Fertility Awareness-Based Methods: Filling the Gap in Sex Education
By: Dr. Elizabeth Brehman
Editor’s note: The FACTS elective attracts a broad spectrum of medical students interested in fertility awareness, with a vast range of baseline knowledge of the methods and their efficacy. Elizabeth Brehman was familiar with FABMs, but she wanted to learn more. The FACTS elective filled that gap! As part of the elective, she chose to interview her older cousin about her experiences using the Billings Ovulation Method®, both to achieve and postpone pregnancy.
Learning about FABMs through the lens of a family member
I was motivated to take the FACTS elective to learn more about FABMs, since I have had family members who used these methods effectively. As part of the elective, I had the opportunity to interview my cousin, Anna,* about her experiences using the Billings Ovulation Method. Anna and her husband had spent several years trying to conceive and began to ask questions in the hope of finding answers.
Anna explained that her high school sex education was lacking; she never truly understood her own body and fertility, much less how that information could be tracked to aid in her conception journey. Interested in non-hormonal and non-surgical methods to achieve pregnancy, Anna and her husband sought help from local fertility experts who recommended the Billings Ovulation Method®.
Using the Billings Ovulation Method®, Anna learned to recognize her signs of fertility, signs that she had never learned to look for before. Her previous education and the attitudes around sexual education left her uncomfortable discussing sex, fertility, and conception with anyone – she was afraid to ask for help. However, this all changed with the Billings method. She felt so at ease with her Billings instructor and mentioned to me that this experience truly changed her life. Eventually, she felt confident and capable in taking ownership of her own fertility and body. With the help of her Billings instructor, she learned how to observe and identify her cervical mucus patterns and determine her peak day of fertility. The new concept of a peak day changed the way Anna and her husband perceived her fertility, and she loved that learning to recognize her peak day gave them the ability to time intercourse to maximize their chances of conceiving. Anna’s introduction to the Billings Ovulation Method® simplified her fertility journey by helping her to focus on the timing. The method made sense to the couple, and the timing and control was in their hands.
“Her previous education and the attitudes around sexual education left her uncomfortable discussing sex, fertility, and conception with anyone – she was afraid to ask for help.”
As Anna noted, Billings is one of the most straightforward FABMs, requiring women only to observe the sensation in the vulvar or vaginal area to determine when they are likely to achieve pregnancy – no touching of the mucus or internal examinations are required. In fact, the World Health Organization found that 90% of women in five different countries identified their day of highest fertility in the first month they used the method.[1]
But is Billings just for women and couples trying to achieve pregnancy?
No! The Billings Ovulation Method® is designed for women (and couples), at different stages of their reproductive life. A woman who uses Billings will be able to understand her unique menstrual cycle and monitor her reproductive health, even if her cycle is irregular. The Billings method is also ideal for educating adolescents; it is the foundation of the Teen STAR program, a developmental curriculum, founded by Dr. Hanna Klaus, MD that “helps adolescents and young adults come to terms with their emerging sexuality and fertility and assist them in making responsible decisions.” [2]
Another student in the FACTS elective conducted an interview with Katie*, a fifteen-year-old young woman who learned at an early age to know and trust her physiology and use charting as a tool to monitor her health. Prior to exposure to Teen STAR, Katie used a simplified model of the Billings Ovulation Method® to track her cycle for over a year. As Katie and her mother explained, the Teen STAR program educates young women and men about sexuality, the female body, the menstrual cycle, and all aspects of healthy relationships, including emotional, intellectual, and physical health. Over the course of 12 Teen STAR sessions, Katie learned to pay attention to her body, track cervical mucus and menstruation, and chart her findings using an app on her phone.
Not only are Billings and Teen STAR great resources for adolescents, but the Billings method is also perfectly adaptable to women and couples looking to avoid pregnancy. After the birth of Anna’s first child, she wanted to follow the advice of her Ob/Gyn to avoid pregnancy for a period of time to allow her body to recover and prepare for future healthy pregnancies. She was thrilled to learn that she could also use Billings as a means to effectively avoid pregnancy. She loved that the method did not rely on synthetic hormones and was immediately reversible whenever she wanted to try for another pregnancy. Furthermore, this form of pregnancy prevention was low-cost and without side effects. Lastly, she appreciated her continued relationship with the same Billings instructor who helped her attempt her first pregnancy. Using the Billings Ovulation Method® for pregnancy prevention gave her a similar sense of empowerment as her previous use in conception. FABMs gifted her a greater appreciation of her reproductive health, with no need for hormonal methods to prevent pregnancy.
“FABMs gifted her a greater appreciation of her reproductive health, with no need for hormonal methods to prevent pregnancy.”
Anna confided that using Billings for both pregnancy achievement and prevention not only empowered her but also strengthened her relationship with her husband. The method allowed him to become involved in the process, and their relationship flourished.
My cousin’s overwhelmingly positive experience using the Billings Ovulation Method® taught me how FABMs can enable women to achieve or avoid pregnancy, and also equip both women and couples with a beautiful confidence and sense of empowerment. Her testimony is a powerful witness to the holistic nature of FABMs and an important reminder to me, as a medical student, of the responsibility of healthcare professionals to consider both a patient’s medical goals and overall well-being.
*Name has been changed to respect the privacy of the interviewee, and all information is shared with permission.
Sources
[1] A prospective multicentre trial of the ovulation method of natural family planning. II. The effectiveness phase. Fertil Steril. 1981;36(5):591-598. doi:10.1016/s0015-0282(16)45856-5
ABOUT THE AUTHOR
Dr. Elizabeth Brehman
Dr. Elizabeth Brehman graduated from the Philadelphia College of Osteopathic Medicine and is now completing an Ob-Gyn residency at University of Pittsburgh Medical Center. She completed the FACTS elective as a 4th year medical student.
