Is fertility awareness a long-term solution for preventing pregnancy?

Couple by the sea

I do not want 12 kids.  I have nothing against families with 12 kids, but it is not what I envision for my family (if you want to see a cool trick, say the words “twelve kids” to my husband and watch all the color drain from his face).  And I don’t mean to be a downer, but I also don’t want to be having any babies when my babies are having babies.  Again, if that’s you, rock on!  I know if that happens, we will welcome and raise a very loved baby. However, because of the physical, emotional, and behavioral risks and side effects associated with hormonal birth control, we have agreed not use it, so natural family planning (NFP) it is. NFP has worked great for us during the spacing-babies-phase of life, but I’ll admit, thinking about using NFP for the rest of my reproductive days is daunting.  I might have 20 years of baby making power still left in me!  Can NFP work as a long-term method of avoiding pregnancy?  What does this look like in real, working marriages?  Is that level of strictness and accuracy even plausible for extended periods of time?  I have a feeling I’m not the only person who has these anxieties, so I found some couples who have had success using NFP to avoid pregnancy for the long haul and who were willing to share their experiences.

If you feel strongly that your family is complete, if you have financial, emotional, or medical reasons to stop having babies, or if your spouse needs some convincing that this NFP thing really works, these stories are for you.

I heard from couples who have every reason to avoid pregnancy.  Liza and Dean had very serious medical reasons to avoid pregnancy.  Liza was taking medication for Crohn’s disease that would have been harmful to a fetus.  She wasn’t a candidate for hormonal birth control because she was diagnosed with her first DVT (deep vein thrombosis), at the age of 21, and luckily, she was advised of the risks for blot clots and strokes that comes with the pill.  In fact, when she had a stroke at age 37 due to an extremely large blood clot in her brain, the neurologist thought birth control was the culprit because of how commonly they see this situation in the ICU.  She assured them she had never used birth control because of this very risk, and eventually she was diagnosed with MTHFR A1298C mutation.  Her doctors affirmed and encouraged Liza and Dean’s decision to not get pregnant because the necessary blood thinners would put her and the baby at risk during delivery.   Even while suffering from short-term memory loss as a result of the stroke, Liza charted daily, using a small notebook to help her remember her signs throughout the day.  NFP helped them avoid pregnancy for 14 years, and safely led Liza to menopause with zero pregnancies.

Similarly, an anonymous Midwestern couple with five kids has had success avoiding pregnancy for 16 years!  After their fifth child was born her life was threatened by blood pressure problems caused by negative reactions to the baby’s blood type.  Even though they wanted more children, the risk was too great.  The couple had strong moral objections to hormonal birth control, so even though the doctor was skeptical, he never pressured them into contraception or sterilization.  At age 51, our Midwestern couple is nearing menopause while still charting fairly regular cycles.

Other participants with seven or more years of successfully avoiding pregnancy claimed emotional, financial, or personal reasons to avoid.  One mama of five said they “feel complete” and I hear that!  So how did they all do it?

I asked them what was crucial in their success.  Every single couple that I heard back from had learned a particular method from a certified instructor!  This is so important! Many women reported that having an instructor to answer their questions and review their charts was the main reason for their success, especially women with complicated cycles from endometriosis, PCOS, adenomyosis, auto-immune disorders, or even during breastfeeding/menopause (Yes, you can successfully use NFP if you are in these situations).  Other important factors in their success were being resolute in their decision to avoid a pregnancy and support from their husbands.  (More on those husbands in a minute).

These women used a range of methods, from STM (sympto-thermal), to Creighton, to Billings, etc.  Our Midwestern couple mentioned above (with a 14 year no-pregnancy stretch) even took what they had learned from five years of Creighton and combined it with a modified Standard Days Method to fit her cycle history.  They formed their own simplified method that they were confident in and it obviously worked!  Now that she is in perimenopause, she is adding basal body temperature readings for extra assurance.

For some, charting with an app was easiest, while others made notes throughout the day and charted the results at night.  Husbands were involved in varying degrees.  Some men filled in the chart every night, while others more passively glanced at the chart or asked his wife if the day was usable.  Every person and relationship is different, and so is their NFP system!

Mary, a mother of six who has been avoiding pregnancy for the past seven years, graciously expanded on her experience.

“I do really like that STM gives me three signs to monitor, so that if one or two of them are a bit ambiguous, the third can usually clear things up,” she reported.  “Because I worked straight nights and rotating shifts, co-slept, and exclusively breastfed, there were times when I didn’t have a clear thermal shift as quickly as I liked. It was nice, at those times, that I could count on the mucus and cervical signs.  Now, in perimenopause, I’m having weaker thermal shifts, so again, mucus and cervical signs are helpful.  I also found the cervical sign to be extremely helpful in determining the return of fertility post-partum.”

