Putting it all together

In earlier posts I described three of the main signs of fertility

• temperature
• cervical fluid
• cervix changes

Today I want to talk a little bit about putting these together. The general rule if you want to avoid getting pregnant is to avoid intercourse unless all three signs indicate that you are not fertile.

"Young" mothers

Today I read "The New Unmarried Moms" article from the Wall Street Journal, and a few responses

"4 reasons young women are scared to have kids (and why we should knock it off.)"

"Are 20-something unwed moms the new teen moms?"

Reading these articles, I can't help but feel that this is a consequence of divorcing sex and procreation. If women are encouraged to delay marriage but continue having intercourse in their twenties, it shouldn't be surprising that the subsequent pregnancies are out-of-wedlock. It seems like there are two approaches to this - encourage women to get married earlier or encourage women to delay children, which has its own consequences.

The timing of marriage and children are enormously complicated issues and I think it goes without saying that they are not just personal issues, but deeply political. I think it's a bad time to be a fertile woman in America.

Interpreting cervix changes

Cervix changes are a valuable source of information about fertility. Many women, however, feel uncomfortable checking the cervix.  The good news is that it's an optional sign. Even if it's a sign you want to track, you don't need to track it the entire month. You can use it to cross-check the other signs around ovulation.

The cervix sits several inches inside the vagina and separates the vagina from the uterus. 

From WebMD

Charting apps?

I've been looking for a good app/spreadsheet/computer program for charting, and so far I have not been impressed with what I've found. I'm using the CycleProGo's website currently, but the interface is clumsy and slow and I'm pretty certain I'll want to switch.

Here's what I want from the chart:

• An easy way to input observations.
• Automatic calculations for
• Temperature shift.
• Longest/shortest cycle
• Luteal count.
• A chart view that superimposes cervical fluid observations, cervix observations, and temperature, so I can see them together.

First Couple to Couple League Class

We had our first formal Couple to Couple League class today. There were four student couples, including us. The teaching couple was in their late 50's and had used NFP for 20+ years. We met in a classroom of a nearby Catholic church/school.

There are two things we really liked about the class:

• It was helpful to practice analyzing charts.
• We're looking forward to sharing our charts with the teaching couple in three weeks, at the second class.

There were a few things we didn't like too. The presentation materials were outdated (holy 1980's hairstyles!). The teaching couple was very religious which made the two of us a bit uncomfortable. Finally, the teaching couple emphasized how terrible hormonal control was which was just weird in the context. I think all three of these vary based on teaching couple, so your experience may vary.

Overall, the class was interesting. We felt that everything covered so far could easily be learned by reading "The Art of Natural Family Planning" or "Taking Charge of Your Fertility," but it was a good chance to review it.

How does NFP effect the relationship?

I've been reading a lot about how couples feel NFP effects their relationship. While learning NFP with my fiance has been great so far, I'm hesitant to say anything more since we're abstaining from sex until we're married.

I started by reading this study of the impact of NFP. There's a definite pro-NFP agenda, but it's still quite interesting.

Then I found this blog about when NFP is difficult (the comments are very interesting).

Lots of food for thought!

Interpreting cervical fluid

Interpreting cervical fluid is less objective, but you'll quickly become an expert on your own body. During the day, pay attention to any discharge. This doesn't need to be too involved - generally it's enough to pay attention to any discharge on your panties and while wiping. At the end of the day, note any observations on your chart.

Because evaluating cervical fluid is less objective, every NFP method uses slightly different descriptions. In the Couple to Couple League's method, cervical fluid is described by three categories:

• No observed cervical fluid - There's no observable fluid
• "Less fertile" cervical fluid - Fluid is often white or creamy. It doesn't stretch easily and may be sticky, gummy, thick, pasty, creamy, or clumpy.
• "More fertile" cervical fluid - Fluid is wet and very slippery. There are often mucus pieces that are extremely stretchy. It's often described as being similar to raw egg whites.

This slideshow gives a reasonable description of different types of cervical fluid, and includes photos which may help you decide what you're looking at.

Interpreting temperature

Of the three fertility signs - cervical fluid, cervix changes, and basal temperature - temperature is the most objective and easily observed. Most couples who use NFP prefer to use a basal thermometer, which is designed to be give more accurate readings. Typically household thermometers are designed for detecting fevers, but if you do not want to purchase a basal thermometer, a decent digital thermometer will work fine. If you are interested in purchasing a basal thermometer, there are very affordable options online. This is the thermometer I use. I haven't had any luck finding basal thermometers in local drug stores, so if you know of a store that regularly carries them, let me know in the comments!

