Fertility awareness (natural family planning)

Fertility awareness means not having sex during the fertile times in a woman’s menstrual cycle. It has many other names including natural family planning, or the sympto-thermal, Billings, ovulation, mucous, temperature and rhythm methods.

Fertility awareness requires training from a qualified counsellor, so that the woman knows the fertile times of the month when she is most likely to get pregnant. During her fertile time, which is up to half her cycle, a woman who relies only on fertility awareness must abstain from vaginal intercourse and not have any penis-vagina contact.

There needs to be a firm commitment from both partners for fertility awareness to work. Some women find natural methods work for them, while others don’t find them reliable enough. They give no protection against HIV infection and other STIs.

Cycle lengths do not have to be regular for this method to be used, although irregular periods make it more difficult. A woman is taught to use various signs such as temperature and changes in the vaginal mucous to recognise when she is fertile.

Advantages

• There are no health risks or side effects.
• It can be used to prevent or plan a pregnancy.
• It can be quite effective if used correctly.
• It’s acceptable to couples with religious concerns about birth control.
• The method is free, except possibly for a thermometer, training fee and charts.
• It can lead to a greater awareness and understanding of how a woman’s reproductive system works.
• Some couples find that using natural methods leads to better communication and cooperation, as both partners are directly involved.

Things to consider

• You need to be taught how to recognise your ‘safe’ time for sex. This takes time, effort and practice.
• Using fertility awareness requires a commitment to keeping careful note of daily body changes and is more difficult for women whose periods are not regular.
• Failure rates are higher than the other methods, especially if you break the strict rules.
• Both the woman and her partner must be prepared not to have vaginal intercourse during her fertile time unless a barrier method is used.
• Illness and vaginal infections can interfere with mucous and body temperature and may make tracking fertility more difficult.
• Natural methods do not protect you against STIs or HIV.

Withdrawal (pulling out)

This is when the man removes his penis from the woman’s vagina before he ejaculates (comes) so the sperm don’t enter the vagina. Sometimes this works, but it often doesn’t. Even if the man ‘comes’ just outside the vagina, some sperm may still be able to swim inside, and there can also be a few sperm in any pre-ejaculation fluids from the penis. It can also be very difficult for the man to remember to withdraw in time.

Things to consider

This method sometimes works for some people, but the risk of pregnancy is very high.

Withdrawal does not protect you against STIs or HIV.

---

---

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.