Tuesday, 3 January 2012

Natural Family Planning / Fertility Awareness

Be warned, this post will save you a lot of money. It's my journey to natural family planning / fertility awareness. You'll save money on ovulation predictor kits if you're TTC. That's cool-speak for "trying to conceive".

I spent years on the contraceptive pill, well, every contraceptive pill. I suffered weight gain, mood swings, acne, depression, returning to my doctor every 6 months to a year, having another pill prescribed. I started getting the Depo Provera injection because of it's handy 3 month convenience, I was heading off to Australia, and didn't want the hassle of remembering a pill every 24 hours. I had non-stop spotting on this injection, was told this was a short-term side effect, but it continued for the two years I was on it. It got to the point where I was wearing a tampon every day to deal with the spotting, so a doctor in Oz prescribed the pill to counter-effect the spotting, so for some months I took the pill every day, as well as topping up the Depo. Talk about an overload of hormones. Is it any wonder that a year later I was diagnosed with an ovarian cyst?! A fluid-filled benign cyst that was definitely not cancerous. This was causing me some discomfort.

I was advised a cystectomy, but the surgeon was advocating removing all or part of the ovary too, she couldn't guarantee what would happen until she "went in there". So I was going to wake up to find I did or didn't have an ovary? I wasn't happy with this, and so I cancelled the operation, and haven't looked back since.  (Must note here, in the spirit of feminism I'd chosen a female surgeon as I felt I'd be "safer" in her hands. Ha!) My cyst continued to be monitored every 6 months, and was static at about 5cm diameter, and caused me a little discomfort at times, but seems to have faded away since my first pregnancy 4 years ago. The surgeon was hell-bent on removing it because it had been in situ for a year or two, didn't show signs of shrinking, and "could rupture at any time", causing severe pain and abdominal bleeding, much like a  ruptured appendix. She said it would necessitate an emergency operation, and I said "Fine, I'll take my chances". One of my biggest bugbears with her was her flippancy about removing my ovary, and when I suggested checking to see if the other one was functioning ok, so I could still have children after this operation, she looked at me like I was an idiot, and said "there are no guarantees in this life". I wasn't going to risk my fertility on a non-emergency procedure, and am so glad I didn't undergo the operation.

I started looking into the female reproductive cycle, online, and came across an organisation advocating natural family planning. At the time I was newly married, and not wanting to start a family just yet, so we went along to a nice middle-aged lady's house, were given a paper chart and some colour coded stickers, some were circular= red, yellow, green, and some had little fetus pictures on them. She explained in a lot of euphemisms (probably to "spare" my poor husband) how to watch your vaginal discharge for signs of impending ovulation, and how your discharge changes over the course of your cycle. The stickers were to be used to describe the mucus everyday, and the fetus pictures were to mark the ovulatory stage. I wasn't that keen on the baby stickers to be honest, not wanting a baby, I wasn't too hot on looking at an unborn one. She kept emphasising that during the ovulatory stage we were to "avoid intercourse" for at least 5 days. When I suggested the alternative, to use condoms, she looked at me like I had two heads and said "we don't advocate barrier methods of contraception" . Okay lady, I dig it, you are a word-spreader of the Catholic Church and condoms are evil. We left there, promising to go back after charting for a month or so, and needless to say never did. We didn't even get a cup of tea.

So I read up more on the different methods of natural fertility awareness. One method I tried for a while was the basal body temperature method, where you take your own temperature "at rest" every morning, and the temperature will "spike" at ovulation. All fine here, I kept the pretty white and lilac thermometer by the bed... my only problem was "at rest" means before you exert yourself at all in the morning, even sitting up in bed could trigger a slight rise in temperature, and then where would you be?! So I would reach out for the thermometer in the dark, press the button, put it under my tongue, wait for the beep, check the  numbers, write them down. Bored, boring and hassle. On the days the thermometer wasn't to be seen my husband would be ushered out from under the duvet to root around amid the balled-up tissues and hair clips (the odd crisp packet if I'm to be honest) to find it on the floor.

