FERTILITY AWARENESS
Fertility awareness, or natural family
planning, has been used successfully since the 1930's to predict
a woman's fertile days. These methods are based on the fact that
fertilization is most likely to occur around the time of ovulation.
Intercourse is avoided during those times when a woman is fertile,
thus preventing conception. Fertility awareness methods are the
only methods of birth control which require the cooperation of
both partners. Advantages of these methods are that they are
very inexpensive, do not require the use of artificial devices
or drugs, and have no harmful side-effects. In addition, many
people prefer a natural, mutual method of preventing pregnancy.
Even if fertility awareness isn't used as contraception, every
woman can benefit from understanding the workings of her body.
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Many doctors are reluctant to recommend fertility
awareness methods because of the high failure rate of the rhythm
method, the first natural method to come into widespread use.
However, newer natural methods listed in this section are as
effective as artificial contraceptives. Additionally, users of these
methods tend to be very loyal, continuing to practice NFP longer than
users of any other non-surgical, non-prescription method, which
indicates high satisfaction among couples.
To use fertility awareness
as a form of birth control it is strongly recommended that you
first confer with a trained counselor. Couples who use this method
improperly are more likely to get pregnant than those who misuse
artificial methods.
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A Woman's Monthly Cycle
Above is a pictorial representation of a 32 day menstrual cycle.
For this woman, ovulation takes place on day "17."
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Sympto-Thermal Method
Average Failure Rate: 15%
This method requires that a woman
take her temperature every morning before she gets out of bed
and record the reading. Depending on where she is in her menstrual
cycle, there will be slight variations in her temperature. These
variations are most easily measured with a special thermometer
that has a range of only a few degrees, known as a
basal thermometer.
Before ovulation, the temperature is likely to be between 97.2
and 97.4 degrees F. After ovulation, it will rise by at least 0.5 degrees and
is often above 98 degrees F. When the temperature stays elevated for
at least three days, a woman may assume she has already ovulated.
Intercourse for the rest of the cycle will not result in pregnancy.
To determine the infertile time before ovulation, a woman needs
to look at her pattern of previous cycles. Her last "safe"
day is one week before the earliest recorded day of temperature
rise, or 5 days after the first day of her period.
By recording other cyclic symptoms,
in addition to basal temperatures, the infertile time before ovulation
can be more accurately predicted (see Ovulation Method,
below). Cervical mucus, mid-cycle cramping,
breast sensitivity, and mood swings are all symptoms which give
insight into the progression of a woman's cycle. With careful
monitoring, it is not difficult to predict your fertile period,
when intercourse is to be avoided. An NFP chart
for recording these changes is available to view or print out.
Intercourse during the time before
ovulation is less safe than the time after ovulation because sperm
have been known to live up to six days. For this reason, some
couples choose to have sex only after the fertile period. This
practice, known as the post-ovulatory temperature method, is the
most effective of all methods of true contraception, with a failure
rate of only 1% among perfect users. However, it is not recommended
because it requires a very long period of abstinence.
Ovulation Method
Average Failure Rate: 20%
The ovulation method, or mucus method, requires that a woman be aware of what is taking place in her body. It is based on the observation that, in the absence of mucus, no egg is present, and sperm cannot survive long enough to fertilize an egg which may later be released. During a typical monthly cycle, a woman first has a few days of menstrual bleeding, followed by a few "dry days" when the vagina seems quite dry. Then, closer to ovulation she starts to have more wetness or mucus. As ovulation approaches, the mucus becomes clear and slippery and stretches without breaking, like a raw egg white. The last day of peak wetness is right before ovulation, then come days of less mucus. If any is noticed it will be cloudy. Any time the slippery stretchy mucus is noticed, intercourse should be avoided until two days after it is all gone - about eight days out of each cycle.
Calendar Method
Average Failure Rate: 13-20%
The calendar method, or rhythm method, is the oldest and most widely practiced method of fertility awareness. It is based on three assumptions: (1) that ovulation occurs fourteen days before the beginning of menstruation, plus or minus two days (2) that sperm remain viable for three days, and (3) that the ovum survives for twenty-four hours. For a woman with very regular cycles, she needs merely to count backwards from the first day of her period to locate the day on which she ovulated. Using this information, she can predict when ovulation will occur the following month and avoid having intercourse around that time.
Most women do not ovulate at the same time each month, and no woman's cycles are identical every time. For this reason, the rhythm method is not recommended unless your cycle is always the same number of days.
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