By Kellie Wo
September 19, 2018
Editor’s Note: At FACTS, we are committed to publishing real stories of women and couples who use Fertility Awareness Based Methods (FABMs) and presenting both the benefits and the challenges of this countercultural way to plan a family and manage health. This interview with a couple is an example of a husband and wife who struggled early on while using the Sympto-Thermal Method (STM), yet persevered. The end result is part of the beauty of FABMs as told by Kellie Wo, the 2nd year medical student who interviewed the couple during Dr. Marguerite Duane’s 6-week selective course at Georgetown University School of Medicine.
After learning about all the various FABMs in class, I was looking forward to talking to someone who used them in their own life. I know many people who use oral contraceptive pills (OCPs) or intrauterine devices (IUDs), but I don’t know anyone who relies on fertility awareness based methods. Hormonal methods can seem like such a simple fix, but this means introducing exogenous substances and manipulating your natural hormones. It’s likely that very few women I know chart their cycle at all, even to simply document when they get their period each month. Learning about charting has opened my eyes to how useful this can be, both for fertility as well as overall patient health.
Learning the Method
I interviewed a married couple about their experiences using the Sympto-Thermal Method. To protect their privacy, we will call them Steve and Sara. They learned about STM through a marriage course at their church and have used it for almost five years. They started charting a few months before they got married and plan to continue relying on FABMs all through the reproductive years.
The couple acknowledged that, in the beginning, there were communication barriers. Sara knew what was happening with her body, but Steve wasn’t on the same page. They also didn’t realize how strict the rules were. As with all the fertility methods, the couple must abide by certain rules to avoid or achieve pregnancy. That usually means that, given certain signs, a couple must abstain from sexual relations to avoid pregnancy. Without a solid understanding of the female menstrual cycle, such rules can seem quite arbitrary. In fact, Sara and Steve ended up getting pregnant because they didn’t fully understand those rules. However, they persevered and gave STM another try, and it’s paid off, as they have two beautiful girls. They now teach the course to other couples interested in this method!
Charting and STM
From the charts we had seen in class, it seemed charting may have a steep learning curve. At first, it could be hard to remember to check your cervical mucus, take your temperature, write it all down and keep track. However, Sara assured me that charting is now as easy as brushing her teeth. At this point, it’s become a habit and takes minimal thought. Sometimes Steve will remind her to take those measurements. To be most effective, FABMs require that the couple work as a team. Steve and Sara both know what must be recorded and which rules apply at different times. They’re in tune with each other and know when sex is “on or off” the table every night based on their family planning goals and signs observed.
A Medical Student’s Perspective
Our society seems to look down upon mentioning the menstrual cycle. Women rarely talk about it except to blame mood swings on their monthly period. Pads and tampons are hidden in the back of stores, and very few women understand the intricacies of what’s happening within their bodies.
One of my favorite gems of my conversation with Sara and Steve was hearing how STM has improved their communication and their relationship. Now that Steve knows which part of the cycle Sara is on and how this typically impacts her, he’s learned to time conversations and activities accordingly. He may bring home chocolate some days, and knows when to give her a little more space. I think that’s beautiful. Sara doesn’t need to keep her menstrual cycle and natural body processes hidden. Furthermore, her husband picks up on these signs and knows how to help her manage these times. FABMs help women embrace their bodies’ natural rhythms and live in greater harmony with them.
Sara and Steve’s main qualm with STM was the difficulty using it during the postpartum period. After pregnancy, hormones are off balance, and it takes time to get back to one’s normal baseline. The rules they use postpartum are more conservative, which means more abstinence, since signs such as temperature may fluctuate and become harder to read. This presents an obstacle for using some FABMs during the postpartum period, simply because the body is trying to recalibrate. Certain methods are easier to use postpartum, including the Marquette Model and the Lactational Amenorrhea Method (LAM).
It’s unfortunate that we went through an entire block on reproduction in medical school and barely touched on the practical applications of fertility awareness. We learned how the various hormones work, but after this elective with FACTS, I now understand much more about how this manifests symptomatically. Learning about charting opens a door to so many possibilities. Women can understand their cycles and bodies simply by learning to chart. As they grow more familiar with their normal cycles, women will know when something is different or abnormal. Couples can learn the science behind achieving and avoiding pregnancy and use this information in family planning.
Knowledge is powerful, and charting helps provide such knowledge. The medical school curriculum should include information about these natural, safe, and effective options for women and couples.
Editor’s Note: Although chocolate is widely considered a common craving among women, particularly in the luteal phase, does the evidence support this? Scholarly studies have in fact evaluated the evidence and point to definite cravings for various foods in the pre-menstrual period, especially high fat foods like chocolate. Yet, this doesn’t seem to apply to all women, and certainly not to women in all countries. One clever study considered the impact of acculturation in this phenomenon and found differences among women born in the United States, second-generation immigrants, and women born in other countries. For their interesting findings, read the article HERE.
Author Bio: Kellie Wo is a 2nd year medical student at Georgetown University School of Medicine. She completed a 6-week selective course at Georgetown that introduces medical students to the basic principles of natural or fertility awareness based methods of family planning and the supporting science behind their medical applications. This summary is part of her final project, in which students interview a woman or couple who uses a FABM.
MEDICAL STUDENTS & RESIDENTS!
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based methods and their applications in women’s health and family planning?
Here’s what young physicians are saying about this course…
“The online medical student elective empowered me with the knowledge to share with patients and coworkers about the true effectiveness of fertility awareness based methods. I learned the physiology of the woman’s menstrual cycle with great detail and can read charts systematically like an electrocardiogram. Not only are FABMs useful for family planning but even for diagnosing and treating medical conditions.”
— Chris Galletti (4th year medical student)
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