Sunday, June 3, 2012

Fertility Awareness

I’m going to get a little more personal in my post today, with the upfront disclaimer that I am not making recommendations for anyone --- just sharing my own experiences. 

Before we were even engaged, Cam and I decided together that when we got married we would not use traditional hormonal birth control.  (Er, traditional for the last few generations).  There is a lot of hype in the political news recently about birth control, and there has been on and off since the women’s movement.  Although Cam and I are religious people, our decision was not based primarily in anything religious, which is why it is a shame to me that a decision not to use the pill is often automatically associated in the public mind with some sectarian injunction.  There is nothing wrong with a couple making such a decision based upon their religious or moral values, but there is a broad set of reasons outside of any religious realm that they might consider doing so.  Understanding those reasons might open up a new door for couples who don’t feel that hormonal birth control is for them.

These are the reasons we did not want to use hormonal birth control.  (I acknowledge that for many people, it works just great):
  • Most simply, I did not want to throw off my body’s hormones.  Whether or not birth control would make me moody and unpredictable, whether or not there were any visible harms, I don’t know enough about those chemicals to trust them with my body.
  • I did not want to deal with the various side effects associated with every hormonal method, however benign.
  • I have been a little concerned about potential permanent changes that hormonal birth control can cause in the body.  A couple friends have had trouble getting a regular period again once going off birth control, and have had great difficulty conceiving.  Would that be me?
  • We wanted to be able to choose, without having to undergo any procedures or wait for a regular cycle to return, when we would conceive our children.
  • Cam agreed with me that traditional birth control is not fair.  He is fertile 100% of the month, while I am only fertile 2 days of the month.  So I should be the one chemically to alter my body in order to avoid conception?  We felt it should be a joint responsibility.
But I believe in responsible parenting, and in God-given agency, which led me to feel strongly that Cam and I should choose when we conceive our children.  It is under this same philosophy that most people use birth control.  So we researched the Fertility Awareness Method (FAM) before we got married, and I learned things I always should have known about my body and the reproductive process but that I never knew because people don’t talk about them because they assume you will just use regular birth control someday.  The basic philosophy of FAM (when used as birth control) is that a couple should be aware 100% of the time if a woman is ovulating or nearing ovulation, and when she is no longer fertile each cycle.  They should base their intercourse responsibly upon their data.  Some couples choose to abstain during the fertile period, while others use a barrier method. 

Here are some important basics to know when embarking upon FAM:
  • The woman’s body is only fertile roughly 48 hours of her cycle, during ovulation.
  • Sperm live typically 3-5 days from the time of intercourse (yes, you can get pregnant while out for a jog a few days after the fact…)
  • Every woman’s body ovulates differently, though 14 days into the cycle is a rough average for most women (WARNING: FAM is not the same thing as the Rhythm Method, which is based on a set 28 day cycle that simply does not apply to all women.  Read on to find out how to use FAM for much much greater accuracy)
  • A woman’s body temperature rises about a tenth of a degree the day after she ovulates, and goes back down at the beginning of her next period.  If her temperature fails to drop again for an unusual amount of time, she is pregnant.
  • Cervical fluids increase in thickness as a woman’s cycle approaches ovulation, and the cervix begins to soften and open.
  • A woman’s cycle can see irregularities if she undergoes stress, or a big life change, etc.  Or some women are just irregular.  One cannot depend on the calendar to predict fertility.

Unprotected intercourse should cease 5 days before ovulation (we do 6-7 days before for absolute security), and should not resume again until 48 hours after ovulation. 

