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Introduction: An Exciting New Journey!
If you have landed yourself on this blog post, you have probably already heard a little bit about natural family planning (NFP) or fertility awareness based methods. (Click here to read my blog about the basics of NFP). There are several reasons why you may be interested in making the leap and starting on your NFP journey. You may have always known you wanted to use NFP due to moral reasons and are currently in your marriage prep classes. You may be sick of side effects from your hormonal birth control and are interested in trying a more natural method of avoiding pregnancy. You may just be extremely interested in learning more about your body and natural fertility cycle, and for some, you may be having fertility issues and wanting to use NFP to help try to conceive. No matter what your reason is for starting this exciting journey, everyone has to start from somewhere. While NFP and fertility awareness can seem overwhelming at first due to the mountains of new information you are coming across, I want to give you the tools to help you get started using natural family planning and to help make this exciting new transition in your life go as smoothly as possible.
1. Are You Currently on Birth Control or Any Contraceptives?
If you are currently using any type of birth control or contraceptive, let your PCP know that you are planning on discontinuing use of birth control. If you are taking oral contraceptive pills, then you will simply have to stop taking the pills, which you were previously prescribed. If you have something such as the Nexplanon or an IUD, then you will need to make an appointment with your PCP or OBGYN to have this removed.
As a forewarning, if you do not already go to an NFP-friendly physician, this is likely going to be a difficult conversation to have with your doctor. Most physicians receive little to no training on natural family planning and fertility awareness methods, and therefore believe that NFP is very ineffective. However, if you go in to your appointment mentally prepared to get some push back from your physician, it will make the conversation easier since you can go in with the mindset to be firm with your decision and present your PCP with the reasons why you are choosing to discontinue birth control.
Make sure to read my blog about the nine myths of NFP and the true effectiveness rates of NFP (and how previous studies were flawed) prior to your appointment because these posts will help prepare you to answer any questions regarding NFP.
2. Prepare Your Body to Be as Healthy as Possible. Start a Prenatal Vitamin!
Whether or not you are trying to conceive at this time, you should start taking a daily prenatal vitamin for optimal women's health if you haven't already. According to the USPSTF (United States Preventative Services Task Force), all women of reproductive age should be taking daily folate, which is found in daily prenatal vitamins. Check out my blog post to find out more about the best prenatal vitamins.
3. What is Your Current Goal for Using NFP? Are You Trying to Avoid or Achieve Pregnancy?
Trying to Avoid (TTA): If your current goal in using NFP is to avoid or postpone pregnancy, then it is recommended that you abstain from interourse for a couple of cycles while you are learning and mastering an NFP method for maximum effectiveness. This is because it can take some time to gain confidence in learning the intricacies of each method. If you are not confident in being able to detect your fertile window, there is the potential that you may accidentally have intercourse during your fertile window and thus have a high chance on conception.
Trying to Conceive (TTC): If your current goal of NFP is trying to conceive or neither TTA nor actively TTC, you can continue to have intercourse as usual. However, now that you will be incorporating NFP, you will be more aware of when your fertile window is and therefore when your days of highest probability for conception fall.
4. Choose Which Method of NFP is Best for You.
An easy way to help get you started on picking an NFP method is to reflect on a couple of factors. If you have an irregular work or sleep schedule, or frequently wake up throughout the night or at different times each morning, then the cervical mucus method is likely best for you. If you have a regular work/sleep schedule and you prefer objective data and technology, then the basal body temperature method (BBT) or the sympto-hormonal method may be a better fit. The BBT method tends to have some more budget friendly options, and the sympto-hormonal tends to have the MOST quantitative data available for information about your cycle. Check out my blog post for even more detailed information on choosing the best NFP method for you.
5. Find an NFP Teaching Instructor and an NFP physician.
Although there is lots of information available both on this blog and online in general, it is really important to find an NFP instructor to teach you all of the little details about each method and help you gain the confidence to chart and understand your own cycle. I know from personal experience that without an NFP instructor, I would not have been nearly as successful at avoiding pregnancy with NFP due to the lack of knowledge of identifying the type of mucus observed, but I also would not have learned all of the in's and out's about the rules for "perfect use" of this method. At least for the cervical mucus method, it is not as simple as just having your period app predict ovulation day and avoiding sex on that day, or just avoiding until obvious large amounts of raw egg white mucus is visible. If you are not taught how to identify even the smallest amounts of fertile mucus that might not seem as obvious when first starting with NFP, then you may miss that you have entered your fertile window and end up getting pregnant during those days.
Additionally, it is important that you find an NFP physician. Take it from me, medical school and residency teaches very little about natural family planning. Most physicians still believe that natural family planning is equivalent to the rhythm method and therefore very ineffective at preventing pregnancy. The majority of physicians are not even familiar with the different methods of NFP. Finding a physician that has sought out the information and received proper training in NFP, will ensure that your physician will understand your charted cycle and be able to properly interpret it. Plus, having an NFP physician means that you will not have to worry about being pressured to use contraception because your physician will understand and have confidence in natural family planning and fertility awareness.
Click here for a directory of NFP-only physicians in your area.
6. Start Charting Your Cycle With Something Other Than Your Period App.
After you have picked a method of NFP, found an instructor to help you master it, and found an NFP physician to help manage your health and any cycle irregularities, it is time for you to start charting your cycle! You can go about the original way with paper charts if you are more comfortable that way. Otherwise, there are many apps out there that can help you track your cycle such as Natural Cycles, Tempdrop, Mira, Inito, NFPCharting, and Premom.
However, contrary to popular belief, typical period apps are no where near sufficient for charting your cycle, even if your period app predicts ovulation or allows you to input the appearance of your cervical mucus or discharge. These apps work by using algorithms to not only predict when your next period will start, but also when you will ovulate. These apps work similarly to the old rhythm method or standard days method by using a formula to estimate when ovulation could occur. This relies not only on the assumption that you have regular periods and ovulate on the same day each cycle, but they also assume that you ovulate around day 14 of your cycle, which is not true for many women.
7. Identify Your Fertile Window, and Use This to Determine the Best Times to Have Sex Depending on Your NFP Goals.
After at least 3 months, you should be able to start seeing a fairly consistent length in luteal phase (days from ovulation until the start of your next period). If you are seeing this consistency, then you can feel confident that you are accurately identifying your peak day (day of ovulation). If you start to see any irregularities within your cycle (read my blog post about irregular periods for information on how to identify irregular cycles), make sure to discuss it with your physician.
If your goal is to try to avoid pregnancy (TTA), then avoid having sex during your fertile window along with 3 days after peak day (ovulation). A common misconception by many women who are new to NFP is that they can simply avoid having sex on the day of ovulation, and the rest of their cycle is free game without risk of getting pregnant. There are about 6 days during every woman's cycle in which she has the potential to get pregnant. Read my blog post about when a woman can get pregnant to find out more information about the fertile window.
If you are trying to conceive (TTC), then make sure to be having intercourse during that fertile window to increase probability of getting pregnant.
Conclusion: The Journey is Just Beginning!
Although starting the process of NFP and fertility awareness can seem overwhelming with an abundance of new information and reading material, it is an exciting time as well. It is an empowering time in which you can get off of any artificial hormones (if you are currently using contraception), grow closer with your spouse, and get to know more about your health and natural fertility cycle. Hopefully this blog post has helped to give you some answers about where to go and how to get started using natural family planning. Welcome to the natural fertility and hormone-free life!
Click here to visit my "Resources" page to find more information such as helpful links, products, and phone apps to help kickstart your NFP and fertility journey.
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