Fertility awareness, or natural family planning, has been used successfully since the 1930's to predict a woman's fertile days. These methods include the old calendar rhythm method and sympto-thermal or basal body temperature methods, as well as newer techniques such as the standard days method (CycleBeads), the TwoDay method and fertility computers.
Fertility awareness 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. These techniques are sometimes called periodic abstinence. 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.
Unfortunately, doctors are reluctant to recommend fertility awareness methods for a variety of reasons. Although recent studies report adequate failure rates for natural methods, national surveys find fertility awareness methods among the least effective. This is due in large part to inadequate support from medical professionals in using these methods. For example, when doctors were asked by a patient for information about natural methods, most described either calendar rhythm or basal body temperature methods, rather than newer, more effective fertility awareness methods. In another study, nurse-midwives also offered little information on natural methods, based on their perception that these are not effective or not right for their patients. In a recent annual report, Planned Parenthood Federation of America reported providing fertility awareness-based methods to only 0.2% of clients seeking contraceptives, whereas hormonal methods were provided to 64%. Thus, there appears to be much provider bias against natural methods.
The newer natural methods listed in this section are as effective as artificial contraceptives. Additionally, users of these methods tend to be as satisfied with NFP as users of any other non-surgical, non-prescription methods, as indicated by comparable annual continuation rates.
Most surprise pregnancies are due to risk-taking — having sex during identified fertile periods — rather than an inability for couples to properly interpret patterns of fertility. Many other failures are due to improper teaching and poor use. Many couples opt to use a condom or cervical barrier method during fertile periods, which is safer than risk taking, but will still decrease the effectiveness of these methods.
| Chances of Pregnancy by Day of Intercourse (day zero is ovulation) | ||||||||
| -5 | -4 | -3 | -2 | -1 | 0 | 1 | 2 | 3 |
|---|---|---|---|---|---|---|---|---|
| 0% | 11% | 15% | 20% | 26% | 15% | 9% | 5% | 0% |
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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