In a November 9, 2025 article titled “The MAHA-Fueled Rise of Natural Family Planning,” Le New York Times journalist Caroline Kitchener significantly mischaracterized the facts about natural family planning (NFP), oftentimes referred to as fertility awareness methods (FAMs) or fertility awareness-based methods (FABMs).
In fact, not only did Ms. Kitchener woefully misrepresent the efficacy of these methods, but the whole tenor of the article communicated a false picture of an ineffective form of family planning only practiced by religious, ideologically-driven demagogues. Furthermore, the article was dedicated to making the claim that these methods have only gained popularity in the wake of the Make America Healthy Again (MAHA) movement originally spearheaded by now-HHS Secretary Robert F. Kennedy Jr., during his 2024 presidential campaign.
Contrary to these falsehoods presented by Ms. Kitchener, Natural Womanhood has been educating women (and men!) about their bodies and connecting them with professional resources to address family planning and personal health issues that surface in their cycle charts since 2012—well before the existence of MAHA (or MAGA, for that matter). And the science and legacy of NFP have, in fact, been around for longer than that.
The NYT makes the debunked claim that FABMs are only “77% effective”
The Marquette Method, which is taught by the Whole Mission organization referenced throughout Ms. Kitchener’s article, teaches women and couples to observe and track liquide cervical along with urinary hormone metabolites of two reproductive hormones, hormone lutéinisante et œstrogène. More recently, some Marquette instructors have started teaching clients to use “FemTech” devices like the Moniteur Mira instead of the original Clear Blue Fertility Monitor. Marquette users also have the option to only track cervical fluid, only track urinary hormone metabolites, or cross-check between the two biomarkers of ovulation.
Even with the Marquette Method’s “choose your own adventure” variations for use, studies at Marquette University (including Fehring et al., 2017) have found a perfect-use pregnancy rate of approximately 1–2 per 100 woman-years (98-99% effective) and a typical-use pregnancy rate around 7 per 100 woman-years (93% effective), depending on user demographics and experience [1]. (For reference, combined oral contraceptives, aka “the Pill,” boast efficacy rates of perfect- and typical-use nearly identical to those of the Marquette Method.)
As with all FABMs, this method is most effective when taught by a certified Marquette instructor. (Furthermore, Marquette instructors are also allied health professionals, i.e., nurses.) This is a far cry from the “77% effective” statement made by Ms. Kitchener, and counter to the article’s implications that these methods are only perpetuated by those without scientific or medical backgrounds.
In fact, the Marquette Method (which is never mentioned by name within the article) isn’t even the le plus effective FABM when it comes to pregnancy prevention.
If pregnancy avoidance is a FABM user’s top priority (unlike contraception, FABMs can be used for avoiding ou achieving pregnancy), the most effective FABM for pregnancy avoidance is the German-based method called Sensiplan™ which boasts 97-98% typical use effectiveness rate (similar to the U.S.-based Couple to Couple League’s SymptoThermal Method). This method has users monitor their cervical fluid secretions and basal body temperature along with optional cervical position. Certified Sensiplan™ instruction has been available in the U.S. since 2017, and the Couple to Couple League was established in the U.S. in 1971. Ms. Kitchener makes no mention of either.
Ms. Kitchener also fails to mention the original FABM, the Méthode d'ovulation Billings, developed by the Australian Drs. John and Evelyn Billings in the 1950s. Subsequent validation studies, including those by the World Health Organization in the 1970s and 1980s, have confirmed the reliability of these mucus-based indicators. Furthermore, as a method which requires no materials, the Billings method has been successfully taught and used all over the world by women of low- to no-literacy, and of nearly every race, creed, and socioeconomic background—in fact, as a sensation-based method, it is also the only FABM that can also be used by the visually impaired. (The Creighton Method, FEMM, ChartNeo, and Boston Cross-Check are among the other popular evidence-based FABMs which Ms. Kitchener fails to mention or discuss, and all have similar effectiveness rates when it comes to pregnancy avoidance. Creighton, FEMM, and Neo also have the distinction of dedicated medical protocols to address menstrual cycle- and reproductive health issues.)
Rather than discuss or cite the most recent data on any of these FABMs, Ms. Kitchener links to an out-of-date graphic used by ACOG which states the false “77% effectiveness” statistic; a newer, more updated version of the same graphic (from the same source ACOG uses, which can be found ici) acknowledges that, like contraceptives, FABMs exist on a spectrum of efficacy, correctly noting that: “Multiple FABMs exist. As a group they span categories 2 and 3.”