So how do we know when I will be fertile?  There are four ways which, when combined together, make for perfect accuracy.  I Will Not Write All The Details Here Because If You Are Interested In FAM You Need To Prepare Yourself to Practice It Responsibly By Reading Up.  I keep a detailed chart every month of all the following.  It really takes no time at all:
  • It might sound like a pain, but this is not any harder than popping a pill every day.  Every morning when I wake up, I take my temperature and write it down.  (Funny story, when I started charting a few months before marriage, I woke up in the middle of the night a few times to find myself taking my temperature.  Yes, I sleep-chart).
  • I monitor my cervical fluid throughout the month, writing “dry, slippery, stretchy, etc.” on my chart every day.
  • I monitor the position and softness of my cervix, by feeling inside.  This measure and the preceding one don't take any extra time.  I just check them when I am using the bathroom once a day when I am approaching my fertile time.
  • I keep track of previous cycle lengths to get an idea of how long the next might be.  Do not use this method alone, but it helps when combined with the other three.  If you are really expert, you can also keep track of moods and cravings.  But these are not as scientific as the first three measures.

FAM will fail you as a birth control method in the case of human error.  The pill or other birth controls can fail you too, even if you make no errors on your end.  FAM is as reliable as you are.  You are leaving nothing to chance.  That’s comforting, no?

I can think of only one time I made a miscalculation on my charting.  It was the only time that 1) I wasn’t meticulous in my estimate of when I would ovulate and 2) Cam wasn’t fully aware of where I was in my cycle.  (This really is a team effort).  That was the time I got pregnant --- a highly unlikely scenario when you know all the details.  I actually noticed my error before I knew whether I was pregnant or not, and prayed that I wasn't.  But then my temperature never dropped.  I feel God led us to this, especially now as I write about it while nursing my beautiful baby boy.  Unlike many other birth control methods, FAM if practiced properly cannot fail you.  It’s physically impossible. 

Incidentally, if you are trying to get pregnant, you can use FAM to predict ovulation to time intercourse for the optimal chances of conception.

These are the reasons we have loved FAM:
  • No crazy hormones, no undesirable side effects.  It’s natural. 
  • Cam is aware of my body and its patterns.  We are a team.
  • In the beginning, we practiced abstinence during the fertile period for greater security (although one can use a barrier method), and found that we enjoyed discovering many varied ways to show love to each other.  Cuddling on the couch, kind words and acts of service, some old-fashioned kissing, etc.  We also found that it keeps a little spark alive to have some anticipation build a bit every month.  I have heard some orthodox Jewish friends talk about this as well, since intercourse is off limits for them during menstruation and a little afterward each cycle. 
  • It keeps our thoughts and hearts focused toward God on the question, “When should we conceive a child?”  Although intimacy is important for a couple for many reasons, it is inherently connected to child-bearing.  FAM helped us maintain that connection in our hearts.
  • The best reason on my end: I learned so much about my body.  I didn’t even know what my cervical fluid was before I started studying, let alone what its purpose was, let alone that aberrations in your normal pattern can signal that something is wrong.  (Women have caught cervical cancer before because they were practicing FAM).  Even if you don’t want to use FAM as a birth control method --- and the only reason not to, in my opinion, is that it takes a bit of conscious effort --- it feels fantastic to chart your body’s patterns and be aware of its cycles.  Our wonderful bodies need our detailed attention.  If we give it to them, we learn to love them more.
Finally, a note on postpartum FAM.  I have done a lot of research on this, and although people say it is possible to practice FAM postpartum, I believe the only real security is in abstinence, a barrier method, or traditional birth controls until a regular cycle resumes.  Breastfeeding is not reliable birth control.  My recommendation, if searching for natural birth control, is to use a barrier method until your regular cycle resumes and you can begin charting again.

Thanks for bearing with an intimate post.  I share these things because they have been very important to me in my journey toward natural living, and because they have given me confidence, joy, and a sense of empowerment.  Knowledge is beautiful. 

To learn more about FAM, and to understand how to practice it correctly, read this book.  Or to understand your cycles and hormones and what's really happening to you every month.  Or read it anyway:

p.s. I had fun choosing labels for this post.


  1. I love the site for keeping track of things. It's largely responsible for my being able to conceive my last two children (after 4 years of nothing).

  2. I am a huge fan of Toni Weschler's book. I recommend it to all my friends whether they are trying to get pregnant or trying to avoid. I think it is very empowering for women to understand their body so well.

