March 9, 2023
The Reach of FABMs Beyond Family Planning
By Sabel Hicks
Editor’s Note: Sabel Hicks, a former FACTS elective student, interviewed Jeni,* a friend who has been using fertility awareness-based methods (FABMs) to track her cycle for years. They discuss Jeni’s reasons for pursuing FABMs and how using these methods affected her relationships, and changed her career goals. The interview format provides a unique opportunity to learn about the real-life impact of FABMs and the multifaceted changes employing FABMs can have on a person’s life. If you have used FABMs and would like to share your story with one of our elective students, let us know here!
Journey to Fertility Awareness-Based Methods
Sitting down together, Jeni and I had a lot to discuss. She was enjoying the first months of marriage and was eager to share more about her journey using fertility awareness-based methods (FABMs). She shared that she had always felt that her health suffered while using hormonal-based contraceptive methods. She reported feelings of fatigue, changes in her appetite, and decreased sex drive; Jeni was looking for a new option.
Unfortunately, Jeni’s experience and dissatisfaction with hormonal contraceptives is not unique. According to a 2019 study from Alspaugh et al. in the Journal of Midwifery & Women’s Health, a distrust of hormonal contraception was a common concern reported in their literature review on women’s attitudes towards contraception. 
When Jeni first learned about FABMs, it felt like the perfect fit. She wanted a way to gain more control over her fertility and overall health and was excited to move away from options that required artificial hormones. After discussing options with her partner, they decided to give FABMs a try and chose to use a sympto-thermal method — which included tracking both her daily basal body temperature, cervical mucus and position.
As Jeni learned more about FABMs and began to use them as a method of family planning, she realized how making this change was positively affecting her interpersonal relationships. In her romantic relationship, she discovered she had a supportive partner who was willing to back her decision to use FABMs for family planning and to learn about FABMs with her.
“As Jeni learned more about FABMs and began to use them as a method of family planning, she realized how making this change was positively affecting her interpersonal relationships.”
The Alspaugh et al. study also discussed the themes of power imbalances between partners and their subsequent impact on women’s perceptions about contraception.  In Jeni’s case, the dynamics in her romantic partnership were those of support, understanding, and care, which increased her confidence in her significant other. Their relationship has since blossomed into a supportive marriage, and she feels that her strong knowledge of sympto-thermal methods has prepared them to switch from avoiding pregnancy to trying to conceive when the time is right.
Additionally, Jeni and I reflected on how discussing FABMs had affected our friendship. One of our first conversations quickly delved into women’s fertility. She was using FABMs, and I was in my OB/GYN clerkship. We bonded over our love of women’s health and the exciting prospect of FABMs to allow women to gain a better understanding of their fertility and overall health. We each felt inspired by the other, and it showed me how FABMs can strengthen friendships, as well as romantic partnerships. Sharing our journeys surrounding fertility left us both feeling empowered.
Life Planning and Career Goals
FABMs not only shaped Jeni’s relationships, but also eventually her professional goals. After using FABMs, Jeni decided to make changes to the overall trajectory of her life and career path. After years working a desk job, she decided to follow her passions and pursue a new field. She became involved in a company that provides all-natural products for perinatal and postpartum women and completed training to become a certified doula.
The lifestyle changes prompted by FABMs also inspired Jeni to examine more critically other aspects of her life, including her long-term priorities. She realized that she wanted to be more involved in the women’s health field and use skills she had learned from FABMs to contribute to the well-being of those around her.
Another theme that arose in Alspaugh et al.’s literature review on women’s contraceptive perceptions was the ability to enhance personal agency through contraceptive decision-making.  Similarly, Jeni experienced a strong sense of personal agency when deciding to use FABMs to enhance her understanding of her body and as her family planning method. This agency then extended to the decisions she continued to make in her life, such as choosing a supportive life partner, supportive friendships, and a career centered around providing compassionate care to other women. For Jeni, prioritizing her personal values allowed her to also share the best side of herself with others. She no longer felt plagued by the side effects she had experienced while on hormonal contraception, and she felt more in touch with her body than ever. She continues to enjoy the benefits of this life path and looks forward to where the future will bring her.
“Jeni experienced a strong sense of personal agency when deciding to use FABMs to enhance her understanding of her body and as her family planning method.”
The FACTS elective provides an opportunity for others to share in this empowerment, to learn about FABMs, and impact change for others. The elective provides incredibly valuable information about different options in FABMs and gives learners the tools to share this knowledge with others, increasing the impact that FABMs can make. Jeni’s story contributed to my decision to pursue the FACTS elective and now share the value of both the elective and FABMs with others. Whether or not FABMs are the right option for a woman or couple, the empowerment that comes with understanding the benefits of tracking fertility for overall health is something that should be shared with all. My first hand witness of changed lives reiterates how beneficial it can be to provide education of and access to fertility awareness-based methods.
“Whether or not FABMs are the right option for a woman or couple, the empowerment that comes with understanding the benefits of tracking fertility for overall health is something that should be shared with all.”
*Names have been changed to respect the privacy of the interviewee and her family. All information is shared with permission.
 Alspaugh A, Barroso J, Reibel M, Phillips S. Women’s Contraceptive Perceptions, Beliefs, and Attitudes: An Integrative Review of Qualitative Research. J Midwifery Womens Health. 2020;65(1):64-84. doi:10.1111/jmwh.12992
About the Author
Sabel Hicks is a fourth-year medical student at University of Nevada, Reno School of Medicine in Reno, NV. She completed her degree in Neuroscience at the University of Nevada, Reno in Reno, NV. She plans to do her residency in OB/GYN and is extremely interested in reproductive justice and access to health information. She enrolled in the FACTS elective to gain a better understanding of natural family planning methods and manners in which to share these methods with future patients so they can feel empowered over their health and reproductive decisions.