The Role of the Fertility Awareness Instructor

I frequently share about the necessity of having an instructor when learning a method of fertility awareness. There are several reasons for this that often surprise women. 

First, fertility is not static, and navigating the changes that women naturally experience from one cycle to the next is best aided by a trained professional, especially during wonky periods like postpartum, menopause or when coming off of hormonal birth control.

Second, the effectiveness statistics for all methods of fertility awareness, for both perfect and typical use, are taken only from those women who have received formal instruction. This doesn’t mean that women can’t successfully avoid or achieve a pregnancy by learning on their own, it just means that whether or not they do so cannot be attributed to the method.

Finally, if women use a method of fertility awareness in order to identify health issues, the instructor ensures that they accurately chart their biomarkers so that it will be an accurate diagnostic tool for appropriate treatments. 

The relationship between instructor and client is therefore a vitally important one, and finding the right fit is just as important as finding the right method. Fertility touches deeply personal and intimate aspects of a person’s life, and success with any method is going to depend on the relationship between instructor and client being respectful, open and in sync.

What the Instructor’s Role Isn’t. 

Recently, I received several disturbing messages and comments through my blog from someone who took care to remain anonymous, styling themselves as “ An NFP Instructor.” This person openly gloats about manipulating their clients into “risking” knowingly fertile days when trying to avoid, seemingly for the purpose of curing their “contraceptive mentality.” This person went so far as to describe their tactics of coercion as “fun for the instructor” and “the beauty of NFP.” In follow-up comments, this person even asked what was wrong with “sprinkling a little baby dust on the [client’s] chart”. I have screenshots of the comments at the end of this post if you wish to read the full text. 

The scope of everything that is wrong in this person’s comments is overwhelming and impossible to address in a blog post, but worthy of bringing to light and refuting. Their beliefs and tactics are an egregious abuse of their power, emphatically unethical, and at best, a twisted and misguided interpretation of Catholic teaching about family planning. In truth, this person treats women and couples with the same perverse condescension as doctors who dole out birth control to their patients without telling them how the pill actually works, and with no interest in identifying the root cause of the cycle issues their patients may be trying to treat. 

It is no secret that the Catholic Church has been accused of promoting NFP over birth control because NFP doesn’t work, and the Church not-so-secretly wants couples to have all the babies no matter the costs or risks. Comments and tactics like the ones “ An NFP Instructor” shared perpetuate this perception, which is why I felt compelled to bring this to light and have a constructive discussion about the role of the fertility awareness instructor and their relationship with their clients. I will share a Part 2 to this post to address “NFP Instructor”s notions about “contraceptive mentality”, and look at what actual Catholic Church teaching states on that subject.

Let’s dive in. 

The Role of the Fertility Awareness Instructor. 

No matter what method they teach, an instructor’s primary purpose is to ensure that their clients understand the protocols of their method and are confident in their observations to be able to accurately identify their fertile and infertile windows. Instructors meet women and couples in a very vulnerable space, one in which the instructor has the advantage of knowledge. Like any student/ teacher relationship, this power imbalance can be abused as can be seen in the comments shared in full at the end of this post. 

A good instructor understands the power of this vulnerability, and is able to meet women and couples where they are and guide them effectively and compassionately as they navigate fears, struggles and relationship difficulties that are often a natural part of the practice. In almost all cases, instructors either have or are currently practicing the method they teach, and are able to encourage and advise their clients using their own personal experiences and the combined experience of teaching many women and couples, making their insights invaluable. Because of the nature of this intimate space, instructors are perfectly situated to refer their clients to appropriate medical, psychological and spiritual treatments or counsel to help their clients achieve truly holistic health.  

It is no secret that many fertility awareness method founders, instructors and users are Catholics, and that the relationship between client and instructor can at times make this is a space where different beliefs and backgrounds interact. Thus, I thought it would be constructive to have real instructors of various methods share the way their respective methods trained them to interact with their clients, especially around the area of family planning.

Boston Cross Check. 

The instructor training program for Boston Cross Check includes an entire module dedicated to principles of adult education. Among these principles is that NFP instructors should effectively communicate and personally uphold the values which are required for successful NFP use, but we are never permitted to impose values and are expressly prohibited from pressing the client to follow any particular course of action. We seek to bring couples to method autonomy in an environment of respect and acknowledgement that clients are free to accept or reject any advice or services offered.

– Christina Valenzuela, owner of Pearl and Thistle

FEMM.

FEMM’s scientific approach to family planning allows a couple to understand the signs of fertility, timing and potential for conception during the fertile window, red flags associated with cycles that may impair conception, and the protocol to follow by which to either try to conceive or avoid a pregnancy. Our scope of practice regulates us from interfering with a client’s health or family planning decisions, “FEMM teachers provide education only and are not responsible for the health and family planning decisions of their clients.” We are expected to, “provide the client with information to enable informed consent and decision making in healthcare and family planning.” FEMM teachers are also expected to, “provide education that is science and evidence-based, and respectful of the client’s autonomy.”

– Mairead Suthoff, Lumina Health Services (quotes taken from “Scope of Practice” document)

SymptoPro.

Johnna Wilford, a certified SymptoPro practitioner, shared the follow excerpts from her training manuals.

“Teaching NFP is not the place to play ‘I’m better than you.’ Evaluate your feelings and how you view other people before teaching a class.”
“It is important to accept the feelings and the actions of the client.”
“…you need to learn the limits of your involvement…an NFP Provider’s role will mainly be in trying to focus on eliminating any confusion about the method itself in the couple’s relationship.”

Billings. 

