Stress and Success in Postpartum

Written by Anne Marie Williams. Originally published in Family Foundations

The postpartum period is uniquely full of the emotional highs of welcoming new life into the world as well as certain stresses like sleeplessness, round-the-clock caregiving, and adjustment of expectations between husband and wife. Couples practicing natural family planning and seeking to avoid pregnancy encounter the added challenge of interpreting sometimes confusing signs of fertility before the woman’s regular cycles return. While some stress is unavoidable, success in postpartum is absolutely attainable. Here, we share several stories of couples who have successfully utilized natural family planning during the postpartum period, including while facing tremendous adversity, and whose marriages were strengthened as a result.

For the Briens, the Sympto-thermal Method was a Family Affair

5 years ago, Gabe and Joan Brien of North Dakota learned the sympto-thermal method through Couple to Couple League (CCL) during marriage prep. Joan’s parents were a CCL teaching couple, but Gabe and Joan chose to learn CCL’s STM method for two reasons. First, CCL is unique in that it assumes the active participation and involvement of both husband and wife. In keeping with the Catholic Church’s recognition that fertility is a gift rather than a burden,  the responsibility for properly stewarding that gift is shared by the couple, not shouldered solely by the woman. Secondly, CCL is “much more couple-empowering”, meaning that couples are taught “here is the information, now you’re the experts about your own bodies” and they themselves decide “what are we called to do right now, and how does the data in our charts fit with that intention?”

An Unthinkable Diagnosis

Fast forward four years after the Briens learned STM from CCL. While seven and a half months pregnant with their second child, Joan noticed a significant lump in her breast. At 39 weeks pregnant, they found themselves at the Mayo Clinic in Minnesota, facing the unfathomable reality. Joan had metastatic breast cancer. The day after the diagnosis, in late December of 2020, Joan was induced and gave birth to their son David. Just one week later, she began weekly chemotherapy treatments which concluded when David was 3 months old. Since that time, Joan has received immunotherapy infusions, intravenous (IV) infusions that help activate her body’s immune system to fight the cancer and prevent its spread.

A Serious Concern

The Briens had a very serious reason to avoid pregnancy while Joan underwent chemotherapy. And while immunotherapy has relatively few side effects for the patient, in a pregnant woman it can cause low amniotic fluid leading to birth defects or miscarriage. If Joan were to conceive on immunotherapy, she shared, “the treatment would have to be halted and my cancer would most likely grow very quickly.”

Before beginning chemotherapy, Joan’s medical team had asked if they planned to have more kids. When the Briens shared that they hoped for a large family, their medical team told them that hormonal contraception was contraindicated in cancer patients, but recommended they use either barrier methods such as condoms or an intrauterine device (IUD) to prevent pregnancy.

The Briens had used breastfeeding to space their children, so they were aware that they didn’t have enough knowledge to say for sure that they could use NFP effectively to prevent pregnancy. But contraception was never on the table. Joan observed, “Neither Gabe nor I had any doubt at all in our minds or hearts that contraception in all its forms makes loving more difficult. It hampers the love that as a couple you’re giving your life to nurture by total self-gift.  And it has never done anything for the women in our culture – to put it bluntly, it is widely accepted misogyny.” She continued, “It’s always been very clear to us the harm that contraception can do, and neither of us wanted that for each other.”

Given all this, Joan told her doctor that they’d be using abstinence. The doctor looked quickly at Gabe, who “rather offended at the implication that he would be unable to control himself to do what is best for his marriage and his wife,” affirmed “We’ll be using abstinence.” The doctor echoed, “Abstinence works great!” and the matter was settled.

Navigating Uncertainty….Together

The Briens subsequently reached out to teachers and medical providers trained in multiple NFP methods in order to learn what was known about the impact of chemotherapy or immunotherapy on return of fertility, and whether they could in fact use NFP rather than just total abstinence to avoid pregnancy. They found success in layering tools from Marquette, Creighton, and CCL in tandem to clearly identify phases of fertility and infertility after Joan’s cycle returned four months postpartum, one month after stopping chemotherapy.

The couple have harnessed technology in innovative ways to ensure that they are both maintaining responsibility for their shared fertility. For instance, while Joan wears the Tempdrop wearable thermometer, the readings sync to Gabe’s phone so that he can record them in their chart.

While the Briens are using multiple biomarkers, they’ve benefited most from a personal relationship with a CCL instructor and coach. They’re particularly grateful that their current teacher has both CCL and Marquette experience in her background, as well as working relationships with medical researchers actively exploring the interplay between cancer, cancer treatments, fertility, and observable biomarkers. Now, the Briens feel very comfortable reliably avoiding pregnancy via natural family planning.

Unexpected Blessings

Speaking about the couple’s experience practicing natural family planning in the context of their cancer journey thus far, Gabe observed succinctly, “When you’re trying to do a good thing, you need the grace of God.” He noted that when a couple is facing difficulty of any kind, they naturally seek to build intimacy with each other in order to get through the hard times or hard thing together. He said, “One of the largest challenges we faced was to trust that God was and is calling us to precisely what we needed at the point that we needed it, and that if He’s calling us to abstinence, that that’s what we needed at that time.” He continued, “In our experience, the greatest consolation was to know that we were trying our best to carry out what God was asking us to do. Some of the deepest and most intimate moments of our marriage have come during times of abstinence, when we were being called to pour out our hearts in conversation or in a few moments together. This deepened intimacy has really served to make our times of consummation even more vital, fulfilling, filled with joy. Love’s greatest compliment is to give everything: mind, body, and soul. To leave or forget one of those three is to miss a part of love that cannot be replaced. In the joy of marriage, we are called to love completely, fully and eternally. To give all of ourselves and to receive all of our spouse.”  Joan added, “we had to trust that God was going to bring us closer together through abstinence- that abstinence was going to be the vehicle that was going to draw us closer, even closer than our marriage act. And what we’ve experienced was that that trust was not unfounded.”