By: Abby Koski
Director’s Note: Research conducted among fertility awareness-based method (FABM) users often makes a distinction between “perfect use” and “typical use.” This story highlights the importance of motivation with the use of these methods and the way that “typical use” can be “perfect” for a woman and her family. This week we share an interview written by Abby Koski, a former FACTS elective student. She spoke with Carol,* who was first introduced to FABMs in middle school but did not put them into practice until her 20s. Now more than 20 years into marriage, Carol shared insights gained throughout many years and several methods. For more by Koski, consider reading her summary of research that evaluated the impact of Vitamin D3 on sperm parameters in infertile men, published as part of our 2022 series during National Men’s Health Month.
Being Real about FABMs
Carol* has been using fertility awareness-based methods (FABMs) to chart her cycles for more than 20 years. Despite decades of experience, she was hesitant to speak with me at first, stating that she doesn’t “practice perfectly” and might not be the best person to interview. She clarified that she did not always implement the guidelines precisely, which could impact the effectiveness of these methods. However, she noted that she did practice in a way that was perfect for herself and her relationship.
Charting
Carol was first introduced to charting in middle school. Her teacher instructed the students on how to chart cervical mucus and what was occurring in their bodies that produced that mucus. Using hand lotion and Vaseline to describe the different types of cervical mucus, Carol vividly recalled the visual more than 30 years later. Although she did not start charting at that time, this knowledge about her body gave her a sense of ownership and empowerment as a young girl. This early introduction to charting piqued her curiosity and prompted her to learn more about FABMs as a young adult.
“Carol was first introduced to charting in middle school. Although she did not start charting at that time, this knowledge about her body gave her a sense of ownership and empowerment as a young girl.”
Billings Ovulation Method
In her early 20s, Carol began independent research on the Billings Ovulation Method for charting cervical mucus and decided to implement it into her daily routine. With the Billings Method, women chart their cervical mucus daily and follow four rules regarding timing of intercourse to avoid pregnancy. Carol stated that she immediately felt confident about her ability to detect her fertile window because she felt that her body gave her “clear signs.” This confidence, in combination with her understanding of the method, made me wonder why she felt she didn’t practice the method “perfectly.” To better understand this sentiment, we transitioned the discussion to her family-planning goals.
“With the Billings Method, women chart their cervical mucus daily and follow four rules regarding timing of intercourse to avoid pregnancy.”
Carol elaborated that she and her husband were initially intending to avoid pregnancy in the early years of their marriage. However, they both agreed that a pregnancy would still be a blessing, and they felt confident that they would be able to care for a child if she were to conceive. Therefore, they did not strictly follow the rules of the Billings Method for avoiding pregnancy. Furthermore, Carol’s husband had a military career and was deployed five times throughout their marriage. The restricted time together, and combined with their openness towards pregnancy and children, made following the guidelines precisely a low priority.
Lactational Amenorrhea Method
During more than two decades of their marriage, Carol and her husband have had 10 children. Their adherence to the guidelines for avoiding pregnancy varied throughout the years based on their ability to see one another and their goals for spacing pregnancy. They were able to space most of their children by two years, with a single unintended one-year gap. During Carol’s postpartum periods, she continued to chart her cervical mucus daily. Although she did not name the method she used, she described the Lactational Amenorrhea Method protocols to avoid pregnancy during the postpartum window. The Lactational Amenorrhea Method can be utilized by postpartum women who have not had a return of menses since delivery, are exclusively breastfeeding, and have a baby 6-months-old or younger.
“Their adherence to the guidelines for avoiding pregnancy varied throughout the years based on their ability to see one another and their goals for spacing pregnancy.”
New Goals in Perimenopause
Now that Carol is perimenopausal and no longer desires pregnancy, the couple is closely adhering to guidelines for avoiding pregnancy. They also took a class together on charting, which Carol reports has improved their communication immensely.
She admits that using these methods is not without challenges. She found it difficult when her husband had not taken the course, leaving her to be the one to deny intimacy often. She recalls it could be stressful at times but feels that working through stressful situations improved their relationship. Charting has brought them closer as a couple because, in her own words, “if you can talk about mucus, you can talk about anything.”
Teaching the Next Generation
Carol is so pleased with what charting has given her that she has begun teaching her children how to chart. Her three teenage daughters have been taught about charting and why they see the changes in their bodies that they do. Her teenagers feel empowered by the fact that they can understand emotional or physical symptoms they are having based on the phases of their cycles. She will not force her daughters to use FABMs exclusively, but feels that, regardless of what they decide for family planning, it is an important tool for them to have.
“Her three teenage daughters have been taught about charting and why they see the changes in their bodies that they do. Her teenagers feel empowered by the fact that they can understand emotional or physical symptoms they are having based on the phases of their cycles.”
Carol’s experience with FABMs highlights valuable lessons for women and couples. Although she may not have strictly planned and timed her pregnancies, she used FABMs to meet her family-planning goals in a way that worked for her life and marriage. Furthermore, she has been able to use these methods to gain a better understanding of her body throughout many stages of her life. Now, as she nears menopause, she continues to monitor her health with these methods and is passing down her knowledge to her children. For Carol, FABMs were used “imperfectly” in a way perfect for this family.
*Name has been changed to respect the privacy of the interviewee, and all information is shared with permission.
Abby Koski
Abby Koski is a graduate of Des Moines University, and pursuing a residency in pediatrics. She has a passion for women’s health and ensuring that adolescents have the knowledge to make informed decisions about their lives and bodies.
