Wednesday, March 18, 2009

Fertility Awareness Method (FAM)

I think this is valuable information, so I am sharing it at this week's WorksForMeWednesday (click the link to see what works for other people!)


A few people commented that it was interesting that I knew my date of ovulation, or was aware enough of my cycle to know to take a pregnancy test at scarcely 4 weeks along. I've also heard over and over that "Natural Family Planning" only works "sometimes" or isn't very reliable.
So today I'm here to set the record straight.

Myths about the Fertility Awareness Method / Natural Family Planning

FAM/NFP is based on your past cycles, so if your cycles vary from month to month, or if you have cycles that are longer/shorter than 28 days, it won't work.
I think a lot of people have heard of the old fashioned "rhythm method" which involves counting days from the beginning of your last period, and then making assumptions about when you'll ovulate. FAM does no such thing. FAM relies on observing (and then writing down) your fertility signs in this cycle, and determining on a day-to-day basis whether you are fertile or not. So your cycle can be different every single month and FAM will still work for you.

FAM/NFP fails a lot as birth control
Only if you are intimate on days you are fertile. There are two ways to practice NFP--one is to determine potentially fertile days and then abstain on those days--this always works. The other option is to determine the fertile days and then use condoms or something of that nature on those days--this has the same failure rate as the condom or other method.

Is is a lot more effort than something simple like the pill or just using condoms
I happen to really like using NFP for my family planning, because it means that if we change our minds one way or the other, we can switch from 'preventing' to 'trying' (or visa versa) on a moments notice. No devices to remove, no waiting for hormones to clear out of my system, nothing. I find it superior to long-term use of condoms because, let's be honest, who likes using condoms all the time? With NFP I know whether or not I'm fertile, and the rest of the time we don't have to worry about using 'protection.' Also, NFP has absolutely no side effects: no weight gain, no mood swings, nada.

Charting is a big hassle and takes a lot of time
I put in around 2 minutes a day. It's faster than my morning shower or brushing my teeth, and I don't know anyone who says that those are too much of a hassle!

There is no point in charting unless you are specifically trying to get pregnant/avoid pregnancy
I have found it enormously helpful even in months where I didn't care if I got pregnant or not. I happen to have irregular cycles--they might be 26 days or they might be 36. Usually it's somewhere in the middle, but it is different every month. But when you start charting you'll learn a secret: the follicular stage (between your period and when you ovulate) can be of a different length, but your luteal phase (from ovulation until the next menstruation) will always be the same. SO, if I know which day I ovulated, then I know precisely which day to expect my period. Every month. For someone who HATES to be caught off guard by good old aunt flow, this is awesome and oh so empowering.

I can't chart because I wake up in the night (baby, bathroom, etc), or I work a night/swing shift
This one is somewhat true. In order for a temperature to be accurate for charting purposes, you should have completed 3 or more hours of sleep prior to taking your temperature. If you often wake at 3am though, it's ok to take your temp then. If you sleeping during the day and wake at 5pm, you can take your temp then. The point is not so much about what time it is, as it is about being consistent. If you are often consistent, but just have occasional off days (sleeping in on a holiday, or when a child is sick for example) then you can just skip temping on that one day, and use the overall pattern of the rest of the days.
My 2yo Bear is still waking in the night with some regularity, and that has affected my own sleep patterns of course. So even though I had begun temping, and was able to see somewhat of a pattern, it was a little bumpy. It helped me narrow things down, even though I wasn't always sure quite to the day, I did know within a couple of days.

(if you have other questions/things you've heard, please leave them in the comments and I will add the answers to the post here)

So what are these fertility signals that we charting ladies monitor?
  1. Take a BBT (basal body temperature) each morning upon awaking. The hormonal surge at ovulation causes a sharp jump in BBT, so on the morning after you ovulate your BBT will show it.
  2. Observe the cervical fluid (CF) that is excreted over the course of the cycle. During fertile times, the CF increases and has a stringy consistency much like eggwhite--this is because the body is trying to facilitate conception by making the route easier for the sperm.
  3. Take note of other symptoms such as cramping, breast tenderness, increased/decreased libido (the hormonal shifts affect this--libido usually surges in the most fertile days).
  4. Some (not all) women take note of their cervical position. This involved sticking a finger in there and feeling your cervix. During fertile times, it gets softer and opens up a bit. (Yes ladies, your body wants to get pregnant each month, even if you don't.)
  5. For those who are trying to conceive, we also make a mark to indicate which days we "baby danced" or BD. This way when we do get pregnant we're better able to pinpoint the actual day of conception, which is darn handy.

If you think all this fertility awareness stuff is worth looking into, I strongly recommend getting your hands on Toni Weschler's book Taking Charge of Your Fertility. It is the quintessential FAM book. There are others that teach pieces of the method, but this is the most complete one I know of. It has extensive information about using FAM for birth control, pregnancy achievement, and just plain reproductive health and awareness.


