Why Fertility Awareness Can Be a Feminist Choice

In this blog, I’m going to refute some of the arguments against fertility awareness. At the risk of losing some of my audience immediately, I have included the word feminist in this blog title. A while back, I got into an argument in a Facebook comment section with someone who was offended by this article that questioned the pill and it’s effect on women. The argument went nowhere fast, but it got me thinking.

In many circles, questioning the birth control pill is tantamount to attacking women’s rights. I have been told that I’m not a good feminist if I don’t support the pill. As someone who fully supports women and their choices, and as someone who only wrote about women in my graduate degree (I did a lot of gender studies topics), this assertion really hurts.

I know that the birth control pill changed many people’s lives. It brought women into the public sphere more than ever before. Women could now work and have sex without fear of pregnancy. It is considered a great achievement. What’s better than that?

The problem is that not many women are not fully informed about what their birth control options are before being put on the pill. In addition, women are put on the pill for reasons other than birth control (things like heavy bleeding, endometriosis and PCOS). However, we now know there there are alternative forms of birth control, and that the pill does not treat gynecological conditions (it masks them).

I was put on the birth control at age 15. I suffered from heavy bleeding, and mostly my mom just wanted me on it out of pregnancy fears. My doctor did not give me any information about the pill or expected side effects. (Some may point out that the packet comes with information, but freshman year aged me from high school did not think to read my birth control pack in depth). I was switched between at least 4 different types of birth control that I remember. The pill gave me migraines with aura (which I recently learned means I should have gotten off of it immediately, there is a link with having a stroke and migraines with aura while on the pill). I would lose vision while at work and had other disturbances in my vision. I also had pretty regular nausea, weird bleeding, depression, and digestive issues.

When I came off the pill for the first time at age 21, everything felt different. My emotions felt different, and my relationships changed. However, I was left with little alternatives for contraception. To me, taking the pill had become synonymous with being responsible, and I felt like I was failing at being a responsible woman and controlling my fertility.

At the same time, I felt so great coming off of it that I knew it wasn’t an option for me any longer. I felt truly like myself for the first time. One line in particular from a short film called Birth Control Your Own Adventure really resonated with me. This film is about how one woman struggles to find the right hormonal birth control. At one point a friend asks her, “How do you even know who you are if you’ve always been on the pill?” And, truly, I don’t think I knew myself while I was on it.

In my search for a better birth control, I stumbled upon fertility awareness methods. I found out that it was possible to track my cycle and determine daily whether I was infertile or infertile. Charting my cycle helped me learn when to expect a period. I had no idea that you could literally count high temperatures after ovulation in order to know when to expect a period. This feeling felt revolutionary, and I wanted to tell everyone.

When I try to share the joy I have found in this method, I often hear a few retorts. I’ve listed a few below along with my responses to these arguments.

The Arguments Against Fertility Awareness

  • Why should I have to plan sex? It seems kind of sexist that you expect women to wait to have sex at certain points in their cycle. On the pill, I can have sex whenever I want.

With fertility awareness methods, you don’t really have to “plan” to have sex. You can, however, choose to have unprotected sex during the infertile times of the cycle. If you are using a secular form of fertility awareness, you can also use condoms or other barriers during other points of the time in the cycle (keeping in mind that these barrier methods have their own efficacy rates).

I think it’s also worth noting how often the average couple has sex. A 2017 study found that the average American couple only has sex once a week. My window for abstaining or using backup protection is only about 9-11 days long. That’s a little over a week and a half a month. (I’m aware that some women have longer fertile windows. This aspect of fertility awareness is very individual and based on your own unique cycle). So, are these women really missing out on having unprotected sex a little less often?

Finally, yes, you can have sex on the pill whenever you want. However, the pill has been known to lower women’s libido and testosterone. Read this article to find out more. So, while you can have sex any time you want on the pill, doesn’t quality of sex matter? You can still have sex pretty often while using fertility awareness, and you may find you enjoy it more too.

  • This method seems really irresponsible. It only takes one time for a woman to get pregnant. What if she decides to have sex in her fertile window?

If someone is fully informed and taught by an instructor, they will know when their fertile window is. Yes, it only takes one time to get pregnant but if you are using fertility awareness, you know when that window is. If she decides to have sex in her fertile window, she may consider a barrier method. Anyone who has sex during their fertile window should be cognizant of the risks of pregnancy. By the way, at a typical use rate of 91%, someone could also have sex in their fertile window without knowing it while on the pill. At least fertility awareness lets women know what is going on in their own body.

  • Isn’t that a super religious method? I don’t care for that. It’s my body and I can have sex when I want.

