Updated: Feb 23
Fertility Awareness Based Methods (FAM), are notorious in some circles. Also called “Natural Family Planning” (NFP), they conjure images of large families and stressed out moms.
The punchline of the old joke: “what do you call people who use the calendar method?” is, of course, “parents.”
If you look FAM up online, you’re likely to get limited information about sympto-thermal methods that might be helpful in achieving pregnancy, but no sane person takes them seriously as a means of preventing pregnancy. They’re impossible to use, inconvenient and they simply don’t work if you have irregular cycles. At least, that’s what planned parenthood seems to think.
All this does beg the question: why do women choose to use FAM, then? Are they all religious zealots? Have they just drowned in their own internalized misogyny?
There are many reasons women (and their sexual partners) choose to practice FAM as a means of spacing pregnancies and none of them are ignorance, self-hatred, or blind obedience to religious authority.
Let’s look at a few of those reasons, shall we?
1. Show Me the Money
Depending on the region in which they live and their economic status, typical forms of birth control may be cost prohibitive to women. Depending on the method of FAM used, the costs range from high up front with some ongoing costs, to low cost in the beginning and practically free long-term.
For methods like Billings and Creighton, the cost can be the initial training (with ongoing paid support recommended), but the cost is low long-term. For some women, this can be a good reason to look into choosing FAM. Especially for women with regular cycles and a strong self-awareness, FAM can be a good fit where money is a concern.
2. You’re Making Me Sick
Given the seedy history of the pill and other hormonal birth control methods, it should come as no surprise that most forms of contraception are… not great for women. The combination pill, one of the most common forms of hormonal contraception, has wildly varying side effects from woman to woman. Many women on the pill have few to no side effects. But many others have mood swings, headaches, weight gain, nausea, or issues with acne, among other, less common side effects. That’s not to mention the documented increased risk for blood clots, heart attack and strokes, and liver problems. In fact, with all forms of hormonal birth control, there is the possibility for unpleasant and sometimes extreme side effects. Some women get fed up.
These women, who find they can’t stand the way typical birth control makes them feel, start to look for alternatives. Fertility awareness methods offer a drug-free (and side-effect-free!) option for family planning and spacing children.
And, despite the bad reputation they have in media, depending on the methods, FAM can be highly effective. In some cases, the rate of effectiveness with typical use can be higher for methods of natural family planning than for the pill.
For women who have extreme side effects from hormonal birth control, some find that choosing a fertility awareness method and abstaining during a portion of their cycle (or using a barrier method of contraception during their fertile window) is the best option for them.
3. A Little Granola Never Hurt Anyone
You may have noticed an uptick in “green” products available on shelves, as the move towards a more natural way of living and consuming has become prevalent. Concern for the harmfulness or beneficence of the things we put onto or into our bodies has become increasingly important to women in our culture, especially younger women. Young women have grown up hearing about the needs of the environment. We grew up learning about the adverse health effects of things like pesticides — the way they can build in the ecosystem and wreak havoc on nature. And we’ve been making the move towards a cleaner way of living.
Women have been trending more towards organic eating, natural health products, and preventative health movements. It should come as no surprise then, that some women would have this approach when it comes to choosing a method of family planning.
Hormonal birth control can build up in the wastewater systems of industrial cities, as the excess amounts are expelled in the urine of women taking the drugs. These hormones are both difficult to filter out of drinking water and can cause downstream problems for the local ecosystems. The conscientious woman, taking these issues seriously, is liable to turn towards more natural methods of preventing pregnancy.
FAM is one such method. Fertility awareness methods are all natural, have no long-term health effects for the women practicing them (or others!) and don’t pathologize a woman’s healthy body. Rather than seeking to subvert a woman’s natural fertility, treating it as a disease, methods like Billings or Marquette, work within the context of a woman’s natural hormonal rhythm.
For women who opt for the more natural option, a method of birth control that works with, instead of against their bodies is incredibly appealing.
4. Woman, Know Thyself
Knowledge is power, so they say. Self-knowledge is empowering. When we know our strengths and weaknesses, our tendencies and needs, we can respond, plan and grow.
A woman’s menstrual cycle affects every aspect of her life, from mood, to weight , to concentration. Knowing and understanding her fertility, her natural cycle, and the ways that she responds to hormonal fluctuations through her cycle, can help a woman to know herself and what helps her to feel healthier and happier throughout the month.
Regardless of the method of FAM chosen, women will gain deeper knowledge of their fertility. Moreover, through tracking their fertility signals, they can start to associate their fluctuating experiences with the stage of their cycle. Many women choose FAM, out of a desire to know themselves. And many get to know themselves really well.
