December 22, 2022
The Culture of Support Needed among FABM Practitioners and Medical Professionals
By: Obianuju P. Nwamah, DO
Editor’s Note: Dr. Nwamah took the FACTS elective as a fourth-year medical student and shared how she was blown away by the wealth of knowledge she gained — information that she had never been exposed to in medical school. After gaining a better understanding of fertility awareness-based methods (FABMs), Dr. Nwamah interviewed Brittany Kudrna, a DNP to explore the incorporation of FABMs into a medical practice. Like many healthcare professionals, Dr. Kudrna* did not learn about FABMs through her training program, but rather through outside organizations, including FACTS. If you are a medical professional interested in deepening your knowledge of FABMs and their role in women’s health, we encourage you to register for our recently-expanded 8-part online continuing medical education course, now approved for a total of 128 CME credits. If you would like to make it possible for residents to enroll in our CME course for a 50% discount, please make a tax-deductible donation today … every dollar counts!
Brittany Kudrna is a family nurse practitioner who practices in Bismarck, North Dakota. She earned her Doctor of Nursing Practice (DNP) degree from the University of Wisconsin and chose to focus her practice on preventative and natural health, including natural family planning. Kudrna was first introduced to natural or fertility awareness-based methods (FABMs) through the pre-marriage counseling she and her husband attended. She first learned the Creighton Model, and later learned about the variety of FABMs available through FACTS and Marquette University. She is now a certified Marquette Model teacher with an interest in training in the Sympto-Thermal Method and FEMM Medical Management. Outside of her practice, she also teaches FABMs to medical students and others in her community.
A Culture of Support is Necessary
Kudrna has been a Family Nurse Practitioner for over seven years and, for the past three years, she has been practicing family medicine in a Catholic organization with a family physician trained in Creighton and NaPro technology. She also works with local Marquette and Creighton instructors and collaborates with the Marquette Professional Association, which provides ongoing support to Marquette educators.
Kudrna said she was grateful that her community had the support of so many FABM-trained educators and healthcare professionals — a support structure that is missing in many other places.This kind of support, Kurdnra said, extends not only to the women and couples using FABMs, but also the physicians and clinicians who teach and use these methods. Dr. Kudrna discussed the benefits of having local, in-person FABM instructors and medical professionals who are open and supportive of FABM use. She mentioned how many couples have had negative experiences trying to find a healthcare professional knowledgeable and accepting of natural family planning. Many of her patients have shared stories of being dismissed by previous clinicians who refused to read their chart or even look at it. For many clinicians, simply having the knowledge about FABMs is not enough if they plan to incorporate these methods into their future medical practice.
Physicians and clinicians should also be prepared to guide patients in the use of these methods, both for family-planning purposes or as a diagnostic tool. Help from FABM-trained instructors, healthcare professionals, and fertility awareness organizations is also invaluable when practitioners or patients find themselves uncertain of the next step or frustrated with the process. Kudrna also mentioned how she was grateful to work for an organization that allowed her to practice medicine in accordance with her personal ethics. A supportive atmosphere is not always a given, and she highlighted the importance of a culture of support that ensures the needs of women, couples and medical professionals are met.
“Help from FABM-trained instructors, healthcare professionals, and fertility awareness organizations is also invaluable when practitioners or patients find themselves uncertain of the next step.”
Areas for Continued Learning
As a FABM-trained healthcare professional, there are abundant opportunities for continued learning and growth. For example, Kudrna hopes to become more familiar with billing for natural family planning counseling and restorative reproductive medical services. She typically begins by identifying medical diagnoses through a woman’s chart to then target a patient’s workup. Regarding lab testing, she usually discusses possible cost and insurance coverage of any labwork. She frequently encourages patients to ask their insurance what labs are covered and has found workarounds for patients who may not have insurance or cannot get their labs covered.
She also continues to investigate how to best diagnose the root cause of hormone dysfunction or fertility issues and identify the necessary treatment. Her education in both Creighton and Marquette has equipped her to identify abnormalities in her patients’ charts, but determining the next steps in management is not always straightforward. Eventually, her questions led her to pursue the FEMM Medical Management training to fill this knowledge gap.
Looking Towards the Future
Kudrna’s experiences made me realize that learning about FABMs is just a first step in the path towards using them in practice. Medical students like me must undergo further training to truly understand the methods we decide to incorporate into our practice. Furthermore, there will always be new knowledge to keep up with — just like any other area of medicine.
“Learning about FABMs is just a first step in the path towards using them in practice.”
As we concluded our conversation, I asked Kudrna what most surprised her about FABMs. She responded: the exploding interest in her own community, citing the growth of her practice over the past few years due to rising interest in natural methods and the use of apps. She hopes that all healthcare professionals continue to learn more about these methods and be open to offering patients more comprehensive treatment options. She also hopes more research will be done on these methods and their applications to diagnose and treat the root cause of infertility and health problems in women and couples. To students who want to use FABMs in the future, she said: “Be able to read a chart of any method, become knowledgeable about all FABMs and take a big approach to it so as not be biased to just one approach.”
“She also hopes more research will be done on these methods and their applications to diagnose and treat the root cause of infertility and health problems in women and couples.”
About the Author
Obianuju Nwamah is a 1st year OBGYN resident at St. Joseph Mercy Oakland in Pontiac, Michigan. She participated in the FABM elective as a 4th year medical student because she wanted to learn about natural family planning. She is hoping to use the knowledge from the FACTS course to educate patients about their overall female health and give alternative options for contraception.