NFP: Help a Sister Out and Gimme Some Answers

Sometimes, I get caught up reading things. There’s a lot of varying discussions out there on NFP.

#1 “It worked great for us! We had 3 planned children, and have been using it for 18 years!”
#2 “After following the rules to a tee, we had 3 unplanned babies in 3 years. I was off for a vasectomy after that.”
#3 “We struggled with it, and have had 1 planned child and 3 oops. I’ve lost faith in it and am looking into an IUD.”

I’d love to know, because I don’t know and can’t seem to get an answer. I obviously can’t speak from personal experience. For those women that “follow the rules to a tee” and have multiple pregnancies while TTA – what happens? Are they just super fertile? What phase were they in? How many of these are “misreading a chart” and how many are truly method “failures” (I do hate to use the word failure in this context, but can’t think of a better way to put it. So I do apologize.) How often do true method “failures” happen? And when do they occur? How do they occur? (I assume phase 1, but I have heard of a woman that had a phase 3 complete surprise oops baby, talk about a miracle. She said her charting teachers were completely dumbfounded.)

I think genetics and different bodies determine how “easy” or “hard” NFP charting can be. Obviously, some women have pretty regular cycles with obvious fertility patterns. Other women are wildly unpredictable, with temperatures jumping all over the place. But even still, how do you follow the rules and have it happen three times?

And I’m aware, from a Catholic standpoint, a “failure” is not a failure, as we are called to be open to life. I’m sort of coming from a more secular standpoint in this post. A biological, scientific standpoint. I would like to know, biologically, what is the difference between woman #1, woman #2, and woman #3? How is it that NFP can be so radically successful for some women, and so completely on the other end of the spectrum, unsuccessful for others? Anyone? Bueller? Bueller?

Join the discussion here, cuz I wanna converse! I’m curious and confused.

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14 responses to “NFP: Help a Sister Out and Gimme Some Answers

  1. From our experience and those of others…

    1. No matter what your NFP instructor may say, not every method works well for every woman. This is true both physically and psychologically. Some women are better off checking multiple symptoms. Other women are better off with something simpler. Even a different look at the same symptom can make a BIG difference (Creighton vs. Billings).

    2. Not all NFP classes/materials are created equal. We’ve taken three and read TCOYF. The best classes/materials teach women to recognize their own patterns of fertility so they can know what “normal” is and notice when something is “off”. Many just focus on filling out the charts and memorizing the fertility rules and may not give women a true understanding of what is going on. The worst are when the instructor controls and limits the information based on what they think is best for the couple.

    3. Couples, especially Catholic couples, may try to rely on the method before they really understand it. Learning fertility isn’t always easy. It does take work. Sexual frustration and wishful thinking can make a couple think they are safer than they really are. Some couples try learn the method while breastfeeding, which is especially difficult. They can get caught in a “trap” of breastfeeding and pregnancy and may have several unplanned children close together.

    4. Couples may not feel comfortable discussing their sex life with their instructor and, as a result, they may not ask for help when they need it.

  2. Well, this one is sort of hard to answer.
    1st and 4th babes were completely planned. I followed the sympto-thermal rules.

    2nd and 3rd babes upon looking back at the cycle I realized I read it wrong but I was sort of lazy charting a bit b/c my cycles had not fully come back after nursing, and well, then they DID fully come back.

    My kiddos are all around 2 1/2 to 3 1/2 years a part, with the closest in age being the 3rd and 4th (planned lol) .

    Few things you find as you start having children:

    1. Some people really find that avoiding just isn’t as important to them. Some realize that each child is really an extension of their love and they just want more babies. Some just really embrace the Churches teaching on fertility and relax a bit.
    2. Some people find that they really don’t have the fortitude for it. They honestly just don’t have the will power to say no at that moment. It really does get hard sometimes, to deny yourself when you MOST want to be together. And to resent it b/c “no one else has to say no” in today’s society.
    3. When you are nursing/after pregnancy, some things come back differently and you sort of have to relearn. They really didn’t use to tell us that when we took the class 13 years ago. I am glad that they DO DO a discussion about this now and they have a training book just for it through Couple to Couple League.
    4. I don’t know many people with a high fertility that truly were able to avoid without adding multiple symptoms. Mucous gets really confusing after you have kids. Ovulation may start and stop and you may have multiple mucous patches as your fertility slowly returns after a child. Mucous also changes with age. Charting my temp has really really helped a lot to keep that part straight.
    5. Many people don’t try to learn NFP until after they have had a child. It is the dumbest time to try to learn in my opinion. And you have never had to learn what to do when you want to be intimate and can’t. Honestly, without the “before my cycle went crazy” information I probably would have been completely lost in reading a post-baby cycle
    6. And sometimes, the wife and husband are NOT on the same page. One may want a child and the other not and this is their “battle”.
    Really, there are many factors as you get years into this. .

