Core Competencies for Accreditation as a Fertility Awareness Educator (FAE) by the Association of Fertility Awareness Professionals (AFAP)

Introduction

This document outlines the body of knowledge that the Association of Fertility Awareness Professionals (AFAP) considers essential for providers of Fertility Awareness education and counseling. Fertility Awareness Educators (FAEs) who have demonstrated these competencies can be accredited by AFAP.

Currently, only graduates of specific AFAP accredited training programs are eligible to receive AFAP accreditation.

Notes on terminology used in this document

1. The term “Fertility Awareness-Based Methods” (FABMs) is used here to refer to all methods of fertility management that are based on observing and interpreting the signs of fertility (see item 2). The term “Fertility Awareness Educator” (FAE), however, is used exclusively to refer to educators whose teaching practices do not espouse a particular set of religious values, and whose training was and whose practices are imbued with the inclusive principles described herein (see section 6C).
2. Professionals who help others to learn and practice FABMs may refer to themselves as educators, practitioners, counselors, or facilitators, among other titles. AFAP has chosen to use the term Fertility Awareness Educator (FAE), as we feel that education is at the heart of the work that we do and is the “common denominator” in our varied practices. However, we recognize that counseling is also an integral part of our work. Thus, we reference both teaching and counseling skills in this outline of competencies. Similarly the people who seek out our services may be referred to as students, clients, or any number of other terms. While “student” is the logical corollary to “educator,” we feel that its hierarchical implications are not appropriate here, so we have chosen to use the term “client”.
3. In this document we use the term “fertility signs” to refer to the biomarkers of fertility (cervical mucus/fluid, basal body temperature, and cervical position), which are the hallmarks of observational FABMs. The word “biomarker” is medical parlance for what FABM professions may refer to as fertility signs, fertility symptoms, or menstrual cycle events. Members of the professional FABM community hold varied opinions as to what terminology is best to use. We have chosen to use the term “fertility signs” because it is the most common and recognized term at this time.

Authors and Contributors

The authors of this document are:

• Sarah Bly, FAE, DEM: sarah@graceofthemoon.com
• Geraldine Matus, HRHP, PhD: geraldine@justisse.ca
• Ilene Richman, FAE, LMSW: ilene@fertaware.com
• Michal Schonbrun, MPH, CHES: mschon@netvision.net.il
• Rose Yewchuk, BA, MA, FAE, HRHP: rose@roseyewchuk.com

We wish to thank our colleagues whose feedback was invaluable to the development of this document:

• Jane Bennett, BSW, DCH
• Basia Kielczynska, DMH, MS, LAc
• Jenny Koos, HRHPE
• Megan Lalonde, BA, HRHP, LMT
• Lisa Leger BA, HRHPE
• Danielle Miller, MD
• Francesca Naish, DCH, MATMS, MANTA, FNHAA
• Malin Soderberg, PhD, HRHP

Core Competency Requisites

1. Prerequisites

Academic Prerequisites

1. A minimum of a two-year undergraduate degree, diploma, or certification in any field. (Other educational experiences that demonstrate ability to undertake academic study will be considered.)
2. Completion of an introductory level college/university anatomy and physiology course taken within the last five years (or less recently if one is currently a healthcare provider).
3. One or both of the following:
   • Completion of an introductory level college/university women’s or gender studies course.
   • Work or research in the field of reproductive justice.

Fertility Awareness Prerequisites

1. Having charted one’s cycles for at least one year using a recognized symptothermal or mucus/cervical fluid-based FABM.
2. Having received instruction regarding one’s charting practice (including follow-up) with a certified Fertility Awareness Educator (FAE) to the satisfaction of that FAE.

Other Prerequisites

1. Basic counseling and facilitation skills, such as non-violent communication, motivational interviewing, and active listening.
2. Teaching and/or facilitation experience in classroom, workshop, or tutorial settings.

