What is it? When used as birth control, it involves using body signs to estimate when a pregnancy is most likely to occur and avoiding intercourse or using another birth control method such as condoms on those days of the menstrual cycle. It can also be used to help someone get pregnant.
Effectiveness: approximately 76% effective in typical use.
Price: No immediate cost
Other information: It is difficult to tell for sure when the “safe” times are, especially if you have irregular periods. Things like stress, illness, travel, and aging can cause your cycle to change. It is most effective to use condoms during the safer times and have no sex during the unsafe times.
What is Fertility Awareness?
Fertility awareness (also called natural family planning) is a way to predict when in the month you are more or less likely to get pregnant. Fertility Awareness methods (FAM) are based on body signs, which change throughout the month. Almost all pregnancies happen from sex in the 5 days before you ovulate (release an egg) and up to 1 day after. Fertility Awareness helps determine when ovulation happens so that we can avoid intercourse or protect themselves in another way, like using condoms, during that time.
The main body signs that are used in FAM include tracking past periods, basal body temperature (the temperature when we wake up after at least 6 hours of sleep), and how our cervical fluid feels and looks. These signs are written down on paper or an app to learn when we are most likely to be fertile (able to get pregnant).
How effective is Fertility Awareness?
Fertility Awareness methods have a high failure rate compared to other forms of birth control. They are about 76 percent effective in actual use, which means that an average of 24 users out of 100 get pregnant when using them for a year. This is because they can be hard to use, take a lot of work, and if we make a mistake we can be having unprotected sex when the risk of pregnancy is highest. FAM can also take time to get used to; it can be good to track cycles for several months before relying on it as a form of birth control.
FAM is also only as effective as the method that we use during the fertile times when we can get pregnant. Condoms and withdrawal themselves have a high failure rate (condoms are approximately 82-85% and withdrawal is 73-78 percent effective in actual use), and so using these when we are most fertile can lead to unintended pregnancies over time. The most effective way to use FAM is to not have any sex at the time you might be able to get pregnant, which can mean no sex for up to 12 days of the month (technically its only 6-7 days, but we can’t always pinpoint exactly when that is and so may need to add a few days to be more sure – how many extra days depends on how clear our body signs are).
What are the advantages and disadvantage of Fertility Awareness?
Compared to other birth control methods, fertility awareness methods are inexpensive, don’t require a prescription, and there are no health risks or side effects (outside of the ones associated with unintended pregnancy due to its high failure rate). They can also help us learn about our body, know when we are pregnant, detect certain kinds of health conditions, and are an excellent tool for helping us get pregnant when we want to be. In some cases it can even develop greater communication, cooperation, and collaboration between partners.
However, it also comes with some disadvantages. It has a relatively high failure rate and can require periods of abstinence (up to 12 days a month) to be most effective. The effectiveness can also be impacted by many different life circumstances:
- Even people with a regular period can have ovulation happen at a different time from one month to the next
- The texture and appearance of our cervical fluid can be masked by semen from past sex, vaginal infections, lubricants or spermicides, or even our own natural lubrication when we have sex
- Our basal body temperature can be altered by sickness or waking up in the night
FAM can also require a significant amount of work and time, particularly when someone is first learning the method. It requires high commitment levels from both partners and good communication. It provides no protection against sexually transmitted infections (STIs), usually cannot be started quickly and reduces spontaneity in sex.
FAM may not be a suitable option when someone has difficulty abstaining from unprotected vaginal sex during fertile periods, their partner is unsupportive or not committed to following the method, they have frequent vaginal infections or circumstances in their lives that affect body temperature regulation (fever, insomnia, irregular sleeping habits, a tendency to wake up in the night, shift work), they have unpredictable or irregular periods, they are at high risk of getting an STI or they really need to not be pregnant for health or personal reasons (where a more effective method would be recommended).
Myths about Fertility Awareness
We ovulate 14 days after first day of period: although this is a rough guess of when ovulation happens, the timing of ovulation can differ from person to person and month to month. This means that just knowing when your last period was (this is sometimes called the Calendar Method) is not enough information to do Fertility Awareness effectively.
The app on my phone can predict when I am fertile: unless you have an app that also tracks your basal body temperature (your temperature when you wake up) and changes to your cervical fluid, then app is just guessing when you’re fertile based on your past periods and on the myth that we always ovulate 14 days after the first day of our period.
“I just know when I’m ovulating”: although you may have other more subtle ovulation symptoms, these symptoms are not usually accurate enough to prevent pregnancy effectively. You are also more likely get pregnant from sex that happens before you have those symptoms, as sperm can live inside the vagina and uterus for up to 5-6 days.
Planned Parenthood: www.plannedparenthood.org/learn/birth-control/fertility-awareness
Options for Sexual Health: www.optionsforsexualhealth.org/facts/birth-control/methods/fertility-awareness-method/
Taking Charge of Your Fertility: www.tcoyf.com