The Postpartum Conundrum of NFP

There’s a BBC series called The Durrells in Corfu (currently streamable on Prime), the delightful “true” story of an eccentric English widow and her four children who pack up their shambles of a life in England and move to Corfu, Greece right before the start of World War II. Early in the first episode of season 3, son Larry Durrell is juggling 3 girlfriends, and his mother, Louisa makes it her mission to get him to give a couple up. At one point, Louisa asks her friend Florence, the island doctor’s wife who just had a baby, for advice about Larry.

Louisa: “Do you have any remedies for excess libido?”
Florence (nodding, deadpan): “Childbirth.”

I can’t tell you how hard I laughed at Florence’s response, particularly because I had just had my second child, and the accuracy was too good. There’s nothing quite like the experience of childbirth to put you off the idea of having another child any time soon. 

Consequently, a big concern for most couples navigating postpartum is how to have some semblance of a sex life before the woman’s fertility returns, while still allowing appropriate time to heal psychologically, physically and emotionally before getting pregnant again. The question then becomes: Which method of fertility awareness (FA) will ensure that outcome? 

This post won’t answer that question outright. For one thing, no method of FA can guarantee a desired outcome, no matter what it is. For another, there is no “best” method of FA for everyone, even when it comes to the postpartum period. What this post will hopefully offer is a framework for looking at your method options, and making an informed choice for what you think is best. 

If you need to know more about method options, click here for a comparative Q&A series.

My story. 

In the interest of full disclosure, I wanted to share my own postpartum story. 

I first learned the sympto-thermal method (STM) through the Couple-to-Couple League during marriage prep, but didn’t want to practice it after I had a baby. My first baby was a scheduled C section due to being full breech, and my doctor told me we needed to wait 9 months before conceiving another child if I hoped to attempt a VBAC. 

A friend recommended switching to Creighton, and the idea of tracking only one symptom sounded like the simplicity I needed. (At the time, I wasn’t aware of all my options for other methods.) Even though we worked very closely with my instructor, I couldn’t navigate my continuous mucus symptom correctly. Every follow up resulted in being told we had sex on a potentially fertile day, or abstained on a day that would have been fine. It was beyond frustrating, and caused a lot of strain on our marriage. 

When I was about 8 months PP, I felt nauseous for a full week and took a pregnancy test. When I saw the blazing plus sign, I crumpled on the bathroom floor in tears. We found out that I had conceived at 7 months PP, two short months shy of my window for attempting a VBAC, and our son was born via another scheduled C section. I spent the whole pregnancy in spiritual darkness.

Needless to say, I did not return to Creighton for the second round of PP. Several friends had switched to and loved the Marquette method, which has a simple postpartum protocol to follow. It was another chunk of change invested, but for my psychological and marital well-being, it was worth every penny. 

The Moral of the Story. 

Believe it or not, the takeaway from my story is not: Creighton and STM for PP, bad. Marquette for PP, good. It’s simply what worked and didn’t work for me. I’ve learned since that time that there are many women who prefer other methods for postpartum, who can navigate continuous mucus successfully without a monitor, and who receive benefits from other methods I hadn’t known were available. 

But how do you know if you should stick with your method or switch, and if you should switch, how do you pick the best method for you?  Or if you’re learning FA for the first time PP, where do you even begin?

It’s first important to know every single method of FA has a protocol for the postpartum period that requires learning from a licensed instructor. It’s easy to think that because FA is natural means it should be easy, but that is absolutely not the case, especially when it comes to tricky periods like postpartum. 

Below I offer a few questions to help you think about choosing a method. I use my experience with Creighton and Marquette to illustrate examples, but I by no means suggest that these are the only or best options. 

1 Was I using a FA method prior to conceiving and did I like it?

Not to get political, but if you like your method, keep your method. Just make sure to follow up with an instructor to learn the protocols. 

As I noted above, I knew I didn’t want to practice STM for PP after our first child, and needed to switch methods after our second child because of the psychological scars. 

If you want to switch methods, a good place to start is understanding how the methods work, talking to friends who use a method you’re interested in, or reaching out to instructors for a 15 minute phone consultation (many offer this free of charge). If possible, it’s helpful to do this research during your pregnancy so you don’t have one more thing on your plate in those early weeks with a newborn.

2 Does my instructor hear me?

One of the most difficult things for me looking back is realizing that my Creighton instructor was not a good fit for me, and that was a contributing factor to my lack of success. She was not able to meet me where I was and offer the coaching I needed practically and psychologically to implement the method protocols well.  

A good instructor will listen to you and want what is best for you, even if it means you need to switch methods. If you don’t feel heard but you like the method, you may just need to switch instructors.

