Over the last year Mark and I have had the opportunity to introduce several of our friends to Natural Family Planning, including three engaged couples. If I have learned one thing from this experience it's that NFP can get very confusing very quickly. In this post I hope to lay out the basics of NFP in an attempt to make it less confusing for those of you who are in the process of learning. This is by no means an extensive explanation of how or why NFP works, but it will give you an overview of the most important information you need to know to get started. I can not stress enough how important it is to do further study for yourself if you choose to make NFP part of your marriage. It is important to take a class, meet with an NFP doctor, or at least buy a book on the subject to learn more. I always tell couples that one of the reasons Mark and I are so confident in NFP is because of how much we have studied it-- we have taken a class together, I met with an MD for several months to review my charts, I bought a book, and I have an NFP-certified RN I still contact with questions occasionally. Basically, we've had several experienced medical professionals patiently and graciously teach us everything we need to know. So if you want to feel confident about NFP, I recommend doing more than reading this blog.
I must also add that although NFP can be used to achieve pregnancy, this post is geared towards those who want to use NFP to avoid pregnancy. It is also important to note that the rules and observations for postpartum women are slightly different than the ones listed here.
Let's get started.
Supplies:
One of the things that is great about NFP is that it doesn't cost very much. There is only one item that you really need to buy--a basal body thermometer. The total cost should be $10-$20, depending on which thermometer you buy. Here are a couple that have worked great for me:
In addition to a thermometer you may choose to buy a fertility monitor. This isn't absolutely necessary (NFP is still 98% effective without the monitor), but it does give you extra assurance, which is especially nice when you are first learning. My NFP instructor recommends the Clearblue Easy Monitor. It is a little costly upfront, but after the first couple of cycles you do not need to use it nearly as often, so you do not need to buy refills every month. I only have to buy refills about every 4-5 months. Again, this isn't a must-have.
Lastly, if you don't start off by taking a class right away, at least buy this book. It will help with unexpected questions.
Cycle Basics
The first step to learning NFP is understanding the cycle a woman's body goes through approximately every 28 days. Knowing this pattern is key to understanding when a woman is fertile, and therefore able to become pregnant. During her cycle a woman has her period, which is usually 5-7 days. After this, she is infertile for the several days leading up to ovulation which usually happens around day 14. During ovulation an egg is released from the woman's ovary which lives for 12-24 hours. This is the only time during her cycle that a woman is actually able to become pregnant. This event is followed by another infertile period.
The Fertile Window
NFP works by identifying when a woman is fertile each cycle (her "fertile window"). This allows couples to choose to abstain from intercourse during this time so that they don't conceive. The length of a woman's fertile window is usually about one week long, give or take a day or two.
Identifying the Start of the Fertile Window
At this point the natural question should be, "So how do I know when I am fertile so I can know when to abstain?" The answer is quite simple--cervical mucus (CM). My apologies to the gentlemen, but this is very important.
Through the course of her cycle a woman will observe several different kinds of CM. It will begin to appear several days before ovulation and start out sticky before turning creamy, and then to an egg white consistency. Egg white CM is the most fertile kind and it exists for the purpose of keeping sperm alive.
Without the presence of CM sperm can only live inside the woman for a matter of hours, but if the sperm is met by fertile CM then it can live for as long as 3-5 days. This means that if a woman has sex several days before ovulation her CM may keep her partner's sperm alive long enough for it to still fertilize the egg once she does ovulate.
The rule is simple: Couples wishing to avoid pregnancy should start abstaining as soon as cervical mucus is present because this means ovulation is approaching.
I don't want to gross anyone out with a picture, so if you need help identifying the different kinds of CM, click here.
Identifying the End of the Fertile Window
The fertile window ends after the woman has ovulated and the egg has had adequate time to die. Because the egg can live for 12-24 hours, it is best to wait three days after ovulation has occurred before resuming intercourse.
This is where the thermometer I mentioned earlier comes into play. A woman can know when she has ovulated by tracking her basal body temperature (BBT, or in regular people terms, her waking temperature).
During ovulation the woman's body releases a hormone (progesterone) which causes a rise in body temperature. Once a woman sees this rise in her temperature she has ovulated. After recording three consecutive temperatures that are higher than her previous six temperatures, couples can resume intercourse. The temperature pattern may look something like this:
Again, the rule is pretty simple: You may stop abstaining three days after your temperatures rises because this means that ovulation has occurred and the egg has had enough time to die.
A Note on BBT
Taking your temperature really isn't that difficult, but here are some important things to remember:
- Use a Basal Body Thermometer, which can be found at any drug store or online.
- Starting the day after your period ends, take your temperature every morning when
you wake up. For the most accurate results, try to take it at the same time each morning
(Your temperature goes up the later you sleep.)
- Take your temperature before talking, eating, drinking, or moving around too much
for best results.
- Record your results on your chart. (Most thermometers have a recall option, so you don’t
have to write the results down right away.)
Charting
Remembering your mucus pattern and temperature each day is going to be really difficult if you don't record it on some kind of chart. Thanks to modern technology, charting is actually very easy. There are several free charting websites such as fertilityfriend.com and apps like FertilityFriend and Kindara. With the push of a few buttons you can record your temperature, mucus observations, and when you have intercourse. These apps also allow you to record fertility monitor results, pregnancy tests, mood, amount of exercise, medications, and just about anything else you can think of. They are very easy to customize, and did I mention they are free?
Summary
Overall, NFP is pretty easy once you get a hang out of it. The rules are simple: Begin abstaining whenever CM is present.
Stop abstaining 3 days after ovulation (which can be determined via BBT). Chart it. Repeat.
Want to learn more by taking a class? Find one here.
Want to meet with an NFP-only MD? Find one here.
Want to know how I got started on this crazy adventure? Read about it here.
