<\/p>\n\n\n\n
In a November 9, 2025 article titled \u201cThe MAHA-Fueled Rise of Natural Family Planning,\u201d The New York Times <\/em>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). <\/p>\n\n\n\n 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. <\/p>\n\n\n\n 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\u2014well 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. <\/p>\n\n\n\n The Marquette Method, which is taught by the Whole Mission organization referenced throughout Ms. Kitchener\u2019s article, teaches women and couples to observe and track cervical fluid<\/a> along with urinary hormone metabolites of two reproductive hormones, luteinizing hormone<\/a> and estrogen<\/a>. More recently, some Marquette instructors have started teaching clients to use \u201cFemTech<\/a>\u201d devices like the Mira monitor<\/a> 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. <\/p>\n\n\n\n Even with the Marquette Method\u2019s \u201cchoose your own adventure\u201d variations for use, studies at Marquette University (including Fehring et al., 2017<\/a>) have found a perfect-use pregnancy rate of approximately 1\u20132 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.)<\/p>\n\n\n\n As with all FABMs<\/a>, 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 \u201c77% effective\u201d statement made by Ms. Kitchener, and counter to the article\u2019s implications that these methods are only perpetuated by those without scientific or medical backgrounds. <\/p>\n\n\n\n In fact, the Marquette Method (which is never mentioned <\/em>by name within the article) isn\u2019t even the most<\/em> effective FABM when it comes to pregnancy prevention. <\/p>\n\n\n\n If pregnancy avoidance is a FABM user’s top priority (unlike contraception, FABMs can be used for avoiding or<\/em> achieving pregnancy), the most effective FABM for pregnancy avoidance is the German-based method called Sensiplan\u2122 which boasts 97-98% typical use effectiveness rate (similar to the U.S.-based Couple to Couple League\u2019s SymptoThermal Method). This method has users monitor their cervical fluid secretions and basal body temperature along with optional cervical position. Certified Sensiplan\u2122 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. <\/p>\n\n\n\n Ms. Kitchener also fails to mention the original FABM, the Billings Ovulation Method<\/a>, 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\u2014in 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<\/a>.) <\/p>\n\n\n\n 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 \u201c77% effectiveness\u201d statistic; a newer, more updated version of the same graphic (from the same source ACOG uses, which can be found here<\/a>) acknowledges that, like contraceptives, FABMs exist on a spectrum<\/em> of efficacy, correctly noting that: \u201cMultiple FABMs exist. As a group they span categories 2 and 3.\u201d <\/p>\n\n\n\n This updated graphic from ACOG\u2019s 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 \u201c2-23%<\/a>\u201d failure range (a change<\/a> made, in part, thanks to the advocacy work of Natural Womanhood<\/a>). <\/p>\n\n\n\n This updated graphic from ACOG\u2019s 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).<\/p><\/blockquote><\/figure>\n\n\n\n Ms. Kitchener\u2019s mistake (if it can truly be called that) is a curious one to make, given that one of the article\u2019s most prominently featured interviewees\u2014Dr. Marguerite Duane\u2014is the lead author of the most recent, peer-reviewed, comprehensive study on the efficacy of the various most popular FABMs<\/a> [2]. Notably, Dr. Duane\u2019s 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. <\/p>\n\n\n\n In other words, the “77%” statistic used by Ms. Kitchener is unverifiable at best, and inaccurate and misleading at worst\u2014a deeply concerning mistake to make in a 2,000+ word reported piece dedicated to the topic of FABMs.<\/p>\n\n\n\n Tellingly, the NYT article prominently highlights the 28 cycle-syncing app (and its founder, Brittany Hugoboom\u2014also the founder of Evie<\/em> magazine) while failing to name any of the established fertility awareness-based methods for natural family planning and women\u2019s health<\/em>. <\/p>\n\n\n\n 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\u2019s health<\/em>. <\/p><\/blockquote><\/figure>\n\n\n\n Unlike the vast majority of cycle tracking apps<\/a>, 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.) <\/p>\n\n\n\n For further reference, here\u2019s Natural Womanhood\u2019s 2024 review of the 28 app<\/a>, which describes it as an aesthetically-pleasing fitness app for cycle-conscious women\u2014not something that can or should replace one\u2019s FABM. And while \u201ccycle syncing<\/a>\u201d your workouts is trending and may even be worthwhile, it\u2019s not exactly relevant in a discussion on the use of cycle charts for family planning (and neither, for that matter, is the article\u2019s quote from Dr. Sarah Hill, author of This is Your Brain on Birth Control<\/em><\/a>, that she would \u201cnever recommend [NFP] to my teenager.