  3. My background: My parents were in a similiar situation. They used contraceptives for the first part of their marriage. They had belonged to a very liberal parish and thus been told this was justified. When I was about 7, my parents decided to be more obedient to Church teaching. I’m not sure when they learned NFP. I’m 8 years older than my sister, and I know she was planned. My mom has serious complications during the pregnancy. After my sister was born, my mother had 2 unplanned miscarriages between the 2 year gap between my sister and my youngest brother. During the 2nd miscarriage, she nearly hemerraged to death. They tried to use NFP again to prevent pregnancy, but got pregnant with my brother. There were more complications. She got through the pregnancy, but my parents were told that if she got pregnant again, she probably would not survive. As such, NFP was abandoned.

    For years, my parents insisted it didn’t work, but more recently there has been some regret over the decision and a bit more honesty about their situation and knowledge of using NFP. Granted, some things they don’t tell me since I am, after all, their daughter.

    I first began charting several years before I got married. I was writing an essay about NFP failure rates in comparison to contraceptive failure rates. As a part of that essay, I decided to chart to see if I could identify the pattern the books said I would find. I found doing this actually helped me with chastity as a single person. I also liked the health record. I stayed fairly aware of my fertility for years even after I stopped charting. Six months before I got married, I learned Creighton. I have one daughter and we feel pretty confident about making informed decisions about our activity. We feel its very reliable.

    Between my experience, conversations I’ve had, and several books I’ve read on the subject, I believe the majority of the problems stem from the following:

    1. Too many couples are learning NFP while they are sexually active.

    2. Too many couples are struggling to learn NFP during a special circumstance such as while breastfeeding or getting off the birth control pill. Its like jumping into “Advanced NFP” while taking a crash course (without doing the real homework) in “basic NFP.”

    3. The temptation to not abstain is SUPER STRONG while breastfeeding. Your body attempts and fails to ovulate several times. Fertile mucus patches get longer and longer until your body succeeds to ovulate. You don’t know which of these patches you will actually ovulate during (just that the safe side is to abstain), and according to TCOYF, periods of abstinence can lengthen to as long as an entire month.

    3. I know several women who claimed they were using ecological breastfeeding as their exclusive NFP method during that special circumstnce when they did not know or understand the rules. Even in secular circles, doctors still complain about the number of people who think you can’t get pregnant at all while breastfeeding at any level. If you want to rely on breastfeeding without charting, you need to educate yourself. http://en.wikipedia.org/wiki/Lactational_amenorrhea

    I do have a friend, though, who has expressed concerns that the studies on ecological breastfeeding are flawed. She said that the studies were conducted in 3rd world countries where women were also suffering with malnutriention that could also effect whether she ovulated or not. I have no idea. I know the Couple to Couple League has pushed away from promoting ecological breastfeeding. Creighton acts like it doesn’t even exist.

    4. Underlying health issue causes woman’s symptoms to appear fertile the majority of her cycle. Most people with these issues tend to gain the most benefit from the Creighton Model along with a doctor whose been trained in napro. For most of my friends, this means traveling a long ways to find such a doctor. Most doctors simply cover symptoms up with the birth control pill or don’t offer any help. Before doing that, sometimes diet changes help: “Fertility Cycles and Nutrition” is a fairly good book.

    5. People not realizing that antihistomines and decongestines messes with your fertility symptoms.

    6. BBT relies on you getting regular sleep. It isn’t reliable if you’re getting up in the middle of the night to take care of an infant.

    7. Some of my friends complain that they don’t have time to consistantly check their symptoms every time they use the bathroom. Some child emergency happens and they feel the need to abandon the bathroom immediately. Personally, I feel checking my symptoms is so second nature, their complaint doesn’t make much sense to me. Then again, I only have one kid.

    8. NFP can strain a relationship if both people aren’t completely on board with it. It can highlight problems in the relationship. A spouse can guilt and pressure another spouse to have sex while fertile. A spouse may feel like they are the ones always putting on the breaks during the fertile time. Their spouse may react to this rejection by emotionally distancing from their spouse in other ways. It demands a strong and healthy relationship more than it causes one. As such, it might test and cause you to reform your weak points, but it can also make a bad relationship feel worse.

