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Natural family planning (fertility awareness)
Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist
How to use the temperature method
Measure your so-called 'base' temperature every morning after waking from at least five hours of undisturbed rest, and before getting out of bed. It is important that your temperature is measured correctly using the same, accurate thermometer every day. If possible, it should also be taken at approximately the same time every day. Keep a record of your daily temperature. As soon as three successively higher-than-average temperatures have been noted (based on six previous measurements that month), ovulation has taken place. This is called the 'three over six rule'.
How long does this fertile period last?
From the third day after ovulation - the third day of increased temperature - it is almost certain that the egg will not be fertilised and that the woman's body has entered the second infertile phase.
What are the drawbacks or limitatations of the temperature method?
Considerable motivation is required to measure and record the temperature in the correct manner each morning. This technique cannot be used to identify the first infertile phase, ie before ovulation. The temperature recordings may become confused if the woman has an infection such as a cold.
The mucous test
A few days before ovulation (when the egg is released) the mucus becomes transparent, watery and yellowish. On the day of ovulation itself, what comes out is thicker, wet and thread-like (like egg-white) and might also produce a moist feeling in the vagina. Within a day of ovulation there is less mucus and it is thicker and sticky.
How is the mucous test carried out?
Every morning (or every time you use the toilet) check to see what is coming out of your vagina and remove a little with your fingertip. To work out whether the secretion is at the stringy, ovulation stage mentioned above, press the sample against your thumb, then carefully separate your fingers. If the mucus draws itself out into a long 'thread' before breaking, you are probably ovulating. The second infertile phase starts four days after the day of peak mucus production (ovulation).
What are the drawbacks or limitations of the mucous test?
The mucous test isn't a guaranteed form of family planning, so don't rely on it as a way to avoid getting pregnant. However, it is good to combine the test with other forms of contraception, eg condoms or diaphragms and, in cases where contraception isn't available, certainly better than nothing at all. If you wish to become pregnant then identifying when you ovulate will help you to identify your fertile phase.
Where can I find out more about natural family planning techniques?
The opposite is also true; if a woman is having difficulty conceiving then awareness of when she is ovulating will enable her to maximise her chances of falling pregnant.
Although the test is simple, it is important to practice and to record the findings in a diary.
It becomes difficult to assess the nature of the mucus if you have recently had intercourse. This is because the presence of semen will make the mucus appear different and sexual arousal in a woman also makes the mucus more stringy.
It is possible to obtain instruction and advice in the use of natural family planning techniques (fertility awareness) from appropriately trained doctors and specialist family planning nurses. This is strongly recommended if a woman wishes to reduce her chances of falling pregnant and also gives her the opportunity to discuss alternative methods of contraception.
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