First, they’re tracking mucous production, temperature, or the hormones in their urine.
Then, they find it easier and easier to pinpoint ovulation, and to predict when their period is going to start. Before long they’re recognizing the way they’ll feel more anxious during this time of the cycle, more ambitious during that time. More and more they’re able to recognize their physical and emotional changes through the month and plan around them. Maybe it’s better to plan to start a new project right after she menstruates, or better to eat healthy after ovulation. Whatever the lifestyle changes are that help a woman throughout her cycle, are as unique as she is — and FAM can be the jumping off point to figure out what works for her
Knowing her body can improve a woman’s overall quality of life. Many women choose FAM for this reason. Understanding her cycle and fertility can also help a woman find the root of irregular cycles, pain or other confusing symptoms she may experience. Some women choose FAM for this reason.
In medicine, the diagnosis and treatment of a plethora of issues women face is dependent upon a knowledge of the inner workings of their menstrual cycle. Regardless of whether a woman is seeking to delay or achieve pregnancy (or even if she’s single!), consistent tracking of menstruation, ovulation and concomitant details can help a woman understand her body, find answers to troublesome symptoms, and catch changes and issues early on. The self-knowledge FAM can bring, can help any woman under the sun.
5. Knowing Me, Knowing You
You’ll often hear women complain that men should be more involved where birth control is a concern. But, with many forms of birth control being entirely dependent on the women making the decisions, paying the cost and (in many cases) remembering to take a pill or book an appointment, that can seem like a distant dream.
For committed couples using FAM, however, the man absolutely needs to be involved.
If a couple is seeking to prevent pregnancy, and choosing to abstain during a woman’s fertile period, there is going to be a lot of discussion.
There will be talk about their relationship. They’ll constantly come back to the question of whether they’re ready to have a child, the reasons they’ve chosen to hold off — things like their financial situation, their individual mental/physical health, the health of their relationship… One single act of abstaining can open up a whole conversation about their lives, love and family.
This need for constant communication can have really healthy results for relationships. It may be part of the reason that women who practice natural family planning are statistically less likely to get divorced.
Moreover, because FAM requires the man’s cooperation, it also requires him to be more informed. The men who practice FAM have often reported a deeper respect for their wives’ bodies and experiences. Men are able to learn what the woman in their life goes through in her menstrual cycle, trust her more intimately, and express their love for her through restraint.
Now, obviously, practicing FAM isn’t going to completely change a man’s character and personality, but it is an opportunity for growth. Men who want to, can become more understanding. Men who are so inclined, can become more nurturing. FAM can be an opportunity for this deeper connection.
What is Love?
Some may feel I’ve buried the lede here, but yes, some women choose FAM for religious reasons. Does this make them ideologues and zealots who have been brainwashed by the patriarchy? The answer may surprise you!
If we start from a point of trusting that most women are relatively intelligent, thoughtful people, we can trust that they ascribe to a certain religion, because they have deemed it to be the best one (or at least the right one for them). This probably means they agree with the worldview of their religion. This worldview is what informs their personal decisions. The view women hold of human sexuality is what informs their decisions around birth control and family planning.
For some women, the choice to practice FAM is motivated by a particular view of human sexuality, that seeks to promote the full, free gift of self they see as integral to the act of intercourse. The reasons certain religions do not permit (or at least, don’t promote) artificial forms of contraception are too nuanced to really do justice to here, but they flow from a particular teleology of sex. Teleology is, simply, understanding what something is, based on what it is for.
So, when it comes to sex, these religions will answer what it is, based on what it’s for: drawing a couple closer together (bonding) and procreation (making babies). To intentionally subvert one of these natural ends (in this case, procreation) would, according to these religions, be wrong. When women choose FAM for “religious reasons” it’s not to say that they do so because someone in authority told them to. They choose FAM, because they believe that worldview to be true.
It may not be a compelling perspective to everyone, but it’s, at the very least, a reasonable position for a woman to hold.
What’s the Point?
There are many factors that women will weigh when making a choice about family planning methods. It is a prudential decision that most women make over time, looking into the options carefully. Fertility Awareness Methods have come a long way since the ‘60s, are more effective than ever, and have many benefits over against hormonal and other forms of artificial contraception.
For the reasons enumerated above, as well as countless other reasons, there are women who find natural family planning is the right choice for them. Because no two women are the same, generalizations about how and why they choose this form of birth control or another just aren’t going to apply in every case. Here’s the rub: the end-point of that decision making process may be the same, but the journey to FAM is different for everyone.
The reasons “why FAM?” are as diverse as the women who choose it.