Natural Family Planning is based in religious teachings. Fertility Awareness is not. Women can pick what they feel comfortable with based on their intentions. You can also still learn from NFP resources even if you aren’t religious. The method works the same regardless of any ideology attached to it.

  • Isn’t that like the rhythm method? You can ovulate at any time!! That’s not gonna work!

No, it’s not. There are many scientific studies on fertility awareness. Here is one. Here is a recent article reviewing all the studies done on FAM.

Women cannot ovulate at any time. Once ovulation has been confirmed in cycle, it is almost totally impossible for it to happen again. Some people say, “What about superfetation??” This is so rare, and almost impossible to prove. If you are confirming ovulation with a double check method, then you can be safely assured that ovulation will not happen again. At the beginning of a cycle before ovulation is confirmed, it could happen at any time. However, there are rules to follow so that women know when to stay protected.

The typical use rates of fertility awareness (when abstinence is practiced in the fertile window) is higher than the typical use rate of the pill. See my about section for more information.

  • But women need the pill for medical conditions, you know like endometriosis? Do you want women to suffer?

Obviously, I don’t want that. What’s important to know here is that the pill doesn’t actually treat endometriosis, or PCOS, or anything else really. It just masks the problem. If you have extreme period pain, you need expert care. The pill may mask problems that would eventually hurt a woman’s health and fertility. In particular, I want to note that if you are suffering from endometriosis, there is help. Join Nancy’s Nook Endometriosis Education to learn what your options are. For PCOS, Alissa Vitti is a great resource. Here is her website.

  • Isn’t it kind of anti-feminist of you to promote this? Women should be able to control their fertility however they choose.

Ah, my favorite question. I do agree that women should be able to control their fertility however they want. My whole shtick is that they should be fully informed in order to make this decision. With the dearth of good sexual education programs in the USA, almost no one is informed enough. Even doctors aren’t informed enough. Many only take one measly birth control class. Fertility awareness instructors do more than that, and they aren’t even in medical school. If more women knew that fertility awareness methods actually worked, they could make the decision to learn more about their body. I believe that all women should learn about fertility awareness methods as soon as they have their first cycle. It is so useful for girls to know what’s going on in their bodies!

I also argue that we have a #righttoovulate. I saw Dr. Lara Briden post this hashtag a while back, and I love it. Ovulation is amazing. And actually, I think it’s sort of anti-feminist to take that away from women, especially if they don’t understand what they are missing. Women are only fertile for around 24 hours a cycle (men’s sperm life makes up the rest of the fertile window). This is such a small window. Don’t we deserve the benefits of ovulation? Read Dr. Lara Briden’s article, “Ode to Ovulation” to learn more. In addition, some people have argued that it takes 7 years to develop fully healthy hormonal cycles, shouldn’t we be able to do that too? Putting women on birth control when they are young prevents so many of those benefits.

**I will note that I understand that hormonal birth control can be invaluable in domestic violence situations, or when a woman really cannot do FAM, or is forced on HBC for unrelated medical conditions. I just want the average woman to know that she has other options.

What's more feminist than fully owning and living in your own body, while also avoiding pregnancy and planning it as you choose_

Conclusion

Most of the arguments against FAM are from uniformed people who don’t know what they don’t know. Fertility Awareness is actually feminist, and it’s certainly not anti-woman. It allows women to take control of their own fertility (here’s a great book on that). What’s more feminist than fully owning and living in your own body, while also avoiding pregnancy and planning it as you choose? Why should women subdue their own fertility when their fertile window is so short?

Do you want to learn more? Visit my other articles and reach out to me.

Why I Do Not Suggest Using Natural Cycles

Natural Cycles costs around $10 a month, or $80 a year. The app claims to be able to tell you when you are and when you aren’t fertile by using basal body temperature (ovulation strips are optional).

This claim is not true. Natural Cycles only has a 93% typical use efficacy rating. After my experience, it seems even lower than that. I used Natural Cycles for 3 cycles and compared it with the sympto-thermal (STM) method that I use. The method I use is 98.2% effective with typical use.

As a long term charter, I use a doering rule (a rule to limit dry days). My last safe day for unprotected sex is day 5 of my cycle (usually the last day of my period) because of this rule. This rule is included in the high efficacy rates of the sympto-thermal method.

The charts that follow show when my method said I was safe versus when Natural cycles told me I was.

I have compiled 3 of my charts for comparison. During more than one cycle, Natural Cycles told me I could have unprotected sex on the day near my PEAK fertility. Peak day is the most likely day of ovulation, while not always the exact day of ovulation. Suffice it to say, the app told me that I could have unprotected sex on a day when pregnancy was still possible.

