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2/17/2023

NFP "OOPSIES"... UNEXPECTED PREGNANCIES WHEN USING NATURAL FAMILY PLANNING

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If you've used Natural Family Planning [NFP] or a fertility awareness method for any length of time, you've probably heard this joke:
Q. What do you call people who use NFP?
A. Parents!
[Yucka yucka yucka.]
You may have heard that natural methods of family planning have a very high rate of effectiveness at avoiding pregnancy, as high as 99% effective, depending on the rules followed. To achieve this high rate of effectiveness, natural methods of family planning rely on abstinence from sexual intercourse and genital contact without penetration -- yes, contact pregnancies are a thing. So if that's the case, how come "NFP families" tend to be so darn big??!! (Cue family photo here.)
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(Yes; they're all ours.)

Let's get real. How come NFP families tend to be so darn big?
1. Taking chances. NFP requires abstinence. As I said before, "To achieve this high rate of effectiveness, natural methods of family planning rely on abstinence from sexual intercourse and genital contact." How many people do you know who are super good at abstinence from say, junk food? White lies? Gossip? And those aren't even particularly good things. Sex is a good thing. Sex with one's spouse is a very good and wonderful, and yes, pleasurable thing. Let's be real...sometimes the idea of maybe-possibly-who-knows? we could have another baby -- and babies are also very good and wonderful -- doesn't seem like such a Bad Idea. So the couple takes a chance...and along comes little Jenny or Timmy. I won't embarrass my kids by naming names, but let's just say I have personal experience with reason #1. If you are serious about not getting pregnant, you cannot, I repeat, CANNOT, take chances.
2. Being inexperienced or "relaxed". If you don't really understand how NFP works... like maybe you learned from the internet for example...you might not really understand how to observe, record, and interpret your signs of fertility. The evil twin sister of this idea is when you really do know how to do all of the above, but you just get kind of in a mindset that things are usually like "x" so you don't really need to do all the things and poof! just like that, something changes and a couple weeks later you're looking down at two pink lines...ask how I know lol. Natural methods are very unforgiving of missed observations and wishful thinking. You gotta do the method consistently to expect it to work.
3. Changing your minds. One of the benefits of natural methods of family planning is even if yesterday you were darn sure you never wanted another baby, you can change your mind the very next day and there's nothing to worry about or wait for. Go ahead and try! Newsflash: families using NFP don't need to announce their pregnancy intentions to anybody, so even if you assume or they told you that they're using NFP to avoid pregnancy, maybe they changed their minds and that is why they're having another baby! Don't assume the method "failed" -- it actually may have been used to achieve a wanted pregnancy! Thank the method for indicating you were fertile so you were able to have a baby that you wanted!
4. Method failure. While rare, it is possible that the couple used the natural method correctly, didn't take chances, and still got pregnant. If you are having sex, or even just "fooling around" without penetration, pregnancy is possible. This is true of any methods (natural or not), as long as the woman's ovaries and the man's testicles are intact. Even patients who have had a tubal ligation or vasectomy become pregnant from time to time. Life sometimes finds a way, even when the "chance" of pregnancy is extremely low! As with any family planning method, natural methods used correctly may fail to prevent pregnancy. If your sexual organs are intact, complete abstinence is the only way to be 100% certain you will not become pregnant.
Share your NFP stories! I would love to hear from you!

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7/6/2017

On the idea of 'on demand sex' within the loving marriage

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The self-proclaimed egalitarian lifestyle blog, Ezer, recently published a post titled "On Demand Sex Won't Meet Your Husband's Needs," by freelance writer and kindergarten teacher, Bailey, concerning the expectation of "on demand sex" within Christian marriage.  Here are my thoughts on this topic, as a natural fertility educator and happy wife of almost twenty years.
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​"On demand sex" describes a situation in which one spouse (typically, the husband) expects the other spouse (typically, the wife) to be available anytime for sex.  In the Christian marital context, this expectation appears to stem most directly from several verses in the book of 1 Corinthians (quoted in the sidebar).  At first blush, this passage seems to suggest that spouses have a biblical right to demand sex from the other because the other has no right to his or her own body.  But is that really what this passage means?
The husband should give to his wife her conjugal rights, and likewise the wife to her husband.  For the wife does not have authority over her own body, but the husband does; likewise the husband does not have authority over his own body, but the wife does.  Do not deprive one another except perhaps by agreement for a set time, to devote yourselves to prayer, and then come together again, so that Satan may not tempt you because of your lack of self-control.

