Ep. 108: Choosing a Natural Family Planning (NFP) Method

Choosing which form of Natural Family Planning (NFP) to use can take some time and intentionality! There are many to choose from, so understanding the methods, their effectiveness, and which will work best for you can help ensure the most success and satisfaction! Natural Family Planning is not birth control or contraception, but a way to truly understand and engage with your reproductive health and fertility. You may have heard the term Fertility Awareness Based Method used, and often these are used interchangeably with NFP (although some categorize them separately). Some of these methods include, Creighton Model System, FEMM, Marquette Method, and SymptoThermal (couple to couple league, Justisse, SymptoPro, etc). Today's episode will help give you an overview and help you take your next step in pursuing Natural Family Planning! 

NOTE: This episode is appropriate for all audiences.

Register for Creighton Introductory Session:
Register here for our next Introductory Session

More info on the Creighton System:
Ep. 59: Can I really learn Creighton myself??
Ep. 106: Creighton vs. NaProTechnology

Episodes on Contraception:
Ep. 34: Is Contraception a Faithful Choice for Christians?
Ep. 6: The Pill

Effectiveness Studies:
SymptoThermal description and effectiveness overview
Marquette Method effectiveness study
Creighton Model System Effectiveness

Transcript

Caitlin: 0:06

Welcome to the Woven Well Podcast. I'm your host, Caitlin Estes. I'm a certified fertility care practitioner with a master of divinity degree. Each episode will cover a topic that helps educate and empower you and your fertility while honoring the deep connection your fertility has with your faith. Let's get started. Welcome Back to the Woven Well Podcast. These weekly episodes are intended to provide you with real world resources and faithful dialogue about matters related to fertility. And one of those big topics at the intersection of fertility and faith is natural family planning. Now, natural family planning is sort of a general term used to describe any mode of either avoiding pregnancy or timing conception that doesn't really rely on anything other than the knowledge of a woman's cycle and the couple's joint fertility. So you may have heard people use this interchangeably with other terms like fertility awareness based methods, fertility appreciation methods, et cetera . Each of those have their own slight differences, so they're not all exactly the same, but most of the time when people use any of those terms, they're using them kind of interchangeably. They're kind of lumping all of those together in that general way. Now, the reason we can do this that we can understand a woman's fertility in a couple's joint fertility based on her alone is because a woman's fertility is revealed through several reproductive biomarkers in the body, like cervical mucus, basal body temperature, cervical position, et cetera. There are ways to read these biomarkers in order to confidently know when a couple is fertile or infertile when they're together. Now the first attempt at natural family planning was way back in the start of the 19 hundreds, like 1920, around there with the discovery that women weren't fertile. Every day of the cycle, doctors began suggesting the rhythm method to plan families. Basically, it was assumed that women could only conceive during a certain number of days of their cycle, maybe like cycle day seven to 15. And if those days were avoided, then a couple would not conceive. Now I'll go ahead and let you know that was not precisely accurate. There is only one window of time when a woman is fertile each cycle, but we cannot count on it being particular days. Every single cycle there is going to be variability, there is going to be change. Every woman is different, every cycle is different. So it's way more nuanced than that. But thankfully, we have come a long way in our understanding of the female body and reproductive cycle. Instead of using assumptions about days of the cycle, we can actually read and interpret our own biomarkers to give us incredible accuracy and effectiveness. But why would couples want to use natural family planning when there are more " modern" options like birth control, IUDs and injections? Well, there are lots of reasons. One, natural family planning has no side effects like mood swings, acne, unusual bleeding, weight gain, irregular cycles. None of that happens with using a form of natural family planning. Also, natural family planning actually educates and informs women about their reproductive health. Those other options don't tell you anything. They just kind of shut everything down. And really, we are designed to have those regular cycles during many, many years of our lives. Those rise and falls of hormones are there for our good, and we really do feel our best when those are optimized. Women also feel a little bit more supported, or they can when using natural family planning because they don't feel like the whole weight of the responsibility lands on their shoulders alone. If you are using a form of natural family planning as a couple, then you really are learning about how you together as a couple is what makes you fertile or infertile. And so his responsibility, his partnership in this is equal to yours, and that's not something that we necessarily find in the birth control IUD, et cetera world itself. There are also religious or ethical concerns with some of those other options. There are many Christians who are concerned about the abortifacient factors involved with birth control, IUDs, et cetera . And so I definitely encourage you to look into that and research it yourself as you're making these decisions. So there are just lots and lots of benefits and lots of reasons why a couple may want to use a form of natural family planning. But I understand many women originally use birth control or IUDs because they don't have regular cycles, or they do experience some annoying side effects like hormonal imbalance and their doctors suggest using birth control or an IUD until they're ready to start a family. But I believe deeply, and maybe you do too, that our concerns matter now in any season of life, not just when we're ready to have a baby. So if your hormones are off, you're going to feel bad and you're going to have symptoms of that imbalance. Why not? Instead of shutting everything down, why not investigate the cause and help support your body and your hormones so that you have the best quality of life right now while you have thriving cycles? So