Trusting Fertility Awareness for Birth Control (Episode 332)

Full Transcript: Episode 332

Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with us today.

Today, I’m sharing a brand new episode in my Fertility Awareness Reality series. I’m sharing my conversation with my client, Kim. And what I love about this conversation is it really gets into the nitty gritty of fertility awareness, what really has to happen in order to make that mind shift to allow yourself to start trusting the method. I’ve talked about this quite a bit on the podcast, particularly in a recent episode I released all about using non-hormonal contraceptive methods. I really got into just how much we have been indoctrinated to believe that we’re fertile all the time, which predisposes us to opting for hormonal methods of birth control.

When you get it, and you’re kind of convinced on that intellectual level, it certainly still takes a little bit of effort and deprogramming to get yourself to the point that you can trust it. So by no means am I suggesting that this is a process that should be rushed. I firmly believe that every woman should take the appropriate amount of time for her to sort this out, and it’s not the same for everybody. For a woman who is learning on her own through books, maybe part of a couple of Facebook groups, and downloaded some apps, a minimum of three to six cycles is what I recommend before using the method as birth control. For a woman working with an instructor certified in a particular method of fertility awareness, that can be brought down to one to three months. But ultimately, the duration of time it takes you to feel comfortable with this method is going to depend on you, your comfort, and your intuition. Trust your intuition, because every woman I work with gets to a point where she feels ready, and she’s the one who makes that decision. This is all about empowering you to make informed choices about your birth control. So without further ado, let’s jump into my conversation with Kim.

Lisa: And I’m really excited to be here today with Kim. Kim is a member of my postpartum series, the Postpartum Live, which is the first time I’ve done a Fertility Awareness Mastery Live specifically for postpartum. I’ve been absolutely loving it, and we actually just finished one of our guest speaker sessions. So really excited to have you here today, Kim.

Kim: Thank you. Thanks for having me.

Lisa: What I always say, I feel like it’s a broken record at this point, but it’s always true — I really love doing these sessions because I love having the opportunity to have a conversation outside of our class. I recorded a session last week and so much came out that I had no idea about, so I feel like I get to learn more. It also allows this greater exposure of the real experiences of women who are trying to use fertility awareness. So those are the main reasons why I love doing these episodes. With that in mind, I’d love to give you an opportunity to let us know a little bit about your experience with menstruation when you started menstruating, how you were managing your fertility, and basically what brought you to fertility awareness now, because now you are in the postpartum phase.

Kim: Yes. I don’t have a history of hormonal birth control. What brought me to fertility awareness was I got married in 2016, so we were waiting for marriage to have sex, and someone passed me the book. I was already kind of at that point had my foot in the door with holistic ways of looking at the body and feeding the body and treating my body, so I was like, I’m not going to take the pill or anything. Someone gave me Taking Charge of Your Fertility, so I read it and learned as much as I could from it, and I learn well from books. But it can only take you so far learning out of a book — then you’ve got to get to the point where you have a lot of questions. It was working well until I got pregnant. I don’t like saying I wasn’t trying to conceive, because I’m so thankful for my son. We got married in April 2016, and I got pregnant November 2017.

Looking back, I did not know my cervical mucus like I needed to. I was also relying on LH strips and, once I heard your podcast, I realized I shouldn’t rely on apps that use algorithms — that’s what I was doing a little bit. When I look back and analyze what happened, I can see the flaws: I didn’t know my cervical mucus, and I was relying too much on the app day-to-day. So I got pregnant, and I threw fertility awareness out the window for a while because I was pregnant and then postpartum and wasn’t ready to jump back into sex right away. I knew it wasn’t the method — it was me and my lack of knowledge. When you’re postpartum, I just did not have the bandwidth to learn it, so I told my husband, “raising condoms,” I don’t have the capacity to learn this right now while I’m figuring out newborn baby stuff. When your class came up recently, my mind was like, okay, I’m ready to learn this. I talked to my husband about the price and the benefits — we do want to get pregnant again, but there’s the benefit of not having a condom every single time and not having the fear of getting pregnant or the frustration of not having the knowledge.

Lisa: Thanks so much, Kim, for taking us through that. I feel like just that short segment of you sharing how you got to this point, and your experience of conceiving when it wasn’t really intentional — obviously baby was very welcome, but it was a big surprise. And I think that reflection of what actually happened is helpful, because in the class I have a handout on why fertility awareness fails, and I like to address those things head-on.

Kim: Yeah, and I did look back and analyze it. I told my husband, okay, it’s not the method, it was me — relying on the LH strips and the app a lot, the green dot and red dot, go or stop.