Then there was the "cervical position" method, where every day you put a leg up on the side of the bath and root around for your cervix (not easy as I was into Jordan-style false nails at the time) noting it's height within the vagina, the size of the os or opening, and the texture of the cervix itself, spongy or hard. I rarely had much luck, sometimes it was there, sometimes it wasn't. Could never feel a change in it's texture, and as for gauging the size of it's opening, I could barely make it out, let alone test its aperture. So I abandoned that one too.

The old-style calendar method of checking the calendar, and "guesstimating" the ovulatory period is surprisingly common despite it's unreliability. You chart the length of your cycle, from day 1 (start of period) to day 28 (last day before next period). Obviously some cycles are 35 days long, or change from month to month depending on your age, mood, stress levels, who you're interacting with (not a joke, you'll sync with female friends - we're all animals you know!). Then using the (incorrect) idea that ovulation happens mid-cycle, you take the midpoint day and avoid conceiving for a couple of days either side of it, ie from day 11 to day 17. Obviously flawed and you'd have to be an idiot to base yourself on it as a means of contraception/conception.

So back to the cervical mucus method, (CMM) which I was charting alongside these other methods, reading that they are more effective when used in tandem with one another. Well I can say after 6 years of now using just the CMM, that this is not true, I've found it to work perfectly on its own. I avoided pregnancy with it for 2 years, then conceived the first time we tried, as I was sure I was ovulating. Then I avoided pregnancy with it for another few months, and conceived again when we wanted to be pregnant a second time. The beauty of this method is that your body doesn't lie. It doesn’t matter if you ovulate on day 10 or day 20 of a 24 or a 40-day cycle, you body will show you when it's preparing for ovulation, and you'll be able to pinpoint to within hours when you're fertile. (If not feel the ovulation itself which I have a few times - a sharp twinge in an ovary which alternates side to side each month) Our school teachers loved warning us we could get pregnant at any time of the month, so we'd be put off getting intimate with our boyfriends, but this was just not true.

So how does the cervical mucus method work?

Let's recap our monthly cycle, it may be years since you've thought about it like this, so a refresher is in order. Obviously this is an example cycle, the day numbers will differ from one woman to the next, and in the same woman from one month to the next, but the symptoms remain the same.

Day 1: The first day of your period. Even if you only have spotting for a couple of days before the flow starts you still count the first day of spotting as day 1.

Day 8: (or thereabouts) blood flow has stopped. Your vaginal discharge is minimal.

Day 9-15: vaginal discharge increases sticky white / yellow, observed in your underwear, increasing in amount daily.

Day 16: you notice your discharge is more like egg-white or snot, getting clear, and stringy when pulled between two fingers. When wiping after the toilet, the toilet paper "slips" easily.

Day 18, the discharge feels noticeably wet, comes out in blobs, and totally clear. You may feel increased sexual desire / sweating more than usual.

Day 19: Discharge is suddenly gone. You are inexplicably dry.

Day 20-23: Discharge is minimal, like after your period.

Day 24-27:You increasingly feel premenstrual, bloating, mood swings, cramps

Day 28: Period starts (This is now counted as Day 1)

Ovulation occurs at the change between day 18 and day 19. The increased clear mucus is the body's way of making an easy passage for the sperm to travel into the uterus. The PH of this mucus allows sperm to live, and swim fast in its watery consistency. At other times of the cycle, the vagina's PH is not conducive to sperm, and they have a hard time surviving. Coming up to ovulation the body secretes the clear ovulatory mucus in increasing quantities and at the height of this releases the egg from the ovary. Your body wants to make love at this stage in the cycle, you are wet, you feel extra horny, conditions are perfect for making a baby. No wonder so many unplanned pregnancies happen, with the usual refrain "But we only did it once / we only did it for a second", your body literally sucks up the sperm and transports them into the waiting womb to fertilise the egg. If only we women were given this knowledge in adolescence, how much easier our lives would be. But the Catholic Church and the pharmaceutical industry have it sewn up between them, our ignorance helps them recruit numbers and make money, and so we grow up totally ignorant of how our bodies work.

In a nutshell:
You are fertile from the first appearance of the egg-white mucus (in the above example from day 16) to a few days after ovulation ( day 22 or 23 to be sure). Obviously if you don't want a baby, you use a barrier method of contraception during that time, and if you do want a baby you get sexy with your man. That's it. Simple as.

