Integrating Fertility Following Reversal of Tubal Ligation
Question
I am 40 yrs old and had a tubal ligation reversal approx. 5 yrs ago for moral reasons. I conceived 3 children. I had fully intended to use the NFP method until menopause. But I have been confused about how to keep track of my temps while breastfeeding a very wakeful baby. Also I notice my cervical mucus is harder to monitor as I age. I conceived my last baby on a “dry” day while breastfeeding. So basically I got scared and have been using the mini pill for the past 8 mo. I am not thrilled about using the Pill since I feel guilty about going against a moral decision I previously made. But I feel overwhelmed and feel a need to space my next child. Any advice?
Renee
Answer
Last Updated: July 24, 2013
I am honored you came to us for advice, and admire your conscientious struggle to do what is right in your situation.
I know little of your history using NFP—what method, whether you taught yourself, or took an online course, attended a class, or have an ongoing relationship with an NFP Professional. But it is so important in using NFP to have continued contact with a teacher, to be able to discuss the issues you have raised. Our bodies change, and our situation changes, and the guidance and feedback of the teacher, who has experience in the variety of patterns observed and the method’s application in different reproductive categories is essential in not only accurately interpreting the signs, but in gaining confidence. Things are not the same for us in our 30’s as they were in our 20’s, and different still as we enter our 40’s. Using NFP during breastfeeding is different then when cycling. And of course our needs are different when are feeling overwhelmed and strongly desire to avoid a pregnancy, than when we are ambivalent or even desiring pregnancy.
If you learned NFP from a book, friends, or online, then you have not really benefited from the guidance of an expert in becoming an effective user of the method. Even if you took a full course, it is really quite important to attend a refresher following pregnancy and to negotiate the breastfeeding time. And if you have not discussed your chart from the cycle in which you conceived, you would benefit as well from a consultation with your NFP teacher to review the conception cycle. They may have some insights that might shed some light on the circumstances.
I can assure you that the NFP teacher would welcome the call, and the opportunity to help you gain confidence in your charting and use of the method. And it does not reflect on your abilities, but is the nature of Natural Family Planning that it is important to have continued contact and support of an instructor. For example, I meet at regular and frequent intervals with the couples I instruct in Natural Family Planning for the first full year of use of the method, and annually after that (more often if they desire it, or are breastfeeding or have complicated patterns). These annual reviews provide the opportunity to review their observations and charting for the past year, refresh their knowledge, and answer questions that may have cropped up. It is not unusual at this annual “checkup” that I might make new recommendations regarding their application of the method, based on changes in their cycle during that time.
If you are dissatisfied with your teacher, or method, you might consider researching another method of Natural Family Planning. Different methods suit different people. You may benefit from an instructional process that is individualized, where you would receive personalized instruction
You restored your fertility when you reversed your tubal ligation—what a blessing it was successful. The task you face now is learning to integrate your fertility into your marital relationship. I encourage you to enlist the guidance of a good NFP teacher, who would be privileged to help you in this process.
I invite you to call me on our toll free number and discuss this in more detail if you like. I would be happy to talk with you.
I know little of your history using NFP—what method, whether you taught yourself, or took an online course, attended a class, or have an ongoing relationship with an NFP Professional. But it is so important in using NFP to have continued contact with a teacher, to be able to discuss the issues you have raised. Our bodies change, and our situation changes, and the guidance and feedback of the teacher, who has experience in the variety of patterns observed and the method’s application in different reproductive categories is essential in not only accurately interpreting the signs, but in gaining confidence. Things are not the same for us in our 30’s as they were in our 20’s, and different still as we enter our 40’s. Using NFP during breastfeeding is different then when cycling. And of course our needs are different when are feeling overwhelmed and strongly desire to avoid a pregnancy, than when we are ambivalent or even desiring pregnancy.
If you learned NFP from a book, friends, or online, then you have not really benefited from the guidance of an expert in becoming an effective user of the method. Even if you took a full course, it is really quite important to attend a refresher following pregnancy and to negotiate the breastfeeding time. And if you have not discussed your chart from the cycle in which you conceived, you would benefit as well from a consultation with your NFP teacher to review the conception cycle. They may have some insights that might shed some light on the circumstances.
I can assure you that the NFP teacher would welcome the call, and the opportunity to help you gain confidence in your charting and use of the method. And it does not reflect on your abilities, but is the nature of Natural Family Planning that it is important to have continued contact and support of an instructor. For example, I meet at regular and frequent intervals with the couples I instruct in Natural Family Planning for the first full year of use of the method, and annually after that (more often if they desire it, or are breastfeeding or have complicated patterns). These annual reviews provide the opportunity to review their observations and charting for the past year, refresh their knowledge, and answer questions that may have cropped up. It is not unusual at this annual “checkup” that I might make new recommendations regarding their application of the method, based on changes in their cycle during that time.
If you are dissatisfied with your teacher, or method, you might consider researching another method of Natural Family Planning. Different methods suit different people. You may benefit from an instructional process that is individualized, where you would receive personalized instruction
You restored your fertility when you reversed your tubal ligation—what a blessing it was successful. The task you face now is learning to integrate your fertility into your marital relationship. I encourage you to enlist the guidance of a good NFP teacher, who would be privileged to help you in this process.
I invite you to call me on our toll free number and discuss this in more detail if you like. I would be happy to talk with you.
Answered By:
CANFP
CANFP unites under one umbrella all those who use, teach, and advocate for NFP, and our members are our strongest resource: the physicians who provide authentic women’s healthcare, the Practitioners and Certified Teachers of all the natural methods instructing couples in its use, the couples who use NFP and reflect its values in their families and communities, the clergy providing the spiritual formation and context, and the churches, dioceses, hospitals, and profile organizations who collaborate in providing access to these services throughout the state.