your health, your happiness should not depend on whether or not you want to have a baby and whether or not you want to have one right now, that's just my opinion. So if you're exploring using natural family planning, then likely one or several of these things are big motivators for you. Good for you. I love it when women know that they deserve more. They're interested, they're looking into their options, and they're working to find others who support that goal with them. I think that is fantastic, but maybe the scariest part of choosing to use a natural method is the uncertainty about their effectiveness. So I want to go ahead and assure you right now that most of these methods have been tested and researched and are extremely effective when used correctly. So these are not just guesses. They're far more accurate than any algorithm that you'd get on a period app. So heads up if you're using an app to tell you if you're fertile or not, that is an algorithm, which is also known as an educated guess. You could do a lot better. With that in mind, let's take a look at some of the major categories of family planning. The major biomarkers used for family planning are cervical mucus, basal body temperature, LH rise and cervical position. There are other things too, but these are the major biomarkers. So we're going to look at these different categories and the most popular methods within them. It's just an overview for you so you can kind of get started in your research. So when it comes to cervical mucus, the two most popular methods in my opinion, are the Creighton Model system and FEMM. The Creighton system teaches you to truly understand your cervical mucus production so that you can understand exactly where you are in your cycle, what hormones are dominant that day, whether or not you're fertile when you're next period to start, et cetera . It involves making daily observations and charting the most fertile thing that you see at the end of the day. I'll go ahead and share that. I truly believe Creighton is the best system for 99% of women. It's simple. It requires the observation of only one thing, cervical mucus. It's incredibly thorough and has been tested repeatedly. Not only is it 99.5% effective at avoiding pregnancy, it's charting is able to be used by medical professionals to identify hormonal imbalances or reproductive concerns. Creighton instructors, they receive a minimum of 13 month instruction with multiple textbooks, exams, practica and more , so that you can be confident that the instruction you're receiving is excellent and it can be used by absolutely anyone. It doesn't matter if you have long or short cycles, no mucus or tons of it, irregular cycles or unusual bleeding. Any woman can use Creighton throughout her entire reproductive life, even if you are postpartum or perimenopausal or coming off of birth control. But that is not to say that it's the only method out there. I think that the first step in discerning which method of natural family planning is best for you is to identify your priorities. Do you want something that's cheap and quick to learn? Do you want a method that incorporates technology? Do you want to be very involved and knowledgeable or rely on something that can give you an answer without your input? Is it important that it's a system used by medical professionals? Do you want to learn from an instructor or on your own? Do you want to observe one thing or multiple things? Do you want a method that you can use to avoid pregnancy or conceive or just one or the other? So answering these will help guide you to the right method for you. Now, back when I was looking for a method of family planning, I got a rundown of several major methods kind of like we're doing today, and I personally chose to go with the one that checked off my priority boxes. So I wanted something simple where you only had to track one thing , effective so that I could feel confident, and medical so that all my work could be helpful in identifying any health issues that may show up along the way. So for me, that was the Creighton system, but let's look at some of these other methods, what makes them unique, their effectiveness, and who may want to use them. So we'll start with FEMM since I already mentioned that, and because it also utilizes cervical mucus observations. So FEMM instructors also encourage you to take a daily urine sample to test for a rise in your LH hormone. So in my opinion, and as someone who went through the full FEMM training , FEMM feels kind of like a first step to me into the world of understanding your cycle and or trying to conceive. FEMM is taught through an instructor. It's a short course and the curriculum does really a great job of educating you on your body and reproductive cycle. No doubt you will learn a lot. Now, when it comes to who can use FEMM, I think it's excellent for teens and for women who are trying to pinpoint with just a little more accuracy when their window of fertility is. But it may not be ideal for couples wanting to strongly avoid pregnancy as they've had no formal studies done testing their effectiveness. To me, that is incredibly important. I want to know, how effective my method is, and FEMM is a relatively new method and it's just not something that they've done as of yet. Now another major method is symptothermal. So you'll often see it taught by the couple to couple league, although there are many versions of symptothermal out there like Justisse, SymptoPro, and others. The commonality in this approach is that it requires observing two fertility biomarkers or more. But cervical mucus and basal body temperature are the main ones, and it's found to be 99.5% effective. So female bodies will experience a slight rise in temperature in coordination with ovulation. And so identifying this rise along with the presence of a certain type of cervical mucus can point to ovulation. So in order to get this basal body temperature, a woman will get up at the same time every morning and take her temperature before she gets out of bed. Now, there are many tech devices that can measure this temperature for you. Now , you can wear it each night on your arm or your wrist or somewhere , but please be cautious. Technology as fantastic as it is, it can fail, and I personally would not trust my Apple watch to tell me if I'm fertile or not. Now the final major category of family planning methods I'll talk about today is the use of a fertility monitor. So this could be the Marquette method or simply using a really detailed fertility monitor like Inito or Mira . So fertility monitors can provide