“Natural Family Planning” and Method Effectiveness

Refugees from the sympto-thermal method, my husband and I have begun learning the Creighton model for fertility awareness over the last few months. With five healthy children in seven years, as Mary-Alice says so perfectly, we are “drowning in blessings”!

Both the sympto-thermal method and the Creighton model rely on one of the same biomarkers to indicate fertility, and both involve daily charting of signs to determine fertile and infertile days of a cycle. In spite of such noticeable similarities between the two systems, I am rather surprised at how different they are – to the extent that the systems sometimes directly conflict on when data is collected and how it is interpreted.

When we were learning the sympto-thermal method before marriage, through the Couple to Couple League, I was fine with giving a decent shot at a decent Catholic method of fertility awareness. The manual was written by a Catholic couple—in fact, the course material included a lecture and readings on the Theology of the Body as well as on the practice of ecological breastfeeding. The sympto-thermal method was a definite upgrade from the rhythm method, and I was happy to receive a refresher on the Theology of the Body and to ignore the business about ecological breastfeeding. I liked the method’s emphasis on openness to children: do your best to observe and chart and abstain, but if the method fails or if you don’t practice it accurately, praise God!, another baby, another soul.

But maybe our jolly providentialism has delayed the earnest pursuit of a method of fertility awareness + periodic abstinence that works for couples in all the different possible circumstances – like breastfeeding, for instance.

So far, the Creighton model strikes me as an upgrade – the result of earnest, ongoing study and analysis by professional scientists and doctors. It was inspired by Catholic teaching, but no classes in theology or parenting philosophies are included. Just precise descriptions of biomarkers, constant data collection, and detailed charting. There is no “normal” cycle—Creighton is about interpreting this day of this cycle. It is also highly effective for avoiding pregnancy during the first year postpartum and during breastfeeding, as well as for treating infertility, postpartum depression, and the whole broad spectrum of conditions that can be understood by fertility awareness.

In short, it seems the time has come for a method of fertility awareness + abstinence that is objectively reliable. Leave the subjectivity to the discernment process. Once a couple has generously welcomed children and then has prayerfully discerned a grave reason to delay the next pregnancy, it would be nice to have a method that actually works.

But then again… what happens when doctors and scientists bring us a nearly perfect method of determining fertile days in order to minimize abstinence and dramatically reduce the number of “unplanned” pregnancies among Catholic couples? Even if the method is still consonant with natural law, less abstinence with fewer babies is starting to look a lot more like modern-day birth control.

On the front end, I want to know that, when we discern a grave reason to delay the next pregnancy, we will not conceive. But in retrospect, I can’t imagine our one “user error” baby and our one “method error” baby not being a part of our family.

  • KC

    Totally agree, JM! We learned STM and I charted more in the months leading up to our wedding than I ever did after (even 7.5 years later). We haven’t had need to “re-train” with Creighton, but I tell every young Catholic woman I meet to just start there, knowing what I do now from reading/hearing about it and esp. knowing so many women whose health has been improved by finding hormonal imbalances through Creighton/FertilityCare. It really is a gift, but as you say, one that *can* be misused if approached within marriage as “Catholic birth control” as people so often say. God bless your family!

  • Adele

    I also found STM to be very stressful while breastfeeding, and now use the Marquette method with the clearblue fertility monitor. Though it’s $10 for the test strips, it has taken almost all of the guesswork out of it for me, and I wish more people were aware of this option.

    I never know what to think when I read pro-NFP articles that claim that NFP is 99% effective, just as effective as the pill, etc. All I can say is that almost everyone I know has had at least one surprise baby with NFP. Blessings, to be sure, but I wish we were more honest about this when advertising NFP to outsiders.

    • http://motheringspirit.wordpress.com/ mothering spirit

      I agree with you, Adele, on the benefits of Marquette – using the monitor has been an additional cost, but this method has brought us SO much more understanding of my cycles and peace of mind in the post-partum method. I only wish more people had the opportunity to learn about it!
      But your comment about NFP surprise babies made me think. Certainly I know of many families that have them (e.g., my youngest brother!) but I also know SO many families with surprise babies from contraceptive use – within our extended families, a handful of good friends, parents I meet in preschool/ECFE classes. Just this week a friend shared that she recently got pregnant while using an IUD. So in some ways I do not think the 99% claim is false – the Pill claims nearly the same and I can think of a good number of families I know who got pregnant while on the Pill.

      • BMM

        Yay Marquette!! It has been such a blessing for us too! :)

        Yay for any NFP method that is working for any married couple for that matter! ;)

  • Kimberly

    I just began using the STM for the first time. I have also been married for seven years, but I have been using Ecological Breastfeeding to space my babies and I only have three so far. I have not had a grave reason to postpone pregnancy any longer than the 17 months that Eco-bf. provides me with until now. I never tried to use STM while breastfeeding a newborn. My baby is 22 mos. old right now and doesn’t nurse much more than 3-4 times within 24 hours, and so far I haven’t noticed anything too irregular from what the Kippley’s talk about in their book. I’m only on my second chart, however, and I am sure there is a lot about the way my body functions that I don’t comprehend. So far, using this system and every possible avenue it leads to (cervix, internal, external and temp. signs) has been quite easy and comprehensive.
    I have noticed that as soon as I got into this mentality that I have to try to avoid pregnancy, not having any more kids has become more and more appealing. I don’t want to think that way! I know that without a doubt, if God sends me another baby I will adore him or her. But in the mean time, I have become more impatient with the little struggles of caring for small children because of my “contraceptive” mentality. I have noticed it distinctly. I used to view it all in a much more selfless, surrendered mind-set. I am hoping home schooling will keep me in the child-rearing, busy state that prevents my having “idle hands” and living for myself more than is wholesome and healthy.

