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As a woman, you’re probably looking for birth control or will be at some point in your life. And maybe you’ve even heard about something called a Fertility Awareness Method, or FAM, birth control. Sometimes this is also referred to as Natural Family Planning (NFP). But what is FAM? It’s simply being aware of your own body’s natural cycles to determine when you’re fertile. It is not just the calendar or rhythm method. Women use this method to attain or avoid pregnancy, as well as just for understanding their own health.
Birth Control 101
Our crazy world has come up with so many methods of birth control. Many of these work against our bodies rather than with our bodies. Often they are split into two main categories: hormonal and non-hormonal. Here are a few basics about the two different categories.
- Hormonal contraceptives (IUDs, implants, “The Pill”) are all designed to trick your body into not producing its own hormones for an extended period; some people are taking these hormonal treatments for decades, which they isn’t how they were ever intended to be used.
- Non-hormonal contraceptives (FAM, barriers, withdrawal, etc.) may have lower pregnancy prevention rates than hormonal contraceptives, but many people are more comfortable with them since they don’t change chemicals in your body. Also, most methods of FAM actually brag success rates as high as the most effective hormonal methods.
If you’d like to know more about these, I have a separate article that talks about different types of birth control and how they work or affect the body.
One of the false assumptions that underlies most modern notions of birth control is that women are always fertile and can therefore become pregnant at any time; women typically aren’t taught anything different. Men are, in fact, always fertile while women only have an egg that is able to become fertilized 12-24 hours in a typical cycle (up to 48 hours if two eggs are released during ovulation). Since sperm can live for up to 5 days in ideal conditions, only seven days would theoretically be considered “risky” in an entire cycle. If we add a couple of days to that in order to give us a little bit of a cushion, we get about 10 days in a cycle which should actually be treated as though a woman can get pregnant. Through charting, you can determine which days those are.
FAM Birth Control Basics
A few methods fall under the umbrella of “Fertility Awareness Method” (or FAM) birth control. Different methods have different rates of accuracy. A few variations include the following, ranging from lower accuracy to higher accuracy.
- Rhythm Method – The rhythm method assumes an ideal 28 day cycle and predicts ovulation (when you are fertile) off of that. As many women don’t have 28-day cycles and even those who do may have other variations within their cycles, this method is relatively inaccurate.
- Calendar Method – The calendar method is similar to the rhythm method in that it is based on a perfect 28-day cycle, though you should be looking at your own past cycles to predict your future cycles. Even if you have regular cycles, they can change at any time so this method, similar to the rhythm method, could use a little more science.
- Temperature-Only Method – The calendar method has you track your basal body temperature (waking temperature before moving) to determine when you ovulate. Most women have a distinct thermal shift just after ovulation which indicates a transition back into the non-fertile period.
- Cervical Fluid Methods: 83% to 95% typical use, depending on method. – Cervical fluid methods are the most accurate so far in this list. By checking the consistency of cervical fluid, a woman is able to determine how fertile she is on a given day.
- Sympto-thermal Methods: 98.4% typical use, 99.6% perfect use. – A sympto-thermal method (note that there are many, but most studies have been done on the Sensiplan method that I am aware of) trumps the others ahead of it in our list. It combines the temperature method, cervical fluid method, and a few other indicators to draw an extremely accurate chart of a woman’s fertility cycle. For the sake of this post, I will be equating FAM to this method because it is the most accurate.
Please note that for the remainder of this course, I will equate FAM to the sympto-thermal method, which is the most accurate and has the highest success rates.
I learned a lot of what I know about FAM through Taking Charge of Your Fertility (TCOYF), by Toni Weschler. It’s one of the most well-known books about this method of birth control. I’ve also found some other wonderful resources, including Facebook communities, NaturalWomanhood.org, and Kindara.com.
How FAM Works
The FAM birth control method has one key aspect to it: charting changes in your body. As I mentioned above, there are a few main components to charting:
- waking (basal) body temperature.
- cervical fluid.
- cervical position (optional).
I chart every day, and it takes about two minutes of my time in the morning (or less, however long it takes to check my temperature), plus a few extra seconds scattered throughout the day. Just jot these down on your chart every day – or put them into an app that fills out the chart for you – and go about your day as usual.
As you learn to interpret these signs, you’ll be able to determine “safe” days. On days deemed “unsafe,” if you follow FAM strictly, you’ll abstain. If you’re less strict, you may use at least one barrier/withdrawal method on these days. Since they are the days that you are most fertile, they’re the times that the failures of birth control methods matter most since they’re the only days you can really become pregnant, so many FAM resources say to use two forms of barrier/withdrawal birth control.
Process of FAM
The hardest part about FAM birth control is learning how to use it correctly. It took me about 3 months to start really recognizing all the changes in my charting and interpreting, and this is the suggested amount of time to wait before going unprotected at any point in your cycle. Some people find it easier to jump all in charting everything from day 1 while others start with the basics and add optional signs (such as cervical position) later.
Let’s clarify a few items before we get started.
- The start of your cycle is your first day of bleeding that requires a cup/pad/tampon (if you don’t know what a cup is, you can read about it here). You may spot (small amounts of usually brown-ish blood) before this day, but that’s considered part of the last cycle.