really some cool information. I think they can be a great resource for many women, especially those who don't like getting their blood drawn or who want a more detailed look at the specific rise and fall of hormones. So they want to know their exact amount or how much it's changing on a day-to-day basis. But fertility monitors are technology, so like I said earlier, they can fail, so heads up about that. They also do require constant repurchasing of test strips for as many months or as many years as you'd like to use them . So keep that in mind. Now, they are also more often used to conceive than they are to avoid pregnancy. But with the right instruction, you can use these monitors to successfully avoid pregnancy with roughly a 97.2% accuracy. So if you're looking for a natural option that doesn't require any real engagement or education on your part, then I'd recommend this category. And I don't mean that to say that you don't have to learn anything in order to know how to do this. You still should work with an instructor. In fact, regardless of which method you choose, I cannot recommend enough that you learn from a trained professional. So every method is going to have instructors with different requirements to learn. So some of them go through a very short class in order to be instructor. Some others like Creighton instructors go through a 13 month process, but they're all going to be taught how to instruct you and they all want you to succeed. So trying to learn a natural family planning method on your own is kind of like trying to learn Chinese or German on your own. You can do it, but it's so much harder and so much more uncertain than if you had a personal instructor. So that's my advice. Make sure you have someone you can trust, ask your questions, build your confidence very quickly. Now, once you're using a natural system, some of their common benefits will start becoming obvious very quickly. Unlike hormonal forms of contraception, each of these methods I mentioned will have a teamwork component. So we don't want any woman to feel like she's managing her fertility alone. A couple can only be fertile when they're together. So it only makes sense that the couple would share the process and the responsibility in planning their family Methods of natural family planning. Incorporate this into the system to help with success and with satisfaction. There's also incredible flexibility in how you use a method of natural family planning. You can use it one way when you're very strongly avoiding pregnancy, but totally differently when you are open to conceiving, there's no one else involved in making that call. You have the flexibility as a couple to make those decisions together with God's guidance, and you can immediately respond to whichever direction you feel led. I love that flexibility about a natural system. Now, that's not to say that there aren't challenges to consider with as much as I absolutely love natural family planning and all that it has to offer, I think it's important to also acknowledge that this approach to fertility is counter-cultural. You may be the only one in your life or your friend group who isn't on birth control or who doesn't have an IUD. Without the right support, it can feel lonely and it can be easy to question if it's worth it or not. I will say that that's a part of why we're here at the Woven Well Podcast so that you can hear other women talk about their experiences and what it's been like for them to use a natural system like the Creighton system so that you know you're not alone and there are other people out there. But I do think that it's worth talking about some of these important things with your spouse. So some differences worth talking about with your spouse are, do we want to avoid pregnancy or conceive pregnancy right now? How can we begin communicating about our joint fertility? How can we still show one another love and affection? If we're in a window of fertility and we're avoiding pregnancy, how can we keep communication open about how we use this system? How can we share the responsibility of our joint fertility? You may have noticed here, the key is communication. Now your instructor can help you walk through each and every one of these questions if you want, so you can really figure out how to do this as a couple and not just on your own. But every couple needs to ask these questions and work together as a team to really get the most out of the experience and really thrive in their use and not just kind of survive. Now, you may notice that these are not questions that you would necessarily have to ask if you were using birth control or an IUD , so it does take practice to get used to having that level of communication about these things. But boy, is it worth it to really develop that teamwork. Doesn't mean that you have to start off feeling like a strong team, but you can get there together. I hope this has been a helpful overview. I know it can feel overwhelming when trying to decide which system to use , but I hope it's also encouraging and maybe a little bit exciting . There is a whole field out there dedicated to a woman's health and a couple's fertility. Like I said earlier, I'm still sticking to Creighton as my number one choice. Once you learn it, you have it the rest of your life, you only have to learn one thing. You have the support of an instructor like myself, who--I believe Creighton instructors--have the most, you know, that 13 month education process, which was important to me. There are no tech costs or malfunctions. There's an entire field of medical support. It's one of the most longstanding medical support fields. They also prioritize teamwork. It is a prospective method, meaning you can see your fertility window starting, not just ending. And of course, it can be used successfully to conceive pregnancy or to avoid pregnancy with couples of any type of cycles. But you may have felt more excited about the Marquette or SymptoThermal method. That's great. Finding the method for you is the best way to be truly successful in your use. If you do want to learn more about Creighton though, your best next step is to attend an introductory session. We offer these each month, and they are an online presentation that shares all about the Creighton method, how it works, and what it reveals about your health and fertility. I'll have a link in the show notes for you, and when you register, make sure to tell us you found us through the podcast, if that's the case. As always, thanks so much for listening as we continue to explore together what it means to be woven well.