    • I actually have found that the “My temp is not regular because of sleeping” is not completely accurate. I think those are people who just don’t feel like sticking the thermometer in their mouths for 2 minutes and going back to sleep if they need to. You really can still get an accurate temp and be up with a baby most of the night. I actually have done it. And am doing it now.

      Ecological breastfeeding… I have actually used it. And there IS a point you realize your body is about to ovulate, even if you are still nursing.

      Maybe the “problem” is really a lack of willingness to follow through with it all?

      Anyway, very good points.

      • I was just giving the advise on BBT that I’ve read. I also had a roommate who was preparing to get married. She was obsessed with getting to bed by 8pm each night and waking up at exactly the same time. It made writing my papers very difficult because I often got most of my best work done later in the evening. I also didn’t have a laptop at the time so to get my papers done, I had to frantically ask other friends if I could borrow there’s (since the library was closed). She insisted any mess up in her sleep would mess up her BBT.

        My family also has struggled with BBT a lot. I did just do a google search and apparently being a mouth breather can have that effect and we are definitely all mouth breathers.

        As for breastfeeding, it may well depend on the woman. My mother pumped, used pacifiers, etc, and she was convinced it was impossible to get pregnant while breastfeeding. She weaned her kids all at 6 months (she thought longer was gross) and her cycles returned on cue. (She told me this during my pregnancy) Meanwhile I have friends who’ve obsessed over ecological breastfeeding and who’ve gotten their cycles 4 months after giving birth.

        Creighton insists that even with exclusive breastfeeding, you need to start charting 56 days after giving birth. I really don’t know what telling sign there would be that would make the breastfeeding time easy. I know several friends who complained about being terribly confused and then ended up pregnant. I certainly found it frustrating. I was so happy when the cycles returned to basically normal!

      • Dear Ange,
        Some women’s temperatures are more easily disturbed by circumstances than others. Some women do need to have four solid hours of sleep and then take their temperature immediately upon waking. Some babies or their parent’s sleep cycles don’t let their parents get four whole hours of uninterrupted sleep every night. Please don’t generalize.

        For me, I’ve been trying to figure out how to take my temperature while having two babies under two and breastfeeding both of them (although I don’t allow the toddler to nurse at night). For a while I was having success taking my temperature when the baby aroused me for the first nursing after midnight, which usually allowed for about four hours of sleep. Babies having colds and waking more frequently threw that off, and then my waking before the babies because I was used to them waking more frequently threw it all off. If I slowly wake up and only take my temperature when I’m fully awake my temperature is an awake temperature and no longer my basal temperature. It is very difficult to figure out what affects it and how to accurately get a temperature while waking frequently at night.

        I’ve found that ovulation strips have helped me look for the “window” and so know ovulation is approaching. I have the “OvuView” app on my phone, and it compares rules across several NFP schools, which also helps.

      • uncommonlore: It’s all interesting actually because once you start actually having children, there are so many “catches”. For BBT, I have found in my experiences and with those I know that it is not the waking itself but fertility not completely returning/hormone imbalances that cause the fluctuations.

        My youngest is 18 months and a good night of sleep for him has been waking up 5 times a night throughout these last 18 months. I had irregular temps until my fertility started truly returning back. It actually very closely followed a pattern in the Couple to Couple Leagues new books about returning to cycling after having a child, mine was just delayed out longer.

        And truly, I meant no offense by my “generalization”, only responding to Honestly Catholic’s “generalization” about tissue readings. I have only found that temp fluctuations are a sign of cycle problems more than waking problems. That being said, drinking alcohol completely throws off my temp every time. But if I were a “regular” drinker, I believe my body would adjust to it, just as my body has adjusted to all the waking I do for my baby.

        LH stripes actually are inaccurate at this time in my life as I am at a perimenopause state. They will turn days before I have a high temp. And the temp is not wrong. My doctor has confirmed that they can show a positive but then the body delays ovulation after all.

  4. These are all very interesting points. It sounds like at the end of the day, it’s as “effective” (again, I hate to use that word in terms of creating lives) as you are motivated to make it. And the true “failures” (I’m assuming the 1% of the perfect use, as in “we followed all of the rules and still got pregnant”) happen, but aren’t the norm? I can count on one hand a number of women who have gotten pregnant even on artificial hormones….only one 100% effective way, I suppose!
    I have been charting for about a year now and have found temps to be practically useless. (Same time, every morning, in bed.) Sometimes they’re all over the place, sometimes I see a distinct rise, but it often doesn’t stay there. Again, I’m not overly concerned about it because I’m not using it for family planning. But I likely will one day. I wanted to get as much practice and knowledge about my body, regardless of my marital status!
    I have thought about how child bearing must really complicate everything. Even though I’ve been incredibly regular all my life, I am curious to see if that will change if I ever do have children.
    I also agree with James that every woman is simply different. I’m honestly so regular the Rhythm Method would be fairly reliable. (But I like to know my body, and see the cyclical change!) I wish every woman was taught charting so those that were interested could get a lot of practice without the pressure of “Now I’m engaged I have to get this perfect.” I have found it helpful to not have pressure, I’m just charting and discovering, there are no “mistakes” to be had.

