Jamie and Martin Smith use a relatively obscure birth control method that is 100 percent natural, costs nothing and by some accounts, can be as effective as the pill. Still, when Jamie Smith first heard about natural family planning, or fertility awareness, she was suspicious and skeptical.
Eight years later, the Smiths have had no surprises, two children deliberately spaced three years apart and unexpected marital benefits. The Oak Park couple believes so firmly in natural family planning–a system that involves charting a woman’s fertility signs daily to avoid or achieve pregnancy–they now teach other couples how to use it.
“Sitting in that first [NFP] class, I thought, `This is never going to work. I’m going to be pregnant by Christmas, and we’re never going to be able to have sex,'” said Jamie Smith. “Happily, I was wrong on all counts.”
While couples can chart a woman’s fertility in different ways, the Smiths use the Sympto-Thermal natural family planning method, advocated by the Couple to Couple League, an NFP teacher-training institute, based in Ohio with local affiliates across the country. With Sympto-Thermal, women meticulously record and cross-check three fertility signals: morning basal body temperature, the consistency of cervical mucus and the position of the cervix.
To avoid pregnancy, couples abstain from intercourse during the woman’s fertile period, which might last from six days to two weeks. If they want to conceive, they know the best time to try.
Though modern NFP is based on the riskier rhythm method of the 1930s, it is distinctly different and more effective if practiced correctly. The outdated rhythm method depends on a calendar and can be ineffective for women with irregular cycles. NFP gauges fertility as the woman’s daily chart evolves.
“The drawback that comes up the most often is abstinence,” Smith said. “But after getting used to it, couples say it keeps things fresh. . . . It pushes you to communicate and express affection in different ways.”
Initially, natural family planning served as a viable birth control option for Catholics, whose beliefs forbid using artificial contraception. But fertility awareness methods are now making inroads with women from all faiths and lifestyles, including those who are looking for natural, healthy, non-chemical alternatives to hormonal contraceptives or barrier methods.
Not only is fertility awareness used to plan or prevent a pregnancy, it also can help couples discover a pregnancy, impaired fertility or a need for medical attention. Women who know when they are fertile can make informed, conscious choices about their health.
While the basic tools–a thermometer and calendar–are inexpensive and easy to find, new fertility awareness products are in the pipeline. Around the Moon, an Oregon company, is developing a reusable, compact microscope that allows the viewer to see ferning patterns resulting from the hormonal changes reflected in saliva. According to the company, a woman’s hormonal cycle is reflected in her saliva. Saliva forms microscopic fernlike, crystalline structures in the presence of increased estrogen and other electrolytes during the fertile days. The pocket-size microscope is designed to help women view these crystals and monitor their fertility.
About 7,000 couples per year learn NFP through the Couple to Couple League’s classes and home study course, according to the organization’s director, Mark Hayden. Some women who turn to NFP have had aggravating side effects with the pill or worry about the possible dangers. Some find barrier methods messy and unromantic. And others simply don’t like the idea of tampering with their natural reproductive system.
Maureen Schumar used a diaphragm and condoms before she and her husband discovered NFP fit into their holistic lifestyle. “I just was looking for a natural means to prevent pregnancy,” said Schumar, a River Forest mother who belongs to an organic food co-op, eats vegetarian, home-schools her three children and uses a homeopathic physician. “If you take out the religion, it is still scientifically proven and time tested. And there are variations. You can use NFP with a condom.”
Women who use the Sympto-Thermal method take their daily temperature the minute they wake up and record it on a chart. At the time of ovulation, a woman’s temperature rises slightly. The woman also checks the consistency of her cervical mucus. Normally cloudy, sticky mucus will become clear and slippery in the few days before ovulation.
When this happens, women are in their most fertile phase and may notice other changes, such as pain in the area of the ovaries, bloating, low-back ache and breast tenderness. While it might take two to six months to become familiar with the cervical mucus and changes in the cervix, according to Jamie Smith, women can become temperature savvy in about a week.
Some studies say the Sympto-Thermal method is 99 percent effective–nearly equal to the pill–if practiced correctly. Depending on the method, couples using fertility awareness have a 1 percent to 9 percent chance of becoming pregnant during one year of use, according to the Institute for Reproductive Health at Georgetown University Medical Center.
Though many couples are initially worried about the reliability of fertility awareness, they soon grow comfortable with it.
“We got beyond those issues of control,” said Doug Lintz, who practices NFP with his wife, Stephanie. “As a result, our relationship has drawn even closer. Now we’re sharing in something we don’t have total control over, yet we’re working with an alternative that we feel is much safer and much more proper than the alternative of the pill.”
“For most of my life I never saw any moral reason not to use contraception,” added Stephanie Lintz, who started using the pill as a teenager and continued several years into her marriage. Her views changed when she became a Catholic three years ago.
“[Throwing away the pill] was the toughest decision I’ve ever made in my life. But after a few months of using NFP, it turned out to be the best decision we made for ourselves. We had such a respect for the way our bodies worked and saw fertility as being a gift. I had never looked at it that way before. I had looked at it as a nuisance.”
But fertility awareness, which does not protect against sexual transmitted diseases, requires dedication, cooperation, practice and specialized training. It is “very unforgiving of inconsistent or incorrect use,” said Susan Tew of the Alan Guttmacher Institute.
Of married women worldwide using some form of family planning, approximately 15 percent claim to use a form of periodic abstinence. Yet a very small percentage of these couples actually are using a natural method correctly, according to the Institute for Reproductive Health.
In the United States, 1.6 percent of women of childbearing age use periodic abstinence, and of those, 0.2 percent use natural family planning, according to the National Center for Health Statistics.
“It’s a fairly reliable predictor, but some women, even when fertile, might not have changes, so there can be a misunderstanding that would allow for conception rather than contraception,” said Dr. Mary Molo, a reproductive endocrinologist at Rush-Presbyterian-St. Luke’s Hospital. “Men’s sperm has different longevity. We’ve seen situations where a couple would clearly have had relations when we knew it should have been safe, yet when we examined the woman, we could see the sperm moving in her reproductive tract.
“The people I see doing it are married, and if there was a conception, they would not view it as catastrophic,” Molo said. “Most couples that are really trying to avoid pregnancy are not likely to use this as the primary method.”
Indeed, many families who use NFP are open to having children. Hayden, the executive director of the Couple to Couple League, has nine. Daria and David Skrzypczynski of Downers Grove, use NFP and have seven children.
“You don’t start out [wanting to have seven children], but the more you understand the gift of fertility, the more you realize how blessed you are,” said Daria Skrzypczynski.
The Skrzypczynskis took their first NFP class to fulfill the Catholic custom of pre-marriage counseling 12 years ago and now both credit NFP with changing their perspective on marriage and saving the relationship. “I don’t think half the people who came to our wedding thought we would make it a year [in marriage],” said Daria, 37. “But forced abstinence changes your focus. For us it provided a courtship we never had. We were sexually active pretty early on. Now it’s interesting to pull out the Scrabble game or do things we haven’t done. It was quite a lifestyle change.”
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For more information on the Chicago Couple to Couple League visit www.chicagoccl.org. The Couple to Couple League International: 513-471-2000 or www. ccli.org
