Fertility Awareness Methods
Fertility Awareness Methods – what are they?
Fertility Awareness Methods (also called FAMs) are the practices of observing a woman’s signs of fertility and interpreting them to determine her fertile and infertile days. A woman observes these signs daily and records them on a simple chart (this takes only a couple of minutes a day). Then, either on her own or with her husband’s help, she interprets her observations according to her chosen, science-based methodology (there are a few) to identify the fertile and infertile stages of her menstrual cycle.
A woman’s cycle lasts from one menstruation to the next and during that time her fertility status changes from infertile to fertile and then back to infertile. The external fertility signs accurately reflect what is happening with the woman’s reproductive system internally. By learning how to interpret these signs, a couple can decide each month whether they would like to achieve or avoid pregnancy.
What they are NOT!
FAMs do not include withdrawal nor the Calendar/Rhythm method developed in 1930’s. The latter is based on calculations only and does not rely on observing and interpreting individual signs of fertility. As such, it is not very reliable.
FAMs are not an alternative form of contraception, as they respect the unitive and procreative aim of marriage. The total gift of self that a husband and wife make to each other remains intact, they couple are simply choosing when to engage in intercourse. They are not closed to the gift of new life.
Fertility awareness methods are natural, highly effective and in agreement with Catholic Church teaching. They improve couple communication since a couple who uses natural fertility awareness to plan their family necessarily have to discuss matters relating to sexuality, mutual wellbeing and family issues frequently.
FAMs can be used at every stage of woman’s life and do not require her to have a regular cycle. As such they can be used with confidence when breastfeeding or nearing menopause.
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Are Fertility Awareness Methods Effective in Preventing Pregnancy?
Fertility awareness methods are 99% effective in avoiding pregnancy when used correctly (which means following the rules taught by a FAM method of your choice). Their effectiveness is comparable to that of a hormonal contraceptive (such as the combined oral contraceptive pill) and better than that of a condom.
Fertility awareness methods are science-based and have been studied and tested over the past 60 years using scientific research methodologies. Much is published about them in research journals; they are supported by a wide research database that is gathered from thousands of women. (For example, a study from a peer reviewed medical journal Osteopathic Journal of Medicine studied 8,200 women in over 107,000 cycles.)
The effectiveness of various fertility awareness methods is published in international research journals (please see references section for more information).
Can FAMs help us conceive a child?
FAMs are very helpful in helping a couple achieve pregnancy as they enable them to identify their most fertile window. It has been reported that amongst those using those methods and trying to conceive, 80% will achieve pregnancy within 6 months. If a couple is having trouble conceiving, learning FAM can highlight problems with fertility and in many cases enable their correction, so that a couple can go on to conceive naturally (read more in For couples having problems conceiving).
What are the Fertility signs we need to observe?
*NB This section is designed to give you an overview of the science behind the methods, but it is important to learn from a qualified teacher in order to be sure you have learned correctly.
Healthy men are fertile all the time, whereas a woman’s fertility is cyclical, and follows a ‘monthly’ rhythm, alternating between fertile and infertile stages. During the so called fertile phase a woman is fertile (that is, the egg is only viable) for only about 8 ‘ 24 hours. But because sperm can live in female reproductive tract for up to 5 days (depending on the presence and quality of mucus), it is considered that the couple together is fertile for up to 6 days each month. This period is sometimes called the fertility window. Identifying this time period forms the basis of all fertility awareness methods.
Hormones are the major chemicals in the human body that orchestrate fertility. In women, the action of the various hormones cause the egg to mature in the ovary and its release at the appropriate time (an event known as ovulation). While this is happening, the hormones cause the uterus to build its lining in preparation to accept a new life. These internal changes are reflected accurately by external signs, and these are what a couple is taught to observe.
Those signs include:
- changes in quality and quantity of cervical mucus (healthy vaginal discharge that is especially noticeable around fertile days, and which facilitates sperm function)
- shifts in basal body temperature (indicating that ovulation has occurred)
- changes in position and presentation of the cervix (which change during the days around ovulation)
Some women may also experience tenderness or pain in the abdominal area and breasts around the time of ovulation.
Mucus: The length of time that sperm can survive in the female reproductive tract is dependent upon the presence and the quality of cervical mucus. The function of the mucus is to nourish the sperm and facilitate its travel towards the fallopian tubes where it may fertilize the egg. The more watery and stretchy this mucus is, the better it supports the sperm. This is known as fertile mucus and a couple would abstain at this time if they were looking to avoid pregnancy, or have intercourse if they were trying to conceive. This mucus is regulated by hormone oestrogen (which is simultaneously preparing the lining of the uterus for implantation of a newly conceived baby. After ovulation, oestrogen decreases and is replaced by a rise in the hormone progesterone. Mucus under the influence of progesterone is thick and forms a mesh like structure, blocking the entrance of sperm. This sign indicates the period of post-ovulation infertility.
