By: Sarah Miller
Editor’s Note: Fertility awareness-based methods (FABMs) are true methods of family planning: women and couples can use them to avoid or achieve pregnancy. The variety of methods offer women choices, since some rely on different biomarkers, such as tracking cervical mucus or basal body temperature, some measure urinary hormones, and others offer a “cross-check” for patients wanting an extra layer of peace of mind. Sarah Miller, a fourth-year medical student on the FACTS elective, interviewed a woman who has used three different FABMs. Each method served a purpose during the various phases of her life, and she and her husband are grateful.
FABMs Meet Different Needs
Mrs. A is well versed in a variety of fertility awareness-based methods of family planning. Starting at the age of twenty-five, her curiosity drove her to teach herself the Sympto-Thermal Method (STM), which allowed her to notice some irregularities in her cycles. After she got married, she noticed she had continuous mucus, which made it difficult to identify the end of her fertile window. This led the couple to learn the Marquette Model. Although she still enjoys the Marquette Model for family planning, she pursued the Creighton Model after experiencing a miscarriage, wanting to access NaProTechnology as a way to better understand her overall health.
Just like there is no one “perfect” FABM for everyone, only a method that works best for each individual woman based on her needs, there is no one “perfect” reason to use FABMs. Like many women, Mrs. A chose to use FABMs for multiple reasons. Her faith encourages her to use these methods, but she was also intrigued by their ability to help her understand and address her health concerns. She wanted a more functional solution instead of the “Band-Aid” of the “normal” bleeding pattern that hormonal birth control pills would provide.
Gaining access to FABM training is not always easy. Living in a small town, she had to turn to virtual visits with both FABM educators and FABM-trained medical professionals even before the COVID-19 pandemic. Although she recognizes the perks of being able to receive on-demand education when learning a new method, she also acknowledges pitfalls. Virtual interactions lack the opportunity to establish a deeper connection with a medical professional and receive in-person exams.
Cultivating Relationships
In spite of these limitations, using FABMs has helped her cultivate a variety of relationships. In the age of the COVID-19 pandemic, she has been able to join a few groups on social media for people who use FABMs to connect with each other. She finds it helpful to see others’ charts and feels less alone as an FABM user, when most of our media presence is oriented towards hormonal birth control methods.
Mrs. A has also established a connection with women who attend her church and use FABMs. She enjoys having them as a resource to discuss the different methods that work best for them as well as their collective struggles and questions. This built-in network was especially helpful when she experienced a miscarriage, as many of those friends knew of her pregnancy early on and were able to support her and her husband during that time.
Using FABMs helps encourage healthy conversations with her husband as they discuss their goals each month. While they are currently trying to avoid pregnancy, she recognizes that being unsure of her intentions some months keeps them checking in with each other instead of avoiding the difficult conversations, which is easy to do when using other forms of family planning. There is a spectrum from attempting to achieve to trying to avoid pregnancy, and where they fall along that line is often not so black and white. This requires patience and meaningful conversations.
Perhaps most important, using FABMs has helped her cultivate a relationship with herself. She wishes she learned about these methods earlier in life, as she may have noticed some of the subtle shifts pointing to health issues earlier, enabling them to intervene sooner. Using FABMs also helps her check in with herself mentally and emotionally as she reassesses why she has chosen to use these methods for family planning even when abstinence can be difficult. Still, she knows anything beneficial in life requires some sacrifice.
Just Ask
While she has never been dissuaded from her choice to use FABMs or told these methods don’t work, like some women have experienced, she still feels frustrated that many healthcare professionals do not understand what the different methods entail or even that there are different methods at all.
Mrs. A believes wholeheartedly that most women using FABMs are more than happy to help their medical professional understand their FABM. She wishes more people in her local medical team were eager to see her chart or know what biomarkers she uses. She hopes future medical professionals will take the time to show an interest in learning how FABMs work for her and other patients. In her mind, the solution is simple…. Just ask.
Editor’s Note: Whether in small towns or in large cities, many couples still have difficulty finding FABM-trained physicians and instructors who teach a particular FABM. For this reason, FACTS created a Directory where medical professionals and educators can list their practice information, making it easier for patients to find a trained professional in their local area. Instructors and medical professionals trained in FABMs may add their practice to the FACTS Directory at no cost.
ABOUT THE AUTHOR
Sarah Miller
Sarah Miller is a fourth-year medical student at the University of Texas Rio Grande Valley School of Medicine in Edinburg, Texas. She is passionate about women’s health and looks forward to using the lessons she learned during the FACTS elective to better care for women across their lifetime.
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