What’s the Best Postpartum Fertility Awareness-Based Method?
One of the beautiful things about Fertility Awareness-Based Methods (FABM) is that they can be used at any stage of a woman’s reproductive life, whether she’s got a regular menstrual cycle or not. Often, women and couples learn a natural family planning methods when they are preparing for marriage or when they are trying to conceive a child. So, while there will likely be mention of the postpartum application of the chosen method with the instruction, it isn’t usually the focal point for couples first learning, and it isn’t immediately put into practice.
There can be a lot to take in when you start charting, so a couple new to Fertility Awareness-Based Methods may not really register the different guidelines used in the postpartum period if they don’t need them yet. As anyone who has used a FABM knows, you learn a lot once you start to see your biological signs of fertility charted on paper, and your FABM instructor’s check-ins can offer insight to help you accurately interpret a chart that may look indecipherable on its own.
As anyone who had attempted to chart her cycle postpartum knows, using FABM after having a baby can be a whole different ball game. Your body is going through a slew of changes, and there are so many factors that impact when your hormones will return to the cycle they did before your pregnancy. There are also different patterns to look for as you await the return of your fertility.
Invest the Energy to Make a Change
The good news is that there are methods to fit a variety of postpartum situations. Whatever method you first learned offers guidelines for how to make charting most effective in this time frame. It also could be that the method you used before having a baby doesn’t make sense for you anymore (that was once my situation!). Meanwhile, it can feel overwhelming to learn a new method when you’re trying to care for an infant and keep yourself well, too. But I can tell you from experience that the peace of mind that comes from having a method you’re confident with is worth the initial struggle of making time for being trained.
If you’re a planner, perhaps you’re reading this early, looking to be ready with a new method before a baby’s born. As admirable as that instinct is, keep in mind that you can’t predict what your life will look like after you deliver, nor can you know what your unique baby is going to need. As in every aspect of parenting, flexibility and openness to change per your child’s needs go a long way.
Choosing Your Method
What follows is an introductory guide to the postpartum protocols of each of the major methods to help you figure out where to get started. Many methods assume initial breastfeeding and include that factor in postpartum practices. If this doesn’t apply to you, speak with your current instructor to learn how to observe your body in your circumstances. Whether or not you’re looking to conceive again, knowledge about your body is power to care for yourself—and your family—well.
Please note this guide is not a comprehensive explanation of postpartum protocols for any of these methods. In order to achieve the best results with FABM, always work with a trained FABM instructor.
The Marquette Model uses the Clearblue Easy Fertility Monitor to track hormones in a woman’s urine. In regular circumstances, Marquette may be the most effective method for understanding a postpartum cycle, in part because it is considered the most objective method. You’re working with calculated numbers, rather than individual observations. As Madeleine Coyne reported earlier this year, “analyzing estrogen and progesterone levels in urine is often more helpful in predicting postpartum fertility than observing mucus and temperature,” due to the biology of hormone fluctuations. This doesn’t mean the other methods can’t be effective (they can!). But for those seeking clarity, Marquette may prove to be a great starting point for many postpartum women.
Billings Ovulation Method
The Billings Ovulation Method relies on external observations of cervical mucus to identify ovulation and the days leading up to it. While a woman is breastfeeding, this method employs its Basic Infertile Pattern, which basically means no change is observed day to day. If a couple is looking to avoid pregnancy, once change is observed in sensation or discharge, the woman observes whether or not the changes lead to signs of Peak Day. If it does, she is considered fertile leading up to Peak Day and three days afterward. If it does not, once the change passes and she has another three days of the Basic Infertile Pattern, she is again considered infertile.
Because the Creighton Model was built upon Billings, the protocol is very similar. The postpartum woman charts external mucus observations, and when there is a change, looks for other signs that her fertility is returning. If the couple is trying to avoid pregnancy, it may mean short periods of abstinence in an otherwise infertile window as hormones fluctuate. Here, as with any method, it’s important to note that ovulation can occur before the first postpartum menstruation (thus making pregnancy possible), so waiting for her period to return may not be effective in avoiding pregnancy.
The Sympto-Thermal Method combines mucus and cervix observations with temperature readings. While the tricky part about using this method postpartum can be the timing a good temperature reading, that part of the observations need not start right after birth. Cathy Nix, teacher of the Sympto-Thermal method with the Couple to Couple League, told Natural Womanhood, “at the first sign of mucus, it is recommended that a woman start to chart again and take her temp.” As with Billings and Creighton, the postpartum woman is considered infertile until she sees signs of cervical mucus.
Lactational Amenorrhea Method (LAM)
The Lactational Amenorrhea Method is the technical name for avoiding pregnancy by exclusively breastfeeding for the first six months after delivery. Typically, the hormones released while a woman is nursing her child delay the return of ovulation. As long as nursing is frequent, and basically on demand, this can be a temporary but effective method of postponing pregnancy. It doesn’t work for everyone, though, and if a couple is looking to avoid pregnancy, LAM should be used only until a woman has another sign (such as those mentioned above) that her fertility is coming back.
Embracing the Postpartum Stage
Most first-time moms I’ve encountered have had a pretty good resource base with which to understand and manage the myriad changes that come with pregnancy. From books and websites to midwives and obstetricians, many women in our age seem generally well informed about prenatal care, and have somewhere to go when there’s a question they can’t answer on their own.
The postpartum period, however, is still something of a mystery. But it doesn’t have to be. We’re making progress, especially with awareness of the realities of postpartum depression and anxiety, and that you can’t expect your body to “bounce back” to its pre-baby status like a celebrity on a grocery store magazine. The more we share the constructive reality that charting your cycle postpartum is both possible and beneficial, the stronger we all become as women and as families.