    • The user effectiveness is pretty low. The method effectiveness is high. “Natural Birth Control” covers multiple methods and is pretty clear that most failures are likely do to people knowingly using their fertile time. The book also says that couples in the studies were more likely to report a great indifference to pregnancy than couples who typically contracept. Most of these claims, though, seemed antedotal.

      Creighton is the only method with a high user effective statistic. Couples who knowingly used their fertile time were counted as a couple trying to get pregnant. Only in the intro class was the statistic of how frequently people do this given. Its not in the instruction book and I’ve only been exposed to the statistic once. I think it gives a statistical look at user failures in regards to knowing their fertility. The training manual heavily emphasises that there is no such thing as taking chances as, if you have normal fertility, you have a very HIGH chance of getting pregnant within the first month you use your fertile time. This has been our experience.

      We have one friend who said according to her chart, she was well in her luteal phase and should not have been able to get pregnant. She had just been accepted into law school. Convinently, she gave birth just after a semester ended. She has told me its important to trust God more than a method.

      • Wow! That is the second time I’ve ever heard of someone conceiving while all signs pointed that ovulation had already occurred. I was under the impression that that was physically impossible. So how exactly does that happen? Is there a false detection of peak temp/CM and the body sporadically does ovulate without all the impending signs??

        Also do you think that because the “trusting God” factor, NFP (or FAM, really, differences aside) requires a religious faith? The whole idea that some stuff is really out of our control? Or maybe it’s the same with artificial contraception, as I said before, it too, can fail even if used “perfectly”. But perhaps more faith is needed for something like NFP or FAM? I always thought fertility charting should not be exclusive to Catholic women, because the health information gained is so valuable. But I am starting to think it requires the user to be *somewhat* okay with an unplanned pregnancy…

        How common would you say true “method failures” occur? And is it possibly unethical that Creighton puts those in the instant “TTC” category when they simply made an error in analyzing their chart?

        I don’t know – these are just my thoughts…

      • She was using Creighton and thus was not taking her BBT. Stress can cause you to double peak. That is to say that you’re body prepares to ovulate (you get a patch of mucus) but then your stress hormones suppress it and thus delay ovulation. Creighton relies on asking yourself if you’ve experienced unusual amounts of stress and if anything seems atypical about the mucus pattern compared to your usual pattern. I think she said she also suffers from PCOC which is part of the reason she’s using Creighton.

        Fertility Awareness Methods do exist outside of Catholic circles. In fact, for awhile, I felt they were advancing beyond the Catholic Church — though mainly in regard to charting web applications and digital devices. The method tends to be primarily used by couples trying to get pregnant. People looking to get away from hormones and the side effects of other contraceptive methods also have some interest. They typically, though, are turned off by Catholic organizations because they don’t like the preachiness. Usually, I refer people to “Taking Charge of Your Fertility.” There is also ladycomp which is a really expensive BBT Thermometer. There is no chart. It flashes lights on you when you’re fertile and it seems to auto-adjust your temp if you failed to take it at the right time. Oddly enough, CycleBeads isn’t entirely unpopular either though it is a modification of the Rhthym Method. Its really strict though. Your cycles have to be regular enough and within a certain range length. It basically gets you to your lutael phase. My husband found a study on the user effectiveness and apparently the its more effective among users when the beads are made out of wood rather than cheap plastic — odd since it has nothing to do with the method.

        Sympto.org is a non-American site (some of their material is not in English) that teaches sympto-thermo. Its a really nifty looking chart. The iphone app I heard is very confusing though and it took me a few watches of the tutorial video to realize it gets women into their luteal phase. All other days are automatically considered fertile. There are also a number of non-Catholic apps as well.

        A number of them don’t bother to give instructions for special circumstances. Those that do (like TCOYF) still tend to be brutally honest about how challenging special circumstances are. Generally speaking, more people use the method to try to get pregnant. Those that do try to use it to avoid approach it similarly to a woman who would like to shoot for a natural birth, but only sticks with it if things are kept simple and if the doctors don’t pressure epidurals and the like. You have to be REALLY motivated to stick with it. I know Catholics who’ve given it up because they tentatively were giving the Church’s teaching a chance but didn’t feel right about it in their heart. They found that NFP made every non-fertile day feel like a “you must have sex now” which put a lot of sexual pressure on them. They didn’t like how this effected their relationship so they quit.

