The Truth About Fertility Awareness–Based Birth Control Methods and Natural Family Planning Everyday Health MenuNewslettersSearch Sexual Health News 6 Family Planning and Natural Approaches to Birth Control That Are Legitimate Contraception MethodsOften dismissed or misunderstood, fertility-awareness methods (FAM) are science-based, effective approaches to pregnancy prevention. By Cheryl AlkonMedically Reviewed by Kacy Church, MDAugust 2, 2018Everyday Health ArchiveMedically ReviewedTracking waking body temperature each morning along with other patterns of biological changes during the month are key to fertility awareness.iStock (2)For many reasons, some women choose not to use contraception with hormones, barriers, or anything else other than the body’s natural changes. Collectively known as family awareness methods (FAM), these options include elements such as tracking a woman’s biological changes throughout the menstrual cycle, relying on exclusive breastfeeding when feeding an infant, and using a calendar. RELATED: Best and Worst Birth Control Options FAM Is a Contraception Option Say Experts FAM options can be considered effective and modern forms —meaning they should be included with other types of birth control in family planning programming — according to a study published in the March 21, 2016, issue of Global Health: Science and Practice. “The United States Agency for International Development (USAID) supports FAMs as modern contraceptives because these methods meet the criteria for a modern contraceptive,” the authors write. According to the study authors, in particular, “FAMs:Are effective at pregnancy preventionAre safeAre based on a sound understanding of reproductive biologyInclude a defined protocol for correct use, andHave been tested in appropriately designed studies to assess effectiveness under various conditions.” RELATED: Birth Control Resource Center Effectiveness Varies No Contraception Is Perfect That is not to say that FAM, or any type of birth control, is fail-safe. Efficacy and failure rates should always be considered when evaluating contraception options. Fertility-Awareness Contraceptive Approaches Deliver Bonus Benefits Because FAM can be difficult to use, the efficacy rates aren’t great (76–88 percent effective). In other words, a woman using a FAM method with an efficacy rate of around 80 percent would face a 20 percent chance of pregnancy over one year's time. Still, efficacy rates are one of many factors to consider when weighing one's contraception options. According to the authors of the study published in 2016, FAM methods have other unique benefits. They “are knowledge-based, relying on women’s understanding of their fertile cycle and, in one case, of how breastfeeding practices can temporarily suppress fertility. They do not require clinical intervention, such as hormones, devices, or procedures. They are controlled by a woman and her partner. They increase a woman’s understanding of her fertility and biological processes and can provide the opportunity to facilitate pregnancy planning.” RELATED: Birth Control in America: A Brief History of Contraception Where to Find FAM Information and Guidance Sometimes referred to as the rhythm method, FAMs can be offered through a wide variety of channels, including settings completely outside the health system, the authors write. It’s a good idea to combine these different forms of FAM, for higher effectiveness. Doing so is called the symptom-thermal method. It’s also a good idea to work with a healthcare provider or sex ed counselor who knows these methods well. Different health issues can affect how the menstrual cycle operates, so talking to a provider can uncover any health issues that may affect the cycle. Here’s a breakdown of different FAMs. 1 Standard Days Birth Control Method Women who have tracked their menstrual cycles for at least three cycles have learned how long those cycles typically run. For those with cycles between 26 and 32 days long, this method can work. It involves avoiding sex (or using a condom) from the beginning of day 8 through the end of day 19. 2 Two-Day Birth Control Method This method involves checking for cervical mucus from the vagina twice a day, and tracking patterns on a chart or app. The body will secrete mucus during the fertility window; the mucus can range from watery and clear to thicker and yellowish. These secretions help the body move sperm up toward an egg and are considered your body’s most fertile times. During two days in a row that are dry, you are considered least fertile. 3 The Cervical Mucus Birth Control Method Cervical mucus has different consistencies throughout the menstrual cycle. There are several ways to measure cervical mucus, and it can be done first thing upon waking in the morning. You can wipe the vagina before urinating, observe mucus on the underwear upon waking, or reach into the vaginal opening with clean fingers to see and feel the mucus. RELATED: The Politics of Contraception in Modern America Recording the description of the mucus on a calendar or app will help you see patterns during the menstrual cycle. Menstrual blood hides mucus, so consider period days fertile ones. Once the period ends, there are typically dry days that may be considered less-fertile days depending on the length of your cycle. As an egg begins to get ready for ovulation, cervical mucus will appear, typically yellow, white, cloudy, and more or less sticky. Just before ovulation, mucus gets slippery so it can best help sperm move into the vagina to meet an egg. This is the most fertile time and when it is best to avoid unprotected vaginal sex if pregnancy is unwanted. After several days, the secretions get more cloudy and sticky, and then disappear. Once there are no secretions, this time is considered infertile and least likely to promote pregnancy. This phase continues until the period begins again and the monthly cycle starts over. RELATED: What Is Emergency Contraception? 4 Cervical Mucus Plus Basal Body Temperature Tracking Another method often used along with cervical mucus tracking involves taking the body’s basal temperature upon first waking up in the morning. The body temperature rises slightly when you ovulate, so tracking the rates for at least three months can give you an idea of when to avoid unprotected vaginal sex for when you are most fertile. It is recommended to take your temperature at the same time in the morning every day, yet it is important to understand that different factors can affect the body’s temperature, such as illness, stress, fatigue, smoking, drinking alcohol, or using a heating pad or electric blanket. Talk to your healthcare provider or qualified counselor about tracking your results and how to best read a chart of at least one month of data. 5 Lactational Amenorrhea Method LAM of Birth Control This method is when new mothers exclusively breastfeed their new babies for a period of up to about six months. Exclusive breastfeeding means the baby is nursed on demand (during the day and at night), does not use any bottles or pacifiers, is not eating any formula or other foods, and the mother hasn’t had her period return yet, not even spotting, since six weeks after delivery. Effective rates on LAM are about 98–99 percent if the mother follows all the above conditions, but start to decline as soon as a baby eats more than breastmilk, nurses less than on demand, or the mother’s period returns. In these cases, using a second form of contraception, such as a condom, is a good idea to prevent an unplanned pregnancy. 6 Combined or Sympto-Thermal FAM-Based Method of Birth Control Call it the greatest hits of family planning methods. Using two or three different FAM approaches, such as cervical mucus observations along with calendar planning or basal body temperature charting to predict ovulation, the symptom-thermal fertility awareness method increases effectiveness and reduces failure rates compared with utilizing one FAM method alone. NEWSLETTERS Sign up for our Sexual Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. The Latest in Sexual Health The Four Best At-Home STD Tests of 2022 At-home STD tests offer accurate results, and in some cases post-diagnosis care, without the need to leave your home. Check out our guide to the best ...By Chrissy HolmOctober 6, 2022 People Are Flocking to a Hotline With Their Miscarriage and Abortion QuestionsCalls to this free, anonymous service are up substantially since the fall of Roe v. Wade.By Meryl Davids LandauSeptember 23, 2022 8 Myths About Medication Abortion and Abortion PillsQuestions about medication abortion? 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