Mallory said...

I'm always getting eyes rolled at me when I say I practice NFP/FAM. Some people just don't care to understand how great it really is!

Katrina said...

I LOVE FAM because at long last I understand what my body is doing. The feeling out there is that women's bodies are a mystery, which is what I felt about my irregular cycles for many, many years. But, if you know this information it is INCREDIBLY empowering, whether you are TTC or not. (Oh, and I agree that as a b/c method, this is much better than flooding my system with hormones.)

Kim H. said...

Oh my gosh - I'm going out today to get this book! I'm in the midst of an infertility struggle, and I need all the help I can get. Sadly my doctor just put me back on the pill... but I'm only giving him one month to see if his remedy works.

Jessica said...

Visting from WFMW. I practice a watered down version of FAM and love it. It's nice to not have to deal with hormones but still know when we need to use protection. I am currently TTC so it's mighty helpful for that too!

Kelly said...

One reason I went away from trying to chart was because I almost never stay in bed or asleep for the full night - before kids, I used to get up for bathroom trips or just wake up and be restless for a while around 5 before falling back to sleep and getting up an hour or two later, and after kids - well, we co-sleep, so I don't think I've slept straight through for years! ;-) So I was never sure that my basal temperature could be consistent with all that waking and getting up and such - is that true or not? I had trouble noticing a consistent jump when I tried it for several months, so I don't know if it was working for me.
I should mention I had that book or a very similar one, but I lost it when we moved and never got another copy.

Mommy Bee said...

Kelly, I've responded to your question back in the post now...yes, having an irregular waking pattern can make it difficult to take accurate temps. If you are open to just being generally aware, you can just observe CF and have a pretty good idea of what is going on. If you need to know more exactly, there are ways to improve your chances of accurate temping (even with night waking).

Future Mama said...

I'm excited about this!! I just may try it as a method of BC... When I wouldn't mind getting pregnant anyway that is! haha. But weren't you a little off with getting pregnant with this little one? hmmm hmmm ;)

Mommy Bee said...

Future Mama, just for clarification, this month I had two things affecting my normal signs--a nightwaking toddler, and the fact that I had post-miscarriage hormones still clearing out of my system. That means I didn't have a good 'start' date to count from (as one usually would with a normal period), and I was not always able to get reliable temps.
I WAS watching my CF, and since we wanted to get pregnant, I was pretty sure of when I was fertile and we timed things accordingly. The part I was not sure of was my exact date of ovulation--I was pretty sure it was one of two days, but wasn't sure which. For the first week after ovulation I really thought I was probably pregnant (based on the fact that I had several high temps in a row, which is unusual for me), but then I was not having my other normal early symptoms, so then I concluded that I must not be pregnant.
When I was a day 'late' I wasn't totally sure if I was late yet or if my ovulation had been a day off of what I thought. It turns out the latter was true, but it was close enough that I still got a + on the test. :) By that point I had more or less convinced myself that I wasn't pregnant (it's easier than the monthly letdown I usually have) so the + was a pleasant surprise--but honestly, not a very big surprise. :)

Jenny said...

I did NFP, when we were having infertility issues. It turns out I'm a sperm killer, so that method didn't help, but now 5 years later I still remember the NFP stuff.

I don't chart or take my temperature, but I no the signals of my body. I really wish I didn't! LOL!

Lisa said...

I've temped and charted in the past too, even though I also have infertility issues and have never gotten pregnant. Charting enabled me to see that while I do ovulate every month, my temperature rises very slowly, and my ovulation is probably "weak".

Even though I no longer chart because I am not ttc and doing so would make me insane, I am still keenly aware of my body signs. I always know when I am about to or have ovulated, and when my period will come. (I am very regular.)

Sanity said...

I have charted for years and I LOVE the freedom it gives me to know my body. What I HATE is going to the clinic for a free pg test and getting a glare and an eyeroll when they ask me what bc I use and I tell them NFP, so then they assume I'm some dumb kid who doesn't know shit.

Sorry, that was off topic. But I love being able to chart and know when I am pregnant.

Keya said...

That's what I do too. I read that book. It helped a lot. Also the website is a great help for all that is new to this.