​~1 Corinthians 7: 3-5, NRSV
In a genuine, loving marriage, one's spouse must be more than a convenient means to one's own pleasure--a perverse state which is in fact, self-love.  In contrast, married persons are called to "love, honor and cherish" their spouses--as so beautifully stated in the traditional marriage vows.  Elsewhere, Paul encourages Christian husbands to "love their wives as they do their own bodies" and to "nourish and tenderly care" for their wives as they do their own bodies (Ephesians 5:28).  The proposed 'selfish' interpretation of this passage from I Corinthians seems strangely at odds with the entire Christian faith, which is one of self-sacrifice, not indulgence.  And certainly, a Christian marriage, where husband is called to symbolize Christ, and the wife, His Bride, (cf. Ephesians 5:22-23) must not be self-seeking, but one of mutual love, tenderness, and care.  Indeed, Paul tells husbands to imitate Christ who "gave himself up" for His bride (Ephesians 5:25).  It is completely incongruous to imagine the same Paul who calls Ephesian husbands to give themselves up, even to the point of death, would here be giving Corinthian husbands carte blanche to indulge themselves in sexual intercourse at whim without concern for the desires of their wives.
But what of the end of this passage, where Paul seems to criticize, or at least strongly caution against, the abstinence from sexual intercourse upon which natural family planning methods are based?  While I haven't conducted a survey, there is no doubt a wide range of frequency of intercourse between individual marriages.  And certainly, depending on the stage of life one is in, within the same marriage over time there will be seasons of frequent intercourse--and seasons of infrequent intercourse.  Nonetheless, a loving marriage normally includes the good of intercourse as often as the spouses decide, as a beautiful means of uniting them, and delighting each other, as well as helping to bring children into the world, when they are so blessed.  I do not believe that this passage is so much a condemnation or discouragement of natural family planning, so much as an encouragement that spouses not hurt the other by stubbornly refusing sex.  My interpretation is based on the inclusion in 1 Corinthians 7:5 of that one important concept: mutual agreement.  Any mature marriage will necessarily go through some periods in which sex cannot be a daily (or hourly!) habit, depending on busy-ness, illness, care of small children, work trips or responsibilities, etc.  So surely Paul is not saying here that it is inherently dangerous for the couple to refrain from sexual relations from time to time.
The concept of "on demand sex" is at odds with the practice of natural family planning, because on demand sex falsely elevates one spouse above the other, who is treated as an object. In contrast, the marriage enriched by the practice of mutual self-restraint calls the spouses to view each other as partners who are at least symbolically co-laboring on the work of building their family, by cooperating with their natures--whether the goal is to conceive a new child, or to avoid pregnancy, or even to accept whatever will come, but with 'eyes open' due to the awareness of the possibility of pregnancy (the vast majority of the time).
A word of encouragement: for those with spouses who are at the beginning of this journey of self-mastery--the practice of natural family planning, with its inherent encouragement to cooperate together with the natural rhythms of fertility and infertility (depending on your pregnancy intention) is quite beneficial in encouraging growth in self-control, if freely chosen by both parties.  I repeat: it must be undertaken with mutual agreement (as Paul so wisely encourages).  Properly understood, I believe that this passage from 1 Corinthians must not to be taken as a license for one spouse to demand sex from the other, but for both spouses to humble themselves to each other, as they grow together in learning to more perfectly express the language of physical intimacy.

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4/25/2016

What is the Fertility Matters Charting System?

