Is NFP finally breaking into medical schools?

Dr. Marguerite Duane didn’t know about fertility awareness-based family planning until she had finished medical school. When she learned by happenstance that there were natural and effective ways to track a woman’s cycle, she was shocked.

“Why didn’t I learn about this in medical school?” thought Duane, who at that point was 29 and in her medical residency. “Why didn’t I learn about this in college? Why didn’t I learn about this when I was going through puberty and starting my cycle?”

Today, Duane has devoted much of her career to educating medical professionals about natural family planning, or NFP, which also can be called fertility awareness-based methods, or FABMs.

Duane is the co-founder and executive director of FACTS about Fertility, a medical educational organization. As an adjunct associate professor at Jesuit-run Georgetown University in Washington, she teaches an elective about FABMs. Duane is also the director of the Center for Fertility Awareness Education and Research at Duquesne University College of Osteopathic Medicine in Pittsburgh.

She hopes by the end of her career, she won’t need to advocate for NFP any more.

“This is good women’s health care, it’s not just good for Catholics. It’s simply good science,” Duane told OSV News. “We need doctors who are trained, and the challenge is most doctors aren’t. That’s what’s limiting the widespread adoption of these methods.”

Though many NFP organizations do a great job educating couples about their fertility, FABM users often run into difficulties when they share their knowledge in the exam room.

“These women and couples go to the doctor and the doctors (say), ‘That doesn’t work, let me give you this pill,'” said Duane. She’s experienced it personally, and she’s not alone. “FACTS did a study a few years ago where we surveyed women about their experiences talking with their clinicians about their use of FABMs, and fully a third of the women said they had a doctor laugh at them, mock them or ridicule them,” she said.

Duane first began the “FABMs for Family Planning and Restorative Reproductive Women’s Healthcare” elective at Georgetown in 2010.

The first half of the class focuses on the different available methods, such as the Billings Ovulation Method, the Creighton Model and the Marquette Model. It’s taught largely by guest lecturers, including some of the creators of these methods.

The second half focuses on how cycle charting can help diagnose common women’s health conditions, including premenstrual syndrome, or PMS; polycystic ovarian syndrome, PCOS; and endometriosis.

The elective has helped students really learn the science behind a woman’s cycle and feel comfortable recommending FABMs to future patients.

“It’s always amazing to me sitting in these live case studies (lectures) — I can literally see the scales falling off the eyes of these students who for three years have been fed (the idea) that birth control is the best thing since sliced bread, that the pill is the panacea for all that ails women,” she said.

Today, the elective is available to any medical student in addition to Georgetown students, and 1,000 students have taken the course. A continuing education course is available for current medical professionals, too.

One of Duane’s newest roles is as director of the Center for Fertility Awareness Education and Research at Duquesne. In 2022, the school announced that an anonymous donor had given $2.5 million to provide medical students with fertility-awareness training as part of their overall medical education.

“We are thrilled to have a gift that helps us educate medical professionals to use a wide array of tools at their disposal to treat the whole person,” said Dr. John Kauffman, dean of the medical school, in a press release announcing the training. “Fertility awareness is a tool that goes beyond family planning and ensures that physicians have a comprehensive understanding of their patient’s health.”

To the best of Duane’s knowledge, it is the only medical school in the United States that integrates education on FABMs at every level of the medical school curriculum. “This is huge — this has never happened before,” said Duane. “I’ve been teaching this course at Georgetown but it’s an elective, you have to want to take it.”

She’s also talking to other medical and nursing schools about how to include education about a woman’s cycle into their curricula. “I’ve received calls from the founding dean of Benedictine College (in Atchison, Kansas), which will be opening up a medical school,” she said. “I’ve met with the dean at Catholic University of America School of Nursing (in Washington), so I definitely think there’s an openness to this.”

The growing interest of medical educators as well as the growing awareness of the culture of FABMs makes Duane hopeful for the future.

“I think it is moving in the right direction,” she said. “Restorative reproductive medicine as a topic is more and more in the headlines, and (recently) ACOG (American College of Obstetricians and Gynecologists) came out against it and attacking it, so clearly we’re starting to make headway.”

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