Misty said...

well, you officially have a new blog stalker, lol! i happened upon your friend's blog (babymaking machine) and her post about being crunchy, chewy, or soggy, and i just loved what you had to say. all that being said, i've been on your blog for over an hour reading thru some past posts, but i wanted to ask a specific question regarding NFP. mind you, i've never technically taken a class or read a book (this one sounds like an awesome place to start); just done a bit of internet research (sketchy, i know) and have tried to figure out what my body's doing. none of my pregnancies have been "planned" per se, but that's not to say they weren't welcome. w/ my first i simply got off BC b/s i was finally at a point where i knew it was NOT ok for my body or my spirit. i got pg w/ #2 when #1 (whom we also call bear on my blo and is just a month or so older than your bear!) was 7 mo old. i had been charting what few things i could: CM and temps, but there were 2 things going against me: i was exclusively BF and so hadn't had a period, and i was night waking due to cosleeping. and basically that happened this time as well, getting pg w/ #3 when #2 was 9 old. so my question for you is when you arent' having a period and you don't know if your temps are reliable due ot the night waking, is there any other way to figure out your cycle??? i mean, i know what egg white CM looks like (but i also know that sperm, ahem, can feel similar!) but i guess i feel like i've never given my body a chance to tell me what it does b/cs i've just gotten pg so quickly. does this make sense? we are NOT desiring a 4th baby in teh near future (possibly not at all) and i'm still opposed to hormonal BC, so i really want to make NFP work for us in preventing pregnancy til we feel led another way. any insight you can give would be very helpful! i love your blog and will back to browse some more!

Mommy Bee said...

Hi Misty,
the book TCOYF does have a set of rules to use for charting while breastfeeding and also for irregular sleep patterns. I know that both of those things can really throw off normal temps, and yeah, CF can be obscured by other fluids. ;) There is also a set of rules for using breastfeeding as birth control, but if your #2 was only 9 days old them I'm fairly sure you hadn't broken any of them's things like using the breast for all feeding and all suckling (no binkie), nursing at least every 6 hrs, nursing through the night, etc. It is about 95% effective through six months, and it seems to be effective for an average of 14 months...but of course there are women like me (who go 20 months) and women like you (who go 9 days) sounds like you're part of the 5% who isn't going to be able to rely on breastfeeding for birth control, and while that's probably frustrating, at least you know, you know?
It sounds as though you are remarkably fertile, and honestly you might do better with using something else along with NFP. I appreciate the desire to avoid hormonal methods, but in your case I might think about something like an IUD. The main alternative is just to assume that you are always fertile, and to utilize barriers or spermicides all the time until your baby is old enough that you are 1-able to chart better or 2-willing to allow the possibility of pregnancy.
(by the way, when they say wait 6 weeks after birth before doing *it*, there are reasons beyond just feeling sore...) ;)

Misty said...

oh! just to clarify, my 2nd was 9 MONTHS old when we conceived #3!! that got left off!! oops. :) we DEFINITELY waited the prescribed 6 weeks and then some, lol!!! i was soooo sore!
i think i'm gonna check that book from the library just to read thru it and see what i can figure out for myself. dh is allergic to latex and i am not sure i have enough wherewithal to use the diaphram (sp?) b/cs sex is so sporadic when you've got little ones sleeping with you! we exclusively breastfeed for the first 9 months or so and yes, that consists of during the night and about every 2-3 hrs so i think we fit the bill pretty well for the using BF as a mini-form of pg prevention. but b/cs this time around (unlike previous two times) we want to prevent a pg i think you're right and we should use *some* kind of back up!! thanks so much for taking the time to respond to my questions! it's much appreciated!

Jessica said...

Okay, first off I have to say that FAM is fabulous and TCOYF is a must for the library of every ovulating woman. I even bought it as a gift for a friend who has had issues with her cycles for years and recently got married.
That said, I only have one issue with FAM: We really don't like the barrier methods, and after doing more research I have seen some good reasons not to use them. However, my libido is ridiculously high during ovulation. I switched to FAM after I realized that my winter blues wear worse then they ought to have been. A blood test revealed that my testosterone level was super low but there's nothing a doctor can do about it during childbearing years. I thought about what might be causing it and realized that it was the BC pill I was on at the time. I decided there had to be a better way, and found FAM.
Anyway, after being depressed for months and having NO libido, it was awefully hard to just "abstain" when all of a sudden I had that peak once a month. We'll probably have to use barriers (once ovulation begins again after this baby is born, lol), but I still have some issues with that and don't know how to resolve them. Hm... any suggestions?
(sorry if this is too long, you don't have to publish it if you don't want to.)

Mommy Bee said...

I dont' know anybody who really *likes* barrier methods, LOL! And yes, your libido is supposed to go up when you're fertile. That's because your body is hardwired to try to get pregnant. LOL!!
The only one-time-use options I know of are either barriers or there's condoms, diaphrams, foams, gels, and at least one kind of spermicide comes in a little sheet that you can poke in and then it melts (but it's easier to insert than the regular gels). I lean toward the various spermicides personally, because I don't like barriers either...but I know people who have allergic reactions to them or who have moral opposition to killing their husband's sperm. *shrug*
I don't know that there's a perfect one-size-fits-all kind of answer. I just know that FAM has given me awareness that I never had before, and has given me choices...what i do with those choices is up to me. :)

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