April 13, 2023

The Benefits, Burdens, and Beauty of FABMs

By: Sandra Spychalska

 

Director’s Note: Sandra Spychalska shares a thoughtful interview that explores one woman’s journey with fertility awareness-based methods (FABMs) and the learning curve across three different methods. It highlights the versatility of the methods and the importance of identifying the method that best meets the needs of the individual woman or couple, as well as the unexpected benefits that couples experience when using FABMs. Unfortunately, the geographical location made it challenging to find trained practitioners in her fertility journey, but through the FACTS elective we hope to train the next generation of physicians to fully appreciate the value of charting the female cycle with these methods. Your support can make a difference! To increase access to FABM services, consider applying to be listed in our directory if you are a FABM-trained medical professional or educator.

 

Jane* is a 33-year-old woman who has been using fertility awareness-based methods (FABMs) for seven years. She and her husband Bill* have three children, ages 5, 3, and 7 months. Over the years, she has tried the Creighton Model, Lactational Amenorrhea Method (LAM), and the Marquette Model. Her experience with FABMs has been a positive one, and it eventually led her to become a Marquette Model instructor.

Jane first learned about natural family-planning methods through her friends and contacts within her church. She explained that her religious beliefs were about 50% of the reason she chose to use FABMs, but the other 50% was her preference for natural methods not reliant on prescriptions for contraception. She states that she started using the Creighton Model about one year before she was married to monitor her cycle and simply learn more about her body. She and her husband first used the method to avoid pregnancy, but later tracked her biomarkers to successfully achieve pregnancy. Five months into her marriage, she became pregnant with her first daughter. After giving birth to her daughter, she used the Lactational Amenorrhea Method throughout the first six months postpartum. She was staying at home and breastfeeding her daughter at least eight to 10 times daily, so it was an easy method for her to follow. At six months postpartum, even though her menses had not yet returned, she switched back to the Creighton Model. However, in the following months, she found it very difficult to interpret the inconsistent cervical mucus signs. Since she was less confident in her use of the Creighton Model, she decided to switch to the Marquette Model.

Jane has now been using the Marquette Model for the last five years and finds it easier to understand, compared to the Creighton Model. When she began with the Creighton Model, she had regular meetings with an instructor, which made the transition easier. However, with the Marquette Model, she felt like she had a good grasp right away and did not need someone “holding her hand as much.” After an initial consultation, she was ready to use the Marquette Model on her own with confidence.

“She reports many benefits to using FABMs, including improved communication with her husband.”

She reports many benefits to using FABMs, including improved communication with her husband. FABMs necessitated the couple be clear about their intentions for pregnancy, and open communication allowed them to identify and resolve other relationship struggles. She reported some initial difficulties getting used to abstaining from intercourse at certain parts of the cycle, but it became easier with improved communication. She also mentioned how helpful it was to have support from her friends who also use FABMs. Living in New Mexico, there are not a lot of doctors trained in FABMs, so it was hard for her to find a practitioner who understood her. She recalled the disappointment she felt after bringing up concerns about low progesterone levels during her pregnancy to a physician who did not understand. Eventually, she found a new clinician an hour away who was knowledgeable in FABMs and she was finally able to share her fears. Even though she did not end up starting progesterone, she knew her concerns were taken seriously and felt capable of making an informed decision. Several of her friends have had similar experiences, with some reporting negative interactions with physicians or clinicians that discouraged them or even shamed them for using FABMs. “There is a lack of medical professionals knowledgeable in or friendly toward FABMs,” she said.

“Coming from a nursing background, Jane appreciates the improvements she has seen in her health and her marriage through the use of FABMs.”

Coming from a clinical nursing background, Jane appreciates the improvements she has seen in her health and her marriage through the use of FABMs. Though never formally diagnosed with polycystic ovary syndrome (PCOS), she found that her cycles were around 35 days long after beginning charting. By continuing to chart, she noticed her cycles improved with decreased gluten and sugar intake, and she felt better overall. Beyond use as a diagnostic tool, charting and using FABMs also allowed the couple to achieve pregnancy in one cycle once they decided to have intercourse in the fertile window.

“Beyond use as a diagnostic tool, charting and using FABMs also allowed the couple to achieve pregnancy in one cycle once they decided to have intercourse in the fertile window.”

She did, however, report one method failure at 14 months postpartum after the birth of her first child. She was using the Marquette Model at the time and her monitor indicated that she had gone from low to high to low, without a peak. She interpreted this to mean she had not ovulated, but she actually ovulated later and became pregnant. Rather than give up on the method, she began to realize the effects of the postpartum period on the reliability of the methods, and she knew to look for other signs of fertility in her subsequent postpartum period. Her message to other women wanting to try FABMs is that the methods can be successful and the knowledge gained is very beautiful.

*Name has been changed to respect the privacy of the interviewee, and all information is shared with permission.

 

About the Author


Nisha Mandla

Sandra Spychalska

Sandra Spychalska is a fourth-year medical student at the University of Illinois at Chicago. She completed her undergraduate education at the University of Notre Dame. She plans to do her residency in family medicine and looks forward to providing full-spectrum women’s health care to her patients in the future, including the option for FABMs.

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