What is fertility awareness?
Fertility awareness is a collection of methods using your body's
natural and normal functioning to determine the days of the month
you are most likely to get pregnant. It is also called Natural Family
Planning (NFP), the Sympto-Thermal Method, the Ovulation Method, or
the Billings Method.
Fertility awareness or Natural Family Planning is a method of birth
control that does not use any drugs or devices. It combines the calendar/rhythm
method, the basal body temperature method, and the cervical mucus
method.
The fertility awareness method is used both as a means of preventing
pregnancy as well as targeting the most fertile time for getting pregnant.
How does fertility awareness work?
The calendar; basal body temperature; and cervical mucus methods
are combined to give you the awareness of when your body is most fertile.
As you become familiar with your body's ovulation and fertile periods,
it provides you the opportunity to abstain from sexual intercourse
or use one of the barrier methods during that time.
How do you use fertility awareness?
The first objective within fertility awareness is to become familiar
with your menstrual cycle and to begin charting your fertility pattern.
The average menstrual cycle is between 28 to 32 days, however there
are two parts related to your cycle: before ovulation and after ovulation.
Here is a glance at an average cycle to give you a gauge for examining
your cycle:
Day 1: The first day of your menstrual flow is the beginning of
the calendar.
Day 7: By day seven your egg is preparing to be fertilized by sperm.
Days 11-21: (based on 28-day cycle) Hormones in your body cause
the egg to be released from the ovary around this time. This process
is known as ovulation. The egg travels through the fallopian tube
towards the uterus. If sperm penetrates the egg, the fertilized egg
will attach to the lining of the uterus and begin to grow. If fertilization
does not happen the egg breaks apart.
Day 28: Hormone levels drop around this day causing the lining of
the uterus to be shed making up your menstrual flow.
It is important to realize that the first part of the menstrual
cycle (before ovulation) is different in every woman and can even
change from month to month. The variation usually occurs from 13 to
20 days long. The last half of the cycle is usually more similar for
every women, because there are about 14 days from day of ovulation
until the start of the next period. This is why women are encouraged
to track their cycles and count back 14 days from their LMP to narrow
down their most fertile time of the month.
Calendar tracking method: Your past menstrual cycles
will work as a guide for estimating your fertile times. In order to
track your menstrual cycle and to identify your expected ovulation
follow the step by step process below:
Step 1: Plan on tracking your menstrual cycle for 8 to 12 months.
Step 2: Day 1 will be the first day you start menstruation.
Step 3: Pick the longest and shortest of the cycles from your monthly
tracking.
Step 4: The first day of your fertility period is determined by
subtracting 18 days from the length of your shortest cycle. If 26
days was your shortest menstrual cycle, take 26 and subtract 18 to
come up with the number 8. This means that the first day of your fertility
window starts on the 8th day of your cycle.
Step 5: The last fertile day is determined by subtracting 11 from
the length of your longest cycle. If 32 days was your longest menstrual
cycle, take 32 and subtract 11 to reach the number 21. This means
that the last day of your fertility period ends on the 21st day of
your cycle.
The time in between these two days is considered your fertility
window. In the above example, your fertility period would be from
the 8th day of your cycle to the 21st day of your cycle. Your ovulation
is expected during this time frame. You cannot get pregnant everyday
during this period, but it is sometime during this period that pregnancy
can occur.
If you are trying to avoid getting pregnant, you need to abstain
from sexual intercourse or use a barrier form of birth control during
your fertility window. If you are trying to get pregnant, this fertility
period would be the targeted time for sexual intercourse.
Basal body temperature method: Your basal body
temperature measures a change in the temperature that occurs after
ovulation and remains elevated until your next period. By looking
at charting from a few cycles, the temperatures can reveal a pattern
from which ovulation can be anticipated. The steps below can help
you as you begin to track your temperature and identify when you are
ovulating.
Step 1: Take your temperature orally each morning before you become
active.
