Quick Takes on 4 Common FABMs To Help You Choose Your Best Fit

posted on February 17, 2018 by Kathleen Taylor Kathleen Taylor

So you have made the decision to use Fertility Awareness Based Methods. What now? Which fertility awareness method is best for you? Whether your goal is greater health awareness or natural family planning, choosing the right method for you can at first feel overwhelming. But with a little refresher on the four most common evidence-based methods of FABMs or NFP, it doesn’t have to be. Each method has its advantages and disadvantages tailored to the individual woman considering it. 

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What follows is not an exhaustive list of methods or training organizations, but a quick overview of some of the most commonly used methods—in particular, the SymptoThermal, Creighton, Billings, and Marquette methods—along with insight into how each might affect your daily routine. 

SYMPTOTHERMAL

General information:

The SymptoThermal method is one of the more common methods and is used by both NFP users and FAM users. It tracks three different signs, which makes it popular because you don’t have to rely on one single observation. Users of this method monitor for changes in cervical mucus (sensation, consistency, stretchiness), basal body temperature, and optionally, cervical position and firmness (low/high, open/closed, soft/firm). Changes in the cervix and cervical mucus can tell you when you are fertile and when you are likely ovulating. Your basal body temperature can confirm that ovulation has happened by seeing a spike in temperature.

What it looks like in your daily routine:

SymptoThermal method users are encouraged to check their cervical mucus every time they use the bathroom so they don’t overlook any changes. This means wiping and looking at the toilet paper before and after using the bathroom. It can be helpful to test the sample between your fingers to note the specific observations mentioned above, but this is completely optional. Checking the actual cervix is also optional, and is typically done at night. For some, checking their own cervix is a very reliable observation, but for others it just creates confusion. It is completely up to the user. Taking your basal body temperature, however, needs to be consistent and done first thing every morning. Many users set an alarm to make sure their readings are consistent. Every day these observations should be recorded on a chart or in an app. (There is software specific to this method!)

Can you use this method in the postpartum period and while breastfeeding?

Yes! As with most methods, the protocols during breastfeeding are different, and it’s important to utilize an instructor during this time. Days are considered to be infertile after a certain amount of dry days. Temperatures can be sporadic, so this method may call for a lot of abstinence while avoiding pregnancy during this phase of life. With accurate and consistent charting, you can see the first ovulation and know when to expect the first postpartum period.

My two cents:

I personally decided against this method the moment I learned I would need to take my temperature every morning. Considering my strengths and weaknesses, I knew anything that involved the morning wasn’t going to be a great choice for me. SymptoThermal incorporates the main components of every other method and information is readily available. It also has some flexibility. If you are interested in this method I would grab a copy of Taking Charge of Your Fertility, and look for an instructor through the Couple to Couple League or SymptoPro

CREIGHTON

General information:

The Creighton method tracks cervical mucus, making observations similar to SymptoThermal, but since this is the only biomarker, it is extremely important to be consistent and detailed in your observations. The recording system has over 18 codes to classify all types of normal and abnormal cervical mucus for accuracy. Additionally, the chart comes with different colored stickers for menstruation, mucus, dry days, and fertile mucus so a pattern or abnormality is easy to spot at a glance. An accurate and detailed Creighton chart can be used by a Natural Procreative Technology (NaPro) doctor to diagnose important health issues, including infertility and hormonal imbalances. When used accurately, this method boasts of similar pregnancy-avoidance effectiveness rates to the Pill.

What it looks like in your daily routine:

Because consistency and detail are key, users need to make observations before and after each bathroom break, or anytime there is chance you might miss detection of cervical mucus, like around showers and workouts. Observations are done by noticing the sensation on the perineum when wiping and finger testing the sample. This is crucial because the color and consistency is often different during a finger test than how it appears on the toilet paper. Once the routine is established, observations become second nature, and it only adds about 10 seconds to your bathroom routine. Protocols for timing intercourse range from anytime of the day, to only end of day on certain days, depending on phase of the cycle and experience with the method.

Can you use this method in the postpartum period and while breastfeeding?

Yes! With Creighton as well, this should only be done under the supervision of an instructor because during the postpartum period, so many things can affect the cervical mucus. A very basic summary of the breastfeeding protocol is to avoid sex (if trying to avoid pregnancy) any time your cervical mucus is different than it was the previous few days. This is because a change in cervical mucus could signal return of ovulation.

My two cents:

This was the method I chose when trying to space babies number 2 and 3. I picked it because the details were impressive and I felt confident knowing that everything had an explanation. I was attracted to the science and the association with NaPro technology in case any problems were to arise. Learning this method was more expensive than others, but we were able to meet with an instructor one on one via Skype. I highly recommend forking over the money for this method, because to me, this information is invaluable. Click here for more information and to find an instructor. (Seriously, don’t even try this one without an instructor!)

BILLINGS OVULATION METHOD

General information:

The Billings method is another mucus-only method, although unlike Creighton, it doesn’t require any touching or finger testing of the mucus. Instead Billings puts strong emphasis on the sensation and requires users to mentally or physically note the sensations during the regular activities of the day. Users create their own personalized classifications in a way that makes sense to them.

What it looks like in your daily routine:

Billings users pay attention to the sensation on the vulva throughout the day, specifically dryness, wetness, and slipperiness (associated with infertility, fertility, and peak fertility/ovulation, respectively). Visual observations, like thickness and clearness, are also noticed, but this can be done during the users’ regular bathroom and hygiene routines. Billings can be done without the visual observations, especially while learning, because the visual observations can sometimes be confusing. When trying to avoid pregnancy, it is recommended to only have intercourse in the evening, after the sensations have been sufficiently observed and classified as indicative of an infertile period. Check out the “4 simple rules” of Billings on their website.