I've told this "secret" to about 6 women, friends and family, who had all mentioned they'd been  trying to conceive, and they all reacted the same. Incredulity at hearing how simple it is, and then pregnant within a month or two.

You don't have to spend a fortune on ovulation predictor kits, just watch what’s happening in your knickers. Obviously this is how it works in the normal, fertile woman, and some may have hormonal complications which affect their cycle, but if you are having periods regularly you can safely assume you are ovulating.

There's no need to do fancy spread sheets, buy colour-coded stickers or make wall-charts of your cycle, unless you want to. You don't have to keep track of your periods, either. All you have to do is look for the bare necessities, the simple… sorry. All you have to do is look out for that clear, stringy mucus, and act accordingly (ie. Get pregnant or Don't get pregnant). So don’t worry yourself with "But my cycle was 26 days last month, and now it's 34…" all this keeping track is going to wreck your head. It's your body, it's nature, it's going to vary all the while because it has it's own way of doing things, so stop trying to control it, just learn how it works, and appreciate the beauty of nature.

That's all! So if any of you conceive using my advice, I want the babies named after me. (No Hollywood-style spellings, Neev, Neve, Niav etc)

Niamh x

Disclaimer: It feels ridiculous having to say it, but I will anyway (you know how some people are):
I AM NOT A DOCTOR! I'm just a mom. This post is not intended to be taken as medical advice, it is anecdotal, and you follow my advice at your own risk. Do not hand me a baby in a year's time and tell me it's my fault it was conceived and I've to help raise it / breastfeed it / pay part maintenance for it. Jesus, some people!


  1. omg i really want to try this! so dont wanna go back on hormones..had the coil for 3 yrs and the weight crept on gradually..got it out and within months i was slim! was slim for a few months (inc my wedding) then got pregnant so all went to pot! lol what do you do before your af returns whilst bf? have been chancing my arm but really dont want to get caught out :)

  2. Hi Niamh, really enjoying your posts!

    I read the book Taking Charge of Your Fertility & it rocked my world! Isn't it a pity every woman isn't more informed about her body. It's amazing all these things it does & we don't even realize.

    Well put, & a good refresher for me, esp. the 'in a nutshell' part.


  3. Gab, re "chancing your arm" before your af returns, mine didn't until my first son was 21 months old. From time to time if he was eating more solids I'd get spotting, so knew my hormones were at a delicate balance. what I did because I most certainly didn't want to conceive yet was to lessen his solids intake and up the breastfeeding and hey presto the spotting would go. It was a balance, and I was watching for signs of ovulation, ie mucus, acne, mood changes as well as the spotting. Read up a bit more on it and you'll be grand. I haven;t read Taking charge... as Aine mentions above, but I'd say it covers all bases so sure to put your mind at rest.

  4. I have tried this method too and it defo works. I seen you on t.v. Fair play!

  5. Niamh, you crack me up! I too hate all the 'Hollywood-style' spellings of a perfectly good name!! I've flicked through a lot of your previous posts and really enjoy your writing, you're funny, witty, and informative, you get me laughing out loud! I love this method too, I also read 'Taking Charge of Your Fertility' -- they should be teaching this stuff in schools. Love the blog, thanks for the laughs!

    Niamh S.

  6. defo trying this

  7. Amazing how simple it can be to communicate with people and have them understand a certain topic, you made my day.

    Family Planning in Oxnard, CA

  8. What about when breastfeeding? My cycle seems all over the place after my period returning at 9 months PP. Baby's 1 year now and I've had 2 more periods since but no rhyme or reason to it... i'm not feeling confident i could follow my cycle! tips? niamh s.

    1. Sorry Niamh S, has taken me a while to reply! There is no need for regular periods to be happening, that is my point! Forget the calendar completely, just watch your knickers! You have to build up the mucus if you're going to ovulate, so just watch out for the signs like I described above.There's no "following your cycle", just have a poke around every day or two and get used to what's going on "down there"!

  9. I have a 24-27 day cycle. I have been actively ttc. I have tried the cervical mucus method and I find it hard to spot my fertile days. I have missed it for so many months. It's very hard for me. Any suggestions??

    1. Sonia I know the body produces less mucus when slightly dehydrated, so I would suggest consciously drinking more water and less caffeine and salt, that should help you see clear signs of the fertile mucus when approaching ovulation x


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