Lots & Lots of Fertility Awareness-Based Methods (FABMs)...

There are lots of Fertility Awareness-Based Methods (FABMs)... and keeping track of all of them can be confusing sometimes! So here’s some help to understand it...

Fertility Awareness simply means being aware that some days in a woman’s cycle are infertile (intercourse on those days will not lead to a pregnancy) and some days in a woman’s cycle are fertile (intercourse on those days may lead to a pregnancy). *Newsflash - A woman is not fertile every day of her cycle.* So then how these days of fertility and infertility are determined varies by each method. When I meet with individuals and couples, I explain that Fertility Awareness-Based Methods fall into 2 categories: Statistical Methods and Observational Methods. I teach a method found in the latter of these 2 categories; it’s called the Sympto-Thermal Method (STM).

Statistical Methods rely on past information to predict future fertility interpretation; this includes the Standard Days Method (SDM) and Lactational Amenorrhea Method (LAM).

  • Many are familiar with the Rhythm Method and this is where a woman looks at her past cycle/fertility information to predict or calculate her future cycle/fertility information. A standardized and evidence-based version of this is called the Standard Days Method (SDM) and many women use CycleBeads to answer the question at the end of each day, “Am I fertile? Yes or No?” Today’s answer is based on what happened in the past. Cycles must always be between 26 and 32 days; as soon as a cycle varies from this, SDM is no longer recommended. These methods are often call Calendar Methods because they look at the number day of the cycle (or the day on the calendar). Lots and lots of apps use these mathematical calculations to predict when a woman will and will not be fertile... granted, they're better than nothing but I do not recommend apps like that.
  • LAM (or Ecological Breastfeeding) may be used when all 3 of these guidelines are true for a postpartum mama: she is exclusively (or nearly-exclusively) breastfeeding throughout the day and night, her baby is less than 6 months old, and her period (or other bleeding) has not occurred. Again, it uses past information (studies done on other women) to predict her future cycle/fertility information. The answer to the question, “Am I fertile? Yes or No?” is determined by these 3 guidelines. (As an educator, I don’t recommend this method to my clients who want to avoid pregnancy while postpartum and/or breastfeeding.)

Observational Methods rely on daily observations to determine today’s fertility interpretation: this includes Mucus-Only Methods, Temperature-Only Methods, Sympto-Thermal Methods (STM), and Sympto-Hormonal Methods (SHM). When a woman keeps track of the changes in her cervical fluid, and/or the changes in her morning temperature, and/or the changes in her urinary hormones, and/or other fertility signs, then she can answer the question, “Am I fertile? Yes or No?” each day. She doesn’t look at past data to determine future fertility... she observes her fertility each day.

  • Common Mucus-Only Methods include Billings Ovulation Method (BOM - may include religious teachings), Creighton Model System (CrMS - may include religious teachings), and the TwoDay Method. Many postpartum and/or breastfeeding women use this method in addition to a secondary fertility sign (like the position of her cervix).
  • Common Temperature-Only Methods include devices such as Lady-Comp and Baby-Comp.
  • Common Sympto-Thermal Methods (tracking cervical fluid and morning temperature) include methods taught by the Couple-to-Couple League (CCL - may include religious teachings), explained in the books Taking Charge of Your Fertility by Toni Weschler and Garden of Fertility by Katie Singer, taught by the Justisse Method, and used by the myriad of apps that keep track of this information as well as sometimes use the Statistical (or Calendar) information discussed earlier. This is the method I teach... and it can be adjusted to accommodate postpartum/breastfeeding mamas, those who work night shifts, and women who have irregular cycles.
  • Common Sympto-Hormonal Methods include the Marquette Method (MM - may include religious teachings) and devices such as OvuSense and OvaCUE (but not all of these are recommended for those wanting to avoid pregnancy).

Now... there are also the differences between the terms Natural Family Planning (NFP) and the Fertility Awareness Method (FAM)... which is covered in this blog post.

There isn't a “best” method. There’s definitely a “best method for you” or “best method for this phase of life,” but not one of these methods is the “best” method of Fertility Awareness. It depends on how it fits in with your life, what intention you’re using it for, what effectiveness rates you want, and lots of other things. Also, using Fertility Awareness to achieve a pregnancy or avoid a pregnancy isn't the best choice for certain women and couples and that’s why there are lots and lots of other options out there.

So... have you used these methods of Fertility Awareness in your life?

When and where and why and how?