4 Common Myths About FABMs

Who's had this conversation before:

You: "I want to avoid getting pregnant right now, but I'm not happy with the pill."

Doctor: "I understand. Let's switch you to this type of birth control instead."

You: "Um...no, I don't want hormonal birth control at all."

Doctor: "Oh, I see. You want an IUD?"

You: "Actually, I started using fertility awareness, and it's..."

Doctor: [Interrupting you while shaking their head] "I'll see you in a month or two to confirm pregnancy."

I practice an evidence-based fertility awareness method, NOT the rhythm method. However, many people, even doctors, still think fertility awareness is a glorified name for the rhythm method. In this article, we will examine 4 Common Myths regarding FABMs and learn the truth behind the misconceptions surrounding natural birth control.

MYTH 1: FABMs are the Rhythm Method.

Rhythm Method 101: Definition & History

Roughly 100 years ago, in the 1920s, two scientists in different parts of the world discovered a connection between ovulation and menses. Dr. Ogino (in Japan) and Dr. Knaus (in Austria) found that ovulation, on average, occurs anywhere from 12 to 16 days BEFORE a woman's next period starts. This discovery was exciting news, and the findings began spreading quickly within the medical world.

In 1932, a scientist, Dr. Leo J. Latz, living in Chicago, brought this idea to the general population in America. The term "Rhythm Method" seems to have originated from Dr. Latz's published book, The Rhythm of Sterility and Fertility in Women. In this publication, Latz, utilizing the discoveries of Ogino and Knaus, presented a "fairly predictable" calculation that a woman could use to achieve or prevent pregnancy. If a woman were looking to avoid pregnancy, she would not have intercourse between days 12 to 16 in her monthly cycle (assuming she had a 28-day cycle). 

The book quickly gained popularity and had sold over 200,000 copies by 1942. Along with Dr. Latz's book, a new "device" came on the market, The "Rythmeter." The Rythmeter was a hand-held calculator that women and doctors could use to estimate fertile and infertile periods of the menstrual cycle. However, even the inventor of this new device warned women not to use it without having a record of at least nine months of past menstrual cycles. Man, oh, man, now that's commitment!

[Image used from https://case.edu/affil/skuyhistcontraception/online-2012/Rhythm-method.html]

 The rhythm method is no longer considered an evidence-based fertility awareness method (FABM). Present-day FABMs are based on your body's biomarkers, such as bleeding, mucus, temperature, and hormonal indicators in the urine. These methods are backed by sound research and are adaptable to each woman and each individual cycle.

These days, the evidence-based FABMs recognize that calculating the time of ovulation can be tricky. There is no one-size-fits-all calculation. Ovulation varies from woman to woman, and a woman can ovulate at a different time each month. Stress, illness, or interruptions in the normal routine can also alter a woman's cycle.

MYTH 2: FABMs aren't effective in preventing pregnancy.

Effectiveness rates for avoiding pregnancy can be very high—over 98 percent in some studies. However, keep in mind that your effectiveness will be highest only if you follow all the instructions of your method and ideally, if you work with an instructor. 

There are three main types (or categories) of FABMS:

1. Cervical Fluid/Mucus-Only Methods 
   Included in this category are the Billings Ovulation Method and the Creighton Model FertilityCare System. These methods rely heavily on cervical mucus (plus other discharges) throughout the entire cycle to determine fertile and non-fertile days. 
2. Sympto-Thermal Methods
   Included in this category are NeoFertility, SymptoPro, TCOYF, Couple to Couple League, and others. Sympto-Thermal methods rely on both cervical mucus (some encourage increased attention to cervical mucus such as NeoFertility) and temperature shifts in the cycle to determine fertility.
3. Sympto-Hormonal Methods
   Included in this category are Marquette, FEMM, and Boston Cross Check. These methods may incorporate both cervical mucus and temperature, but they rely on testing hormones in the cycle, such as utilizing the Clearblue Fertility Monitor or LH strips,

MYTH 3: You can't use a FABM if you have irregular cycles.

People who make this claim are still thinking of the rhythm method. FABMs are all about reading your body's fertility signals directly (by measuring urine metabolites of hormones) or indirectly (by observing symptoms like cervical mucus and basal body temperature). Additional cross-checks to fertility may include the wet or dry sensation while walking and your cervix's position throughout your cycle. 

When cycle length changes, chart observations change, and the fertility window then also shifts. A certified instructor will be able to help you navigate your cycle. Women experiencing abnormal cycles due to PCOS, endometriosis, continual mucus, or postpartum may need additional support from their instructor.

MYTH 4: FABMs are expensive to learn and use.

Prices do vary, but they aren't all expensive. Many of the price points may depend on if the instruction is being held online or in-person. Prices also vary due to the instructor's training and experience working with clients. You also can find membership models, group coaching, or one-on-one coaching. There is an option available for everyone. FABMs are not a one-size-fits-all just like our cycles are not one-size-fits-all.

Written by: Chavah Brooke Hull, CYC Fertility Coach

References:

1. Museum of Applied Arts and Sciences, NSW Government, accessed 25 June 2020, https://collection.maas.museum/object/345735
2. Case Western Reserve University, 2012, accessed 25 June 2020,  https://case.edu/affil/skuyhistcontraception/online-2012/Rhythm-method.html
3. Fertility Appreciation Collaborative to Teach the Sciences, M. R. Duane and E. Adams, 19 June 2018, accessed 25 June 2020, https://www.factsaboutfertility.org/a-brief-history-of-scientific-advances-and-development-of-nfp-methods-part-i/
4. TW Hilgers, Reproductive Anatomy & Physiology: A Primer for FertilityCare Professionals. (Omaha: Pope Paul VI Institute Press, 2002), 6.
5. P. Frank-Herrmann, G. Freundl, C. Gnoth, E. Godehardt, J. Kunert, S. Baur, and U. Sottong, "Natural Family Planning with and without Barrier Method use in the Fertile Phase: Efficacy in Relation to Sexual Behavior: A German Prospective Long-Term Study," Advances in Contraception : The Official Journal of the Society for the Advancement of Contraception 13, no. 2-3 (Jun-Sep, 1997): 179-189.
6. G.K. Doering, "Regarding the Reliability of the Temperature Method for the Prevention of Conception," NFP and More Web, last modified March 15, 2010, http://www.nfpandmore.org/Doering-1967-100315.pdf
7. Thomas W. Hilgers and Joseph B. Stanford, "Creighton Model NaProEducation Technology for Avoiding Pregnancy: Use Effectiveness," The Journal of Reproductive Medicine 43, no. 6 (1998): 495–502.