Beyond rhythm: A new contraception

A woman's body tells her what she needs to know
By MICHAEL CASTLEMAN  |  March 28, 2008

This article originally appeared in the March 28, 1978 issue of the Boston Phoenix.

Every morning, San Francisco medical student Anne Carlyle, 25, takes her temperature, examines her vagina, records her findings on a chart and mentions them to her husband. This simple routine is how Carlyle practices birth control. She uses the “fertility awareness” method, a modernized rhythm system that enables women to identify fertile days each month by examining their cervical mucus.

“I’ve used pills, condoms, a diaphragm—and prayer,” says Carlyle, who has relied on fertility awareness for a year. “We still use a condom or diaphragm when I’m fertile, but when I’m not, there’s no need to use anything. Every birth control method causes some hassle. Why use one if you don’t have to?”

Fertility awareness and traditional rhythm methods both attempt to identify a woman’s fertile days, the week to 10 days each month around the time she ovulates. The key difference between the two is that in the latter, a woman pays attention to the calendar. To practice fertility awareness, she pays attention to her body.

“Fertility awareness teaches women to communicate with their bodies directly,” says Karen Faire-Hammond, a consultant to the US Department of Health, Education and Welfare in California.

“The body clearly announces its fertile time each month if a woman is trained to recognize the signals.” Faire-Hammond, who has used the method herself for five years and has taught it for two, says that calendars are unreliable fertility indicators. Traditional rhythm, she explains, assumes that women ovulate regularly, but few women do. And the menstrual cycles of those women who do ovulate regularly can change unexpectedly when they travel, get sick or suffer emotional stress.

Studies to date indicate that fertility awareness works as well as other birth control methods, Faire-Hammond adds. A five-country study of 2000 couples in 1975, by Dr. Claude Lanctot at Fairfield University, showed the method to be up to 98 percent effective. And fertility awareness is “more than just a method for preventing conception,” says Deborah Rogow, a health educator who teaches the method for the San Francisco Health Department. “It can help couples who want to conceive a child by pinpointing the fertile days.”

The National Institutes of Health is now testing the effectiveness of fertility awareness at Cedar-Sinai Hospital in Los Angeles. Results are expected next year. Experts caution that women should take courses in the method before attempting to classify their mucus, since individual women have different mucus cycles. “It takes some time to learn,” says Rogow, “but it becomes like second nature, like driving a car.”

Women can identify ovulation by studying their temperature every morning. Temperature rises noticeably during ovulation, and the cervix undergoes changes as well. It opens, softens, and lifts away from the vagina around the time an egg is released, then closes, hardens, and drops back toward the vagina when the woman is no longer fertile.

Rogow’s course in fertility awareness meets three hours every other week for three sessions. A dozen women attend each course, and many bring husbands or boyfriends. Rogow says she explains the physiological basis for fertility awareness and individually discusses each woman’s chart. She advises that a woman chart her mucus, temperature and cervix size for several months before relying on fertility awareness for contraception.

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