Here is an example of why our petition asking the CDC to change the way they represent Fertility Awareness Based Methods’ effectiveness on their website is so relevant: two weeks ago this Planned Parenthood web page showed up on my Google Alert about Fertility Awareness. I was happy to read some positive and accurate information in their review of FABMs, such as the fact that “FAMs are safe, inexpensive, and hormone-free.”
But it also includes damning inaccuracies about FABMs, the main one concerning their effectiveness rate: “FAMs are about 76% effective: that means 24 out of 100 couples who use FAMs will have a pregnancy each year.” The data comes from the CDC report, which is itself based on a survey of FABM users, of which 86% reported using some form of the low-effectiveness rhythm method. The sentence above is likely to stop most visitors of their site from reading any further.
It’s a problem because if you google “contraceptive options,” Planned Parenthood’s website comes up as one of the top sites, and so they are influencing many women (another site that comes up at the top is the National Campaign and it seemed more balanced concerning FABMs and avoided using numbers about effectiveness in the page I read).
Here are a couple of other serious errors in the Planned Parenthood review:
“If you use the temperature, cervical mucus, and calendar methods together, they’re more effective at preventing pregnancy: between 1 and 20 couples out of 100 have a pregnancy each year while using these 3 methods combined”: first, it is never recommended to use a mix of methods. Second, the effectiveness is not dependent on the number of signs but on following rigorously the method you choose, whether it’s relying on one sign or several. For instance, Billings, an “Ovulation Method,” which only uses the cervical fluid or mucus sign, has an effectiveness rate of 98.9% when use perfectly.
“They’re also not good methods for people with irregular menstrual cycles.” That’s only true of the Standard Days Method, which is a calendar based method. However, the majority of FABMs are effective with irregular cycles, because every woman produces visible signs that can show when the fertility window starts and ends. In fact, the methods remove the fear and uncertainty that often comes with delayed periods and can help diagnose why a cycle is irregular.
So I thought it would be a good exercise to propose a more positive and accurate version of the Planned Parenthood review of FABM, with the hope they would consider making these changes. I kept their outline. Obviously, I took a lot of liberties with the content, but kept some of theirs. In fact, my additions are italicized, and the Planned Parenthood copy is in normal font. Here we go:
Are fertility awareness methods right for me?
FAMs are safe, inexpensive, and hormone-free. While they require more effort and commitment, they teach you about your body, and are as effective as other types of birth control once you are trained to follow a set of simple rules.
Want to learn how to track your fertility? Find a Health Center → Comment by me: This links send you to a page where you can look up a Planned Parenthood clinic near you, which makes sense from a marketing point of view. However, I am not sure that these clinics offer FABM classes by trained instructors as of yet. Shouldn’t they refer to FABM providers instead?
How safe are fertility awareness methods?
Fertility awareness based methods (FABMs) are totally safe. Because you’re not taking any medicine nor putting any foreign device in your body, they have no negative side effects, though as you’ll see, they do have some positive ones.
How effective are fertility awareness methods?
Based on the highest quality published medical research, the effectiveness rates of FABMs with correct use are between 95.2 and 99.6%, depending on the method. With typical use, the effectiveness rates of FABMs are comparable to most commonly used forms of birth control, with unintended pregnancy ranging from 2-14%.
FABM effectiveness is not dependent on the number of signs you use: some methods only use the cervical fluid sign (Ovulation Methods), some cross check it with temperature (Symto-Thermal) or hormone level (Marquette). Here are some key considerations when thinking about using FABMs:
- Are you interested in learning about your body and willing to be more autonomous when it comes to family planning? FABMs require you to learn and follow a few simple rules. These rules are not complicated but require some discipline and a few minutes of observation every day.
- Can you dedicate time to take a class and learn from an instructor (1 hour per month for 2-3 months, available online or in-person)? A trained instructor will help you understand your unique fertility pattern and how to identify which days you are fertile or not.
- Is your partner on board? Is he open to learning and supporting you? Couples who use these methods don’t have sex less frequently than other couples, but it does affect the pattern of your sex life.
Are you interested in such a side-effect free and low-cost family planning method? Take this quiz to find which FABM may be best suited for you (I put this quiz here instead of the one they had about all forms of birth control; they probably wouldn’t do that).
Do fertility awareness methods have any side effects?
There’s no risk of side effects with FABMs. By charting specific observations and working with a trained health professional, FABMs can help find root causes of certain ongoing gynecological symptoms such as cramps, irregular cycles, PMS, post-partum depression, infertility, or recurrent miscarriages, and treat them effectively. Women who are not sexually active can therefore also benefit from learning to chart their cycles.
Can anyone use these methods?
FABMs are safe for everyone, and anyone can learn them regardless of their level of education, their socio-economic or cultural background.
They are especially appreciated by:
- Women interested in learning more about their bodies and their cycles,
- Women interested in avoiding pregnancy in a natural, environmentally-friendly way, without drugs or devices,
- Women interested in achieving pregnancy sooner and more effectively,
- Couples in a stable relationship who want to share responsibility for sexual decision-making or women who want to invite their partner to take equal responsibility,
- Women who experience gynecological symptoms, subfertility or infertility.
FABMs won’t work for you if: (note: that’s from the original copy)
- You or your partner don’t want to avoid vaginal sex or use another form of birth control for a certain number of days each cycle.
- You have a sexually transmitted infection, vaginitis, or a lot of discharge that isn’t normal. (FABMs providers would likely object: it is possible to work with these conditions)
- You can’t track your fertility signs daily and keep careful records. (Note: most women are quite capable of doing so when the motivation is there. )
What are the advantages of fertility awareness methods?
The benefits of fertility awareness based methods are that they’re basically free or cheap, have no side effects, and increase your literacy about your body and your fertility. They can also enhance communication with your partner and improve your emotional and sexual relationship.
Do fertility awareness methods protect against STDs?
Nope. Like most birth control methods, FABMs offer no protection from sexually transmitted infections.