 | Fertility awareness has a terrible reputation. Never mind the Rhythm Method jokes - what about the statistics? According to one very reputable source, the typical effectiveness rate for fertility awareness based contraception is only 76%. That means it fails one in four women. |
 Using condoms might be an alarming prospect if it's a while since you last used them.
Or your most vivid memory is sniggering while you rolled one onto a banana at school... They can work very well, but you need to know what you're doing - a bit like fertility awareness. Here's some tips: I wrote this letter [Free link] with Emma Pickett after reading this research about improving access to postpartum contraception.
We suggest that breastfeeding, and so child health, could be supported more effectively if those providing postpartum contraception: 1. Routinely offered the Lactational Amenorrhea Method (LAM) as a contraceptive option. LAM can be over 98% effective so long as a woman meets all three lam rules: fully breastfeeding, her child being less than six months old, and her periods not returning. The "fully breastfeeding" rule means it supports good practice in terms of breastfeeding. LAM is not always communicated effectively, but that seems like grounds for research into effective communication, not a reason to dismiss it. 2. Adopted a more cautious approach to prescribing hormonal postpartum contraception. There is substantial anecdotal evidence that this can cause breastfeeding problems for some women. Problems are less likely if women who want to use hormonal contraception start with the progestogen-only pill before moving on to the injection or implant. Please see this web page for further information. As mentioned in the above post, I wrote this letter with Emma Pickett after reading this research about how to improve postnatal contraception. The full text is here, in case the other link doesn't work:
 Reading this book made me realise how lucky I was with my breastfeeding experience. Thanks to absorbing information from friends and ante-natal classes, I expected breastfeeding to be a doddle and it was. Time-consuming but a doddle. There's worse things than having to sit around for hours at a time with a baby attached to your boob. Unfortunately, not everyone has it so easy. We might be designed to breastfeed but we are also from the generation that was most likely to be fed formula ourselves. What was once routine can now seem mysterious and intimidating. We hear the glib message “breast is best” but that doesn’t always help. "Best" is all very well but who achieves that? Women need support not just slogans. That's what this book is all about. BPAS kindly nominated me a Champion of Choice for my fertility awareness work so I wrote this:
Fertility awareness (natural family planning) is not a contraceptive choice for the faint-hearted. This isn’t because the method is difficult or ineffective. You need to know what you’re doing, and you need to be able to handle your fertile time, but it’s not rocket science. The hardest part is probably telling your doctor (and your friends) that you’re relying on it to avoid pregnancy. I’ve heard reports of eye-rolling and angry sighs from some doctors, or more dramatically “Well, don’t come back to me if you need an abortion”. [Not all doctors are like this, mine was lovely]
Funny, clear and wonderfully well made, this film has a freshness and honesty that makes it compelling viewing whether you’re new to fertility awareness as contraception or you've been using it for years. The tone is steady, measured and not overly evangelical, which I found a relief. I love fertility awareness but I don't want anyone to feel like they don't have options. Those interviewed talk briefly about how profit affects healthcare but this doesn’t overwhelm the main messages, and the film is sympathetic to healthcare providers wanting to do the right thing by their patients.
That said, please stay in bed to take your waking temperature!! The film shows a woman standing up with a thermometer in her mouth. I'm sure there were reasons for this but I can almost hear fertility awareness/natural family planning users crying “Nooo!!” when they see this. Your temperature changes once you get up and about. One of the advantage of fertility awareness is it means you have an official reason to stay in bed for a few more minutes. Even so, this is a brilliant film and beautifully done. Watch it!
 One of the first things you’ll be asked if you're choosing contraception is whether you’d like to have periods.
Many methods of contraception have "no periods"* as a selling point - even the pill can be taken more or less continuously, with just a few pill free days every so often to stop irregular bleeding. If you’re using fertility awareness as contraception there isn't a "no periods"  If you want to get pregnant, the NICE Fertility guidance recommends that you have vaginal sexual intercourse every 2 to 3 days.
For many this is great news. At last – freedom from contraception! Woo Hoo! Others will find that their hearts sink. Maybe you don’t have sex that often (which is fine - you're not alone*), or your patience is limited, or you have a slightly more varied approach to sex (which is fine as well - just so long as everyone is happy). If that any of that sounds like you, then you might benefit from having some |