\u201d) <\/p>\n\n\n\n In truth, the menstrual cycle has been well-established as a woman\u2019s \u201cfifth vital sign,\u201d with ACOG first calling the menstrual cycle a vital sign for girls and adolescents in a Committee Opinion issued in 2015<\/a> [3]. More recently, in June 2025, Fertility & Sterility Reviews<\/em> published a comprehensive report<\/a> on menstrual irregularities in all women\u2014not just younger women\u2014along with associated health outcomes including cancer, diabetes, and heart disease risk [4]. <\/p>\n\n\n\n The 2025 report\u2014a collaboration between Harvard T.H. Chan School of Public Health and other leading health institutions\u2014links cycle length irregularities to serious health risks including low bone mineral density<\/a> (which increases risk of fractures), irregular heart rhythms<\/a>, and metabolic conditions<\/a> like obesity and Type 2 diabetes. The results were so significant that the study authors advise clinicians to regularly document female patients\u2019 menstrual patterns (not just during adolescence), because tracking cycles can help detect disease, monitor wellness, and guide treatment. <\/p>\n\n\n\n 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\u2019 menstrual patterns, because tracking cycles can help detect disease, monitor wellness, and guide treatment. <\/p><\/blockquote><\/figure>\n\n\n\n Organizations like FACTS about Fertility<\/a> are seeking to upskill medical professionals by teaching them to understand and integrate menstrual cycle parameters into their general and acute women\u2019s health assessments. Again, Ms. Kitchener\u2019s 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\u2019s life\u2019s work<\/a>, however, is not about policy\u2014it\u2019s about the CME and CNE-approved education of health professionals<\/a> who need to learn to assess parameters of the female cycle the same way they learn to assess EKGs for cardiac health. <\/p>\n\n\n\n On the lay person front, individual FABM instructors like Lisa Hendrickson-Jack<\/a> have been reaching the masses of health-conscious women long before MAHA. Hendrickson-Jack\u2019s book, since The 5th Vital Sign<\/em><\/a> <\/em>(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<\/a>, Dr. Lara Briden<\/a>, 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\u2019s health for years. <\/p>\n\n\n\n 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 \u201ccould be a sign that it is time for a baby,\u201d 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\u2019s the perspective from which they want to learn a FABM, Ms. Kitchener clearly made a choice to highlight this element of the organization\u2019s ethos, resulting in the impression that the Whole Mission approach is representative of all FABMs.<\/p>\n\n\n\n While it\u2019s 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\u2019s 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<\/a>, the termination of unplanned pregnancies, or the instruction of LGBTQ couples seeking cycle support for IVF or IUI. <\/p>\n\n\n\n While one would never guess this from reading Ms. Kitchener\u2019s 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. <\/p><\/blockquote><\/figure>\n\n\n\n Some instructor platforms<\/a> 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. <\/p>\n\n\n\n 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. <\/p>\n\n\n\n If Ms. Kitchener\u2019s 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 \u201c77% effective\u201d 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. <\/p>\n\n\n\n Furthermore, while one hopes this isn\u2019t the case, Ms. Kitchener\u2019s article seems intended to harm the mission of fertility awareness advocates everywhere, who desire to give women more<\/em> autonomy, informed consent, and freedom of choice over their health and reproductive decisions<\/a>, not less, as seems to be the thrust of her article. <\/p>\n\n\n\n \u201cWe\u2019re already fighting incredible bias against FABMs, especially among clinicians serving under-resourced populations,\u201d says Katie Vidmar, founder of The Body Literacy Project<\/a>. The vast majority of Title X clinicians<\/a>, for example, are ignorant of the real science behind the methods, and view these reliable, evidenced-based methods of family planning as \u201cnon-viable options\u201d<\/a> for the populations they serve [5]. \u201cIt\u2019s a shame,\u201d notes Vidmar, \u201cthat rather than breaking this bias and working to end women\u2019s disempowerment through better health literacy, Ms. Kitchener and her editors instead chose to perpetuate the status quo.\u201d <\/p>\n\n\n\n \u201cIt\u2019s a shame,\u201d notes Vidmar, \u201cthat rather than breaking this bias and working to end women\u2019s disempowerment through better health literacy, Ms. Kitchener and her editors instead chose to perpetuate the status quo.\u201d <\/p><\/blockquote><\/figure>\n\n\n\nThe NYT makes the debunked claim that FABMs are only \u201c77% effective\u201d <\/span><\/h2>\n\n\n\n
In a 2,000+ word article on FABMs, the author doesn\u2019t name a single<\/em> method<\/span><\/h2>\n\n\n\n
The author relies on out-of-date graphics to paint a picture of fertility awareness as ineffective<\/span><\/h2>\n\n\n\n
\u201cCycle syncing\u201d apps are not natural family planning methods, but they are prominently featured in the article nonetheless<\/span><\/h2>\n\n\n\n
Cycle charting is also about women\u2019s health\u2014but not because MAHA or conservative influencers say so<\/span><\/h2>\n\n\n\n
FABM instructors and<\/em> users are a diverse bunch<\/span><\/h2>\n\n\n\n
Reading between the lines: An attack on fertility awareness\u00a0is an attack on increased autonomy in reproductive health<\/span><\/h2>\n\n\n\n