There are many things that will effect your temperature - exercise, time of day, the temperature of the surroundings, alcohol, illness, etc. We want to control for as many of these factors as possible, so the temperature differences we observe are caused by changes in the concentration of the hormone progesterone. The easiest way to control for these factors is to record your temperature at the same time each morning, before you get out of bed. I am not a morning person (understatement!) so I set the alarm on my phone for 7:00 am every morning, the earliest time I get up during the week. I keep the thermometer and a pad of paper on the nightstand and, on mornings that I can sleep in, I wake up just enough to roll over and take my temperature.

Timeline for learning NFP while engaged

It's often advised that couples collect 3 to 6 months of observations before using NFP to avoid pregnancy. This means that it's best for couples to start using NFP during their engagement. Here's the recommended timeline:

• 12 months before wedding - If you're using hormonal birth control for non-contraceptive purposes, meet with your doctor and discuss discontinuing it. 
• 10 months before wedding - Find an NFP-friendly doctor. Ask about any health problems or medications that might effect pregnancy. 
• 9 months before wedding - Research different types of NFP (here's a thorough list). Consider what would work best for both of you. Read everything you can about it.
• 8 months before wedding - Start observing fertility signs. Get familiar with your cycle and develop the habit of carefully recording your observations.
• 6 months before wedding - Enroll in an NFP class. (Catholic hospitals and churches often keep lists of instructors and classes). By the time your class rolls around, you will have a few months of data, making the class more interesting and much easier to follow.
• 5 months before wedding - Attend NFP classes.
• 1 months before wedding - Review the 6 months of charts you've collected and  look forward to your wedding!
• The wedding!!! - Put what you've learned into action :D

Great NFP advertisement :)

Hormones disrupted: the biology behind the pill

The menstrual cycle: the biology behind NFP

The Menstrual Cycle

The menstrual cycle starts on the first day the woman gets her period. In the first few days of the cycle, the hormone FSH rises, stimulating the ovarian follicles.

As estrogen increases, a woman notices more cervical fluid, starting with "less fertile" fluid that is sticky and gradually turning into "more fertile" fluid that is stretchy and wet. This gives the woman and her husband warning that she is approaching her fertile time frame. Since the couple cannot calculate exactly when to expect ovulation, the couple decides when to abstain based on cervical fluid and data from past cycles.

Materials for NFP class arrived!

We're starting our Couple to Couple League NFP class next weekend, and the "getting started" packet just arrived. It contains a textbook, "The Art of Natural Family Planning," a book on nutrition and fertility, a thermometer, and charts.

The textbook, "The Art of Natural Family Planning," looks very useful. It's easy to read and has charts to practice interpreting. It clearly explains guidelines to avoid pregnancy, and explains how to apply these guidelines to unusual situations, like discontinuing birth control. I think it provides much more "how to" instruction in preventing pregnancy than "Taking Charge of Your Fertility." The textbook's target audience is engaged or married Catholics and parts of the text, especially the explanations of Catholic theology, reminded me a little too much of high school religion class.

The nutrition book, "Fertility, Cycles, and Nutrition: Self-care for improved cycles and fertility," is more of reference book. It includes sections on a variety of issues common to menstrual cycles, fertility, and pregnancy. There are suggestions on general nutrition as well as on supplements.

I think the biggest advantage of enrolling in a CCL class is the membership to CCL. In addition to being enrolled in NFP classes, we'll be able to get help with interpreting our charts from teaching couples (experienced charters who've been trained to teach and assist). We're looking forward to our first class!

Smart people use NFP!

Professor Williams, a mathematics professor at Harvey Mudd College, speaks about the powerful impact of knowing your own body and tracking how it works in this fascinating Ted Talk.




There are a few things I hear over and over again when I talk about NFP. The first is, "Oh! Isn't that what people used before the pill was invented?" The second is, "what do you call people who use NFP? Parents!"

Both bug me for the same reason - they assume that the reason people use NFP is because they have no other options and don't know better. Even more respectful descriptions of NFP often assume that the only practitioners are the extremely religious who refuse all other contraceptives. The fact of the matter is that many smart, educated couples chose NFP to prevent, space, or try for children.

Preparing for pregnancy

While we will be using natural family planning to delay pregnancy, we're simultaneously preparing for pregnancy and children.