As a Billings Ovulation Method teacher, I was taught to interview clients about their intentions upon entry. Once they tell me their intentions, my goal is to inform them of “possibly fertile” days. It is then up to the couple to decide whether or not to use those days based on their understanding of the rules and the pregnancy chances on those days. At the end of the intake form for Billings, we inform clients that this is an educational service provided to the community and that it provides no warranties on how a couple chooses to use the method. Choose is the keyword here. It is always in the client’s ballpark how they choose to use the method.

Leslie Rewis, MA, MLIS, Chart Your Fertility

Creighton.

“FertilityCare Practitioners (FCP) are trained to be impartial regarding a couple’s family planning decisions, as that discernment is the responsibility of the couple and the couple alone. 
It is the FCP’s job to ensure that the couple know on any given day how to identify whether the day is fertile or infertile, so that they can make decisions around intimacy and family planning with clarity and confidence.
Further, FCPs are trained to understand the delicate nature of fertility challenges, as well as the early weeks of pregnancy. Both of these instances—as well as discerning trying for a pregnancy—can bring out a lot of complex emotions, and clients often feel vulnerable. Our role as FCPs is to be supportive, understanding, and affirming of a couple’s capacity to parent their children, assisting as much as we’re reasonably able.
If a couple feels significant pressure from an NFP instructor to grow their family, or as through their personal boundaries and discernment process are not being respected, this could be considered a breach of their own professional ethics.

Rebecca McEvoy, FCP, Charbel Centre

Marquette.

Bekah Knobeloch, RN of Feminine Genius Ministries shared some excerpts from the Marquette tmanuals on how they are trained to engage with their clients, particularly when there are differences in beliefs. 

Within your NFP practice, you will regularly deal with moral-ethical issues, such as birth control, abortion, premarital sex, and living together out of wedlock. Reflect on the quote below, taken from your session notes.
“Maintaining confidentiality, building trust, being non-judgmental, and respecting cultural and religious beliefs is important. However, this does not mean that personal, religious and cultural beliefs and practices cannot be challenged in a respectful, non-judgmental and truthful manner.”
…[C]onsider this quote as it relates to your NFP teaching. Specifically, how will you challenge immoral and unethical personal, religious, and cultural beliefs and practices that arise with your clients in a respectful, non-judgmental, truthful manner? This is a deep and thought-provoking question that requires ample consideration.
Catholic church teaching instructs us that we must work on our conscience throughout our lives and form it through prayer, education, and conversation. It is important to work on our conscience so that we may be prepared to make decisions when opportunities arise. “Conscience is the voice of God resounding in the human heart revealing the truth to us and calling us to do what is good while shunning out what is evil”. We can work to form our conscience through being open to what is true and right, studying the sacred scripture and teachings of the church, and prayerfully reflecting.

As you can see, instructors are trained to understand their role as first and foremost ensuring their clients understand the protocols of the method they teach, and have the confidence to identify their windows of fertility.

When You Should Find a New Instructor (and resources to do it).

The example of “An NFP Instructor” is an extreme and obvious example of when a woman or couple should seek out a new instructor. Unfortunately, many women are under the impression that the reason must be extreme in order for them to switch instructors. Sometimes this is due to lack of resources and knowledge of where to go to switch. Sometimes it can feel like breaking up from a serious relationship, and is consequently an emotional investment that can be difficult to make. Sometimes frustrations can mount, and fertility awareness is abandoned altogether.

In my own experience, I’ve had instructors that were not good fits. I didn’t have great follow up support from my CCL instructors after our initial classes, and my Creighton instructor wasn’t someone I could really open up to in our sessions when I was postpartum. I didn’t realize at the time that these were valid reasons to try to find a new instructor, but I also didn’t have the resources to find a new one if I did (I didn’t even know what my method options were at the time).

Switching instructors doesn’t always mean switching methods, though it can. A woman can absolutely switch instructors but continue practicing the same method, though it may difficult to isolate whether the method itself is a bad fit, or simply the instructor. Fertility awareness does come with a lot of trial and error, and while that isn’t a process we embrace in general, it is a normal aspect of this practice.

Allow me speak directly to you for a moment – yes, you – and I want you to take this to heart: Finding the right instructor is just as important as finding the right method, the right therapist or even the right spouse. It is an intimate relationship that requires mutual respect and openness, and you can walk away at any time for any reason to find someone new if you believe that is the best choice for you. It may take time and some mental and emotional energy, but it is 100% worth it!

Here is a very small list of perfectly valid reasons to find a new instructor:

  • A client does not feel that she is heard or respected when voicing fears or confusion regarding method protocols or family planning intentions
  • A client senses diminished or little support when they share or change their family planning intention, whether postponing or achieving a pregnancy
  • An instructor does not respond in a reasonable amount of time to questions (most tell their clients what their timeline is for responding), or is not available for follow ups (follow ups are often essential for successful practice
  • An instructor disparages other methods, believing they teach the best one (there is no such thing)
  • An instructor is unwilling to incorporate other biomarkers to increase a client’s comfort level with confirming ovulation (even if the reason is because they are not trained to do so. In this case, a method switch may be warranted).

Many of the reasons for switching instructors don’t necessarily mean an instructor is bad. Instructors are human too, and can get caught up in life or make mistakes or just aren’t the right fit for any number of big or small reasons. Switching instructors is not an incrimination, but simply an affirmation that their job is to ensure their clients understand the method they teach. If that most basic need isn’t being met – no matter the reason – the client has every right to look elsewhere.


Be on the lookout for Part 2: Contraceptive Mentality later this week.


The troubling comments from “An NFP Instructor”

Anonymous email from “An NFP Instructor”
Anonymous comment on the blog post, “Why I Don’t Refer to Fertility Awareness as Contraception,” presumed to be from the same “NFP Instructor”