“I Had No Idea” – Bridging the Fertility Knowledge Gap for Physicians and Patients

By: Andrea Soto Abarca

Director’s Note: In this week’s interview, former FACTS elective student and future family physician Andrea Soto Abarca notes the value of patient encounters within the FACTS elective to transform lectures into real-life lessons. Before the elective, Soto knew nothing about the evidence behind fertility awareness-based methods (FABMs), and recognized how FACTS is filling this gap in holistic patient care. As we continue this important work, please consider making a gift today to help us advance our mission to transform women’s healthcare.

TODAY, we celebrate Dr. Marguerite Duane’s birthday and look forward to her upcoming new role as the Director of the Center for Fertility Awareness-Based Education and Research at Duquesne University (starting in July!). Help us wish her a happy birthday with a gift to FACTS today. Thank you for your generous support!

Nicole* began her journey into the world of fertility awareness in her twenties as she and her fiancé began preparing for marriage. During this time, Nicole and her partner Marcus* prioritized communication about their shared fertility; they began to understand their roles together as a team. Now married, Nicole shares how the Billings Ovulation Method helped them plan their pregnancies.

The Billings Ovulation Method is a natural family-planning method that relies on a woman’s observations of sensation of her cervical fluid to identify potentially fertile and infertile days [1]. Nicole was grateful to find an alternative to hormonal birth control, such as the pill, since she had concerns about the side effects associated with synthetic hormones. With the support of her instructor, Nicole learned the Billings method to track her cycle.

Learning to use a natural method wasn’t always straightforward, and Nicole remembers there was a learning curve in the beginning. She had been using the Billings method for about eight months before she felt confident in her charting. Charting refers to a tracking system that enables a woman to record observations of physical signs or biomarkers that reflect the changes in her reproductive cycle. Women can use a paper chart or track electronically.

“Charting refers to a tracking system that enables a woman to record observations of physical signs or biomarkers that reflect the changes in her reproductive cycle.”

Nicole remembers early on how she would call Marcus at night to share her observations of cervical secretions for charting purposes. They would count the non-fertile days and make sure to mark their ovulation window, which facilitated a flourishing relationship and marriage. Nicole is grateful for Marcus’s constant support and remarked that, “without my husband, I would not have been able to successfully use the Billings Ovulation Method — it would have been too difficult.”

As she reflected on the role of the Billings Ovulation Method, Nicole reported it provided her with the skills to track her health and fertility. The method not only equipped Nicole and her husband to meet their family-planning goals, but also allowed them to live their life in alignment with their faith. Nicole shared that, to this day, she still utilizes the Billings method to monitor her overall health.

Through her journey with FABMs, Nicole gained a unique sense of self awareness. Thanks to charting she felt in sync with her cycle. Using the Billings Ovulation Method empowered Nicole by enhancing her understanding of her reproductive health and increasing her confidence in her own body. She was better able to trust her body because she understood the science behind her cycle. Furthermore, knowing and understanding their shared fertility helped Nicole and Marcus to embrace the emotional and spiritual aspects of their sexuality. Grateful for the gift of FABMs in her own life, Nicole hopes to one day share this knowledge with her children so they too have the tools to understand their health in a way that makes them feel confident and empowered.

“Using the Billings Ovulation Method empowered Nicole by enhancing her understanding of her reproductive health and increasing her confidence in her own body.”

Nicole’s story helped me to better appreciate the long-lasting and broad impact of FABMs on many aspects of her life.

One thing I have learned in medical school is that classroom learning does not always translate to real patient care. But through the FACTS elective, I witnessed how physicians who utilize FABMs in their practice tend to see the patient as a whole. Instead of focusing exclusively on the patient’s reproductive anatomy and function, these medical professionals ask important questions about mental and emotional health. They intervene with lifestyle modifications to improve their patient’s overall well-being, and these changes can often be implemented throughout a patient’s lifetime.

“Through the FACTS elective, I witnessed how physicians who utilize FABMs in their practice tend to see the patient as a whole.”

As a future family physician, I want to be able to offer my patients this alternative to hormonal or implantable contraceptives. Before this course, I knew nothing about any of these evidence-based methods of family planning. The gap in training for family physicians, OBGYNs, pediatricians, and even other specialists needs to be bridged by future generations of healthcare professionals. Additionally, medical schools across the country should consider including the basics about FABMs in their reproductive health curricula.** As graduates of the FACTS elective, it is also our job to share this information with our colleagues and help increase awareness about FABMs throughout the communities we serve.

*Names have been changed to respect the privacy of the interviewee. All information is shared with permission.

**To learn more about reproductive health topics taught in medical school, read An Evaluation of US Medical Schools’ Reproductive Health and Family Planning Curricula, a 2022 study co-authored by our executive director, Dr. Marguerite Duane. To help us advance our mission of expanding FABM education in medical schools, please consider making a gift to FACTS today!

References

[1] Bhargava H, Bhatia JC, Ramachandran L, Rohatgi P, Sinha A. Field trial of billings ovulation method of natural family planning. Contraception. 1996;53(2):69-74. doi:10.1016/0010-7824(95)00269-3

ABOUT THE AUTHOR

Andrea Soto Abarca

Andrea Soto Abarca, is a 4th year medical student at University of Texas Rio Grande Valley School of Medicine in Edinburg, TX. She participated in the FACTS elective due to her interest in reproductive care and women’s healthcare. She is applying to family medicine for residency and hopes to seek out further training in order to offer these tools and knowledge to her future patients as a primary care physician.