3 Do I plan to breastfeed?

Though it can prevent ovulation for extended periods of time for some women, breastfeeding is not an accurate means of spacing pregnancies. Even for women practicing ecological breastfeeding, fertility can return any time following the first 6 weeks after birth. Consequently, it’s important to learn the PP protocols for a FA method from a licensed instructor before resuming intercourse. 

For some women, breastfeeding produces continuous mucus and that can be difficult to navigate. I have learned that women who successfully chart using a mucus-only method have a very supportive instructor and/or developed a firm understanding of the method prior to conceiving.  Women who don’t have that understanding going into PP tend to fare better with a method that uses a monitor or other biomarker check.

4 What is my psychological state/ personality type?

My psychological state after my first C section was not good. The experience left me feeling like I hadn’t given birth, and wanted to avoid another at all costs. However, at my 6 week PP checkup, my doctor told me something I’ll never forget when I refused birth control: “Men have needs.” I was in such an emotionally vulnerable and sleep deprived state that I unknowingly internalized that and felt it was my job to ensure we had as much sex as possible.The stress nearly broke me. Personality-wise, I do not operate well when sleep-deprived, as it only compounds whatever negative emotions I feel at any given time.

Switching to Marquette relieved most of that, because a computer was now my scapegoat for long periods of abstinence, and charting was just a matter of remembering to pee on a stick and reset a monitor. Also helpful was actually talking to my husband and realizing that he wasn’t the insatiable unfeeling sex fiend my doctor tried to tell me he was.

No matter what, postpartum is a stressful and complicated time. Preserving your mental health and understanding how your personality and temperament plays a role is a huge factor in choosing the right FA method. 

5 Am I suffering from or at risk for postpartum depression or other hormonal disorder?

I recently learned that those who chart with Creighton who suffer from postpartum depression (PPD) can use their charts to target bio-identical progesterone supplementation that relieves the symptoms of PPD. Women who suffer from PCOS also benefit from the information they get from continuing a mucus-only method PP to continue their treatments and supplements as they did prior to and even during pregnancy. 

Other non-mucus-only methods also offer targeted treatments for PP based on charting information, and are worth investigating depending on your priorities and answers to the questions above.

Postpartum Abstinence. 

A question that always lingers between the lines when choosing a FA method is, which one will allow us to have the most possible sex? We can definitely be tempted to think the grass is greener when comparing our method to another, but don’t be fooled. Every method you practice during the postpartum period will likely present long windows of abstinence until fertility returns, and the best method for you doesn’t by extension mean the least amount of abstinence. 

In Marquette, for example, it is common for women to experience long strings of High readings, and therefore abstinence, leading up to the return of fertility without ovulation immediately following. Those with continuous mucus who may be learning Creighton for the first time can feel a lack of confidence in their observations or understanding of yellow stamping, and abstinence can also drag on for long periods. I once read an account from a couple who practiced STM who abstained for an entire year after having a child due to their extreme circumstances. 

It is vitally important to remember during those periods that fertility is shared in part because men are always fertile. As a woman waits for the return of fertility, it is not her “fault” if these windows drag on to eternity. A FA chart does not calculate a woman’s fertility alone, but the combined fertility of man and woman. Always. The need to avoid a pregnancy is a decision a couple makes – and bears – together.

You are Capable.

I know this is an area that can feel crushingly overwhelming. On top of keeping a new tiny human alive, you are staring down a period of fertility that is the definition of whackadoodle, and you have to navigate it all on maybe 5 seconds of sleep, along with possibly other children. But I want to tell you something in case you don’t hear it from your doctor, your family or your friends:

You are capable! You can do this! Deep breath. It will not be easy, but it is not impossible.

If you struggle, reach out for help. There is no shame in that. I guarantee you someone has been in your shoes, and that woman would probably consider it an honor and a joy to walk you through a tough time like the one she had.

Getting Started.

So that’s all great, but where the heck do you start?

Below are links to some of my favorite instructors from several methods. I highly recommend that you contact them for further information about how their method can work for you, and connect with them on social media where they share an incredible amount of helpful information touching on all aspects of fertility awareness.


You, Me and NFP/ Sarah Tramonte, RN
Feminine Genius Ministries (several instructors)
Sara Flood, BSN, RN
Whole Mission/ Theresa Sullivan, RN


Mary Bruno, CRMS
Lisa Morvant, RN, BSN, FCP
Fertility Coaching and Wellness/ Holly Baril, CFCP

Charbel Centre, Canada/ Rebecca McEvoy, MSc, FCP


Leslie Rewis MA, MLIS
NFP Aware/ Kristin Putnam

Boston Cross Check.

Christina Valenzuela (Currently not taking clients, but still an excellent resource for understanding BCC)


Celine Kinneberg, RN
Cassondra Moriarty (Cassondra is also a postpartum doula and lactation mentor)

Sympto-Thermal (Couple to Couple League)