SPRING CONFERENCES
Modern Fertility Awareness for Family Planning & Women’s Health
In response to the growing interest in FABMs, the FACTS team is coordinating three one-day conferences in 2019. Join us in Cleveland, Indianapolis or Dallas to learn about timely issues in women’s reproductive health!
February 23, 2019
8:30 AM – 5:00 PM
April 5, 2019
8:30 AM – 5:00 PM
And stay tuned for more details, as this conference will be offered in Dallas, TX in the fall as well! We hope to see you!
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