  • Kimberly

    Oh, I forgot to post this: http://www.youtube.com/watch?v=utOIt6CoJGA&feature=youtu.be

    It’s a video I made recently on Ecological Breastfeeding.

  • Amy B

    My husband and I have used Creighton since we got married. I have also greatly benefited from Napro technology, with progesterone therapy during and after my pregnancies. Though creighton is a more scientific method, I find that it requires more days of abstinence during times when we are postponing a pregnancy, in particular during breastfeeding (maybe this is why it is so effective). I actually added the temperature for a little extra certainty. I never understand how NFP can be compared to contraception. With ample days of abstinence, the sacrifice of abstinence, at least in our case, seems to make it impossible to use it for selfish reasons. Maybe we would feel differently after we are “done” having children. For now, though, I don’t see how NFP even comes close to contraception.

    • Juris Mater

      I’m just beginning to get a sense of how much abstinence is required in the Creighton model! Maybe that’s the reason for its effectiveness : ) A white marriage is one way to go…

  • Sarah

    My husband and I also use the creighton model method after starting with STM. And with God’s grace and the wonderful creighton method counselor and doctors we worked with, we now have two beautiful daughters. We struggled with infertility for 3.5 years, and were proceeding with adoption when one last procedure helped us succeed with our first pregnancy.

    I was amazed at how little I knew about my own fertility prior to learning the method. I was also amazed at how little the typical Obgyn doctors I saw were ready to support me. They suggested IVF and similar options even after I explained what we were willing to try. They also didn’t really know what to do with the data I had.

    The hormone support alone from the method was instrumental for us. From the creighton model method, I needed progesterone supplementation the entire pregnancy. Standard Obgyn protocol is only support the first trimester, unless you have miscarried in the past. But why go through a miscarriage if with a little help you can save that baby’s life? I wish many aspects of the method could at least be part of doctor training/support…

    I agree that knowledge of our own fertility can lead to to many attempts to control on the part of parents to be. On the other hand, at least there are no chemical/physical barriers in place to prevent the chance of pregnancy. And I think the way that both members of the couple have to be involved and choose to abstain or try at specific times involves a lot more conversation and will power than taking a pill or using other artifical methods.

  • http://www.buildingcathedrals.com Mary Alice

    I agree with Amy. In fact, I think that there is so much abstaining that it makes you really think hard about whether you can be open to a new life. We really dislike the times that we are not able to be open to conceiving, and so we really never have to question whether we are slipping into a convenience mode.

  • Kimberly

    Please explain to me why you are choosing not to post my comments.

    • Bethany “B-mama”

      Kimberly, I can see them just fine now. It might have been a momentary glitch on Patheos. We do not moderate comments unless they are inappropriate, which yours are not! Thanks for contributing.

    • Kellie “Red”

      Kimberly, because you are a new commentor, your comments had to be approved by one of the builders. I just approved them now, so they are showing. We were having problems with spam comments, so comment moderation is in effect for all new commentors. You will not longer have to wait for your comments to appear. I apologize for the inconvenience. Thank you for commenting!

      • Kimberly

        Thank you! :-)

  • Kellie “Red”

    I also agree with Amy and Mary Alice, there is so much abstaining required in the proper practice of any method of NFP, it can hardly be compared to contraception.

    I strongly caution against being “down on sympto-thermal.” I have studied both methods, and chose to teach sympto-thermal because it never made sense to me why the temperature sign would not be used (if it was a good sign for a particular woman). And I also happen to think Creighton is very top down, not making their materials available to people unless they sign up for long classes and ongoing counseling. While that is great for some, it doesn’t work for others –there is no learn at home option, which is a shame.

    As for the parenting stuff and “ecological breastfeeding,” CCL broke with the Kippley’s years ago, and updated all their materials to make them much more user friendly. The term ‘ecological breastfeeding’ is no longer used. If I am correct, you never bought the new materials, or learned their updated, and much more streamlined approach. I think we need to be VERY careful to knock a particular method of NFP that has been shown to be very effective for couples using it properly.

    That being said, I am overjoyed that Creighton has been a positive experience for you! I think having many grass roots efforts out there making NFP knowledge available is wonderful!!!! And I’m happy to hear that you are taking the time to learn and follow a method that works for your family.

    • Kimberly

      The term “Ecological Breastfeeding” is widely used, but I understand you were referring to it’s use in CCL. Their choice to stop teaching this method is something I consider quite a shame, as was their decision to split ways with the Kippleys. John Kippley wrote a book about the way it happened called “Battle-Scarred”, and I assure you, that is an organization that I want no part of. He could not have published this book if it was not true, or they would have sued him. Catholics should have access to every possible form of NFP. While it might not work the best for some it works extremely well for others.

      As for making the STM more user friendly than it was before, how so? I have found it very easy to catch on to and I have looked to nowhere other than John and Sheila Kippley.

