How to Use the Creighton Method

Planning and preparing for pregnancy can be a complicated effort, and when you’re feeling lost or confused about your fertility status it can be hard to tune in to your body.

Most of the work in fertility care, both on your own and with the help of a provider, is in identifying your fertile window. This is the time when you are most likely to get pregnant, as you’ll ovulate at some point during this time frame. About 12 to 24 hours after ovulation, the ovum released “dies off” and you’re no longer fertile.

There are many different options when it comes to cycle tracking, and therefore lots of flexibility in how you choose to identify your fertile window. Every window is different so it’s a little more challenging to use a specific date or window of time to assume that you’re going to ovulate or have ovulated.

One option that can be useful is the Creighton method! The Creighton Model, or Creighton method, relies on observation and charting of biomarkers that indicate when a menstruating person is fertile or not. It is a standardized version of the Billings method, which is focused on monitoring changes in cervical fluid throughout a menstrual cycle. By using the Creighton Model, a person can either plan a pregnancy or attempt to avoid a pregnancy, making it distinct from a “natural contraceptive” such as abstinence or the rhythm method. Some physicians are trained in the use of this method to help patients learn about their reproductive health and make decisions about pregnancy.

NOTE: Given the state of reproductive health care in some parts of the world, it’s important to know that some providers hold pro-birth values and use the Creighton Model as part of faith-based fertility practices. This means there is a possibility that providers recommending the Creighton Model are anti-choice and your reproductive rights are not safe. You can check some online databases to see if your physician is one of them.

Here’s how you can integrate elements of the Creighton Model!

From day one of your cycle, make a daily note of cervical fluid that you notice in underwear, on toilet paper or on a liner. During your period it will most likely be tinted with blood and contain some tissues so we often consider these “unsafe days” or “possibly fertile days” because we can’t tell if there are indicators of fertility status, and it is possible to ovulate early. It’s best not to count changes in fluid after sexual activities as this is more likely arousal fluid. In general, you’re most likely to notice stable observations mid-afternoon.

Over the follicular phase, as estrogen gradually increases, we notice that cervical fluid becomes more creamy and tacky in consistency. Think body butter or lotion in appearance! This is the beginning of the fertile window – sperm can live in the uterus for 5 to 7 days, whereas an ovum will only live for 12 to 24 hours. If you were to have intercourse without a barrier method, there is a possibility of pregnancy.

As the body approaches the ovulatory phase, we find that cervical fluid becomes more watery, increases in volume, and may also be sticky like egg whites. There can be changes in chest tenderness, energy levels, sleep quality and cramping that can compliment this observation, and identify ovulation. The peak day is the last day in which you notice this egg white, thin, watery fluid.

After this peak day, fluid returns to a creamy consistency, until it becomes dry, absent and then menstruation starts again. After fluid returns to this creamy state, generally the fertile window is closed and your chance of pregnancy is minimal to none; it may be minimal in conditions such as PCOS where ovulation may be attempted frequently but is unsuccessful.

Some people don’t notice any patterns to their cervical fluid, or they have the same type of fluid for their entire cycle. The Creighton Model is unique in that it can adapt to these situations. We can use other possible body signs of ovulation to guide avoidance or attempts of pregnancy, and we watch for any change whatsoever from present fluid patterns to indicate potential for pregnancy.

If your provider knows you have a condition that impacts ovulation, you may undergo other treatment to stimulate ovulation or track a different set of data to identify ovulation such as basal body temperature tracking.

If you’re trying the Creighton Model but aren’t finding it helpful, or are having difficulties using it, it’s okay to take a break from it for a period of time! We can sometimes miss the forest for the trees, and fertility tracking is not exempt from this. Using alternative forms of contraception such as barrier methods, hormonal or non-hormonal birth control or abstinence for a period of time can take the pressure off until you’re ready to try again.

You could set reminders to check fluid changes at limited times during a cycle, at about the halfway mark and before an expected period, so you’re not staring into your underwear every month feeling overwhelmed.

And of course, you can chat with a provider who has experience with fertility tracking for an outside perspective (make sure they’re pro-choice!).

Fertility tracking doesn’t have to be a guessing game, and with practice and time you’ll be an expert in your own ovulatory patterns!