Lisa: Well, and you’re right, I haven’t specifically released an episode on vasectomies, and I think I’ll make a note of that, because that’s a really important topic. There are certain side effects people should be aware of — not that it’s a no-go for anyone, but when people say there are no side effects, I think, well, it’s surgery, so there are specific side effects to be aware of. Sterilization is actually the most common form of birth control, and it goes back to everything we’re learning — inform me of the whole story so I can make an informed choice.

All right, let’s jump into the session part. So we’ve had one session in our group so far. Where are you in your chart?

Kim: I ovulated day 14, and I’ll start my period around day 29. My husband and I had unprotected sex for the first time since I was pregnant, basically. I waited until my mucus was completely dry — I gave it a big gap, waited to day seven of my post-ovulatory phase. So I don’t have a success story yet since I haven’t started my period, but that should happen in a couple of days.

Lisa: Let’s break it down for the audience. This is a topic I think will come up more on the podcast — the concept of easing into fertility awareness because of the years of indoctrination that we’ve all been subjected to. We’ve been told the lie that we’re fertile every day, and it really sticks. You can learn the science, read the books, take the class, and have the instructor explain it, but there’s a difference between head knowledge and experiential knowledge. At some point, for most women using fertility awareness, there’s a big jump from the theoretical to actually having unprotected sex. One of the things we talk about, of course, is confirming ovulation using the cross-check method — looking at temperatures (three temperatures higher than the previous six) and looking at the mucus rules to identify peak day, then counting the fourth day after peak as the first infertile day, going with the later of the two. When you’re easing into this and looking for a buffer, it’s totally reasonable to add a few more days so that you’re even more sure and less scared. How did you feel? Were you terrified?

Kim: Oh, I had a lot of emotions. On day five and day six I kept thinking today’s the day, but then backed out. My poor husband — he was very supportive. By day six or seven of my luteal phase, I was diligent about checking mucus, confident in my temperatures, and I just had to trust the science in front of me. By day seven I was ready. It felt exhilarating — a real paradigm shift mentally. It was very freeing. I trusted the data, and it felt like a sense of freedom and confidence that we could make love the way it was intended, without that underlying fear. I’m still not ready for pre-ovulatory unprotected sex right now — I need a couple more cycles of practice — but that’s why I started with the post-ovulatory phase.

Lisa: I really appreciate you taking us through that, because this is why I love doing these episodes — it gives the reality of what this actually looks like. With an IUD, it’s inserted, and then you don’t have to do anything. This method is completely user-dependent. I always use the analogy of driving a car — you could read a book all you want, but if you’ve never driven, it’s going to take time before you can be safe on the road. The natural progression women go through: step one is learning and familiarizing yourself with the information; step two is charting before you ever have unprotected sex. Working with an instructor, that can be one to three cycles; learning on your own, three to six cycles is the recommendation. Step two is only pre-ovulatory — sorry, post-ovulatory — until you’re very comfortable and confident confirming ovulation and sticking to the rules: temperature rules, cervical mucus rules, put them together, later of the two, every time, no exceptions. Once you’re comfortable with that, you can move to the pre-ovulatory phase.

For anyone new to fertility awareness — the reason this works is that if we break the menstrual cycle into the pre-ovulatory and post-ovulatory phases, pregnancy is only possible in the pre-ovulatory phase, because that’s when cervical mucus is produced as the egg develops. Once ovulation occurs, if conception doesn’t happen, the egg disintegrates within 12 to 24 hours. In the second half of the cycle there’s no egg, the mucus dries up, the cervix closes with a mucus plug, and the vagina becomes acidic, so sperm can’t survive. That’s the theoretical knowledge. But the hard part is that taking the leap feels like it goes against everything you were ever taught, even when you know the science.

Kim: That’s what I read, yeah.

Lisa: Once you start using the method, follow the rules, have sex during your confirmed infertile window, and your period comes right on time, cycle after cycle, that’s when you really know it works. I know it works because I have 20 years of cycles behind me.

Kim: Once I do this, more questions come up than I can focus on for the pre-ovulatory phase. What’s nice about the class is that each week something different is happening in your cycle, so more questions come up than I expected. I like the Facebook group for that — I can post a question right when it comes up, even if it’s not answered immediately, just to remember to ask it later. That’s been more helpful than just learning from a book, because mucus observation isn’t always straightforward.

Lisa: It’s interesting, because as much as I talk about this, you can’t really bring it up with everyone in your life the way you can in the podcast community or the class.

Kim: Yeah, you’ve got to find someone to celebrate with. My close friends know a lot about the topic already, but even so, I don’t share every detail. But the podcast is great because the information is out there — you chose to hit play, I’m not forcing it on anyone.