- Ovulation is typically 10-18 days prior to the start of your next cycle. It’s the day you release an egg.
- The time period between ovulation and the beginning of the next cycle is called the luteal phase, and it typically stays very regular in length for each individual woman, not varying more than 1-2 days naturally.
- An egg is only viable for 12-24 hours.
- Sperm can live for 3-5 days in ideal conditions.
So what are the signs you will be charting?
Basal Body Temperature
Taking your basal body temperature regularly may be the biggest annoyance of FAM, but it is so worth it. If you take your own temperature manually, you do have to take it at about the same time every morning before you start moving around; typically the later you wait, the higher your temperature will be, so you just need to be consistent and relatively early. If you wake up early during the week, you will need to get up around the same time on the weekend for your temperature.
The good news is that if you get a nice thermometer that will save your temperature (like the iSnow I reviewed here), you don’t even need to write it down until later. Even better, there’s an awesome thermometer called a Tempdrop which you just wear overnight and it collects your temperature – check out my review on it here. Speaking of temperatures, you will need a thermometer that can register temperature to at least 1/10th of a degree (Fahrenheit). That’s one that will know the difference between 97.1 and 97.2. Most fever thermometers only measure to 2/10ths of a degree (which would make 97.1 either 97.0 or 97.2), but we need to be much more accurate for measuring fertility. You can find a good one on Amazon that will save your temp so you can record it when you’re actually awake for $10-25.
Sometimes referred to as “cervical mucus” (which I dislike because of the negative connotation of the word mucus) or “cervical discharge,” this is the female equivalent to the male seminal fluid. Cervical fluid ranges from dry (non-fertile) to eggwhite or watery (very fertile). The progression is dry, sticky, creamy, eggwhite, watery.
In checking your cervical position, you will be checking where your cervix lies on the spectrum from low and firm (pre-ovulation) to high and open (post-ovulation). This sign is optional, but the most reliable sign beyond temperature and cervical fluid to confirm ovulation.
Other signs vary by individual, and they may even vary between cycles in an individual so they’re less likely to be reliable. Some such signs include
- ovluation spotting.
- ovulation cramping.
Benefits of FAM
FAM allows you to go unprotected without being on hormonal birth control, and not worrying thereafter if you’ve gotten pregnant. For a few minutes every day, I think that’s reward enough! But there are other benefits, as well, including increasing infertility knowledge and charting to value your health.
One of biggest, non-quantifiable benefits of FAM birth control is understanding your own body and gaining confidence in it. My dad is a doctor, and whenever something happened when I was growing up that required medical attention, his first order of business was to reassure me that I was a “normal human” and everything could be explained by science. Everyone wants to feel normal and understood, and what better way to start than to understand your own basic biology?
Because of the nature of FAM, it helps you not only when trying to avoid pregnancy, but when trying to attain it, or even just understanding your body’s general health. It’s knowledge that will help you in life. Honestly, the general idea of charting is useful to all women.
Most women have non-perfect cycles, where the perfect cycle lasts 28 days with ovulation in the center at two weeks. One of the best parts about using FAM birth control methods and charting is that you can recognize if your cycle is natural, even if its length is short, long, or irregular.
Using FAM, many women find they can predict the start of their next cycles within a day or two, weeks before it even comes, even with irregular cycles. This is because the period between ovulation/temperature shift and the start of the next cycle rarely varies more than a day or two, even because of sickness or stress. No more worrying about if you’re pregnant if you have a long cycle because of stress or travel!
Supplies to Get Started
Resources about FAM birth control are a bit out of the way – it’s not mainstream because it means you have to care about your health every day, rather than hands-off methods such as hormonal birth control and copper IUDs. But that doesn’t mean there aren’t excellent resources with science to prove the method! The best beginner’s book is Taking Charge of Your Fertility, by Toni Weschler. She has spent decades learning about fertility cycles in women.
As mentioned above, you will also need a thermometer that measures to 1/10th of a degree.
Finally, you’re going to need a way to chart. Some people chart in the good old pen-and-paper way, which is perfectly acceptable. There are also countless apps out there. I used Kindara when I started charting, but I’ve recently started using OvuView, which has a cleaner interface and no bugs in comparison to Kindara on Android. OvuView allows you to have custom data points, has easy navigation and, best of all, syncs with my favorite thermometer, the TempDrop.
My Challenge to You
Fertility awareness methods of birth control are all about understanding signs your body is sending you – just like you know that you’re hungry when your stomach growls, or that you’re tired when your eyes get heavy. In my opinion, all women should have access to this knowledge about their own bodies. Rather than having 5th grade girls debate pads or tampons (see the post about my favorite option here), maybe we should teach them a few of these basics and teach them to start charting.
I don’t remember how I found out about FAM birth control, but I’m incredibly grateful that I did because it helped me take a more active role in my health. I would love for this knowledge to be much more commonplace. If you learn about and come to appreciate it as I do, I challenge you to try to share it with at least two friends. If everyone did that, this knowledge could spread like wildfire. It’s incredibly inexpensive birth control, but more importantly, it’s an awareness and understanding of your own body.