Women don’t need to fear using natural fertility awareness methods for family planning

A February 2021 TIME magazine piece about the Natural Cycles birth control app mimicked the skeptical, gloom-and-doom tone of most mainstream commentaries on fertility awareness-based methods of family planning (FABMs). The article trotted out the same concerns about their potential “inconvenience” and difficulty of use, as well as the claim that “it takes a very specific patient to be a good candidate to use FAMs as contraception.” Fortunately for girls and women seeking a hormone-free alternative to conventional birth control, the facts about modern, evidence-based FABMs of family planning are far different from what potential users are often led to believe.

Myth: FABMs are “inconvenient” and “difficult” to use.

The TIME article quoted a Seattle-based OB/GYN taking issue with Natural Cycles’ utilization of the woman’s waking temperature each day. She stated, “Taking your basal body temperature should be done before you move out of bed in the morning. And depending on how well you wake up, getting that accurate reading is really difficult and usually takes months of practice, because you literally have to do it before you get up to pee or move your body. So you have to reach over and take your temperature and then have the wherewithal to record it as well. It’s difficult for most people to do.”

Portraying the taking and recording of one’s own temperature as “difficult for most people” is arguably an exaggeration, not a statement of medical fact — especially given the simplicity of typing it straight into an app. Why should a woman who is considered capable and motivated enough to take a birth control pill each day be incapable of checking her own temperature?

In a world where women in particular often pay extraordinary detail to the food they consume and the chemicals in the products they use, the “inconvenience” and “difficulty” arguments don’t hold water. Certainly, women have other fertility awareness options that do not require a daily recording of one’s temperature, but automatically assuming that many or most women are incapable of this basic task is patronizing.

Myth: Very few women can use FABMs to successfully prevent pregnancy.

While the TIME article acknowledges Natural Cycles’ admirable effectiveness rate when it comes to pregnancy prevention (93% with typical use, comparable to the birth control pill, and 98% with perfect use), it quotes several medical professionals downplaying the statistics with various what-if scenarios.

One provider states that “If you’re someone who has irregular menses, or sometimes skips periods every other month, or has longer or shorter cycles, then this can make tracking your periods very difficult.” She adds, “An app (like Natural Cycles) does not take into account travel that you might be doing, stress from working night shifts, stress from childcare, stress from being in a COVID-19 pandemic, stress from an argument that you had at work, and all of those things can significantly affect your cycle.” She concludes, “These aren’t things that would necessarily be tracked in a fertility awareness method application, and a particular stress could make the fertility awareness method unsuccessful.”

READ: New Georgetown elective will educate future doctors on fertility awareness

The article fails to mention that Natural Cycles’ app takes into account the possibility of irregular periods, sickness, and more, and still boasts the effectiveness rate mentioned above. Other evidence-based FABMs also have similar pregnancy prevention rates even given the factors listed above. The single most important factor for pregnancy prevention when using an evidence-based FABM is learning the particular method from a trained instructor, who can answer follow-up questions and help the woman understand her own body as she begins to put what she learned into practice. Certainly there is a learning curve when a woman begins for the first time to get in touch with the natural patterns of her own fertility and infertility, and a trained instructor can help her interpret the signs and identify what she sees.

Here’s the truth: FABMs teach women to get in touch with their own bodies.

At one point, the TIME article accurately captures the beauty of FABMs, quoting a healthcare provider who says, “[FAMs] really allow the patient to become more aware of her own menstrual cycle and have a much greater awareness of her own body and her own fertility in a way that does not necessarily happen if she’s on some type of prescribed contraception.” This is exactly the message that truly pro-life, pro-woman health care communicates.

Women’s bodies are inherently beautiful, not broken, and fertility is actually an indicator of overall health, not a liability or a burden. Learning the natural patterns of fertility and infertility in their own bodies and utilizing that knowledge to plan their families empowers women at their core, in a way that suppressing, altering, or destroying a functioning reproductive system never can.

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