When I first came into the NFP world, I felt like the printing press had just been invented and I was entering a whole new period of enlightenment. I thought, “If people only knew about this, we could really be gaining new knowledge about women’s bodies and health. This is it! This is the revolution that needs to happen.”
I quickly learned that in this business, there are a lot of critics and you will get eaten alive if you don’t learn the appropriate time to speak and the appropriate time to keep your mouth shut, no matter how benevolent your intentions.
The basic, scientific, organic biology of the female body is left in the dark for many. I had someone tell me yesterday, “My birth control pill doesn’t stop ovulation, I know when I’m ovulating. Every month, I can just tell. I still have periods and everything, it just prevents pregnancy.” I was standing there, utterly speechless, completely astounded as I had the staggering realization, “This girl has no idea of the biological workings of her body, including the medication she puts in it every day.” It was a horrible insight. When I explained that the primary contraceptive effect of OCP’s was suppressing ovulation (Most of the time. I understand that breakthrough ovulation, while rare, can occur.) she staunchly purported that I was incorrect, and that her calendar app (which used no observational signs, merely the counting of days) alerted her when she was ovulating.
I stopped talking. Because this was a losing battle from the start. She has been fed misinformation about the reproductive structure of the the female anatomy, and even more sadly, she is a nursing major.
Fast forward thirty minutes or so. This is where I should add, I was in my Human Sexuality class. While I have been known to talk about FAM in totally non-academic settings (yea, judge me now, I’m a FAM nerd), this actually was a pertinent time and place.
I mention, Natural Family Planning, to which a male scoffs in reply, “You mean pulling out? Yea, that’s a good one, real effective.” Trying to keep my cool, I explain, “No, using a woman’s cycle to determine fertile and infertile times.” He gives me a blank look then sneered, “You mean the rhythm method?” Still trying to remain cool, I said, “No, the rhythm method has been long outdated. Modern methods are based on science, not guessing and counting days.” He still looked rather blank, and then answered, “Yea, that’s got an efficacy rate of like 50%. But hey, those Catholics, they pop out babies anyways.”
Another losing battle from the start.
So I got to thinking, just how “effective” can FAM be as a family planning tool? When you Google FAM effectiveness, numbers range drastically from 70% to 99.97% success. That’s a radical difference in terms of efficacy; nobody wants to hear that their family planning tool will result in unplanned pregnancy .03% of the time, but maybe 30% of the time.
In order to really determine efficacy of FAM for family planning, you have to go so much further than the numbers. There are 3 major problems when looking scientifically at FAM studies.
1. The rhythm, calendar, standard days, and cycle beads method all get lumped in as part of FAM. If you looked at a study of JUST cycle beads, the rates of unplanned pregnancies would be ridiculously higher than a study of, say, solely Creighton or Billings method. (Which are often associated with the lowest of unplanned pregnancy rates.) It drives me up a wall when people associate these unscientific, unreliable, and outdated methods with Symptothermal and Ovulation methods. Because these “counting days” methods have nothing to do with actually looking methodically at biological signs, they really shouldn’t be put in the same category as other scientific methods. But they are. So when you are looking at efficacy rates, you really have to look at the different types of methods used. If the rhythm, calendar, standard days, and cycle beads are part of the study, the number of unplanned pregnancies is going to be insincerely high.
2. We get wrapped up in studies – have you ever heard that dark chocolate is good for you? Probably. Have you heard that the upper limit of dark chocolate in order to get the health benefit should not exceed the size of one dove dark chocolate square a day? Probably not. When looking at studies of effectiveness in family planning tools, we look at the outcomes without really sifting through the details. In many FAM studies, it is not determined in the unplanned pregnancy rate how many couples willingly entered a risky day for intercourse. Having charted myself, I know my cycle pretty darn well. Although I am not married (re: I only chart), I know what a safe day and a risky day look like. For example, you have a very low chance, but definitely a chance of conceiving on day 1 of phase 2. (First sign of fertility, being cervix change or fluid change.) Did the couple take part in risky business? If you chart, you *know* this stuff. You’re not in the dark, thinking “Gee, that baby came out of nowhere.” The method is simply as effective as you make it.
3. FAM and NFP are two different things. Fertility Awareness has no religious affiliation, whereas Natural Family Planning is very much tied in with the Catholic church. One teaches abstinence during fertile times (if trying to postpone pregnancy) while the other promotes barrier methods (condoms, diaphragms, etc.). I bet you can guess which is which ? I also bet you can guess which is more effective ? Obviously, if you are using a barrier method during fertile times, the method of FAM you are using is only as effective as that barrier method. This misconstrues numbers greatly.
Here I Have provided an accurate, as unbiased study I have ever found that clearly represents ONE method. (Symptothermal)
Go beyond the numbers. Don’t just blindly accept everything you’re told. I know this has been a long post, but I feel this is of great value to the female sex. We deserve more than a shoddy study sans background information. We deserve to know our very basic, innate, biological patterns. It can be terrifying at first – it’s kind of like taking training wheels off. But the more you do it, the more confident you get, it’s no longer a scary big chart with foreign numbers and signs. It’s YOU, it’s YOUR body and it’s very intrinsically yours, when you get to know it, it’s pretty dang cool.