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The Fertility Matters Method:

​Natural

​Christian

​Life-Changing
The Fertility Matters Natural Women's Fertility Monitoring System
Since healthy men are always fertile, becoming pregnant naturally - or naturally postponing pregnancy effectively - depends on understanding whether a woman is fertile or not at a particular time--by regularly observing and interpreting a woman's natural signs of fertility and infertility.  Menstruating women of childbearing age move through a series of three "phases" as they move from their menstrual period, through ovulation, to the time following ovulation, up to the next menstrual period, typically about a month or so after their last menstrual period.  The Fertility Matters Fertility Monitoring System provides couples with a day-to-day visual guide for determining whether she is in the first, relatively infertile, phase; the second--fertile--phase, or the third, quite infertile phase.  Through a series of three classes, couples learn how to observe these natural bodily signs of fertility and infertility; how to record them correctly; and how to interpret what they have observed and recorded, so that, if they wish, they can time when they have marital relations in order to achieve pregnancy or postpone pregnancy.
Fertility Matters classes also include a wealth of information on ways to naturally support or enhance fertility, for a woman's general health and well-being.  One of the core, unique concepts of Fertility Matters classes is the inclusion of the Four Seasons of the Childbearing Year, and the importance of each "season" of a woman's childbearing years--not only fertility, but also pregnancy, childbirth, and breastfeeding--and how each season is beneficial for a woman's health and long-term well-being.  Other special features of my course include my exclusive GIFTs goal-setting process for couples to use to help them better align their actions with their intentions; an optional Bible Study about fertility and sexuality; and private fertility counseling sessions with me, so that couples can feel confident as they learn how to observe, record, and interpret their signs of fertility and what they have charted.
As a natural family planning method, "Fertility Matters" relies heavily on the work and research of Dr. John Billings of Australia, as well as the work of Dr. Konald Prem and John and Sheila Kippley, under whom I was originally trained as an instructor of Natural Family Planning.  The Fertility Matters course includes the book, A Cooperative Method of Natural Birth Control by Margaret Nofziger.  Not a true "method"--since I am not a medical researcher!--the rules used are based on those of Dr. Billings, and the Kippley-Prem system.  Fertility Matters is simply a different, and I would argue, a more intuitive way, to chart a woman's observations of her natural signs of fertility and infertility--one that is easy to interpret correctly.
Time for a little biology lesson, or review, if these concepts are familiar to you.  The three phases of infertility-fertility/ovulation-infertility are referred to as a "fertility cycle."  Usually quite soon after her menstrual period has ended, a woman's cervix (the opening to her womb) begins to secrete a fluid that has the purpose of transporting her husband's sperm through the cervix and into the womb, allowing the sperm to easily achieve their goal--locating the woman's egg typically in one of her fallopian tubes, where, if conception occurs, one lucky sperm is chosen to unite with the woman's egg and a unique, unrepeatable human life begins.  A woman's cervix (and her cervical fluid) also nourishes and even shelters sperm so that if ovulation is somewhat delayed, sperm are released later in a kind of "time release" fashion.  This is why conception can occur days after just one act of marital union.
Throughout her fertility cycle, cervical fluid production follows a "wave"-like pattern.  It typically begins to flow in limited fashion, then, as ovulation nears, more cervical fluid is produced, and it develops the quality of being highly stretchy.  After ovulation, these changes are reversed--the fluid is no longer stretchy and is produced in decreasing quantities until it dries up completely.  Her cervix's special "fertility promoting" fluid will not be produced again until her next fertility cycle, assuming she has not become pregnant.  The last day on which her cervix produces this special fertility-promoting fluid is called the "peak" day of her fertility cycle--because fertility is all "down hill" from there.
It should be clear from this description that for several days before ovulation, at ovulation, and even up to two days after ovulation, pregnancy is likely if the couple engages in marital relations.  It is not possible to definitely determine the exact day of ovulation without ultrasound.  Therefore, for couples seeking to avoid pregnancy, a key concept in interpreting whether a woman is fertile or infertile is correctly interpreting that enough days have passed the likely time of ovulation so that conception is no longer likely--in fact, is now highly unlikely.  As an experienced fertility educator & counselor, I notice that students in my classes often struggle with the concept of "peak" day.  Many students erroneously assume that "Peak Day" is the day on which a woman produces the most cervical fluid, and therefore, begin to count down to the infertile phase too early.  However, as I described above, Peak Day is the last day of any type of cervical secretion that indicates high fertility.  I designed the Fertility Matters charting system to make it more obvious that a woman has passed her Peak Day.  Fertility Matters has the woman chart her observations so that highly fertile observations are placed--literally--at the "peak" of her chart, so that once her observations--again, literally--cross the top of the hill and begin to decline, the couple knows they can begin the countdown to the infertile phase.  Otherwise, they begin the countdown too soon, and an unintended pregnancy is more likely.
While I believe Fertility Matters is beneficial for couples seeking to postpone pregnancy, (given the way observations are charted) I believe it is MOST beneficial to couples seeking to achieve pregnancy.  As I described above, the classes include vital information about natural ways to enhance fertility.  Most natural family planning classes assume students are there with the intention to avoid pregnancy, an assumption that does not meet the educational needs of couples who want help to become pregnant.  For this reason, I developed separate courses--including unique classes and different books--for couples with different pregnancy intentions and different fertility-interpretation challenges, and therefore, different educational needs.  In addition to class goals and methods focused on the needs of couples who want to become pregnant, the Fertility Matters charting system itself benefits couples seeking to achieve pregnancy.  It helps couples better understand when the woman is at her time of maximum fertility, so that they can time their efforts to achieve pregnancy more effectively.  In addition to courses designed for couples seeking to avoid and achieve pregnancy, there are Fertility Matters courses for couples facing the unique challenges of interpreting their fertility in the postpartum time or while breastfeeding; and for couples nearing or passing through premenopause.
At this time, live Fertility Matters classes are only available locally, in the Twin Cities / St. Croix Valley area.  However, I intend to make them available in the future as online classes.  In the meantime, I offer the classes privately, via online technology.  If you are interested, feel free to contact me!

