Answers to Your Questions About Fertility Awareness
Fertility awareness means learning how your reproductive cycles work, naturally! You can use knowledge of your fertility to achieve pregnancy, avoid pregnancy, and even identify signs of underlying health issues. These days, many women are rejecting modern forms of contraception in favor of methods that are ethical, natural, implant free, and drug free. Women who use fertility awareness-based methods of family planning (FABM) learn to trust their own knowledge and knowledge is power!
Isn’t Fertility Awareness Just the Rhythm Method?
Sometimes, when people hear the words “fertility awareness” or “natural family planning” they think it’s just about counting days on a calendar to guess your ovulation day. This method is still used by some women, but is notoriously risky if you are trying to avoid pregnancy! Modern FABM uses a more scientific approach to read the signs of fertility. Depending on the method you use you might be doing one or more of the following:
- Observing changes in your cervical discharge daily
- Taking your basal body temperature daily
- Checking the position of your cervix
- Testing urine hormone levels with test sticks or monitors
- Tracking symptoms unique to you, like arousal, breast pain, or cramping
- Recording your cycles on a chart or phone app
While this might seem intimidating, there are many books, apps, and websites that can help. Some methods can even be taught by a certified instructor who will guide you through the learning process.
What Does My Body do in a Cycle?
Your body responds to changes in your hormone levels throughout your fertility cycle. Many of these changes are signs you can observe. The first day of your period is the beginning of a new cycle. After your period, your body begins producing estrogen to help your ovaries get ready to release an egg. The estrogen also causes cervical fluids to change and become stretchier. You often will feel wetness at the opening of your vagina (vulva) or on your underwear during this time. This cervical fluid helps sperm survive longer in your body and fertilize the egg when it is released. When you estrogen peaks, you also have a surge of luteinizing hormone, which causes the egg to release from the ovary. The egg will live for about 24-48 hours. After ovulation, the hormone progesterone causes your basal body temperature to rise and the vulva to feel dry again. Progesterone helps your womb to be ready to care for a baby if you become pregnant. If you do not become pregnant, hormone levels drop and your get your period again
By understanding the signs of your body, you can identify the days when you are most likely to get pregnant. Using only infertile days for sex allows you to avoid pregnancy without artificial contraceptives. Different methods of FABM teach you ways to know which days are most fertile.
I Have Irregular Cycles. Can I still use FAMB?
Many of us were taught in school that the female cycle is 28 days long, ovulation on day 14, and then have their periods 14 days after they ovulate. Wrong! The truth is everyone’s body is different! A normal healthy cycle might range from about 24 to 36 days. The number of cycle days before you ovulate (the follicular phase) can change based on your health, diet, exercise or even stress! The time after you ovulate (luteal phase) is usually more consistent but can be 11-17 days long in a normal cycle. Using FABM, you can understand your unique cycle even when ovulation is later than you are used to. Even women who are postpartum or approaching menopause can use FABM.
Is There a Difference Between Fertility Awareness and Natural Family Planning?
Natural Family Planning (NFP) is essentially a type of FABM! The biggest difference between FABM and NFP is people who use NFP will abstain from sex when they are most fertile rather than using a barrier method or other temporary form of contraception. Both approaches may use any of the natural signs of fertility to empower couples in planning their families. NFP is the only method endorsed by the Catholic Church because it involves no contraception at all.
I Am Trying to Avoid Pregnancy. Is FABM Effective?
Using specific methods and following the rules carefully increases the effectiveness of FABM. Based on available research, about 1 to 5 women out of 100 will become pregnant during a year of using FABM if they are using their method perfectly. Your chosen method may be less effective for avoiding pregnancy if you do not follow the guidelines! You should have conversations with your partner often about whether you are willing to get pregnant if you break a method rule. This is healthy for your relationship! It is also important to know some methods are more effective than others. For instance, using the withdrawal method or simply tracking your cycle on a calendar are among the least effective. Methods that use cervical fluids, body temperature, or urine hormone monitoring in combination are typically the most effective.
I Am Trying to Get Pregnant. Can FABM Help?
A recent study in North America found women who use fertility signs to identify fertile days were about 50% more likely to achieve pregnancy in a given month compared to women who did not use fertility signs. Using FABM and keeping records can also help you and your doctor discover potential reasons you are having a hard time getting pregnant.
What Can’t FABM Do?
Fertility awareness cannot protect you from sexually transmitted diseases or HIV. You should also talk to your doctor about which method might be most appropriate, especially if you have health issues (read about HPV and pregnancy here). Finding a medical provider who has experience with FABM is very helpful!
Fertility awareness can be used by any woman to help her better understand her own body. By honoring our fertility, we empower ourselves to take control of our health and plan our families in a safe and natural way!
By Lucy McNamee, RNC-OB
This article is to help you learn about fertility awareness. It is not a substitute for medical advice. Please talk to your care provider for advice on which family planning options might be best for you!
Peragallo Urrutia, R., Polis, C. B., Jensen, E. T., Greene, M. E., Kennedy, E., & Stanford, J. B. (2018). Effectiveness of Fertility Awareness–Based Methods for Pregnancy Prevention: A Systematic Review. Obstetrics & Gynecology, 132(3), 591–604. https://doi.org/10.1097/AOG.0000000000002784
Standford, J. (2020). What Can We Reallly Know About the Effectiveness of Fertility Awareness Based Methods? [Webinar]. Cycle Power Summit. https://fertilitypro.kartra.com/portal/Tl1nbdjDeIYf/post/346
Stanford, J. B., Willis, S. K., Hatch, E. E., Rothman, K. J., & Wise, L. A. (2019). Fecundability in relation to use of fertility awareness indicators in a North American preconception cohort study. Fertility and Sterility, 112(5), 892–899. https://doi.org/10.1016/j.fertnstert.2019.06.036
Vigil, P. (2020). Ovulation: The Little-Known Vital Health Indicator. Cycle Power Summit. https://fertilitypro.kartra.com/portal/Tl1nbdjDeIYf/post/327