What Do You Call People Who Use Natural Family Planning for Birth Control?
Parents. HaHaHa. It’s a joke I heard alot growing up and even more in my OBGYN training days. There’s a long story behind the joke, but we will skip it because today we have better science and a strong consumer voice that syas I don’t want artificial chemicals in my body, but I want control over my fertility. We worked out the science decades ago, but we are finally putting it in packaging that people find easy and accessible. So, we’ll go through the less effecrive versions and then move forward to the more effective versions.
The less effective: 80%
Pull and Pray: I’m not sure this is a “method” per se, but it doesn’t work great and there are viable semen in preejaculate fluid and this requires a great degree of self control and awareness, so …
Standard Days: This is based on the concept that if the menstrual cycle is always 28 days, then it must be true that the fertile window is always day 9-15. The number of women whose cycle is so regular that this can be used effectively is fairly small. Also, around times of stress, postpartum, breastfeeding and perimenopause, it’s completely ineffective. That said, if you want the absolute simplest method and you are someone who knows your period starts every 4th Tuesday at 2 pm, this may work for a time for you.
The more effective: 90-95%
Basal Body Temperature: This method works because progesterone produced after ovulation causes (at least) a 0.4 degree rise in temperature. That rise can be detected using a babsal body temp rated thermometer. If you do this every day and plot it, you can see this rise pretty easily. There is one small catch. You must take your temp every morning at roughly the same time after you have been lying down for at least 6 hours and before you get up and start moving. While this method works well for identifying when the fertile window closes, it does nothing to identify when it opens. When doesn’t it work - if you aren’t ovulating at least somewhat regularly, there will rarely be “ok” times for sex for avoiding pregnancy. It can also be interferred with by anything that causes a fever and possibly even by changing locations - hotels, camping, sudden weather change … Mainly, it’s a fair amount of work and I long for six hours in bed many nights.
Billings/Creighton : The most effective of the old school NFP methods. I would argue you don’t need any of the new school tech to get better, but those do alot of the charting work for you. This method has women monitfor their cervical/vaginal secretions for signs of fertility. Sperm can live in the vagina for up to 6 or 7 days under the right conditions. The right conditions are the presense of cervical mucus. This usually shows up around cycle day 8 and lasts until 24 hours after ovulation. The vagina will be “dry” in the immediate aftermath of the period. Cervical mucus shows up and the vagina feels “slick” or “wet” and that mucus then becomes stretchy and completely clear. After ovulation, that will go away and be replaced by a mucus that is white to yellow and more clumpy. It’s not stretchy. Once this is here, you are good until the period starts again. Because this method is so flexible, it can be used in the postpartum period, breastfeeding, perimenopause and beyond. There are companies that make cute charts and stickers for tracking as well.
The New Kids on the Block: 90-95%
The Oura Ring: Tracks your body temp, but you have to figure out what to do with that.
The Marquette Method: Adds a fertility monitor to Billings/Creighton - I think this is honestly more useful for achieving pregnancy than avoiding it, but helps to narrow the days you avoid intercourse.
Natural Cycles: An app that uses your Oura Ring, or iWatch or their own BBT thermoteter that connects to the app via bluetooth to take all of the math out of doing it on your own. The app is FDA approved for pregnacy avoidance. Again, this is most helpful for people with regular cycles and probably not great if you have a new baby in the house.
Mira: More for achieving pregnancy than avoiding it, but it uses urinary hormone tests to predict your fetile window.