Temperature: The basal body temperature increases as a response to the hormone progesterone, which rises directly after ovulation. Women keeping track of their daily temperature (usually taken on rising) can see the thermal shift and know that ovulation has occurred.
Cervical changes: The cervix also rises, softens and opens before ovulation, and a woman can be taught to interpret this fertility sign if she finds it helpful.
The first two of the three fertility indicators are the main ones, and the different fertility awareness methods teach a couple how to observe and interpret either one or both of them. It is important you learn from a qualified teacher in order to be able to apply the method correctly.
The different FAM Methods
There are a few different Fertility Awareness Methods designed to meet individual needs and preferences and to suit different lifestyles. The methods differ by the number of observed fertility signs and the manner of charting. Some require observation of mucus only, other are based on more than one indicator and others incorporate the use of fertility monitors. Generally, they fall into three broad categories:
MUCUS ONLY METHODS
Based on cervical mucus observation:
Billings – http://www.billingsmethodengland.org.uk/
Creighton – https://www.creightonmodel.com/
Based on cervical mucus observations in combination with the use of a fertility monitor:
Marquette – http://nfp.marquette.edu/
Based on cervical mucus observation and basal body temperature measurements. The observation of cervix signs is an additional possibility with these methods:
Couple to Couple League(CCL) – http://www.cclgb.org.uk/
Natural Family Planning International – http://nfpandmore.org/
Natural Family Planning Teacher’s Association – http://www.nfpta.org.uk/
Is it difficult to learn FAM?
No, learning FAM is not difficult. The World Health Organization has reported that women of diverse cultural and educational backgrounds can easily learn to recognize the changes in their mucus pattern (ref WHO-28 from Stanford and WHO 3 months). Each of the providers offers training in their FAM methodology ‘ a couple can attend a course or self-learn at home from their home-study materials. For optimal understanding it is best to learn face to face from a qualified FAM instructor, who not only will teach the method but also answer questions arising when couples start observations and charting. There may be an initial cost for learning the methods and buying the materials but otherwise it is free.
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Benefits for couples
Although the main reason for practicing fertility awareness methods is to interpret the fertile and infertile times to achieve or postpone pregnancy, there are other key benefits for the FAM practising couples:
- Better communication
Through the practice of FAM, couples find their relationship enriched and strengthened. Periods of abstinence, though difficult at times, enable spouses to focus on communication and romance, and to express their affection in different ways. Periods of abstinence lead to a greater appreciation of sexual intercourse since it is no longer taken for granted. In addition, the greater anticipation can add to the intimacy, enriching the bonding experience. When couples interpret fertility signs together they re-evaluate their lives, their families, their priorities. Each month, they are presented with the opportunity to discuss matters of great importance such as children, sexuality, intimacy and their needs.
- Greater appreciation of sexuality
Being able to read woman’s external fertility signs leaves us in awe of God’s creation and the miracle of the woman’s cycle. It is empowering to know how your body works and what it is telling you. Since the spouses’ fertility is unaltered (as it would be by hormonal contraceptives) and the intercourse undisturbed (by barrier methods or withdrawal) both husband and wife can truly be a total gift of self to each other.
The methods are natural and healthy. There are no chemicals or hormones to take, and no devices to use, so consequently there are no side effects.
The Church teaches that God’s gift of sexuality is very beautiful, but should be respected. Contraception can destroy the total gift of self between husband and wife, as spouses do not accept themselves fully by withholding a part of themselves by blocking or eliminating their own fertility. This action also removes God from the equation, closing the door to the potential of his bringing new life into the world. The Church recognises that parenthood should be responsible ‘ there is a middle ground between being generous and being overwhelmed and unable to provide for a very large number of children. Very often, spacing is important to enable everyone to adjust to new circumstances or is required for health reasons. FAMs are perfectly morally permissible and in accordance with the teachings of the Church, whereas contraception is not.
For couples having problems conceiving
Fertility awareness methods enable the couple to determine their fertile window, that is, the time immediately before the ovulation (a 6-day interval before and including the day of ovulation). This is when the couple is most likely to conceive the baby so being able to define this time will significantly increase the chances of conceiving. It is worth knowing that for healthy couples a chance of getting pregnant in a given cycle is about 30%. It has been reported that 80% of those using the methods and trying to conceive will achieve pregnancy within 6 months.