September Cycle (First with Natural Cycles)

On my very first cycle, without any knowledge of whether I had ovulated the cycle before, Natural Cycles gave me clearance to have unprotected sex during my period.

This is totally wrong. Without having confirmed ovulation the previous cycle, there is no way to know if this bleeding is safe or not.

The next BIG issue is that it told me I could have unprotected sex on the second day of my temperature shift (CD17). There is a huge chance that my egg could have still been viable and hanging at this point.

With the symptothermal method, you CANNOT confirm ovulation before 3 high temperatures.

The chart below has my actual safe days as calculated by doering. (Keeping in mind that I did confirm ovulation the cycle before so my period is safe. However, there is no way that Natural Cycles could have known that).

september 1

October Cycle (Second with Natural Cycles)

late september nc cycle

For the second time, Natural Cycles gives me a green light on the second day of a temperature shift in the morning. My egg could still be around! In fact, this green light was less than 24 hours after my peak day!

october 1 cycle

November Cycle (Third with Natural Cycles)

late october nc cycle

During this cycle, Natural Cycles decides that I’m not safe on CD 5 (I am).

It also gives me a green light on CD20. However, I would not be safe to have unprotected sex until the evening of CD21 due to peak day occurring on the first day of my shift.

oct 27 cycle

Conclusion

Natural Cycles does not follow the rules for STM charting.

When charting with STM, one must always wait until the evening of P + 3 and T +3 (three high temperatures and three days after peak). Both rules have to be met before you can have any unprotected sex. With weaker shifts, this wait can be a day longer.

Natural Cycles does not include cervical mucus. Since cervical mucus is what opens the fertile window (and not temperatures), this causes the method to lose efficacy. Cervical mucus is what allows sperm to survive and fertilize an egg. When cervical mucus dries up for 3 days and 3 high temperatures above the coverline occur, ovulation is confirmed for the cycle. Any app that leaves out cervical mucus, but still lets women have green days pre-ovulation, is misleading women and putting them at extra risk of pregnancy.

Another worrisome aspect of the app is that it frequently gave me a green light on the morning of the second high temperature. Temperatures can easily be disrupted, and new charters may not know their normal temperature ranges. Women need to be certain that ovulation is over before having unprotected sex. The third high temp (along with the third day after peak day) lets you know that ovulation is confirmed. Green lights after only one or two temps can put women at a risk of pregnancy, especially when cervical mucus isn’t taken into consideration. In fact, most STM methods require 4 high temps for women who don’t use cervical mucus (or cervical position). The reason that Natural Cycles may interpret shifts wrong is because of its static coverline. Some women may not see much of a change in coverlines from cycle to cycle. However, others may see a change. Having a static coverline can give users green days before they actually have a temperature shift.

Lastly, the app is misleading because it marks the day of ovulation. The only way to truly determine the exact day of ovulation is with a well-timed ultrasound. In fact, ovulation is most likely to occur over a period of about 4 days. Here is the link to the study that discusses which 4 days are the most likely. Since ovulation is likely up to day 2 of a temperature shift, this proves even further why it is so risky for Natural Cycles to give green lights on day 2 of a shift. In the other 9% of cases not hightlighted in the green box below, ovulation happened up to 3 or 4 days before a shift. This is why mucus is so important to record pre-confirmed ovulation. If there is mucus present, the sperm may live. Natural Cycles does not take enough factors into account when drawing its fertile window.

ovulation


If you are coming off of hormonal birth control or postpartum, this app may be an even worse choice for you. Those coming off hormonal birth control and postpartum may experience cycles changing in length and unexpected early ovulation even more so than people with regular cycles.

Anecdotally, I have seen many risky charts from Natural Cycles in the group I help moderate. You can find a link to this group here.

I highly recommend learning a real sympto-thermal method from an instructor and not wasting your money on the Natural Cycles app. I found it quite shocking that is was not very conservative when first learning about my cycles.

Check out my last post to learn how to start charting on a budget. Click here to sign up to learn to chart with me when my course opens in September 2019.

Here are some other articles on Natural Cycles that I recommend reading:

Natural Cycles’ FDA Approval: What’s The Big Deal?

5 Reasons I Don’t Use Daysy Or Natural Cycles

‘I felt colossally naive’: The Backlash Against the Birth Control App

Top 3 Fertility Awareness Mobile Charting Apps

One of the first steps many women take when starting their charting journey is downloading a period app. However, not all apps are created equal. A quick search in the app store comes up with dozens of apps. Sadly, very few of them are suitable for those using NFP or FAM. Most are just forms of the rhythm method, an unreliable from of birth control that comes up with predictions based on past cycles. My review only includes apps that allow women to track cervical mucus and basal body temperature–the two main signs in SymptoThermal Methods. I also tried to only pick apps that allowed self-interpretation. Learning how to interpret your own fertility signs is vitally important when charting.