This updated graphic from ACOG’s preferred source actually places the most effective FABMs within the same category of effectiveness as the Pill, the injectable, the patch, and the ring (in category 2, or 1-7 pregnancies per 100 women in 1 year) and the less effective FABMs with the male condom, diaphragm, spermicide, cervical cap, vaginal pH regulators, the sponge, female condom, and withdrawal (category 3, or more than 8 pregnancies per 100 women in 1 year). Likewise, since 2019, the CDC has displayed an updated effectiveness rating for FABMs, stating that, as a group, they have a “2-23%” failure range (a change made, in part, thanks to the advocacy work of Natural Womanhood).
This updated graphic from ACOG’s preferred source actually places the most effective FABMs within the same category of effectiveness as the Pill, the injectable, the patch, and the ring (in category 2, or 1-7 pregnancies per 100 women in 1 year).
Ms. Kitchener’s mistake (if it can truly be called that) is a curious one to make, given that one of the article’s most prominently featured interviewees—Dr. Marguerite Duane—is the lead author of the most recent, peer-reviewed, comprehensive study on the efficacy of the various most popular FABMs [2]. Notably, Dr. Duane’s study found a 95-99% effectiveness rate with correct use for all FABMs studied, and greater than 85% effectiveness rate with typical use across most FABM studies.
In other words, the “77%” statistic used by Ms. Kitchener is unverifiable at best, and inaccurate and misleading at worst—a deeply concerning mistake to make in a 2,000+ word reported piece dedicated to the topic of FABMs.
“Cycle syncing” apps are not natural family planning methods, but they are prominently featured in the article nonetheless
Tellingly, the NYT article prominently highlights the 28 cycle-syncing app (and its founder, Brittany Hugoboom—also the founder of Evie magazine) while failing to name any of the established fertility awareness-based methods for natural family planning and women’s health.
Tellingly, the NYT article prominently highlights the 28 cycle-syncing app while failing to name any of the established fertility awareness-based methods for natural family planning and women’s health.
Unlike the vast majority of cycle tracking apps, FABMs are evidence-based, and taught by certified instructors who ensure correct observation, tracking, and interpretation of established biomarkers of fertility. Methods also have various rules to help the couple decide to abstain or engage in sexual activity based on shared family planning intentions. (Part of a FABM instructor’s job is to ensure understanding of the rules of the method. They should not, however, play any role in spousal discussions on family planning intentions.)
For further reference, here’s Natural Womanhood’s 2024 review of the 28 app, which describes it as an aesthetically-pleasing fitness app for cycle-conscious women—not something that can or should replace one’s FABM. And while “synchronisation des cycles” your workouts is trending and may even be worthwhile, it’s not exactly relevant in a discussion on the use of cycle charts for family planning (and neither, for that matter, is the article’s quote from Dr. Sarah Hill, author of Votre cerveau sur le contrôle des naissances, that she would “never recommend [NFP] to my teenager.”)
Cycle charting is also about women’s health—but not because MAHA or conservative influencers say so
In truth, the menstrual cycle has been well-established as a woman’s “fifth vital sign,” with ACOG first calling the menstrual cycle a vital sign for girls and adolescents in a Committee Opinion issued in 2015 [3]. More recently, in June 2025, Fertility & Sterility Reviews published a comprehensive report on menstrual irregularities in all women—not just younger women—along with associated health outcomes including cancer, diabetes, and heart disease risk [4].
The 2025 report—a collaboration between Harvard T.H. Chan School of Public Health and other leading health institutions—links cycle length irregularities to serious health risks including low bone mineral density (which increases risk of fractures), irregular heart rhythmset metabolic conditions like obesity and Type 2 diabetes. The results were so significant that the study authors advise clinicians to regularly document female patients’ menstrual patterns (not just during adolescence), because tracking cycles can help detect disease, monitor wellness, and guide treatment.
The 2025 report links cycle length irregularities to serious health risks including low bone mineral density, irregular heart rhythms, and metabolic conditions like obesity and Type 2 diabetes. The results were so significant that the study authors advise clinicians to regularly document female patients’ menstrual patterns, because tracking cycles can help detect disease, monitor wellness, and guide treatment.
Organizations like FACTS about Fertility are seeking to upskill medical professionals by teaching them to understand and integrate menstrual cycle parameters into their general and acute women’s health assessments. Again, Ms. Kitchener’s article profiled (and even pictured) Dr. Marguerite Duane, the founder of FACTS about Fertility, but only in the context of government funding and programs for fertility education. Dr. Duane’s life’s work, however, is not about policy—it’s about the CME and CNE-approved education of health professionals who need to learn to assess parameters of the female cycle the same way they learn to assess EKGs for cardiac health.