• Health - We're both trying to eat healthier and exercise more, which is great for overall health. Additionally, I'm limiting the amount of high-mercury fish I eat, and will be starting folic acid supplements about a month before we marry.
• Childcare - I'm planning on being a stay-at-home mum, but we're leaving the option of me returning to work open.
• Healthcare - Pregnancy care and delivery are 100% covered by insurance. I've found an ob/gyn that I like.
• Finances -  If we keep our current spending habits, we'll be able to live on one income after marriage, with wiggle room for the added expenses of children. We'll be practicing living on one income while saving the difference as long as we're both working. We have no debt, and we've already saved $5,000 already for our "baby fund. "We hope to have $10,000 saved before we marry.

To keep track of our preparation goals, we made this spreadsheet template. (Feel free to use it if you find it helpful. It's set to "view only", but you can make a copy, which can then be edited).

The strangest thing about these preparations is realizing that an unexpected pregnancy would be a happy occasion for us, even though just a few years ago, pregnancy was terrifying. What a difference good jobs and the security of marriage makes!

Why are we using NFP?

When we started researching family planning, we realized very quickly that our previous education in family planning had been dismal! While we'd both learned about contraception in high school health classes, there had been very little discussion of family planning within marriage. We had several priorities to keep in mind when evaluating methods:

• We needed something that was easily reversed.
• We didn't want a method that would hurt our baby if we were to conceive while using it, and this included methods that would prevent implantation of a fertilized egg.

Using this criteria, we eliminated many options - IUD's fails both criteria, sterilization obviously fails the first, etc. After discussing hormonal contraceptives like the combination pill with a doctor, we felt confident that combination pills, when taken correctly, prevent pregnancy by preventing fertilization (rather than implantation) and don't harm the developing fetus if pregnancy does occur, so, while we felt uncertain about it, we kept it on the "possible" list. Barrier methods like condoms also met these requirements and were included in our list of possibilities.

With 8+ months between making our list of possibilities and getting married, we started to explore what would work for us. First, I tried the combination pill, in part because it improved my migraines. I had no negative side-effects, but I was really bothered by how it felt to manipulate my hormones. I felt uncomfortable every time I took the "blank" pills and got withdrawal bleeding, instead of having the normal periods I was so used to. After two months, I decided that hormonal methods weren't going to work for me, and we returned to the list.

My fiance NaturalGuy had liked the sound of NFP from the start. He liked that it was a method that he would be equally involved with, and that it had no side effects for me, or our future children. After deciding to quit taking the pill, we started charting my cycles. We've been learning from the book, "Taking Charge of Your Fertility", as well as in-person guidance through our church. We're also starting classes through the Couple to Couple League in a few weeks We feel very comfortable knowing that if we get pregnant, there won't be any chance that our choice in contraceptives will harm our child. 

We're also finding that learning NFP has helped us look forward to our future children in other ways - we're saving money for our "baby fund," viewing our careers through a family and future oriented lens, and considering how we wish to parent together.

Finally, learning NFP has been fascinating - who knew that there were so many subtle signs, revealing the invisible changes in hormones!

5 things we are and 5 things we are not

I'm starting this blog because when my fiance and I, NaturalGuy and NaturalGirl, started looking into Natural Family Planning (NFP) we didn't find many resources for young couples like ourselves. We would love to have more company!

We are

1. Engaged - We have been together for 4 years and engaged for 6 months. Our wedding is in another 5 months.
2. Young - We're both 22.
3. Catholic - Though we're not lockstep with all Church teachings.
4. Scientifically minded - We come from computer science and mathematics educational backgrounds. We like numbers and statistics.
5. Learning NFP - We're learning NFP now and will be using it to delay pregnancy in our marriage (we're waiting until then to have sex).

We are not

1. Very interested in religious arguments for or against NFP.
2. Morally opposed to "unnatural" family planning (ie. contraception).
3. 100% sure we'll love using NFP.
4. Very worried about pregnancy. We don't want 10 kids and would like to wait a few years to have children, but if we got pregnant on the honeymoon, we'd be thrilled to have a child!
5. Very serious - in fact, we are quite silly :)

When considering family planning, we immediately removed methods that worked by preventing implantation of a fertilized egg, due to religious beliefs. This left us with a couple of hormonal methods and barrier methods. The hormonal methods didn't agree with my system, and we weren't looking forward to using barrier methods in marriage. Family friends had great things to say about NFP and after doing a bit of research, it seemed like a good fit.

In future posts, I'll be writing about how we started charting, and what we're finding easiest and most difficult about NFP.