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1/13/2015

Ecological Breastfeeding Makes Breastfeeding Easier, Spaces Babies

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What is Ecological Breastfeeding?
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See below for photo attribution.
"Ecological Breastfeeding" is a term originally coined by Sheila Kippley, the co-founder of the Couple to Couple League, (now with Natural Family Planning International) to describe straight-up breastfeeding as it has been done since the beginning of time.  Kippley was a La Leche League leader who was studying and writing about the effects of breastfeeding on fertility back in the 1970's when ecology was the rage.  Had she needed to pick a term today, she probably would have chosen something like "green breastfeeding" or, as I call it, natural breastfeeding.  Ecological breastfeeding is more than "exclusive breastfeeding"--although feeding a baby only breastmilk until he naturally starts solids around six months of age is part of ecological breastfeeding.  It also includes six other "standards" to make it clear if a particular mother is (or is not) practicing ecological breastfeeding.
It must be noted that ALL breastmilk and any way a mother feeds her baby is good.  Whether directly from the breast, from an eye dropper, dripped from a spoon, squirted with a syringe, dribbled out of a cup, or sucked out of a bottle--as the saying goes, "breast is best."  The Seven Standards aren't intended to be a measure of whether or not you are "mom enough" (as the now famous TIME magazine cover challenged).  There are seven "standards" because ecological breastfeeding is a means of spacing babies.  As such, there are rules ("standards") to be followed.  If the standards are followed, most women will experience completely natural infertility (for, on average, about 14-15 months after birth) as her body focuses on growing her babe in arms.  She will neither ovulate nor menstruate during this time of natural infertility.  Until mature eggs are released, there is no chance of pregnancy.  As more time passes from birth, the more likely it is that a mother will begin to ovulate again.  Studies of ecological breastfeeding mothers have shown that the actual rates of pregnancy are virtually zero from 0-3 months; 2% from 3-6 months, and about 6% after 6 months, assuming the mother has not experienced bleeding or spotting on two or more consecutive days.  Eventually, full fertility returns and in the natural order of things, within the context of a normal marital relationship, and with nothing but ecological breastfeeding, babies will come about every two to three years.  ...But if natural infertility--babies spaced without charting, abstinence, barriers, medications or devices--isn't something you desire, then ecological breastfeeding isn't for you.
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My two older sons: their births were spaced 37 months apart.
Ecological breastfeeding isn't a litmus test for "good" or "bad" mothering.  However, it is a completely natural way that babies and pregnancies are spaced, allowing the mother's mineral stores to be replenished.  Meanwhile, the older (ex utero) baby is growing, learning to eat, crawl, walk, and talk, so that when the next baby does come along, Mother can concentrate on him or her, without depriving the older toddler or preschooler of vital nutrition, as may happen with a closer spacing (if her milk supply drops during the pregnancy).  Furthermore, big brother or sister no longer requires the intensive attention that a newborn or infant does, so mother's job is a little easier.  The older sibling is old enough psychologically to understand that the new baby needs mama.  These are significant advantages to ecological breastfeeding that no method of "family planning" can approach.
Kippley’s Ecological Breastfeeding Program sets the stage as much as possible for successful breastfeeding.  While it is not for every family, it certainly would benefit some families who are unlikely to hear of it.  Unfortunately, natural breastfeeding continues to be viewed not only as a countercultural relic of the days of the cave woman, but it is also the best kept secret as a means to naturally space children, even in natural family planning circles.
When I first heard of naturally spacing children through breastfeeding, I had never had a baby.  But after being blessed with our eldest child, I followed Kippley’s “Seven Standards” faithfully.  While everything didn’t turn out exactly as Kippley suggested (O Pediatric Dental Bills, you seem so unjust), there is one area that turned out spot on.  Kippley stated that if you followed all seven standards, and had no bleeding episodes after the first 56 days postpartum, your children would (on average) be spaced two to three years apart.  She was totally right.  After seventeen years of marriage, our six children are all spaced two to three years apart--and this was not due to any underlying infertility as I became pregnant the first time I ovulated several times.  (The only departure from this pattern is between babies four and five, who would have been spaced within that range, but two early pregnancy losses extended the spacing to a little over three years apart.)
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The Hagen Family. Children's ages: 1, 3, 6, 9, 11, and 14 years.
A Real-Life Example: 
Christelle's "Periods" since 2000*

