Teaching Natural Fertility Regulation

by Josée

Natural Fertility Regulation or Natural Family Planing (NFP) has been getting some attention in the news and on blogs over the last week. The New York Times published an article titled An Evolving View of Natural Family Planning. The article looked at Bethany Patchin and Sam Torode who married in 2000, wrote a book entitled Open Embrace: A Protestant Couple Rethinks Contraception in 2001, then recanted their statement in 2006 and divorced in 2009. There were a flurry of responses to this news article. Then Danielle Bean wrote an article entitled Five Ways I Don’t Love Natural Family Planning. Where she received quite a bit of support and critique from her readers.

I teach Natural Fertility Regulation. Specifically, I teach the Billings Ovulation Method. Initially it was the Catholic Church’s teaching around family planning (Humanae Vitae) that piqued my interest in Natural Fertility Regulation. Then I started to see the value of Natural Fertility Regulation from a medical perspective and became interested in becoming a teacher.

I believe that all women should have a basic understanding of their fertility. Most women, both young and old, know very little about their reproductive system. But the reality is the majority of women have such limited opportunities for learning about their fertility, school sex-ed classes skim the topic of female fertility and most medical professionals don’t tell women about it either. Some women learn about their fertility from family, friends, the internet or come across books like Taking Charge of Your Fertility and are amazed by what they discover.

There is so much stigma associated to Natural Fertility Regulation. When the topic comes up some of the first things people assume are that it’s not reliable and too difficult to learn. Modern methods of Natural Fertility Regulation methods are well researched and based on scientific knowledge. Yes, some of the methods are more effective than others and some are simpler than others, but when modern methods of NFP are used properly (perfect use) they are 95-99+% effective at avoiding pregnancy. Typical use is around 80%; the typical use for most method of family planning are often lower in effectiveness.

Using NFP to avoid pregnancy can be very effective as long as the couple is motivated and receives proper follow-up by an accredited teacher. But, NFP requires self-discipline and self-mastery especially during the times when a couple needs to abstain during the woman’s fertile phases. I would be lying if I said that this was easy. It isn’t. A woman is often most interested in intercourse when she is fertile.

Some couples choose to mix NFP and barrier methods, at this point it is considered a Fertility Awareness Method. Many NFP methods don’t encourage mixing of multiple methods of family planning because it can cause confusion, lack of confidence and a decrease in the effectivess of both methods. The reality is, however, that I teach a wide range of people who choose to use the method in a variety of ways. I ensure that each client understands how to use the method properly, but I cannot control what she chooses to do after that.

I should note, however, that a couple practicing NFP without the use of barrier methods should not be experiencing months of ongoing abstinence. I come across women complaining of nonstop abstinence while using NFP and it makes me scratch my head. Even Danielle Bean in her recent article on NFP makes this statement and it surprises me. Yes, there might be times of extended abstinence during a time of stress, sickness or transition but months of ongoing abstinence raises red flags. Either it’s the method of NFP or the couple hasn’t received regular chart consultations with an accredited teacher. But, this is not normal and I want to make that clear.

I don’t believe that Natural Fertility Regulation is for everyone. But, I do believe that all women should have a basic understanding of their fertility. What women choose to do with knowledge of their fertility is up to them. They could use this knowledge to avoid pregnancy or achieve pregnancy, but at the very least it gives women the knowledge they need to protect their reproductive health.

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Chelsea Rae July 19, 2011 - 1:36 am

Umm… now I love Danielle Bean but that article left me doing some serious head scratching too.

I really feel like ignorance is our biggest hurdle here. Her article was chock full of misconceptions and assumptions. I am sure a lot of them are based on personal experience which sadly seems to be the reality of most people's experiences with NFP.

It sure would be nice if someone with such a large readership was meeting regularly with an accredited teacher and then wrote about it. It might give a lot of people a lot more hope.

Anonymous July 19, 2011 - 1:48 am

I could see months going by if you are sick for a week, then you are fertile, then your husband goes on a business trip then you get your period, then your children all get the flu one at a time and you are up in the middle of the night for nights on end, then you are fertile, then you have a meeting one day, he has one the next, you are tired on Wednesday, you have your period, so on and so forth. We aren't using any method of family planning (we have low fertility and would welcome a pregnancy) but have had months like this. It's really hard on a marriage.

Josée July 19, 2011 - 3:38 am

@ Chelsea – Yes, I felt the same way too about the article.

@ Anonymous – You're right. This does happen and it can very difficult on a relationship. The article by Danielle Bean mentioned having to abstain for almost a full year because she was always fertile. Natural Family Planning methods shouldn't require this and have ways to identify if discharge is "truly" fertile or not. This is what I was trying to get at. Thanks for the comment 🙂

Jane July 19, 2011 - 4:21 pm

I didn't read the article, but I've experienced months of unknowing in terms of fertility when we were looking for an NFP couple to help us in Canada (I had also learned the method through the US system which is a science book of extremely specific conditions to interpret a chart and very different from the Serena version). There are certain situations where it is not always clear, ex. PCOS. My temp was consistently low, only varying .2-.3 above or below the line, for a couple of months. Ultimately it led me to bring the info to my health care provider who diagnosed PCOS. If one is consistently not ovulating, it can be hard to determine when a safe time for intercourse would be when wanting to avoid children. I can imagine there are other situations that would be similar too. Have you had a lot of experience looking at charts with these types of conditions? We found it hard finding a couple who had experience with interpreting my chart with some confidence.

Josée July 19, 2011 - 5:12 pm

@ Jane – You're right. Irregular cycles and long periods without ovulation can make it more difficult to figure out what is going on. While I don't have a lot of experience with PCOS charting I do have a good amount of experience with charting through brestfeeding which can be tricky too because ovulation can be delayed for months. When women experience challenging cycles it is really important to have regular chart consultations with an accredited teacher. This way the teacher can help the client understand what discharge is fertile and what discharge is not or refer the client to a physician if something doesn't seem right.

Some methods of Natural Fertility Regulation are very difficult to use while experiencing PCOS, breastfeeding, stress cycles, entering menopause etc. and might end up requiring long periods of abstinence. Other are better, but there does need to be more research done in this area.

The Billings Method doesn't depend on regular cycles to be used. Even a women who has long irregular cycles can use the method. The key is looking at the patterns of discharge.
Unchanging patterns of discharge are usually considered infertile while changing developing patters of discharge are considered potentially fertile.

Sometimes finding someone who has experience with more complicated cycles can be hard to find but there are some really great Billings teachers in Canada and I'd be happy to give you their contact information if you are interested.

Thanks for the comment Jane!


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