Sarah’s Story: A Different Method During Different Phases of Life

By: Madalyn Berendes, DO

Director’s Note: At FACTS, our philosophy is that the best method is whichever one works for each woman or couple. This may vary from woman to woman and may even vary for a given woman across various stages during her reproductive life. This interview conducted by former FACTS elective student, Dr. Madalyn Berendes, shares the story of a woman who switched methods three times — a prime  example of the diverse applications of many modern methods now available. FACTS exists to educate medical professionals on all evidence-based natural methods, equipping them to then educate and empower women to choose the best method for them depending on their stage in life. Please consider supporting FACTS in our mission to change the future of women’s healthcare. Together, we can make a difference — one woman and one couple at a time.

Creighton Model

Sarah,* a wife and proud mother of two, first began charting her cycles with the Creighton Model while she was engaged. She and her fiancé planned to use FABMs to track her cycles to aid in both avoiding and achieving pregnancy throughout their marriage. 

The Creighton Model involves recording observable changes in the woman’s cervical mucus or fluid secretions to help determine times of potential fertility and infertility. Initially, this method was the perfect fit for the couple. Sarah was able to note changes in her cervical fluid secretions to identify when she was most likely fertile. Together, she and her husband could use the information from her chart to time sexual relations depending on their family-planning goals — whether that meant abstaining from sexual relations when they wanted to avoid pregnancy or timing intercourse during the fertile window when they desired to become pregnant. Another benefit of the method was the affordability. Once they invested in learning the method, they only needed to use a chart and stickers. However, Sarah did find it challenging to observe changes in her cervical mucus throughout the day, before and after using the bathroom.

“Sarah was able to note changes in her cervical fluid secretions to identify when she was most likely fertile. Together, she and her husband could use the information from her chart to time sexual relations depending on their family-planning goals.”

Lactational Amenorrhea Method

Sarah and her husband successfully used the Creighton Model to conceive their first child. However, Sarah and her husband decided to switch to the Lactational Amenorrhea Method (LAM) to avoid pregnancy during the postpartum period. To use LAM, a woman must not have had a return of her menstrual bleeding, her infant must be exclusively or almost exclusively breastfed during the day and night, and the infant must be younger than six months. This method worked well for Sarah in the first several months after the birth of her child. She was glad she did not have to chart with LAM and appreciated being able to focus on her recovery and care for her baby. Eventually, Sarah no longer met the criteria for LAM and found it difficult to use the Creighton Model. She expressed the challenges of having a young child and remembering to check for changes in her cervical mucus each time she used the bathroom. Due to these struggles, Sarah and her husband decided to switch methods again. This time, they tried the Marquette Model.

“She was glad she did not have to chart with LAM and appreciated being able to focus on her recovery and care for her baby.”

Marquette Model

The Marquette Model relies primarily on urinary hormone monitoring to identify the fertility window. Sarah and her husband found the Marquette Model to be helpful in the postpartum period, especially since Sarah’s menstrual cycle had not returned. The method provided more objective data, and the single daily test was much more convenient for Sarah with a young child at home. Unfortunately, the main drawback of the method was the increased cost. In addition to the expense of an educator, they had to purchase a Clearblue monitor and test strips to be used for each cycle.  However, the couple felt that this cost was worth it to help prevent pregnancy. 

Charting using the Marquette Model also provided Sarah data to share with medical professionals. Months after she had ceased breastfeeding, she realized her cycle was still not following the typical pattern. Thanks to the help of an instructor and medical professional, Sarah and her husband were able to manage the underlying issue and are now the proud parents of two young children. 

A Personal Note

My conversation with Sarah gave me a humanistic view of these methods as a medical professional myself, both for family planning and assessing a woman’s health based on her cycle. The FACTS fertility awareness elective has taught me not only the science behind different FABMs but also how they can be applied to different people or during different phases of life. It was wonderful to see the various methods and applications coalesce in Sarah’s story. Sarah and her husband began using FABMs for family planning, but later were able to use charting to also help identify hormonal abnormalities contributing to later subfertility.

As Sarah was sharing her story, I was amazed by the way she and her husband were able to navigate different methods. Thanks to a foundational understanding of the female cycle and with the guidance of trained educators, the couple was able to transition between FABMs to find the method best suited to their changing phases of life. Through my education in FABMs and conversation with Sarah, it became evident that there is no single best method, nor is a woman limited to a single method over her life. It is my hope that the stories of more women like Sarah will be shared. As women and couples continue to be vulnerable enough to share their experience with FABMs, the rest of us can gain more insight into how these natural methods work in real people’s lives. 

“As Sarah was sharing her story, I was amazed by the way she and her husband were able to navigate different methods …it became evident that there is no single best method, nor is a woman limited to a single method over her life.”

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

ABOUT THE AUTHOR

Madalyn Berendes, DO

Madalyn Berendes, DO is a third-year resident at ECU Health Pediatric Residency. She enjoyed expanding her knowledge of fertility awareness methods and their applicability during medical school through the FACTS elective which she hopes to use in her future career. In her free time, she enjoys spending time with her husband and daughter, hiking, and knitting.

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