    • Mama Turtle

      You make some great points! When were the CCL materials updated? My husband and I took the class when engaged five years ago, and we either had the older materials OR we took it before things were updated. I was really disenchanted with the STM because of the way ecological breastfeeding was presented; I felt like an NFP failure when we put our baby in a crib so that we could get more sleep. I’ll need to check out the newer version of the course for sure.

  • JMB

    My husband and I have used NFP for 19 years of marriage. We have four children. I’ve never charted. I never took my temperature save for the NFP class that we took after we got married. I’ve been fortunate that I’ve had regular periods forever, I nursed all my children and got my period back with each one between 13 and 15 months post partum. After that, I didn’t really care if we got pregnant or not. Every baby is a gift from God, and we kid ourselves if we think we can “plan” these things. I reject the notion that NFP is on par with contraceptives. It’s not. The contraceptive mentality is the (and I used to hear this so often when I was younger and bearing children – TWO and DONE!” The getting snipped, tubes tied, permanent steriliazation – that is a contraceptive mentality, not observing a growing family with growing needs and saying to your husband,” Honey, let’s just put off trying to have a baby for another month because I just can’t handle it now”. In every family there is a youngest child. That is a fact. Sometimes it comes sooner than you wish, or later than you expected, but there is a season to childrearing and it passes, whether you want it to or not.

  • Kimberly

    BTW, my comment at 4:37 p.m. was directed toward Kellie “Red” who commented just before me, and not intended to refer to the article directly.

    • Kellie “Red”

      CCL stopped using the term because it is not an accepted term in the medical community. They wanted their materials to be more user friendly, and more in line with the medical community. Ecological breastfeeding, as you call it, doesn’t work for many women. I’m sure it helps to delay fertility for some, but many women still see a return of fertility far sooner than they would like. CCL’s old materials were not good in this regard. They did little to help women who saw an earlier return of fertility, and in fact, some of the materials actually made the woman feel as though she hadn’t fed her baby properly (used a pacifier, wasn’t nursing enough, wasn’t co-sleeping, etc.) and that was why her fertility had returned sooner.

      In an earlier comment, you described periods of infertilty due to breastfeeding of 22 months, so it seems simply breastfeeding your baby has given you a great deal of space between pregnancies. As a result, this method of child-spacing has worked well for you. I think that’s great. But do be careful about theologizing your preferences. Do keep in mind that everyone has a different situation regarding how they feed their baby, when they introduce solid foods, where their baby sleeps, if their child takes a pacifier or sucks his/her fingers, etc.

      Parenting choices don’t really belong in NFP materials. I think it was wise that CCL moved away from giving that sort of advice and focused instead on clarifying the actual method for those in need of spacing/postponing pregnancy. But I admit that I am biased because the Kippley’s writings and thoughts on these issues were a big turnoff for me.

      • Kimberly

        Well, hopefully the medical community comes up with some sort of term for it, because it certainly is a reality that ought to have some sort of easy reference. Ecological Breastfeeding fits it quite well. It would certainly work for more women if more women gave it a fair chance. I agree that it is not easy, at first, but nothing worth doing ever is. It gets much, much easier with time and practice. I can imagine that for you, after going through Princeton, it would have been a major “culture shock” to adjust to the demands of following the Seven Standards. I think it’s difficult for most American women to go from our busy social upbringing to having children! But that doesn’t mean we don’t have to do it if we choose marriage, and Eco-bf. can get a mother on the fast-track to all the virtues she’ll need to be a good mother. It is a major adjustment, but it isn’t impossible to get through.

        I see no reason why a proven method for spacing babies that is as natural as the breast milk itself should not be included in CCL’s lessons. If a woman is unable to use Ecological Breastfeeding or feels certain it is not God’s Will for her, why should any of the Seven Standards offend her, upset her, or set her against the entire method itself? The Kippley’s didn’t create the female body. This was God’s doing, and it’s a beautiful option! Why should it be kept from all Catholic women because some of them are overly sensitive?

        The Kippley’s never wrote anything that ought to have upset women that were unable to get more spacing than they needed. I can’t imagine how women could feel bad about something that is not between them and “the material”, but between them and God, anyway. If they had been taking care of their baby as best they could, why should they care? A clear conscience should be a peaceful one. If they didn’t get enough space then the STM was always there, ready for their use. And by the way, the Kippley’s have a revised version of that giant book, too, that is ever so handy.

        • Kimberly

          Have to clarify, because I didn’t proof-read properly: I said “The Kippley’s never wrote anything that ought to have upset women that were unable to get more spacing than they needed.”
          I meant:
          “The Kippley’s never wrote anything that ought to have upset women that were unable to get more spacing AND needed it.”

        • Kellie “Red”

          Actually, I think my Princeton education allowed me to see that the seven standards were extremely arbitrary and not good for my family. It allowed me to see that there is a difference between practicing NFP and practicing a certain style of parenting. My education allowed me to see the importance of sleep–for both my baby and me. Life is different for every family, and while there are absolutes (such as don’t contracept), there is a lot of grey in how we discern family size, how we parent, how we feed our children, etc. Since ditching ecological breastfeeding, we sleep well, my babies sleep well, grow better, and our entire family is happier and more open to life. I am able to homeschool my kids, enjoy my babies, and pray. But what works for everyone will be different, which is why it was so important for CCL to stop advocating a parenting philosophy and streamline their efforst into NFP education and method clarification. Dr. Sears and his attachment parenting crew (the Kippley’s) can write about attachment parenting, and I’m sure a certain percentage of women like yourself will continue to follow that method of parenting. But let’s not blur the distinction between a method of parenting and how to practice NFP. There is obviously some overlap, and the new CCL materials cover how to practice NFP in all those different situations. And for that I give them a 2 thumbs up!