Can you use this method in the postpartum period and while breastfeeding?

Yes! Noticing changes in the sensations created by the cervical mucus can tell you when ovulation is coming. Again, this is definitely a time to work with an instructor. The official Billings website states, “you may notice a change in your Basic Infertile Pattern before fertility finally returns. For example, you may be dry for some months, then experience an unchanging pattern of discharge in the following months, until eventually, patches of mucus signal that fertility is returning.”

My two cents:

I don’t have any experience with this method, but I do know couples who very happily use Billings and would recommend to beginners because it is easy to learn. I will admit, its simplicity is very appealing. I think this would be a great option for someone who is looking for a no fuss, less regimented option. Check the website for loads of information!

MARQUETTE

General information:

The Marquette method utilizes the ClearBlue fertility monitor and test sticks to help determine days of low, high, and peak fertility by detecting surges in estrogen and luteinizing hormone. The monitor asks for tests on specific days based on its recordings of your previous cycles. Testing is done with a disposable test stick and the first morning urine.

The ClearBlue monitor was designed to help achieve pregnancy, but Marquette University developed protocols to use it as a method of avoiding pregnancy as well. These protocols go beyond the instructions that come with the monitor, so it’s important to consult with a Marquette instructor. The monitor readings can be combined with temperature readings or cervical observations for increased accuracy. When avoiding pregnancy, the information learned in the first 6 months of use will help determine what day to begin abstaining in future cycles.

What it looks like in your daily routine:

Testing needs to be done in the morning within a pre-determined time window. The woman can urinate directly on the stick for 3 seconds, or dip the stick in a collected sample for 15 seconds. Testing is typically only required after menstruation has ended (although this depends on cycle length) through to the first peak reading. Readings will typically start with “low,” then change to “high,” and then to “peak.” Once you see peak you will know that ovulation is occurring or is likely to occur within 24 hours. If you are avoiding pregnancy, you continue to abstain on the first peak day and for an additional 4 days. Note: abstinence may begin while still getting “low” readings because sperm can live for 5 days, and the monitor can’t account for that, only the hormone shifts. This is why it’s important to follow the correct protocol to know when abstinence begins.

Can you use this method in the postpartum period and while breastfeeding?

Yes! In fact, the Marquette method seems to be the easiest method to use while avoiding pregnancy postpartum before the return of ovulation because you can rely on the monitor’s “low” readings as ok-for-sex days and “high” readings as abstinence days. It is important to be in contact with an instructor during this time (see a pattern here?) because there are special instructions for using the monitor during this phase.

My two cents:

The Marquette method takes much of the guesswork out of classifying observations and gives an objective idea of what your body is doing. It is simple and doesn’t require an action every day of the cycle. There are some drawbacks though. First, the monitor isn’t cheap and you have to buy test sticks every couple months. Second—and this is a significant concern—it is possible for the monitor to miss the peak reading about 10 percent of the time. For this reason, many users also incorporate ovulation predictor test strips to be safe. Third, in a normal cycle, abstinence begins on a specific cycle day regardless of the monitor reading (because of the whole sperm-life thing mentioned above), which might create more days of abstinence than other methods. The general consensus seems to be that people are okay with an extra day or two of abstinence in exchange for confidence and peace of mind.

I love the Marquette method, but I personally wouldn’t use it without also knowing how to categorize my cervical mucus. Marquette University has information for how to use the monitor, the different protocols, how to include cervical observations and temperature, as well as lots of general information on the phases and hormones of the menstrual cycle.

Another great resource for women starting out is FEMM. FEMM is a growing women’s health program, charting system and app. The FEMM app allows you to track cervical mucus, basal body temperature, LH tests, as well as emotional symptoms. It also gives you feedback and tips on achieving your health and reproductive goals. FEMM is similar to Creighton/Napro Technology in that the chart can be used as a diagnostic tool by someone properly trained. Of all the methods listed, I am the least familiar with this one, but it’s seems to be an extremely comprehensive method that is worth considering.

Now that you know some of the basics on each of these most common methods, which feels most right for you? If you’re still deciding, take our Quiz on How to Choose Your Fertility Awareness Method here! Let us know in the comments what you choose—and also if there is another method you personally prefer. We love to hear what works for you.

Posted by Kathleen Taylor Kathleen Taylor
Kathleen Taylor is a graduate of Franciscan University, where her fascination with the science of fertility awareness began. She is passionate about spreading the facts and advantages of fertility awareness and enjoys researching, reading, writing, and all things health and fitness. She lives with her husband and three little girls in San Diego, CA.

4 Responses to Quick Takes on 4 Common FABMs To Help You Choose Your Best Fit

  1. Avatar Colleen Holland says:

    Another great resource for sympto-thermal instructors is http://www.justisse.ca. Justisse instructors train for 2 years and utilize Creighton mucus notations. They teach not only family planning but are also well versed in utilizing chart data to monitor a woman’s 5th vital sign.

  2. Avatar ana says:

    We used NFP International based in Steubenville for symptothermal information. They have 40+ years experience and I have seen them mentioned in Natural Womanhood blogs for breastfeeding information also. Hope that you can add them here: http://www.nfpandmore.org They also have a chapter in their book: “NFP: The Complete Approach” on theology, in a nice question/answer format for those interested, but it is not strictly necessary for the method, of course. Thanks!