Looking back on my history, I don’t think I ever missed a cycle, though I wasn’t really keeping track. But I did notice some mucus discharge patterns I probably should have gotten checked, and reading about it now, I understood what those were. It would have been helpful to know that fifteen or twenty years ago.

Lisa: Of course you can’t go back in time, so I encourage everyone to be gentle with themselves — we’re all doing the best we can with what we know at the time. And now it’s an opportunity to move forward, and maybe share it with a daughter or niece down the road.

Kim: I’ll share my chart with you. This is the beginning of the chart — I’m currently on day 26, and day 21 was the day it happened, with a little heart marking it.

Lisa: This is super common. I like the hot tub analogy for moving into this phase — it doesn’t make sense to just dive in headfirst. For a number of my clients, the first time they have unprotected sex in the post-ovulatory phase, they’ll confirm ovulation and get the rules down, but some will wait until a day or two before their period is due.

Kim: Makes sense — it’s the last time you have to wait.

Lisa: Once you feel comfortable and confident, it’s proof of concept, and you can start following the rules more closely to maximize the days of unprotected sex, if that’s what you’re aiming for — and a lot of my clients are. You’re in good company, Kim, with that strategy. Do you have any method-related questions?

Kim: When I look at my chart, there are a couple of things I want to work on. We talked about vaginal steaming for the brown spotting I get before and after my period, so that’s my next step. I also want to get more comfortable checking mucus, because it looks like I had some mucus every day from my period all the way to peak day, so I need more practice distinguishing peak from non-peak.

Lisa: In terms of the brown spotting, I’ve had a number of clients have success with vaginal steaming — three to five days before your period starts and three to four days afterward, continuing for two to three cycles. It often clears up spotting and improves period color and quality. It sounds like the mucus you’re describing is in the pre-ovulatory phase, since you said you’re dry post-ovulation.

Kim: Correct. I saw a little bit of mucus on days one through three of my count of three, then it dried up on days four and five and stayed dry — the non-peak, lotion variety. Day 15 was borderline; it could have been cloudy or cloudy-clear, so that’s why I waited a couple of extra days before having unprotected sex.

Lisa: I’m trying to remember, did you send me your chart? You mentioned mucus concerns related to a podcast interview you listened to a while back about copper toxicity, and a more recent one on mineral balancing.

Kim: Right, I’m on a similar program to detoxify copper, and copper binds with estrogen, so I’m aware it could affect my cycles or mucus, which is another factor I note in my charts.

Lisa: That’s certainly possible if it’s affecting estrogen — more so pre-ovulatory. Let me look at your chart — there’s the first unprotected day, with a little heart. So you did have some mucus right after bleeding stopped.

Kim: Yes, days six and seven had some brown spotting, then it turned cloudy-clear for a while. I didn’t see as much of that really stretchy, clear mucus I’ve noticed before, though I don’t have written data from before I started charting.

Lisa: That’s an important point — when you chart over time, you’ll notice that every cycle isn’t exactly the same. I’m not sure how much of a factor the detox program is, but stress, life circumstances, and other changes can affect mucus too.

Kim: That could be it — I stopped breastfeeding completely on August 20th after breastfeeding for two years, and I hadn’t even thought to write that down, but that would have affected a lot.

Lisa: Yes, oxytocin suppresses estrogen, so that transition could certainly affect things. When I looked at the research on breastfeeding, it’s actually the frequency and duration of suckling that has the strongest suppressive effect on ovulation. So if a baby is teething or nursing more at night, that can delay ovulation. Now that you’ve finished breastfeeding, you’ve removed one factor that could interfere with your cycle.

Kim: Yes, we had already slowed down to one feed, so it was a smaller shift, but still a change. In terms of timing, based on my temperature and your peak day assessment.

Lisa: I wrote a question mark for peak day 14, then peak day 15 with a question mark, and you started the count of three even after that to give yourself an extra day. Based on the mucus rules, day 19 would have been the first infertile day, and based on temperature rules, day 16. When you cross-check, you often end up with a bit of overcorrection, which is good when you want to apply the method most conservatively. Then in your post-ovulatory phase you’re mostly dry, with one day of mucus on day 23.

Kim: I saw a little mucus on day 23 — I forgot to mention that. I know there’s no egg then, but I wasn’t sure what that was.

Lisa: That’s likely not mucus at all — that’s where the semen elimination technique comes in. Once you start having unprotected sex, you quickly realize it can be hard to tell mucus from semen the day after intercourse. Semen tends to be more milky while mucus stretches more, but they can be confused. That’s why there’s an every-other-day rule in the pre-ovulatory phase — because there’s no fully reliable way to distinguish them the day after sex. What we teach in the class is to go to the bathroom after sex and let the semen come out intentionally, so that the following day’s observation is more reliable. I often recommend trying one day where you remove the semen and one where you don’t, to notice the difference.