          • Kellie “Red”

            Oh, and I say this as a person who exclusively nurses my babies for the first 6 months, slowly introduces solids, and practices extended breastfeeding. So I just want to clarify that I’m a big breastfeeding advocate, but not the “attachment parenting” kind.

          • Juris Mater

            All roads lead back to ecological breastfeeding and the Kippleys : ) I do appreciate the gift the Kippleys have given to the Church in helping to update the STM and other things, they have been pioneers… but yes, the ecological breastfeeding dogmatism is ill-founded.

          • Kimberly

            I’m not wanting to insult you here, but I want to point out that you would very likely have known these things you mentioned without having spent a single day at Princeton. It does not take a lofty degree to be a good mother anymore that it takes a particular form of parenting. You have steeped yourself in a world of adult thinking and dedicated yourself to earning your degree. It’s certainly admirable, and I’m sure that in doing so you acquired many virtues beneficial to motherhood. You became a Catholic, if I’m not mistaken! :) One can easily understand how tedious the switch would be, to have to go from such superior learning to sitting quietly alone, nursing a baby, for literally hours each day (which, as I said, is difficult at first but is like second nature with time- I LOVE it at this point!), and that is all I meant to imply. I was not trying to indicate that your education somehow left you worse off for being a mother, as your response seems to imply.
            I am able to do all of the things you mentioned that you were able to do once you “ditched” Eco-bf. I have never had any problems getting rest, especially because I usually managed to get the daily nap standard in. My kids are robust and as healthy as can be. I home school and we love it. And my husband and I both remain totally open to life in our “will of the spirit” as St. Louis puts it, which entirely sufficient. So as I said before, if some women are able to use this form effectively, it ought to be available to them. I never even heard the term “attachment parenting” until my second pregnancy, and I still do not consider my ways of parenting as something that can be formatted in a “style”. I do not agree that Eco-bf. overlaps with pushing a particular style of parenting. It offers Seven Standards that one may follow if she so chooses, and if she cannot do all seven, it will not work and she should look to another method. Having the benefit of going many, many months without nasty menses or any abstaining or any charting is an awesome incentive! I can’t even tell you how wonderful that break is! I have hated having my periods the last few months; I’ve gotten so used to the freedom from it. How long did you try to do Eco-bf, Kellie?

          • Kimberly

            @JM What is Ecological Breastfeeding dogmatism?

          • Juris Mater

            For starters, their ecological breastfeeding/attachment parenting book is entitled “Breastfeeding and Catholic Motherhood: God’s Plan for You and Your Baby”, and the book is very dogmatic. But I’ll say Kimberly, your mention of no periods and no abstinence for a couple years as a result of ecological breastfeeding just made me give it a second thought! : )

          • Kimberly

            @JM Ha! Well, that is in fact my favorite book of hers. I promote that in the YouTube video I posted. Maybe it is “dogmatic”, but the title pretty much says so, and if you’re not interested in the topic, why would you read it? I found that book to be a pillar of strength. Odds are against the breastfeeding mother having any success. We need to know that God appreciates our efforts, because nobody else does! That’s pretty much the motto of this group, isn’t it?
            I could understand why the CCL might not choose to promote that particular book, although I do not by any means think that it should be kept hidden or looked at as something bad and mean. But there are several other books that absolutely should be given to CCL couples. Her most recent book, The Frequency Factor, leaves all dogma totally aside and gives a brief and complete teaching on what Eco-bf. is and how it works. Reading that helped me succeed in getting even more spacing with my second and third pregnancies.

          • http://www.buildingcathedrals.com Mary Alice

            Kimberly, I’m not sure how much you know about a Princeton education, but I think you’d be surprised at how well it prepares someone to sit alone for long stretches of time. We each wrote a Senior Thesis for which we spent countless hours in a small, dark locker in a library doing reading. In fact, these days I look forward to my nursing times as just about my only time to be quiet and read!

          • Kimberly

            Mary Alice (I love your name, btw), I could see that point as totally valid. I love to read while I nurse as well. I just finished David Copperfield the other day, which had a huge impact on my femininity, by the way! Loved that book!
            Well, I suppose if that is not the reason behind why a woman would feel an instant aversion to the idea of spacing babies with breastfeeding, then there must be some other reason behind it. I do think that it’s something to do with our social lives as American women, but I guess that’s mostly an educated guess. I would like to understand better, but I can’t unless we continue to discuss it respectfully, as we have so far. I used to have a big misunderstanding about systematic NFP, and considered it a lot of nonsense to do all the charting and whatnot when a person could just follow the Seven Standards. But through polite discussion and making friends online, I have come to understand that I was wrong. I’m glad to have a better understanding of it, and to have found smart, Catholic women that challenge my thinking and moral comprehension.

          • Mrs C

            Hear, hear Red!