2. History and Development of FABMs

An FAE needs to have a working knowledge of and critical thinking on the following topics:

1. FABM historical research dating back to the development of the Calendar Rhythm Method.
2. Development of secular FABMs as a distinct subset of Natural Family Planning (NFP) methods.
3. Familiarity with organizations currently offering teacher training and public/professional instruction in FABMs (both international and local organizations).
4. Distinguishing features of commonly used and well-established FABMs:
   • Variations in the definition and interpretation of primary signs of fertility (cervical fluid/mucus, BBT, cervical position), and secondary signs of fertility as used by these systems.
   • Mechanisms of use including the rules for avoiding or achieving pregnancy.
   • How observational data are collected and recorded.
   • Evidence bases.
   • Variations in religious, moral, or philosophical perspectives.

3. FABM-Focused Reproductive Anatomy and Physiology, Sexuality, and Sexual Health

An FAE needs to have a working knowledge of the following topics:

1. Human sexuality, including sexual development and sexual differences between females and males, and familiarity with variations in sexual morphology and sexual identity.
2. Female and male sexual and reproductive anatomy and physiology, including the correlation between endocrine function and the primary and secondary signs of fertility observed when using FABMs.
3. Female reproductive life continuum (transitions from menarche through to menopause)
4. Role of the endocrine system as it pertains to the field of fertility awareness education.
5. Relationship between psychological/emotional well-being and physical health, as well as the basics of body-mind or somatic approaches to health.
6. Relationship between reproductive health and nutrition, diet, lifestyle, and environment.
7. Physiology of conception and the hormonal mechanisms associated with pregnancy, abortion, miscarriage, and the postpartum period.
8. Mechanism, use, side effects, advantages, disadvantages, and statistical effectiveness of widely-available types of contraception.
9. Basic understanding of infertility including causes, diagnostic procedures, and treatments (both female and male).

4. Menstrual Cycle Chart Interpretation Skills

An FAE needs to be able to:

1. Interpret the client’s chart with regard to menstrual cycle events based on observation of the primary and secondary fertility signs.
2. Identify the chart characteristics of physiologically typical cycle parameters across the reproductive life continuum.
3. Identify chart characteristics of atypical cycles.
4. Identify factors that may interfere with the observation, charting, or interpretation of the primary fertility signs.

5. FABM Teaching Expertise and Counseling Practice

An FAE needs to:

1. Have FABM teaching experience that includes introductory sessions and follow-up sessions.
2. Have an organized system for their FABM teaching practice including but not limited to:
   • Chart example gallery inclusive of both typical as well as atypical charts.
   • A resource database including but not limited to:
     • Health care practitioners.
     • Other FAEs.
     • Websites, organizations, and other resources for clients with specific health issues or needs.
     • Research articles & books.
   • Handouts and visual aids.
   • Forms for client intake and care.
   • A confidential client record keeping system.
3. Facilitate informed client decisions regarding FABM use.
4. Identify the need to refer a client to other care provider(s) when client need falls outside of the competency of the FAE practitioner.
5. Employ a mode of practice that is evidence based, empathic, client-centered, and assists the client in developing autonomy and self-directed care.

6. Professional Ethics, Reproductive Justice, and Scientific Literacy

An FAE needs to:

1. Uphold professional ethics and standards similar to those common to the health care professions. [Note: AFAP plans to develop a specific code of ethics for FAEs in future.]
2. Understand issues of plagiarism, intellectual property, and copyright and know how to appropriately reference the work of others.
3. Be culturally competent and curious so that all clients can be welcomed without prejudice or microaggression, including those clients whose needs and identities have not been well addressed by research and institutions in the field of Fertility Awareness. Be cognizant of how institutional oppression (historical and current) impacts both access to health care as well as the quality and type of health care provided. Have considered how these issues manifest in one’s practice and how they can be redressed.
4. Understand concepts that comprise basic scientific literacy.

^[1] Grace of the Moon Teacher Training Program; Justisse College Holistic Reproductive Health Practitioner (HRHP) Training Program; The FAM and Reproductive Health Facilitators Training Program [Poriutivit].