        It took awhile in my marriage for me to not see the non-fertile days that way. My luteal phase tends to be shorter than most women’s and I have bad PMS that for awhile made sex completely unappealing during that time. It didn’t help that I was recovering from vaginismus and was having so many failed attempts at trying to consumate my marriage. I still get nervous occassionally that my body just isn’t going to work. But eventually we just started talking about it as “Let’s spend time together being intimate and be open to whatever it goes. Heavy emphasis on the no pressure.”

      • “Trust God more than a method” is a cop-out. A good method should be able to predict these.

        Our second child came from very similar circumstances, and possibly our first as well.

        Using Creighton, saw peak, was well in the luteal phase when the pregnancy occurred. Our instructor was shocked.

        After taking Billings classes and temping (something we were told NOT to do, even though she was having trouble identifying peak) we figured out what happened. The peak was “different” than a normal peak and the dry up wasn’t as abrupt. Had we been temping we would probably not have seen a shift. We’ve seen this pattern again and were able to successfully avoid.

        Our experience is that Creighton puts so much emphasis on the observations and the coding that we couldn’t see the forest for all the stinkin’ trees. Perhaps this was the instructors, but Billings did a much better job of explaining what to look for and what HER pattern of fertility looked like.

        As for “mouth breathing”, the mouth isn’t the only place to get a temp. IIRC, most European studies don’t use oral temps, but there is a cultural resistance to temping in other places in the USA.

  5. Basically, there are some many factors that contribute to the effectiveness of NFP. I may not be the best person to contribute to this conversation, because we’ve been blessed to never really need to avoid pregnancy. We chart because “it’s a good thing to do,” but haven’t had to rely on it. Breastfeeding seems to have worked well at delaying my fertility, but I know breastfeeding women who’s fertility returns two months postpartum. Everyone’s body is different, and that effects how NFP works.

    The thing is, the same rule applies to all birth control. I know one woman who had six children, each one while on one form of contraception or another. Why does it happen? Who knows? Obviously, no method is perfect, and some women are just more fertile or more prone to “failure” (bad term…can’t get away from it) than others, or it’s a coin toss that they lose. NFP seems particularly susceptible to variations in effectiveness just because so much depends on the desires, persistence, and knowledge of the users in addition to physiological factors. Also, getting pregnant while using NFP to avoid never seems just like the method failed; the users often (usually?) blame themselves, which heightens the frustration considerably. It might be helpful to keep in mind that even secular people who are not opposed to contraception get fed up and switch their birth control because of ineffectiveness.

    Ultimately, simply coming from a Catholic perspective changes the whole tone of the discussion. The Catholic perspective views pregnancy, children, abstinence, chastity, and yes, even suffering differently. So “failure” means something different for a Catholic (or just religiously inclined) NFP user than it does for someone else.

  6. It won’t let me directly comment to the ange and uncommonlove. I don’t know if they will see this, but BBT is the only way to confirm ovulation has occured. Ovulation strips test to see when your hormones levels are high to cause ovulation. They do not actually confirm whether ovulation has happened. Its simply another sign that your body is preparing. The same is with mucus based methods. Mucus will tell you the hormone were there to cause ovulation, but not confirm that ovulation has actually happened.

    Huh…I had remembered reading in one of my books that sympto thermo had a slightly higher user failure rate than billings even though billings is mucus based only. I wanted to confirm that. Apparently in 2000, there was a large clinical trial of the Billings Ovulation Method. It doesn’t sound like they excluded couples knowingly using their fertile time, and yet the user effectiveness came out to .5%. Maybe its just China’s one child policy that gave the couples that extra motivation. I have no idea.

    The study was actually comparing the IUD with the BOM. More couples using the IUD got pregnant than those using the BOM. (IUD had a 2% failure rate in that trial).

    The study also found that the user failures happened more among couples who were more educated. The more educated couples needed more guidence. It was found to be too simple for them to grasp (like they were overthinking it). http://nfpaware.com/2011/08/clinical-trials-iud-vs-billings-ovulation-method/

    Which is interesting because the argument in the book that compared sympto thermo and Billings said that Billings may simply be more successful because its kept simple.

    Very interesting, because I know several college educated women who hated billings because they were getting confused about how to identify the mucus correctly. They loved Creighton because it really set it out straight for them.

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