          • Kimberly

            Thank you for explaining all that to me, Kellie. I don’t think it was too much information. Not at all. It sounds like this really just was not God’s Will for you, as things turned out. He led you in a different direction than He led me, and that’s all there is to it, which is all I suspected.
            Not to be annoying, but I over-produce milk, too! My baby was never for a second willing to sleep anywhere but right next to me. So instead of looking for different sleeping arrangements, I wound up looking into what could cause such a huge over-production of milk. I was literally leaking so much out of one side that I soaked my baby and my bed-sheets on three or four occasions! I wound up discovering that I do not digest dairy products well, and as soon as I cut back on dairy, I stopped making so much darn breast milk! I have not had any problems with milk overproduction or my babies spitting up since I learned that. I also used to get mastitis almost routinely when I was eating dairy! But I have not had anything horrible like that since then, either, except for one time pretty recently when I was terribly exhausted (due to a very stressful situation totally non-baby related).
            Anyway, I really do appreciate hearing your experience. It is always interesting to learn about how God deals with souls, always so differently and yet always with great love. : )

          • Kimberly

            I have to add that I always slowly increase my dairy intake as my baby grows. I could never live without cheese for very long! LOL

          • Kimberly

            I also want to add that my 5 y.o. and 3 y.o. sleep in their own beds already. The 3 y.o. comes in and lays at the foot of our bed in the wee hours of the morning from time to time, still, but we never notice until we get up. The 5 y.o. sleeps all through the night and wakes up like a little lark! So, while I agree that parents have to get their kids in healthy sleeping habits, I don’t think it at all necessary to start them sleeping through the night in infancy. I know you did not say that it was, but I want to make a clear case for the validity of Eco-bf.
            Also, whenever I found that napping was keeping me up too late, I cut the length of it down. Sometimes it’s 2 hours, sometimes it 30 minutes. It just depends on what I can manage/need. And when I had to sneak away it is always easy because they never know when to expect it. There are ups and downs for everything of course. For me there have been enough ups in Eco-bf. that I truly love it.

        • http://www.buildingcathedrals.com Mary Alice

          I know that JM and I both struggle with insomnia, and I wonder if that is a common factor in women for whom temperature recording does not work well.

          I think that a benefit of this conversation has just been people giving voice to various methods; the update of the CCL materials, STM with EcBF, Creighton, I say the more information and choice available, the better. Marquette with a monitor is another that has come to my attention through this post, and I am going to research that for a friend who is struggling to find the right fit for her.
          It is a truth, as well, that it take 2 to tango in this case, and we need to go with what works for our husbands’ preference and temperaments as well. Mine is comfortable with charts, and also pretty radically open to children, but I think that others feel really differently about it. Some husbands really learn and participate in the methods more than others, as well. Some husbands would prefer co-sleeping and EcBF for extended infertility, my husband and I do much better alone in our bed, even if that means that we are abstaining.

          • Kellie “Red”

            Kimberley,
            I tried to do E’bfd for 4 months. During that time, I learned that I cannot sleep with a baby in my bed (neither can my husband!), my babies do not sleep well in my bed, my babies do not need to eat throughout the night (this causes them to spit up constantly), and I am unable to take naps (either I cannot sleep well enough or I do sleep and then I am unable to sleep at night). The lack of sleep with this parenting method caused me, my husband, and our marriage to be miserable! AND, amazingly, my baby was miserable ALL-THE-TIME! Turns out, she needs sleep, just like me, and w/in 1 week of moving her into her own crib she was sleeping for 8 straight hours and was the most pleasant baby on the block! Her daytime misery was related to a lack of quality sleep at night. It is really important to teach our children good sleeping habits, and infancy isn’t too early to start.

            I will also say that my daughter was diagnosed with reflux while I was E’bfd, and the problem cleared up almost as soon as I started giving her a pacifier instead of having her nurse all the time! Nursing on a schedule helped her gain a lot of weight (all that great hind milk!) as it seems I overproduce milk and have almost constant let downs that cause my babies to vomit all the extra milk up, and get mostly the lower calorie first milk. My babies have a strong desire to suck that cannot be satisfied by always nursing.

            So this is probably more detail that you ever wanted to know, but for medical and emotional reasons, E’bfd would not work for our family. I don’t think I’m alone with these sorts of issues, particularly in regards to sleep, which is why E’bfd isn’t the *best* way for every family, but one way that may or may not work for a family.

  • http://www.buildingcathedrals.com Katrina

    JM, we have done the opposite – I learned the Creighton method from a nurse before marriage, and that is what we primarily have used. After the second child, we began adding in the temperature sign, which I agree was difficult to monitor until I was finished breast feeding. For the past couple of years, we have been using all 3 signs, and I must say that I am very happy with how confident I feel. I know that I am in a different situation because I am not nursing a baby or waking up several times a night, but I am still waking up sometimes with a child that is sick, etc. Even on these nights, since I know my basic temp. patterns, I am able to get a somewhat accurate temp. reading. I would encourage even those who are using Creighton to give temp. taking an honest try, and see if it is helpful for you. Get a good BD thermometer – this one is my favorite:
    (http://www.amazon.com/Nexcare-524560-Basal-Digital-Thermometer/dp/B006F5BCLA/ref=cm_cr_pr_product_top)
    It really is incredible how clear the post-ovulatory temperature shift is – it’s like night and day. When we are being very careful, we use only the post-ovulatory time period, which gives us over a week of “safe” days. Like I said, we feel extremely confident in using these days – there is no guesswork involved. Also, there is not a question of whether there was a “false peak” because the mucus sign is coupled with the temp. and internal signs. Basically, we use the sympto-thermal method, but with the accuracy of the Creighton method regarding mucus readings. Our charts are very detailed, but it works!
    The first year (or longer) after a baby’s birth is always an exhausting time of transition. There may be long periods of abstinence, which require a great deal of sacrifice and honest communication between spouses. It has been interesting to be in a position of having our youngest child be 2.5 years old – it has given us both a bit of valuable perspective for the next time we have a nursing infant.

