SPICE and Support With the Creighton Model
By: Brynna Jansen, MD
Director’s Note: This week we share an interview written by Dr. Brynna Jansen, a family medicine resident and former FACTS elective student. She spoke with a woman who first encountered fertility awareness-based methods (FABMs) in nursing school, but didn’t learn the real evidence about their effectiveness until after graduation. The piece highlights the advantages of charting and the effectiveness of the Creighton Model, as well as the increasing desire among women for accurate information about all family-planning options that respect both natural fertility and patient autonomy.
Emma* has been a Creighton model user since she started dating her now-husband two years ago. Although Emma was raised Catholic, she only first learned about natural or fertility awareness-based methods (FABMs) of family planning when she was in nursing school. She recalls spending two weeks learning about contraception and hormonal birth control, but natural family planning (NFP) was only briefly mentioned. Furthermore, these natural methods were described as an ineffective and unreliable method to avoid or postpone pregnancy.
“I felt betrayed as a woman,” Emma said, referring to the lectures. “I desired a more holistic understanding of all the different types of natural family-planning methods. I knew they were reliable methods, but needed more education on them. And I knew I wasn’t going to get that in nursing school.”
“I desired a more holistic understanding of all the different types of natural family-planning methods. I knew they were reliable methods, but… I wasn’t going to get that (education) in nursing school.”
After graduating from nursing school, Emma began working as a missionary on a college campus. It wasn’t long before she met Camille,* a Creighton FertilityCare practitioner who worked at her local parish.
Emma saw the need in her college community for more evidence-based information about FABMs, so she invited Camille to lead an introductory session on the Creighton Model, open to single and dating women. The Creighton Model is highly effective as a means of avoiding pregnancy with a method effectiveness of 99.5 percent and user effectiveness of 96.8 percent – although its effectiveness depends on being taught by qualified teachers [1]. The session was well attended by students from all stages and backgrounds of life, and the women expressed their interest in the topic of fertility and natural family planning. Emma heard a recurring theme from students: “We wish we would have learned this sooner!”
At the same time she was ministering to the female college students on campus, Emma was also learning to chart her own cycle. She and her husband decided on the Creighton Model and began receiving instruction from Camille. Emma decided to chart with Creighton not just because it was the first method she encountered, but because she knew it was a method she could continue to use in every stage of life. The Creighton Model System can be used for single, dating, or married women in any period of life, including coming off of birth control, postpartum, breastfeeding, post-miscarriage or ectopic pregnancy, infertility, perimenopause, and menopause [2]. Not only would charting with this method give insight into her fertile window, but Creighton’s medical protocol could also lend insight into her overall health as she struggled with irregular cycles. As a nurse, Emma valued the evidence behind the method and was blown away by the extensive research backing Creighton.
“Not only would charting with this method give insight into her fertile window, but Creighton’s medical protocol could also lend insight into her overall health as she struggled with irregular cycles.”
Convinced about the Creighton Model’s many benefits, Emma even started leading a weekly support group for women to discuss healthy relationships and how to better connect with their partners through Creighton’s SPICE model — which refers to the different areas of intimacy between spouses and stands for Spiritual, Physical, Intellectual, Communication, and Emotional [2]. Speaking of her own experience as a Creighton user, Emma shared that her relationship with her husband has grown and strengthened through the SPICE model. While using the method to avoid pregnancy, the couple found themselves able to connect on a deeper level, as well as practice other ways to express affection to one another during their fertile window.
Beyond strengthening her relationship with her husband, Emma has also experienced many medical benefits since she started charting. One of the initial challenges she faced was frustration that her chart did not look “textbook perfect.” It was discouraging, but Emma had great support and encouragement from her instructor and her husband. She realized that her chart was revealing something that was off with her body, and she was hopeful she would find answers.
“It is the fifth vital sign, anyways!” Emma said.
After some time, her instructor recommended she see a Natural Procreative (NaPro) Technology medical consultant. Emma followed her advice but was surprised by the lengthy wait time to be seen. Since only a very small percentage of medical professionals are trained in FABMs, finding a NaPro Technology medical consultant is a barrier many patients face.
“There is such a need for more NaPro Technology medical consultants to increase access for patients who desire better care of their fertility. I had to wait five months to be seen, but it was a huge gift in the end.”
“There is such a need for more NaPro Technology medical consultants to increase access for patients who desire better care of their fertility. I had to wait five months to be seen.”
A targeted hormone evaluation revealed new insights about Emma’s cycle irregularities. She was experiencing suboptimal progesterone levels and was instructed to start taking progesterone during her luteal phase. She hopes this will also help with some of the premenstrual symptoms she experiences.
Other interventions recommended by the NaPro consultant included vitamin C and probiotic supplementation, with the goal of reducing the continuous mucus both before and after ovulation.
Emma is optimistic that these interventions will help her feel better physically, prepare her for motherhood, and get her cycle health parameters back in check.
“I felt like I was learning so much about my body and being proactive with my health,” she said. “As my husband and I are discerning children in the near future, I knew I was preparing myself mentally and physically for pregnancy and just optimizing my health overall.”
Immensely grateful to her instructor, Camille, and with the support and encouragement of her husband, Emma has felt called to become a Creighton instructor herself. She hopes to continue ministering to women of all stages in life and share the benefits of fertility awareness.
As Emma shared her personal story, I realized how essential it is for women to have a comprehensive understanding of their menstrual cycle and how it relates to their overall health. “I wish I had known this sooner,” is an all too common theme among women first learning this information. FACTS has a webinar called “Know Your Body” specifically targeted to young teenage girls, empowering them through information about cycle awareness and charting. The FACTS elective has also made clear to me the immense benefits of learning about the biomarkers of the female cycle. The female menstrual or ovulatory cycle truly is the “5th vital sign,” and the biomarkers used in charting can tell a woman so much about what is going on in her body and prepare her for future stages of life.
“I realized how essential it is for women to have a comprehensive understanding of their menstrual cycle and how it relates to their overall health. ‘I wish I had known this sooner,’ is an all too common theme among women first learning this information.”
References
[1] LHilgers TW, Stanford JB. Creighton Model NaProEducation Technology for avoiding pregnancy. Use effectiveness. J Reprod Med. 1998 Jun;43(6):495-502. PMID: 9653695.traception. 1997;55(6):327-336. doi:10.1016/s0010-7824(97)00040-1.
[2] Hilgers, TW. (2020). Creighton Model FertilityCare System, An Authentic Language of a Woman’s Health and Fertility. (Seventh Edition)
ABOUT THE AUTHOR
Brynna Jansen, MD
Brynna Jansen, MD is a resident physician at Sioux Falls Family Medicine Residency in Sioux Falls, SD. She received her medical degree from the University of Minnesota Medical School in Minneapolis, Minnesota. She is passionate about evidence-based restorative medicine to provide more holistic care for patients experiencing gynecological issues and infertility. She has completed a six-month training program to become a medical consultant for the Creighton Model FertilityCare System and NaProTechnology. She also completed the FACTS elective during her last year of medical school to gain a better understanding of all the different fertility awareness-based methods for family planning so she can empower her patients with a more comprehensive understanding of their reproductive health and family planning options.
