Twenty-six weeks into my first pregnancy, I was solidly in the “honeymoon phase” of the second trimester. After finally emerging from the fog of fatigue and nausea, we were preparing the nursery, discussing baby names, and excitedly feeling our baby’s kicks. Unfortunately, our blissful and carefree experience was about to be drastically interrupted by the appearance of a blood clot during my pregnancy.
My blood clot story begins with pins and needles
One evening, my husband and I were watching a movie when I felt pins and needles, like my left leg had fallen asleep. When I got up to walk around, the pain kept worsening, and quickly became unbearable. My leg swelled dramatically and began to discolor. My stomach sank as I realized what was happening.
I told my husband we needed to head straight to the hospital. Upon arrival in the ER, we were quickly taken back for blood work and a doppler ultrasound that revealed a Deep Vein Thrombosis (DVT), a large blood clot nearly occluding my femoral vein. It was a very serious situation. If the clot was to dislodge and travel to my brain or heart, I could suffer a stroke or heart attack. There was also a risk of additional clots developing.
I was immediately started on blood thinning medication. The ER physician was perplexed. I was a healthy 26-year-old, non-smoker, and competitive runner. He said that, statistically, I was at a low risk of this complication, with pregnancy being my only known risk factor.
A blood clot during pregnancy meant hormonal contraception was off the table postpartum
A couple days later, I was in a follow-up appointment with my OB. He too, was both surprised and concerned. He ordered a continuation of the blood thinning medication, twice daily injections into my abdomen, as well as a plethora of labs to try to uncover any underlying condition that caused the DVT. This culminated in 17 vials of blood drawn and a referral to a hematologist.
Although the hematologist and my OB didn’t come to a consensus about the cause of the blood clot, they were in complete agreement that any and all hormonal contraception was off the table permanently once the baby was born. They said it was simply too risky.
And they were right. According to the FDA, the risk of blood clot and stroke for women using hormonal contraception is 6-7 times higher than women not using them. The risk is so significant they advise both women over 35 and smokers to avoid hormonal contraception entirely. Both physicians recommended a copper IUD, with insertion planned for my six week postpartum follow up appointment.
Wanting to avoid more blood clots, but uncomfortable with the risks of the copper IUD
Thankfully, the anticoagulants successfully managed my blood clot for the rest of my pregnancy, and our son was born perfectly healthy. Despite being over the moon as we settled into life with our newborn, we felt unsettled as the six-week follow up approached.
In researching the copper IUD, we began to question if it was the right choice for us. The common side effects of increased bleeding and cramping, often lasting for months, did not sound appealing. However, it was the rarer complications of expulsion, uterine perforation, ectopic pregnancy and PID (pelvic inflammatory disease) that really gave us pause. We hoped to have more children one day, and these serious adverse events had the potential to take my fertility away. How would I feel if I went through with the IUD, knowing these risks, and I lost my ability to carry a child as a result?
My doctors assured me that the copper IUD was in general quite safe, and it was unlikely I would suffer from any adverse effects. But we had just found ourselves on the wrong side of a statistic with the DVT. That experience had made us keenly aware that there is a real person behind each of those numbers, and it was not a gamble we wanted to take.
The search for hormone-free, risk-free birth control
With the IUD off the table, I felt backed into a corner. What options did I have for effective family planning?
I had recently started working as a nurse practitioner in a pediatric clinic, and was adjusting to life as a new mom. We wanted to have more children someday, but I was now taking Coumadin, a blood thinning medication not indicated for use in pregnancy. I needed an effective form of family planning for the time being.
I ended up sharing my concerns with a friend who used a method of Natural Family Planning (NFP), also known as Fertility Awareness-Based Methods (FABM). She suggested I look into NFP, touting its many benefits.
Admittedly, I was initially reluctant. My women’s health training was fresh in my mind. We had been taught that natural family planning was unreliable, and that women should be counseled to use pharmaceuticals or devices with higher efficacy. However, at this point, I had nothing to lose. So I began to delve deeply into a crash course on Fertility Awareness Methods.
Fertility Awareness-Based Methods are actually much more effective than my education in women’s health had led me to believe
The more I read, the more I realized that I had been woefully misinformed in my women’s health training. Fertility awareness had advanced far beyond the “rhythm method” of years gone by, in both method reliability and availability of options. I was astounded to learn there are methods that span an entire spectrum of educational options, from traditional in-person classes to distance and online learning. I was also impressed that these methods run the gamut of technological options from paper charts, to wearable devices that track temperatures and sync with smartphones, and even methods that use the Clearblue fertility monitor—no mucus observation or cervical checks required.
I excitedly told my husband I had found a method of family planning that would work with my body, rather than keeping it from functioning the way it was designed. The appeal of such a method resonated with him as well. Although I still had some trepidation wading into the world of charting for the first time as a postpartum woman, a notoriously tricky time to learn, I had the support of a wonderful instructor who assured me I could be empowered and successful.
Women deserve better options than IUDs, birth control, and blood clots
Now 13 years after that pregnancy blood clot led me to try fertility awareness, I have never looked back. My husband and I have used a variety of Fertility Awareness Methods to both achieve and avoid pregnancy. It has caused a monumental shift in my personal philosophy to the point that both hormonal contraceptives and IUDs (the hormonal IUDs as well as the copper IUD) feel archaic and barbaric.
I used to prescribe oral contraceptives to young women seeking clear skin and a “regulated cycle.” This is unthinkable to me today. I truly believe women deserve so much more. Our bodies operate like a beautiful symphony and I have too much respect for their well being, and the gift of our fertility, to recommend long acting reversible contraceptive devices (like the IUD or implant) or pharmaceutical contraception.
If you find yourself questioning the birth control options offered to you, I encourage you to look into fertility awareness. More and more women are seeking these methods, and for good reasons. These methods offer an all-natural, low cost, side effect-free, and environmentally responsible way to plan your family.
Although I came to fertility awareness through an unexpected path, I can say without hesitation that choosing to learn these methods of natural family planning, instead of using conventional birth control, has been one of the best decisions I’ve ever made.
When this article refers to fertility awareness methods (FAM), or natural family planning (NFP), we are referring to Fertility Awareness-Based Methods, evidence-based methods of cycle charting which can be used as effective forms of natural birth control when learned by a certified instructor.
If you’re interested in learning more about side-effect-free and hormone-free family planning, and how to dive into the world of FAM, check out some of the following resources:
Quiz: how to choose your fertility awareness method
Find a restorative reproductive health provider offering telehealth options here
