Fertility awareness-Based Methods

A fertility awareness-based (FAB) method (sometimes referred to as natural family planning) is a way for a woman to find out what days during her menstrual (monthly) cycle she either is or is not likely to get pregnant. The days she is likely to get pregnant are called "fertile" days.

This is done by keeping track of the changes that occur in her body during the menstrual cycle-the time between the first day of her period and the last day before her next one. To avoid getting pregnant, a woman should not have sexual intercourse on her fertile days, unless she or her partner uses a barrier birth control method, such as a diaphragm or condom.

FAB methods do not protect you from sexually transmitted infections—also called STIs for short—which are diseases, infections, or illnesses that can spread from one person to another through sexual contact. Some examples of STDs are chlamydia, herpes, HIV, gonorrhea, and syphilis. For more information, visit the ARHP STI Resource Center.

What you need to do:

Four very different fertility awareness-based methods are described below. Some FAB methods can take time to learn. For any of these methods, you and your partner must be willing to cooperate with each other.

Pros:

• There are no side effects.
• They can be used in combination with barrier methods during the fertile time (for couples who choose to have sexual intercourse during that time).
• They often are acceptable to couples who choose not to use other birth control methods for religious, cultural, health, or other reasons.

Cons:

• They have low rates of effectiveness when not used correctly.

Effectiveness:

This guide gives effectiveness percentages for two categories of contraceptive use: typical use, which includes people who may not always use a method exactly how and when they were supposed to use it, and perfect use, which indicates how effective the method would be if it were always used correctly.

• Perfect use: If used exactly according to the directions, between 2 and 10 women out of 100 might become pregnant in one year (depending on the FAB method used).
• Typical use: For typical users, between 12 and 25 women out of 100 might become pregnant when using FAB methods for one year. There is limited research on how well these methods work to prevent pregnancy. It depends upon how well a woman observes and records her fertile signs and how well the couple is able to abstain from sex or use a barrier method. The ability to do these things correctly will clearly affect how well FAB methods work.

Make sure you learn about Emergency contraception before using any of the fertility awareness-based methods. Sometimes called the "morning after pill," Emergency contraception reduces the chance of getting pregnant after unprotected sexual intercourse. For more information, visit the ARHP Emergency Contraception Resource Center.

Available Fertility awareness-Based Methods:

The Billings Ovulation Method (Cervical Mucus Testing): With the Billings Ovulation Method, a woman observes the changes in her cervical mucus (the wetness in her vagina) to tell her when she may be fertile. Without this mucus, sperm die within an hour or two. A woman's mucus develops several days before ovulation (release of the egg from the ovary), telling the woman her fertile days have begun. If used correctly, it is about 97% effective. Assistance of a trained instructor is typically necessary to learn to use this method.

• What you need to do:

  You will start to notice some cervical mucus within a few days after your period has stopped. You can feel wetness at the opening to your vagina and see the mucus on your fingers, toilet paper, or underpants. Write down how the mucus looks and feels to your fingers every day on a chart. The mucus starts out as cloudy and feels sticky and then days later becomes clear, stretchy, and slippery. You are most likely fertile from the time you start noticing cervical mucus until four days after you stop having the clear and slippery mucus.
  

The Calendar Rhythm Method: With the Calendar Rhythm Method (CRM), you keep track of the length of your menstrual cycles for 6-12 months to figure out the days when you are likely to get pregnant. It is probably at least 90% effective when used correctly, although more studies are needed on the effectiveness of this method.

• What you need to do:

  Write down the number of days in each of your last 6-12 menstrual cycles. Count the days in each cycle by starting with the first day of your period and ending with the day before your next period. Find the longest and shortest of those menstrual cycles. Subtract 18 from the number of days in your shortest cycle. This number will be the first fertile day of your current cycle. Subtract 11 from the number of days in your longest cycle. This number will be the last fertile day in your current cycle. Avoid unprotected intercourse from the first through the last day of your fertile time. You need to repeat this process with every cycle to find out your fertile days.

The Standard Days Method: The Standard Days Method (SDM) is a new method that is more than 95% effective when used correctly. It works best for women who have their periods every month, about when they expect them.

• What you need to do:

  Count the number of days in your menstrual cycle. Start with the first day of your period (day 1) and continue counting until the day before your next period starts. Avoid unprotected intercourse on day 8 through day 19 of your cycle to prevent pregnancy. On days 1-7 and from day 20 through the last day of your cycle, you are very unlikely to become pregnant.

  Most women who use the SDM find that CycleBeads, a string of color-coded beads, which represent the days of the menstrual cycle, help them keep track of the days in their menstrual cycle and the days when pregnancy is likely.

The Symptothermal Method: The Symptothermal Method teaches women to recognize their fertile days by tracking changes in their cervical mucus, body temperature (at rest), and the position of the cervix. When used correctly, this method is about 97%-98% effective in preventing pregnancy. Ask your health care provider for help in using this method.

• What you need to do:

  Take your temperature every morning before getting out of bed. (This is known as basal body temperature or the temperature of the body at rest.) Each day, look at the color of your cervical mucus to see if it is cloudy, white, yellow, or clear, and feel the mucus to see if it is sticky or slippery and stretchy. Check the position of your cervix, which becomes more open when you are fertile (ask your health care provider to help you learn to do this). Record your temperature, cervical secretions, and the position of the cervix on a chart every day. You can find out when you are likely to be fertile by noticing changes in these three fertility signs.

To learn more about fertility awareness-based and other contraceptive methods, including links to other Web sites, visit the ARHP Contraception Resource Center or ask your health care provider for more information.

To learn more about The Billings Ovulation Method, please visit their Web site: http://www.billings-ovulation-method.org

To learn more about CycleBeads, please visit their Web site: http://www.cyclebeads.com