1. Kindara

kindara2

Available on Android and iPhone.

Perk: The iPhone version allows users to share their whole chart.

Con: The Android version is known to be considerably more glitchy than the iPhone version. On Android, users can select “Share This Chart” and “With Community” to access a screen where they may screenshot their own chart.

Cost

Perk: Free Version Available

Con: Vaginal Sensation and more than four categories are extra. Premium version is $4.99 USD/month or $49.99 USD/year

 

SymptoThermal Rules Interpretation

Perk: I don’t know if Kindara has a monopoly on self-interpretation or what, but it’s one of the only apps to allow users to interpret and mark their own peak day and temperature shift. It also lets users mark their own coverline. This means that Kindara is good for those using a method like Taking Charge of Your Fertility (which has a higher coverline) and those using Sensiplan (which has a lower coverline). Lastly, Kindara has a very easy to read, clear chart. This is so important for users, and for those helping them.

Predictions

Kindara also does not predict fertile windows unless the user is trying to conceive (I recommend ignoring these even if trying to conceive. It is always best to do your own interpretations or ask an instructor if uncertain). It will predict menstruation based on average luteal phase length once it has enough data.

Other Features:

  • Users may share charts and get feedback from the community
  • Counts days past ovulation when shift is marked
  • Cervix Tracking (Height, Openness,Firmness)
  • Sex Tracking (Protected, Unprotected, Withdrawal, Insemination
  • OPK and Pregnancy Tests Tracking
  • Journal Available
  • Pairs with Wink Thermometer (syncs with the app via Bluetooth)
  • Emojis can be used in custom data

2. Fertility Friend

fertlity friend

Available on Android and iPhone 

Pro: Fertility Friend appears to work equally well on Android and iPhone

Cost

Pro: Free, paying is not necessary to be able to chart.

Con: VIP membership available starting at $9.99/month. This is a little expensive. The community sharing feature is only available to those who pay.

SymptoThermal Rules Interpretation

Perk: Coverline can be overridden under settings.  There are options to chart cervical mucus and temperatures.

Con: The app automatically interprets. For new users, this may be confusing. 

Predictions

Fertility Friend does predict fertile windows, period days, ovulation days, and a recommended test day for pregnancy. As always, users should rely on their own interpretations and get help from an instructor if needed.

Other Features:

  • Cervix Tracking (Height, Openness, Firmness)
  • Pregnancy and OPK tracking
  • Ton of Options for Mood, Health, Diet
  • Options for IVF, A.R.T., and Fertility Medication Tracking
  • Weight Data
  • Lightbox (With VIP compare photos of OPK and HPT tests)
  • Chart Overlay (Compare multiple cycles on one chart)
  • Sex Tracking (no option to differentiate unprotected versus protected)

3. OvuView

ovuview

Available on Android Only

Con: Pretty much the fact that it isn’t available on Apple products

Cost

Perk: Free (but with ads). One time payment of $4.99 to remove all ads. This is the cheapest app with the most features for custom tracking.

SymptoThermal Rules Interpretation

Perk: You can pick from multiple methods. Users may turn methods on and off.

Con: No self interpretation available. I have included it because unlike any other app that I have come across that interprets for users, the methods can be turned off. Users may play around with the methods to see if they can mark their chart according to their method’s rules. Turning off all settings would leave a chart for the user to interpret themselves even though they can’t self-mark.  Another con is that the temperature scale is very hard to read. Make sure to round or drop your temps. Ovuview may not always do this correctly.

Predictions

Ovuview predicts future fertile windows, ovulation days, and periods. Users should ignore this in favor of self-interpretation.

Other Features:

  • A ton of custom tracking like medications, moods, weight, etc.
  • Syncs with the Tempdrop device (This is wearable BBT. My review is coming soon. Full disclosure: this link earns me ten dollars if you use it to purchase the device)
  • Cool design. Users can choose their own chart colors, background, custom data colors, etc.
  • Cervix Tracking (Position, Opening, Texture)
  • OPK and Pregnancy Test Tracking
  • Fertility Monitor Tracking (None, Low, High, Peak)
  • Sex Tracking

Conclusion

There are limited options for self-interpretation when it comes to FAM apps. The three apps above are the best I’ve found when it comes to self-marking.

Look out for my next blog on how to chart using Google Sheets. I’ll be creating a Youtube video on how to do this yourself. This method of charting allows self-interpretation, custom data tracking, and users can chart on their computer or phone.

Google Sheets

chart 19

chart192