Kim: That brings up a whole new set of questions I posted in the Facebook group about the pre-ovulatory phase. One of my questions: if you’re pre-ovulatory, have a dry day, have sex in the evening, and then wake up to mucus the next day, can you get pregnant from the semen the night before, or is the vagina too acidic for sperm to survive by then?

Lisa: That’s an excellent question, and it’s essentially everyone’s underlying question about how this method really works. From a theoretical standpoint, you can’t get pregnant on a dry, infertile day because the cervix is closed and the vagina is acidic, so sperm can’t survive. But part of managing the pre-ovulatory phase conservatively is accounting for the fact that not every woman has a straightforward, obvious mucus pattern — some women, especially those coming off birth control, ovulate without producing much observable mucus. Pregnancy is possible in any cycle where ovulation occurs, so we manage the pre-ovulatory phase very conservatively to account for those unknowns.

One of the strategies I recommend for managing the pre-ovulatory phase is what’s sometimes called the “doering rule,” which adds structure by looking at the earliest day you’ve ever ovulated and building in a buffer so you’re not having unprotected sex too close to a potential ovulation. It’s an additional measure of safety. This matters because I’ve worked with women coming off the pill who have dry cycles with no observable mucus at all, even though their temperature confirms they’re ovulating — their cervix is still healing from hormonal birth control. Modern factors that fertility awareness educators didn’t have to account for as much thirty years ago mean we have to build in these extra safety measures. Interestingly, the Frank-Herrmann study that’s most frequently cited for fertility awareness effectiveness — showing 99.4% effectiveness — used a specific cutoff date where participants were following this exact kind of conservative rule.

Kim: That makes sense. My cycles have been pretty regular in terms of timing, which could help, but I’ll definitely need a couple more cycles before I’m ready for anything beyond post-ovulatory. I’m happy with that step for now.

Lisa: As we bring the call to a close, Kim, for anyone listening who’s using contraceptives or on the fence about fertility awareness, what would you want them to know?

Kim: I like to learn and understand things, so I’d say wait for your own timing. My husband was very supportive when I said I wasn’t ready to learn while I was still adjusting to a newborn. When I was ready, learning in my own timing from a book first, then committing to a class, helped a lot with confidence. If you can, get outside support — it’s helped immensely.

Lisa: I’m so glad. We’re only halfway through the class, with four more sessions to go.

Kim: Yes, and it helps to learn the basics beforehand so you can jump in and start asking the deeper questions once you’re working with an instructor. My husband was extremely supportive of using condoms in the meantime, and understood I wasn’t willing to get pregnant yet.

Lisa: I love that so much, Kim, and I think this is something practitioners listening should hear too — one of the challenges women face when they want to use this method is not being believed, not being seen as capable of learning and being patient enough to do so. This method isn’t for everyone, and no one is out on the street insisting every woman has to use fertility awareness. Women who gravitate toward it are willing to do the work, and that’s who this method is for. My message to practitioners is that you don’t have to be the expert in fertility awareness yourself, but you can support a patient by acknowledging that it’s real and can be effective, and encouraging them to seek proper instruction — similar to referring someone to a dentist for a tooth problem, rather than dismissing the method outright.

Kim: Exactly.

Lisa: Really appreciate your perspective, Kim. I love your enthusiasm and your willingness to jump in and learn, and I think you’re inspiring a lot of women just by sharing your story. Thank you so much.

Kim: You’re welcome. Thanks for having me.

Lisa: Thank you for listening. I hope you enjoyed my conversation with Kim today. She highlighted something important right from the start — she had discovered fertility awareness and had been using it, but hadn’t gone into a lot of depth understanding mucus and the rules, so it was more like dabbling with the help of apps, and she found herself pregnant unexpectedly. That’s one of the scenarios where health professionals can dismiss fertility awareness as “just a matter of time” until pregnancy happens, when really it comes down to taking the time to understand the rules, chart consistently, and interpret fertile signs correctly.

I want to leave you with some encouragement: it is absolutely possible to use fertility awareness effectively and reach the highest efficacy rates. There’s no method that is 100% effective, not even the IUD, but when you take the time to understand it properly, symptothermal methods that combine cervical fluid, cervical position, and basal body temperature can reach an efficacy of up to 99.4% when used correctly — on par with hormonal contraceptives. Just as you wouldn’t skip a driver’s training manual and expect to drive safely, take the appropriate time to learn and chart before you rely on the method for birth control. So with that, I hope you have a wonderful week or weekend, whenever you’re tuning into this episode. And as always, until next time, be well and happy charting.