Fertility awareness:
We’ve come a long way since the rhythm method
By Tricia Ballad
We've come a long way since the rhythm method of the 1920s, which was based on a one-size-fits-all theory of fertility. It worked -- as long as your cycles were exactly 28 days long and you ovulated right on schedule at day fourteen. Women's cycles being what they are, it's no wonder we're still living with the old joke: "You know what they call women who use the rhythm method, don't you? ‘Mothers!’"
The Fertility Awareness Methods (FAM) available today work on a completely individualized level. FAM is based on the fact that our bodies exhibit observable symptoms of fertility, and by accurately observing those symptoms we can determine times when we are more or less fertile. Unlike men, women’s reproductive capabilities aren't always “on." In fact, most women are only fertile for six to 10 days out of the month. Once a woman knows whether or not she is fertile at any given time, she and her partner can act accordingly to achieve or avoid pregnancy.
Philosophically, FAM gives women a greater awareness of the changes their bodies go through day by day. It also allows men to become active participants in family planning. Fertility becomes less of a "female issue" to be dealt with between a woman and her OB/GYN and more of an issue to be managed by couples.
| Method Typical Pregnancy Rate per 100 Women
Chance (no method) 85%
Sponge 28% (women who have given birth) Spermicides 21% Periodic abstinence 20% (including couples who broke the rules) Withdrawal 18% Cervical cap 18% Diaphragm 18% Condom 12% IUD 3% Pill 3% NET 0.4% Female sterilization 0.4% DMPA 0.3% Fertility Awareness Method 0.22-1.2% Male sterilization 0.15% Norplant (6 capsules) 0.04% Norplant-2 0.03%
Source: A Literature Review of the Effectiveness of Natural Family Planning, Seth Goldstein, DC; cited in Mothering magazine, July/August 2003.
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Non-hormonal alternatives
Up until a few years ago, I was (like most women) unaware that viable alternatives to barrier methods and hormonal birth control even existed. To be honest, barrier methods were mood killers for my husband and me. I would start taking the Pill, then stop after a few months because I hated how it made me feel: artificial. I didn't like feeling dependent on these drugs. I would become depressed and stop taking them because I was too tired all the time to even think about sex anyway. A few months later, I would start feeling better emotionally but dreaded every physical encounter because of the awkwardness of condoms and the fear of pregnancy. We hated the cycle but didn't see any alternative. When I consulted my doctor, she offered me IUDs or different versions of the Pill. This went on for almost five years.
Then we heard about natural family planning through our church. We were skeptical -- after all, the church is well known for its anti-birth control stance. Of course they would endorse anything that wasn't birth control, right? Tempted by the possibility of breaking out of the cycle we were in, my husband and I immediately began searching for hard, scientific evidence that this NFP thing was legitimate. Uppermost in our minds was the question, "Does it work reliably?"
Ultimately, what we discovered was that when used properly – the same disclaimer used for condoms and the Pill – FAM is more than 99% effective. That’s as effective as the Pill!
The World Health Organization recommends FAM in third-world countries based on its ease of use, minimal cost and reliability. My husband and I decided that if this method could work for couples with little or no education, few resources and everything to lose by creating another mouth to feed, it could work for us as well. So we decided to try it out for a few months.
That first month was a bit scary -- here we were, having "unsafe sex”! We were sure that I'd be pregnant by the end of the month. I had never been so excited to start my period. Yet it was also the moment when I first truly believed that my old cycle of birth control/fear of pregnancy/back to birth control could really be over. After four years, we've never regretted the decision to use FAM. Sometimes the methods can seem difficult, but the momentary difficulties are nothing compared to the problems we experienced with other methods.
Watch future issues of Natural Family Online for further installments in our series on Fertility Awareness Methods, including a look at FAM from a man’s perspective; an exploration of why FAM seems to be so vigorously ignored by mainstream health care practitioners; and FAM methods and techniques.
Tricia Ballad works with Natural Family online. See more about Tricia.