2000: 0
2001: 0
2002: 1
2003: 0
2004: 0
2005: 0
2006: 0
2007: 0
2008: 0
2009: 1
2010**: 8
2011: 0
2012: 0
2013: 1
2014: 0

*2000: the year our oldest child was born
**2010: two of these "periods" were early pregnancy losses
“Who cares?” you may wonder.  “If you hadn't noticed, Christelle, you have a gigantic family...so what's the big deal that your babies are spaced two to three years apart?”  Allow me to explain.  During the past fourteen plus years, I have had exactly eleven "periods".  Other than that--no menstrual bleeding, no cramps, migraines, PMS, or pads; and no ovulations—for years on end.  My husband and I have been free of what others call the “fear” of pregnancy, that is, free to enjoy each other intimately for years without any concerns or even thought given to preventing pregnancy.  No potentially contentious discussions about whether to try for another baby.  No need to chart.  No need to take temps.  Simply letting God plan our family.  By the time my fertility has returned, we have been mentally in the place where another pregnancy and another baby seemed…well…natural!  After all, the next oldest child could walk, talk, and feed herself or himself.  There was space in the family for another baby.
It is not easy to share this most unusual (though completely natural) form of baby spacing with others.  Many are suspicious about how "effective" it really is.  I have heard of many women being told by their health care provider that breastfeeding can't be "trusted" to space babies.  And this is partially true, because assuming a particular mother is following all of the standards, her own length of natural infertility may be shorter than average, depending on her baby's nursing patterns, her own biology, and other factors outside of her control.  While I have no doubt that having normal anatomy and physiology have certainly been in our favor, I suspect that my determination (okay, stubbornness would probably be more accurate) has played as much of a role in our success.  Just as I’ve witnessed when it comes to natural childbirth, those women who are going to “try” to birth naturally frequently do not; so also with those who are going to “try” ecological breastfeeding.  ‘Trying’ means you know you should do it the "natural" way, and if there are zero problems you will do it, but if anything gets tough with the birth or with breastfeeding, you plan to quit.  It’s okay.  Using pain meds during a birth, choosing combination feeding or formula feeding your baby, or using a binky doesn’t make you a "bad" mom.  There are times when these things are necessary.  Just not as often as people think.  More often, they are simply wanted.  This is where the guilt comes in because we Americans don’t allow mothers to want things that aren’t ideal.
Am I adding to the guilt?  I hope not.  My aim is to let mothers and couples know about the most natural form of breastfeeding so they have the option of choosing it, if it is right for them.  
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The first time I got to hold my son in the hospital, 4 days old.
“Ecological breastfeeding” could just be called “easy” breastfeeding.  Not because the lifestyle it requires is necessarily easy (because sometimes it’s not) but because it makes breastfeeding easier.  I know breastfeeding has been easier for me because of following the seven standards of ecological breastfeeding.  As I discussed in my review of the movie Breastmilk, when our sixth baby arrived, I had already successfully fed five babies without a bottle or pump in the house.  However, my sixth baby required special care after his traumatic birth, and if he was to get any of my milk, I was going to need to learn how to pump.  When I sat in that uncomfortable hospital chair, with a sliding curtain providing the only semblance of privacy, I had the unique position of having successfully nursed five beautifully chubby babies before ever needing to use that pump.  