    • Kellie “Red”

      Katrina, this comment is wonderful and so well put. I could not agree more with your sentiments!

    • Juris Mater

      Katrina, I agree. This is an excellent comment all around. I see what you’re saying about temperature, it makes total sense, why not use it combined with extremely accurate other observations. The thermal shift definitely helps for post-peak accuracy.

  • Lara

    Any guidance on using the fertility monitor again after a pregnancy. I’m confused on how it “gets to know my cycles” again. With the time lapse, will it be accurate? I couldn’t find any information on this specifically on the Marquette website.

    • http://www.buildingcathedrals.com Mary Alice

      Lara, I don’t know much about this method, but it looks as though a lot of it is based on past cycle history. If I were you, I would totally start over and either totally abstain for several months or, if you understand it, use their “first 6 cycles” advice. Can the monitor tell what is going on if you are not having regular cycles?
      I have heard in the past of people using Clear Blue to determine only phase 3, but combining it with CM observations seems to make a lot of sense. If we took Kat’s advice and did temp as well, you would really have a tight plan!
      Still, though, 99% effective means that 1 in every 100 times, somebody out there is getting pregnant, so it makes sense that we are going to know people who do. The only 100% effective method is totally abstaining, which I think is what one has to choose in very grave circumstances. After my twins were born (4 children in 3 years), we were not comfortable with that 1% chance!

      • sneakierbiscuit

        Actually, 99% effectiveness means that every *year*, 1 woman out of every hundred has a surprise pregnancy.

  • http://www.buildingcathedrals.com Mary Alice

    Lara, from the Marquette website, about the fertile window instructions:
    “Women who are coming off of hormonal contraception, who recently were pregnant, or who recently stopped breastfeeding should wait until they have at least 2 natural menstrual cycles in a row before using these instructions. There is a separate protocol for women who are breastfeeding and not in cycles. ” But, I can’t then find the protocol anywhere. I think it is worth contacting a consultant or calling Marquette directly. If you do, please let us know what you learn, and encourage them to add the information to the website!

    • BMM

      It’s very late now, but I’d be happy to post a longer comment tomorrow. I’ve used Marquette for two years now – 9 months breastfeeding transition and 15 months normal cycle. I’ll also pull the specific links for breastfeeding monitor protocol, it’s on the website but NOT obvious. They are working on updating the entire website.

      • BMM

        So here is a link to the Marquette breastfeeding protocol for use of the clearblue fertility monitor: http://nfp.marquette.edu/sc_breastfeed_monitor.php

        And here is a link for protocol upon return to normal cycles (once you’ve had you’re period): http://nfp.marquette.edu/monitor_hormones.php

        If you are unfamiliar with how the monitor works (i.e: it actually measures 2 hormones – estrogen and Lh), you should read the second link first, even if you haven’t returned to cycles yet.

        The developers of the method are a physician and nurse (both Creighton trained) who run an online forum though Marquette University – they will evaluate charts and answer questions for free. They also have an nfp only OB/GYN and a bioethicist on “call” for relevant questions. As I commented earlier, this method has been a huge blessing to us. Of course, as others have said, it’s just one more option, neither better nor worse than other methods. Really Marquette isn’t so much a separate method as much as another piece of information for women (couples) to use when evaluating their cycles. The founders are refreshingly open about ALL NFP methods and encourage women to integrate the monitor in a way that works for them. Many women use the monitor and mucus (me!) others use the monitor, mucus AND temps.

        Over the relatively short course of our married life, I have used STM (my sleep patterns just made the temps impossibly unreliable…wish I still could use them!) and Billings (the subjective nature of evaluating mucus alone was just too much for my temperament) – for me, the objectivity of “the monitor indicates your estrogen is surging, Lh surge (and thus ovulation) may be imminent”…or “the monitor indicates the Lh surging, ovulation is likely in the next 24-48 hours” was a huge relief for my husband and me. Ironically, after two years of observing mucus with monitor I now feel far more confident in my mucus observations. Ha! :) Overall, the biggest blessing for me and my OCD tendencies was that the monitor helped me let go of “am I doing this right?!?” (which really impeded our intimacy when we thought we were infertile) and really focus on “what is God calling to us this cycle?” It’s definitely not the end all be all. It probably only shortens the fertile period by a day or two and I have had a couple cycles where mucus was wonky, but was still able to confidently identify ovulation with ovulation, which was great, but overall the big plus for us has been the assurance that what we were evaluating was more than likely “correct.”

        Anyway, if anyone is interested in more information about Marquette, I am happy to answer questions. And sorry for anything that doesn’t make sense here – my toddlers are about and needing mom attention . :)

        • maryalice

          Thanks so much for this great answer. I have also struggled with the subjective nature of observations, but I think that after several cycles it gets more obvious, when you can confirm after the fact that you understood what you were seeing. I am with you on feeling nervous even when the sticker is green! So, the monitor (or temp) would be a great reassurance.