On the lay person front, individual FABM instructors like Lisa Hendrickson-Jack have been reaching the masses of health-conscious women long before MAHA. Hendrickson-Jack’s book, since The 5th Vital Sign (published in 2019) and her popular Fertility Friday podcast (which has over 3.2K followers), have long been staples for the health-conscious woman (as has the work of Dr. Jolene Brighten, Dr. Lara Briden, and others). And these women are not alone. Droves of other FABM instructors and non-conventional healthcare professionals including naturopaths, acupuncturists, nutritionists, pelvic floor physical therapists, and more, have valued the menstrual cycle as relevant to women’s health for years.
FABM instructors et users are a diverse bunch
Instead of highlighting any of the diverse, multi-disciplinary professionals who can be found within the fertility awareness space, the instructor Ms. Kitchener chose to highlight throughout her article (Samantha Kopy, who works for Whole Mission) is obviously Catholic and holds the belief that difficulty abstaining on possibly fertile days “could be a sign that it is time for a baby,” as relayed by Ms. Kitchener, who watched as Ms. Kopy taught a virtual FABM class to Christian couples from her Ohio home one Tuesday evening. While Whole Mission is clear about its faith-based services so that potential clients can decide if that’s the perspective from which they want to learn a FABM, Ms. Kitchener clearly made a choice to highlight this element of the organization’s ethos, resulting in the impression that the Whole Mission approach is representative of all FABMs.
While it’s true that many FABM instructors practice a faith, not all are solely motivated to teach fertility awareness because of their faith or feel the need to incorporate faith into their instruction. Indeed, while one would never guess this from reading Ms. Kitchener’s article, there is a growing number of secular, even liberal FABM instructors who would, for example, support the use of condoms during the fertile window, the termination of unplanned pregnancies, or the instruction of LGBTQ couples seeking cycle support for IVF or IUI.
While one would never guess this from reading Ms. Kitchener’s article, there is a growing number of secular, even liberal FABM instructors who would, for example, support the use of condoms during the fertile window, the termination of unplanned pregnancies, or the instruction of LGBTQ couples seeking cycle support for IVF or IUI.
Certains instructor platforms wisely give instructors the option to include their personal views on sexuality, abortion, etc. within their bios so clients can self-select someone with whom they may feel more comfortable when sharing personal information. The key is that the client decides, and that there is, in fact, an instructor for every age, stage, and stripe of womanhood. But again, this is a reality that Ms. Kitchener ignores within her article.
Given that the author spoke with over 24 people with expertise in the field (including one of the authors of this article), one can only reach the conclusion that Ms. Kitchener was not only aware of this diversity, but that she actively chose to omit it within her article.
Reading between the lines: An attack on fertility awareness is an attack on increased autonomy in reproductive health
If Ms. Kitchener’s goal from the start was to leave readers with the false impression that FABMs are ineffective, she could have saved herself a great deal of trouble merely by placing the inaccurate and unverified “77% effective” statistic up front and center. Instead, she buried the lead in a rhetorically savvy piece that plays at giving FABMs a fair shake while ultimately painting them as ineffective and ideologically-driven.
Furthermore, while one hopes this isn’t the case, Ms. Kitchener’s article seems intended to harm the mission of fertility awareness advocates everywhere, who desire to give women plus autonomy, informed consent, and freedom of choice over their health and reproductive decisions, not less, as seems to be the thrust of her article.
“We’re already fighting incredible bias against FABMs, especially among clinicians serving under-resourced populations,” says Katie Vidmar, founder of The Body Literacy Project. The vast majority of Title X clinicians, for example, are ignorant of the real science behind the methods, and view these reliable, evidenced-based methods of family planning as “non-viable options” for the populations they serve [5]. “It’s a shame,” notes Vidmar, “that rather than breaking this bias and working to end women’s disempowerment through better health literacy, Ms. Kitchener and her editors instead chose to perpetuate the status quo.”
“It’s a shame,” notes Vidmar, “that rather than breaking this bias and working to end women’s disempowerment through better health literacy, Ms. Kitchener and her editors instead chose to perpetuate the status quo.”
Whatever Ms. Kitchener’s and her editors’ motives were for making FABMs, NFP, and the body literacy movement out to be a political ploy, they cannot change the fact that fertility awareness has a rich, scientific legacy of effectiveness. They also cannot change the reality that these methods have been improving the lives and health of millions of women of all races, religions, and economic means long before President Trump, MAHA, or any conservative influencer started talking about women’s health, family planning, or fertility. And finally, they will not change the dedication that countless fertility awareness advocates (including those of us here at Natural Womanhood) have to continue ensuring access to these methods long after the influencers move on.
