By Patricia Okolie
March 20, 2019

Editor’s Note: During National Endometriosis Awareness Month, we tell the story of how charting with a fertility awareness based method (FABM) helped in the diagnosis and treatment of endometriosis, making it possible for a couple to conceive their first child. This interview with the couple is part of our series that highlights the reality of using FABMs, including benefits as well as challenges of the various methods. Patricia Okolie, a 4th year medical student, conducted this interview as part of a two-week online elective with Dr. Marguerite Duane, Executive Director and co-founder of FACTS.

Learning About FABMs
Kelly was first introduced to Natural Family Planning (NFP) and FABMs two years before she met Dan, her husband. She was working at a private school when a team from the Fertility Care Services gave a presentation. Curious to learn more about her normal physiology, Kelly sat through the seminar and discovered that the method described aligned closely with her lifestyle and religious beliefs while offering many health benefits. So she took the opportunity to learn more about the Creighton Model FertilityCare System (CrMS).

With the help of a nurse practitioner trained in the CrMS, Kelly found it easy to understand the system and began charting her menstrual cycles. Dan found it easy to get on board with the method after they married because he saw Kelly’s excitement and confidence with using NFP. The Creighton Model made sense to them because it was natural and didn’t require medications or hormones or have additional costs beyond the initial learning sessions. Happily married for nine years now, NFP has been the only family planning method they have used together.

Infertility and FABMs
Although Kelly found it easy to learn the CrMS, she initially had her challenges with daily tracking, constantly writing down her cervical fluid findings, and wondering about the reliability of the system. Yet, she quickly overcame these challenges, and charting became second nature to her. The real challenge came when it was time to start a family, as they found it difficult to conceive. They didn’t want to do anything extreme and had to rely more on their CrMS healthcare team to find the cause of their infertility.

Thankfully, the CrMS has NaProTECHNOLOGY, which offers more treatment options for couples struggling with infertility. Kelly and Dan were blessed to find a gynecologist knowledgeable in this method. He quickly identified an irregular charting pattern on her monthly charts and developed a treatment plan that optimized their chances of achieving natural fertility.

Support from the Medical Community
Finding the right doctor was key because although Kelly had a medical professional she respected and trusted for years, this doctor was not trained in the CrMS. Her current OB/Gyn physician is a CrMS medical consultant who understands their life choices and supports their decisions. Within two years of trying to start a family, a laparoscopy confirmed Kelly’s irregular charting pattern was due to endometriosis. She received medical treatment and conceived within a year; their daughter recently turned five.

Benefits of FABMs
With a chuckle, Dan shared how charting has helped him understand Kelly’s occasional mood changes of her monthly cycle. He now understands his wife’s monthly hormonal changes better. By looking at her chart he can quickly identify where Kelly is in her cycle. This provides good “insider” knowledge that reveals when she needs a listening ear rather than a problem-solving husband.

Kelly is now in peri-menopause and feels empowered through knowledge of her reproductive health and better equipped to manage changes in her body. They both appreciate the effectiveness of the Creighton Model and that it is supported by research. They agree that having the flexibility to plan when to pursue or avoid pregnancy is an added benefit of using FABMs. Also, NFP encourages shared decision making of their family planning goals, which promotes good communication between them.

Although Kelly and Dan don’t belong to any FABM users’ support group, they are comforted knowing there is a team of professionals within the CrMS network they can call upon if needed. Dan feels it is important for him to be involved in the family planning process and believes strongly the charting and chart reading helps promote communication and mutual respect. Helping with the stickers during charting helps him understand the method better and gives him a chance to ask questions about the various stages in the cycle. The knowledge is also empowering for him because he feels less in the dark about their plans and goals as a couple.

Managing Abstinence
Dan made the analogy that couples sometimes make sacrifices like forgoing certain luxuries such as a vacation to pay off a loan. To them, abstinence is like a shared sacrifice. They believe the decision to have children is a special gift shared by a couple that should be made with great consideration. Abstaining from sexual intercourse during the fertile window can be challenging, but they have found that the abstinence makes them more respectful of the power of creation. Their maturity and years of marriage have taught them that although passion is very healthy in a marriage, it shouldn’t rule their lives. The period of abstinence is a unifying time for them; it forces them to be creative, to think outside the box, and learn other means of intimacy and expressing their love. This ultimately creates genuine intimacy and respect for each other and the life they bring into the world.

Advice for Couples Seeking FABMs
Kelly and Dan suggest that women or couples seeking to use FABMs should get started on a method immediately. They stress the importance of finding a doctor who understands and supports their goals and can help guide them through the process. They further encourage new learners to meet with a certified instructor once a month or quarterly, depending on their comfort level. For Kelly, meeting quarterly with her Creighton instructor helped build her charting skills and ultimately built her confidence with the CrMS.

Based on her experience, Kelly feels the Creighton Model is completely effective when used correctly. You abstain during the fertile window to avoid pregnancy, and you take advantage of the fertile period to become pregnant. She believes FABMs are the only way to completely know what is going on with your reproductive health. She notes that NFP is empowering, completely natural, cost effective, and it works with God’s plan for our bodies. Dan further notes that FABMs are for women who desire to be more in tune with their bodies. Anyone should be willing to try FABMs, considering the high cost of contraceptives and the potential for harmful side effects of birth control medications and procedures. He believes this is reason enough to try FABMs.

Reflections from a Future Physician
My interactions with Kelly and Dan and a few other FABM couples left me with a few impressions. There has been a significant shift in how couples view NFP and how they embrace their fertility management. I am particularly impressed at the active role men play in this process and how it builds a stronger family unit. There seem to be growing numbers of healthcare professionals involved with FABMs who help promote the scientific evidence and health benefits of fertility awareness.

Unfortunately, there is also a large group of healthcare professionals and medical students who are unaware of FABMs. The support from the medical community is particularly crucial for families who want alternative methods of family planning, and for couples that may have trouble learning FABMs or difficulty achieving their fertility goals. I have further observed that using an FABM and attaining a level of confidence in charting prior to marriage empowers the woman and makes it easier to gain the support of her husband. It also seems to promote a smoother transition into NFP after marriage. Thus, it is imperative that more medical professionals learn about NFP and help support women of reproductive age as well as couples in choosing an FABM.

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Author Bio: Patricia O. Okolie is a 4th year medical student at Liberty University College of Osteopathic Medicine. Upon graduation, she will complete a residency in family medicine at York Hospital in Pennsylvania. She is a FACTS student ambassador and has assisted with FACTS research projects. She feels the online elective provided “a unique learning experience and gave me a better understanding of FABMs. I now have information and access to healthcare professionals to share with patients who are seeking natural family planning methods.”