I had the perspective of knowing I can and have produced a supply of milk abundant enough to plump up a baby when I was told by the NICU nurse that I am a “below average” pumper.  I feel sad for first-time moms who hear comments like this and assume that being a “below average pumper” means that they don’t make enough milk.  Feeding your baby, not a pump, sets all the right hormones in motion. Producing milk directly for a baby and producing milk for a plastic pump are two completely different things, and really have no correlation at all.
I encourage pregnant moms and new parents to learn about natural breastfeeding, as described by Sheila Kippley in her books Breastfeeding and Natural Child Spacing and more recently The Seven Standards of Ecological Breastfeeding: The Frequency Factor which you can purchase through the Breastfeed {Naturally} shop, if you wish.  Even if you are one of the rare women for whom breastfeeding according to the seven standards does not produce natural infertility, a choice to parent according to these standards, if made because it feels right for your family to parent this way, will produce a harvest of love and joy, as it has in our family.  …It’s time to present the alternative to the technological form of breastfeeding which has become commonplace in America: natural breastfeeding.  Not to create another ideal that we expect all women to want, but to inform mothers and families of a wonderful set of steps to follow that make breastfeeding easier for many, and have the side benefit of naturally spacing babies without any other knowledge, charts, devices, barriers, medications, or procedures.
It's time to present the alternative to the technological form of breastfeeding that has become commonplace in America: natural breastfeeding.  Ecological breastfeeding makes breastfeeding easier and naturally spaces babies.
Natural breastfeeding moms need to come out of the closet, or more accurately, get out of the house! …and let the world know about this most beautiful way to space babies.  To that end, in the coming weeks, I will describe in detail each of Kippley’s Seven Standards and present evidence-based information and personal anecdotes about each of them.  I will follow this up with a series of posts explaining what moms, dads, relatives, employees, employers, clergy, and others can do to promote and support breastfeeding within your walls.  Make sure to come back in the coming weeks to learn what you can do to encourage the spread of information about natural breastfeeding, to help promote healthier and happier families, mothers, and babies.  Or get my posts directly in your email inbox by subscribing to them in the box in the side column of this blog!

Photo Attribution

"Kabala mother" by John Atherton - originally posted to Flickr as New baby and proud mother, Kabala, Sierra Leone (West Africa). Licensed under CC BY-SA 2.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Kabala_mother.jpg#mediaviewer/File:Kabala_mother.jpg

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    Christelle J. K. Hagen, BfNAE, ICI, SBD is a certified birth doula, certified Baby Signs instructor, Certified Birth & Bereavement Doula, fertility educator, and the President and Founder of St. Croix Birth & Parenting. Christelle helps mothers develop strategies to get pregnant naturally, give birth with confidence, and succeed when they breastfeed!
    ​
    "Blessed are those who trust in the Lord, whose trust is in the Lord. They shall be like a tree planted by water, sending out its roots by the stream. It shall not fear when heat comes, and its leaves stay green; In the year of drought it is not anxious, and it does not cease to bear fruit." ~Jeremiah 17:7-8 (NRSV-CE)

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