    1. It certainly is empowering!

      I told my doctor at my prenuptial check-up what we were planning for birth control. He basically told me I was naive and said he would see me in a few months when I wanted to try something different. (I never went back.) He seemed completely unaware, when I explained it to him, of the various ways a woman can know she when she ovulates and he kept calling it the Rhythm Method (which is based on calendar alone). Believe me, I felt empowered.

      Isn't it great to take charge of our bodies?

  3. I was on birth control for a while, and turned into a monster... It was during Joe's and my engagement. Poor Joe! I remember when it dawned on me why I felt so angry all the time, all of a sudden -- so relieving to know I wasn't going crazy!

    Thanks for posting the information you did, Meredith. I can understand your need to apologize for sharing something so personal, I'm so grateful you did, though, so we can all learn together. Lack of sharing knowledge has lead us to the interesting drought of traditional knowledge we find ourselves in. It's always a little interesting to me when I hear people say things like, "I'm so glad I wasn't born back then! People just didn't know what we know now." Like no one ever knew about the idea of contraception, or real body knowledge. Hah! :) Too bad we are barely scratching the surface of what they really knew. Thanks so much for sharing, Mer!

    1. Cam shared similar anecdotes with me about past experiences with women on birth control. When I asked him how it was that he agreed so readily to the idea of FAM, he first said that he felt it would be best for my body, and then he said, "I don't want you to be crazy."

      I don't remember you being angry all the time. :)

    2. I think you were out of the country during that time. :) I remember one night sitting in front of a restaurant with Joe, crying because of our dinner plans, which consisted of having dinner with Jamie and Melissa (the twins). For the life of me I could not figure out why that would make me so angry -- and it sort of makes me laugh now. Later that night I was crying again to Joe, telling him I just didn't feel "right", I was experiencing emotions that just weren't me. That's when we figured it out. I had only been on the pill for two days at that point.

      I've wondered, and this may sound silly to some, how many marriages would have been made a little easier, and would have made it if men and women knew what those added hormones were doing to women. From my own experience, I wouldn't have blamed Joe at all for calling off our engagement at that point. Luckily we're both big proponents for talking about everything. I didn't want to be so angry, but it really was like there was a monster inside of me, and the only way I could come close to controlling it was by not speaking at all, to anyone. I just felt rage at everything people would say to me.

  4. Ahh yes, is a life-saver. Erin and I can both attest to that! I'm also in the camp of losing my cycle altogether for 1+ year following a synthetic hormone birth control pill. After I learned how to use the website to track all of the markers you indicated, I thought, "why did I ever take those dumb pills? Nobody should! Everyone should know how their cycle works well before being pregnant." I hope my sisters figure it out sooner.

  5. Yes! I love that you posted this and I love taking charge of not just our fertility, but our bodies and knowing what's going on in there. I love that you shared this book with me and now I tell all the married women around me what's going on with their bodies. :)

    Just for kicks and giggles, here's a fun video clip that Disney did on "The Story of Menstruation" back in the 1940s. The video is about half way down the page. If you have 10 minutes it will definitely bring a smile to your face. Taking Charge of Your Fertility is perhaps slighter more informative. Haha. Enjoy!

    1. Wow, love that. What has happened to Disney since the good old 40s?

  6. Thanks for this thorough overview of FAM, Meredith, and for sharing your story. I also love the other book you recommended when you first told me about FAM, "Honoring Our Cycles" by Katie Singer. It's not the text that Weschler's book is, but a simple and understandable introduction to women's health.

    You win the label prize.

  7. Thanks so much for this post! I have been thinking about going off the pill recently but was worried about finding another birth control method since my husband and I are NOT ready to have a baby at this point in our marriage. Your post was super-informative and really made me excited about the possibility of using FAM!

  8. Thank you for sharing this! I started on birth control the month before I got married and got very sick physically and emotionally. I obviously stopped taking it as soon as we pinpointed the problem. We have been married 10 years in bad I didn't know about this 10 years ago!