In her day-to-day routine, Mary took her temperature in the morning, making note of any abnormalities in her routine (for example, alcohol consumption, lack of sleep, etc.), observed her cervical mucus in the middle of the day and again at night, then checked her cervix and recorded it all in her chart. Mary also said that her husband could tell when she was fertile, so he knew even without the chart that it was time to avoid.  How interesting!

While all of these couples have had success with TTA (an acronym meaning “trying to avoid,” which I learned while stalking numerous Facebook NFP and FABM support groups), it wasn’t without challenges.  No matter how accurately, confidently, and diligently you chart, the only sure way to avoid pregnancy is to abstain during fertile periods. Some couples using Fertility Awareness Based Methods do use barrier methods during fertility, but for the women who are 100% sure of their decision to not get pregnant, whose life might be on the line, or who have religious convictions, abstinence is a crucial part of having confidence in using these methods.

It seems by the responses that the time of abstaining is the hardest part, but couples are able to find other ways to bond.  One respondant said, “My desire to live far outweighs my desire for sexual gratification!”  Participants said it was important for them to use their “usable days” and to constantly communicate to maintain closeness.

Liza, mentioned above, stated that, “I never felt NFP was a challenge because it was a HUGE blessing for us.  It was the answer for me on what was the safest and most reliable method to avoid conceiving.”  In fact, all of the women reported that the benefits outweighed the negatives.  NFP has done more for them than just help them avoid pregnancy.

For example, charting helped Peggy, a mother of four, in the diagnosis of endometriosis and adenomyosis.  Liza was able to predict when her Crohn’s would flare up so she could change her diet and medication to minimize the severity of symptoms (she wishes she had known how to chart in high school!).

“One of the best things about NFP is that I have never felt taken for granted sexually,” our Midwestern couple added. “Regular monthly periods of abstinence make both my husband and me appreciate each other” and their sexual relationship.  Likewise, Mary said she has never felt disrespected by her husband; he never demands sex the way that she hears of others doing.  Shelley, who has avoided pregnancy for eight years with NFP, agreed that her marriage is stronger because of the open communication required to be successful.

Of course, I asked for suggestions for the couple who is new or struggling.  The consensus was to pick a method and really commit to it.  Secondly, find a certified instructor.  Having said that, Peggy also wanted to remind us to be flexible. “We had an instructor for a while that we just didn’t like and weren’t on the same page with; we changed and it was the best decision that we made,” she said.

You aren’t stuck with the first method you learn, but it is important to give it some time and dedication before deciding to try something else.  Thirdly, many couples emphasized again the need to keep communication open: be honest about your struggles, be supportive and not defensive, and remind each other of the benefits of NFP.  Be respectful and cautious during fertile times so as to not tempt your partner.  NFP is about love, respect, communication, as well as being aware of how your fertility works.

If, like me, you are struggling with consistency or interpreting observations, you can be assured by the experience of these couples.  They had to be patient and cautious in the beginning, but many women said they felt very confident by the first year of continuous charting.  It becomes so routine that it’s almost second nature.

What these couples have accomplished together is no small feat.  They made an important decision to not add unnecessary, harmful chemicals to their bodies and marriages.  They committed to natural methods even through irregular and complicated cycles, disorders, and stressful situations.  They trusted their bodies and their methods even when facing potentially fatal consequences.  If they can do it, we can surely do it.

If you have used NFP for a significant amount of time to avoid pregnancy, let us know in the comments!

If you are still unsure, read here to see what Natural Womanhood has said about sterilization, the negative effects of conventional contraception, and the benefits of natural methods.

If you are a newbie and want more information on getting started, check here.

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  1. My husband and I learned NFP just before our marriage, with a great instructor couple, and have used it for going on 14 years now! I have no qualms/fears about using it through menopause. I’m so thankful for it! It has helped us to effectively avoid/achieve, and it has really been a great tool for me to be healthy (especially with the new FEMM method). We’ve used a few different methods over the years as well-I’m really thankful for the continued advancements in this area!

  2. 13 years of successful TTA. Wouldn’t trade it for anything.! Communication, respect, and creative abstinence. And any time we are tempted to bend the rules, our youngest acts out and reminds us that we decided to have FIVE, not 6 kids…. Perimenopause is exciting– that first 60 day cycle that promises full menopause is otw. Not difficult to track fertility like I thought it would be….Family of the Americas has awesome teachers and much research on this stage of fertility. Definitely have a mentor. Thanks for this article!!!

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