Step 2: Use a basal thermometer which recognizes small changes in
your temperature. Your body temperature will only rise between 0.4
and 1 degree ferenheit when you ovulate. Buy
a Basal Thermometer Now.
Step 3: Record you temperature every day on your fertility tracking
calendar.
If you record it every day, you will see that prior to ovulation
your temperature is rather consistent. As you get closer to ovulation,
you may have a slight decline, but it will be followed by a sharp
increase after ovulation. The increase in temperature is the sign
that ovulation has just occurred. Because the increase happens after
you have ovulated, this method is best used by those who have time
to track and study their charts for a couple months, to ensure the
best chances of conception. Illness, lack of sleep, and alcohol or
drug use can affect your temperature and make it difficult to establish
an accurate reading.
Cervical mucus method: The consistency of your
cervical mucus changes during the menstrual cycle. In the average
cycle, there are 3 to 4 dry days following a 5 day menstrual flow.
The mucus wetness increases daily, lasting approximately 9 days
until the wettest day. Your mucus is easily recognized at this point.
It should be abundant, slippery, clear, and very stretchy. It has
been described as egg whites.
Ovulation occurs when you have your peak day of stretchy mucus (within
two days). In order to use the cervical mucus method to identify your
ovulation follow the few steps noted below:
Step 1: Collect the mucus from the vaginal opening with your fingers
by wiping them from front to back.
Step 2: Record it daily on your fertility calendar by making note
of the color (yellow, white, clear or cloudy), the consistency (thick,
sticky, or stretchy) and the feel (dry, wet, sticky, slippery, stretchy).
Step 3: Ovulation is recorded on the day that your mucus is clearest,
slippery and most stretchy.
Do not douche or use spermicides which increase your risk for infection
and may wash away or change the appearance of the mucus.
How effective is fertility awareness?
When fertility awareness is used correctly and consistently, it
may reach effective rates around 90%. The effectiveness depends on
your diligence to track and record your fertility pattern and your
commitment to abstaining from sexual intercourse or using a barrier
form of birth control during your fertility window.
Typical use, which refers to the average use, shows a failure rate
of approximately 25%. If you are committed to tracking and recording
your fertility information, you can achieve much higher success rates.
What are the side effects or health risks of fertility awareness?
There are no health risks or side effects associated with fertility
awareness.
Is fertility awareness reversible?
Yes. Fertility awareness does not have any effects on the male or
female reproductive functioning. Pregnancy is possible immediately
following the practice of fertility awareness.
How much does fertility awareness cost?
Fertility awareness is free to inexpensive. Free training sessions
are usually available around your community through health centers,
pregnancy services, or some churches. Thermometers used to measure
basal body temperatures cost between $10 and $15 and are available
at local drugstores, grocery stores or supercenters. You may use one
of your home calendars to record this information, or you can purchase
a fertility awareness chart which cost approximately $8.
What about fertility awareness and sexually transmitted diseases
(STD's)?
Fertility awareness does NOT provide any protection against sexually
transmitted diseases.
Are there any other physical signs of ovulation?
Your fertility period may be identified by paying attention to other
functions of your body. Fertility and ovulation are sometimes tracked
or noticed by women who:
- Experience a change in the cervix
- Have a slight one-sided pain in the area
of an ovary
- Softening of the cervix
- Breast tenderness
Fertility awareness is an acceptable means of birth control for couples
who have religious concerns related to contraception.
Fertility awareness is also used by couples who are trying to get
pregnant. It helps you target your reproductive efforts at the best
times to get pregnant.
What are the pros and cons of fertility awareness?
- The Pros of Fertility Awareness include:
- The Cons of Fertility Awareness
include:
- Requires diligence from both partners
- Requires periods of abstinence or backup
contraception for approximately 1/3 of the month
- Requires consistent and accurate record
keeping
- More challenging for women with irregular
cycles