      • http://www.buildingcathedrals.com Mary Alice

        That would be great, thank you! The ClearBlue website says that it is not effective while breastfeeding, but perhaps that is because they have not researched it, but Marquette has. Also, do you think that the method is the same with other monitors? I gather that people in Europe mostly use Persona.
        Lastly, I don’t know much about Marquette, but can you imagine going to school at a place where they have NFP on the University website?! That is bold.

        • BMM

          Yes, so that’s one big caveat with the method. The Clear Blue monitor was not developed, nor is it marketed, as a device to help women avoid pregnancy during normal cycles, let alone during breastfeeding. The Marquette researchers have spent the better part of a decade figuring out how the monitor works and then developing protocols for womem so that they can use the monitor to avoid (which is why if anyone is going to attempt the monitor in her NFP practice, it’s very, very important to follow the Marquette instructions about establishing the start and end of the fertile period, it’s not just the reverse of the “achieve” instructions). Obviously much of this research is built upon the research done by the founders and teachers of the other NFP methods. However, the Marquete folks have also both used and coducted a number of studies with women who use mucus and the Clear Blue monitor to determine when ovulation actually occurs in relation to observation of “peak” mucus and “peak” on the monitor (basically they did this by doing an ultrsound on women in the studies cycle after cycle to pinpoint the day of ovulation). What they have found fairly consistently, is that “peak” mucus occurs +/- 3 days from ovualtion and the “peak” on the monitor occurs +/- 1 day from ovulation.

          I’m not sure if/how the Marquette method could translate to other monitors. What I think the folks would say, rightly so, is that their research has been focused solely on the Clear Blue monitor (because they believe it is the most accurate monitor on the market and the only one that measures both estrogen and Lh, rathe than just Lh). That said, the Persona monitor you mentioned is actually made by the same Swiss company that developed the Clear Blue fertility monitor! It uses the same technology (measures levels of estrogen and Lh in urine), expcept the Persona monitor is has two modes “achieve” and “avoid.” So it can be used alone for women seeking to avoid pregnancy. Sadly, the Swiss company has run into regulatory problems with the FDA (bascially because the FDA considers it a “contraceptive” device and therefore is subject to very different regulatory standards…ugh), which has prevented the Persona monitor’s introduction into the American market. Many of the studies I referenced in the previous paragraph were done by this Swiss company in developing both monitors.

          All that said, I do think that a women who is confident with establishing the start of her fertile window via mucus could certainly use over the counter OPKs (which just measure Lh) as a corroborator that ovualtion has very likely occured. It wouldn’t really help during LAM from breastfeeding, but I could see how it could work well in normal cycles.

          Also, I just want to acknowledge that the biggest downside of the monitor method is the cost. It’s not prohibitive for us (though I can certainly see how it could be for some), but for us it was worth working it into our budget.

          I hope this isn’t too much information. My husband (who is a physician) and I find this stuff fascinating, in addition to very useful :), so we’ve spent a good deal of time learning about the method and the research. Right now Marquette’s primary research focus is tightening the breastfeeding protocols, as well as developing better protocols for women in menopause. Happy to answer any other questions – either here or via email.

          And yes, go Marquette! :) Bold, indeed.

  • Amy B

    Katrina, I too love the thorough charting of mucus with creighton, but the added post-ovulatory certainty with the temperature. I know some women who can’t get an consistent temperature, but I can use it even if I am waking to feed a baby at night. I never understood why Dr. Hilgers dropped it as a sign, but they never seem to mind that I add it when I have a chart review. I figure the more signs the better! I also love to see my temperature make the second shift when there is a baby on board. Is is almost like the first positive pregnancy test!:)

    • Kimberly

      Interesting. So the temperature makes a second shift down, because of the estrogen? Is that right? I could be confused… very new at this. I would love to know how to detect a pregnancy, though.

      • Amy B

        I am no expert, but I think it is actually related to Progesterone (the hormone which makes us a little incubator). Pretty cool!

  • Mrs C

    Does anyone still use the Billings method?
    http://en.wikipedia.org/wiki/Billings_ovulation_method
    It was developed in Australia where I grew up and Creighton was developed as a variation of the Billings Method. I found it much easier to use than Creighton. Mind you, we’re infertile so I can’t comment on it’s effectiveness in spacing children.

    • Elena

      Mrs. C, I teach billings in Canada. The virtue of the BOM is that it is cheap and requires nothing but observation and trust of one’s body. Over 3 million couples in china , see the china study, use it with 99percent efficacy rate. And, if anyone has grave reason, the Chinese do! Crm is a medicalised version of billings which, due to cost, is really only available to people who can afford it. But, hurrah for any method of NFP that works for a couple. We shouldn’t argue about methods, there are too many people to be taught!

      • BMM

        Amen!

        When my husband was in medical school (large, secular), years ago he sought out independent NFP training at various times (he’s not an OB/Gyn, but thought it would be useful as a Catholic physician have more in depth understanding). He was at a conference at Creighton one day shooting the breeze with an old school family practice doctor. My husband mentioned that it’s a shame NFP, or “fertility awareness” wasn’t taught to medical students given the solid scientific underpinnings. The physician sort of looked at him sadly and said something to the effect of, “well, even if we could convince the medical community of the legitimacy of the methods, there would be too much internal strife and policitcs over which method is ‘best’ to put any cohesive courses forward.” Fighting over methods is pointless and counterproductive – we should be focusing on helping couples find what works for them, their individual termperaments and marriage.