Couples using fertility awareness methods would identify their fertile window and plan their intercourse when the cervical mucus (healthy vaginal discharge) is most fertile that is most stretchy, watery, clear and slippery and resembles egg white.
Fertility awareness methods help to monitor reproductive help and can help to detect cycle abnormalities early (e.g. short luteal phase which is indicated by the number of days from ovulation until menstruation, which may be too short to enable the fertilized egg to implant into the womb. This can often be easily corrected). The various signs a couple observe during their FAM charting can indicate other problems in a woman’s reproductive system, something which doctors may simply cover up by prescribing the contraceptive pill, instead of treating the underlying cause. In many cases cycle abnormalities can be corrected so that a couple can go on to conceive naturally.
Moreover, learning self-observation puts you in tune with your body and is the first step in advanced fertility treatment methods such as NaProTECHNOLOGY, a personalized approach to fertility treatment and an alternative to in vitro methods.
Some people get the impression that the Church teaching on human sexuality, marriage and family life is a list of rules and conditions that focus on prohibition. It is quite the opposite; the Church aims to protect the real meaning of who we are as human beings and what we are called for. The Church’s vision on sexuality, presented well in Theology of the Body and Theology of the Family as well as other documents, stems from the recognition that every person has dignity and value unequalled to anything else on earth and that our sexuality is a beautiful, precious and powerful gift. The ‘rules’ are there to show us the difference between love and lust and to help us find the true meaning of our existence.
We are created in God’s image and likeness and therefore we are called to act like God does, that is to love totally. Human’s vocation is to love and receive love and this is something we naturally relate to; we want to be accepted and appreciated and want to have somebody to whom we can give our love.
We are made up of body and soul, and we have a mind and will to think and decide for ourselves. We are one integrated whole and no part of is more important than the other. We cannot separate our emotions and thoughts from our physical bodies. We all experience this integrity – when somebody cares for us we not only feel good emotionally but also feel physically better. On the other hand, any physical mistreatment or pain that we suffer because of others, touches both our feelings and our body. What we do to our bodies we do to our entire person. None of us wants to be treated as an object, we want to be respected and appreciated. To use the body is to use the person so we should respect the value of the human body.
Through our bodies we express ourselves, all human relationships are expressed through the body. Marriage as the unique relationship between husband and wife, this most intimate and intense human relationship of love is expressed through a special act of love ‘ the marital embrace; ” and the two shall become one flesh. So they are no longer two but one flesh’ (Mark 10:8).
We marry to love each other and to give ourselves to our spouse. The sacrament of marriage strengthens us and enables us to overcome our selfishness and become a total gift of self. The aim of marriage is to give oneself completely and accept the other person completely. Created fertile and knowing that we are made in God’s image, we should learn to accept and appreciate our fertility.
Isn’t FAM just Catholic contraception?
No, FAMs are not contraception. Although both contracepting and FAM using couples may have the same goal, that is to space their children and plan their families, they approach the issue differently. Contracepting couples’ take action to separate the unitive from the procreative meanings of sexual intercourse ‘ their bodily message which says ‘I give myself totally to you’ excludes their fertility. Often there are physical barriers which illustrate this point. The integrity of the sexual act is destroyed.
Couples practising FAM will give themselves totally to each other when they are intimate, using neither devices nor hormones to render their act sterile. They can use their knowledge of a woman’s cycle to time intercourse to achieve or avoid pregnancy. When they have sexual intercourse, it is a full self-gift and in this way, it is different to contraception.
Furthermore, FAM practicing couples would not act against life. During fertile days, when the couple wish to postpone pregnancy, they would abstain from sexual intercourse and express their affection differently. In the case of contracepting couples, they would use devices and chemicals to knowingly act against possible conception.
FAMs can be used selfishly in that a couple may not wish to have children when perhaps they should consider being generous in the service of life, but the discernment which a couple brings to their relationship each month (born of the necessity to communicate the wife’s fertile time) will make it harder for them to drift on for years, never discussing the matter.
Fertility Awareness Methods (FAM)Advisor
For information about learning, about teaching, or about FAM generally, you can be contact us at firstname.lastname@example.org.
Shout out for teachers!
Teaching Fertility Awareness Methods is a rewarding way to pass on valuable information to couples about their fertility. Helping couples to plan their families, or to conceive if it is taking longer than anticipated, can be very rewarding.
The diocese of East Anglia is looking to recruit FAM teachers so that all engaged couples, and couples who want to learn FAM, have ready access to a teacher. If you are using one of the FAM methods and would like to teach, we would love to hear from you. Any training required will be provided. If you would like to learn and then perhaps to teach, that would be great too! Drop us an email at email@example.com