        • Mrs C

          True to a point. I do not, however, think that a good faith conversation about the pros and cons of different methods or their suitability for particular couples constitutes ‘fighting’. To even frame the conservation that way is itself a little aggressive.

          • BMM

            Just to be clear, I wasn’t calling this discussion a “fight” at all. To the contrary, I think this has been a wonderful, open conversation. I was referring to some of the in-fighting in the “catholic” medical community that my husband was privy to when he was in med school and in his training. To hear him recount it, it went beyond discussion of the pros and cons of various methods to the point that some advocates for some methods did not want any other methods taught. Sorry for the confusion.

          • Mrs C

            Oh, sorry! You are right – I was confused. Thanks for clarifying.
            Yes, I think the same problem occurs in other fields too. I’m thinking here of conflicts between pro-life groups.

  • Kathleen

    Phew! After all these comments and talk of abstinence someone should at least give JM a few good movie recommendations to help during this difficult time.
    1. “Of Gods and Men” great movie about some martyred monks… truly powerful flick but a guaranteed libido crusher.
    2. On that note, “For the Greater Glory” fits the bill as well.
    hmm. let’s see.
    3. We loved Foyle’s War series. Nothing says “don’t touch me” like a british crime solving during WWII.
    4. Dan in Real Life was pretty funny, but be warned there is some romance, but it’s Steve Carrell so you should be fine!
    Anyway, congrats on such a beautiful family!

    • Kellie “Red”

      haha! I love this. Perhaps she needs the unlimited Netflix subscription ;-)

      • Kimberly

        Netflix rocks. I think I saw “For the Greater Glory” there recently, but we may have rented that from Amazon. I just found this old black and white with Carey Grant, “Arsenic and Old Lace”. It’s based on a play. At first I thought is was cheesy but I put it on again tonight and I have to admit, it’s pretty funny and very entertaining! Nothing naughty at all. : )

    • http://www.buildingcathedrals.com Katrina

      Kathleen, very funny, I love your comment!

  • FYMW

    Thanks for this post and all the comments! I’m a first-time mom and have been trying to figure out what method would suit our family the best right now. Our only real concern is that the doctor told me not to get pregnant for 6 months and that while exclusively breastfeeding that there was a chance of getting pregnant. Almost 4 months in, not an issue yet, but seems like a good idea to learn more about NFP anyway!

    • Kimberly

      FYMW- I agree that it is a very good idea for you to get familiar with the systematic form of NFP. Breastfeeding is actually highly effective to postpone fertility in the first six months if you’re using all Seven Standards of Eco-bf., but it sounds like you are only exclusively breastfeeding, and that does not have the same high rating of effectiveness. You will certainly need another method.

  • elena

    Is that why I have been watching Foyle’s War so much?!;) And, no, I did not mean to imply that anyone was arguing over methods on this blog. However, there is a lot of fighting that goes on ‘out there’ regarding NFP methods and which one is the ‘best’. I have found that ‘the best’ method is the one that works for that particular couple. Perhaps that is why there is more than one method. I think that we need to respect all the methods and just encourage people to get off the contraception and take a real look at the merits of NFP. One of the ways to do that, as Catholic women, is to be well-versed in a method or various methods and get the word out with joy and humour.

  • http://www.megnanimity.blogspot.com Meg

    I am late to this party, but you know I can never resist defending “ecological breastfeeding” because it works for us. I just wanted to point out that one medical term that is used in the literature for it is “lactational amenorrhea”. I have read actual medical studies about it, for real! : ) Different women feel comfortable with different methods of NFP/child spacing and as a catholic I try to stay as well versed as I can in all of them. Better to keep women off the pill and families practicing their faith!!!!

    Stay safe with the hurricane ladies!

  • Eva

    We (me nad my husband) use Lady-Comp natural birth control / family planning monitor and it is agreat device – easy to use, safe and reliable – has also intelligent software, which learns individual woman’s cycle and can also recognize hormonal imbalances. non ovulation cycles and even potential miscarriage risk (yellow body dysfunction – this is in case of Baby-Comp – there are local distributors worldwide, I bought from: http://www.lady-comp.co.uk – God bless

  • Eva

    There is also very good article about side efftect of the pills ad IUDs (coils) and why they act also in abortifacient way: Hormonal pills and some other “birth control’ methods like intrauterine device (coils) very often act in anty-nidation way – while using them, a woman can still have “breakthrough ovulation”, which occurs in millions of women each year. You can still conceive a baby (embryo), who because of synthetic hormones cannot attach to the uterine lining and dies!

    The pill’s third mechanism is to change the lining of the endometrium (the lining of the womb), which creates a hostile environment for a newly created human life. The tiny baby cannot implant and is spontaneously aborted by the body

    ps. similar mechanism works in case of IUD, like Mirena (physiscal intrusion)

    more on: http://natural-family-planning-store.com/the-truth-about-birth-control-pills-and-iuds-side-effects-list/

    or here: Do birth control pills and IUDs (coils) cause chemical abortions?: https://www.lady-comp.co.uk/en/news/2013/03/15/do-birth-control-pills-and-iuds-cause-abortions/

    God bless


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