If you’ve spent a large part of your ovulating years on birth control (you’re not alone), the prospect of getting pregnant might be the first time you’ve ever really thought about your cycle. And the first time you’ve realized how little you actually know about it. In this case, ignorance is not bliss -- when it comes to your fertilty, the more you know about your body, the better. Understanding your cycle can be a powerful step towards getting pregnant -- or ensuring you don’t.
To get us up to speed, we turned to Katinka Locascio, women’s health expert and founder of Earth + Sky Healing Arts in NYC. The licensed massage therapist, doula and cranial sacral therapist has spent much of her career exploring and advocating for the Fertility Awareness Method (FAM), not only for helping to achieve pregnancy, but also for birth control, and addressing other health and hormonal issues.
“Connecting with your cycle, and becoming more aware of how your lifestyle impacts your [health] symptoms is really empowering,” she says. “It gives a woman a much deeper understanding of her body and how everything is connected.”
Now pregnant with her second child, Katinka recently invited us into her Long Island City studio for a primer Fertilty Awareness Method and shared a 3-step plan to get us started on the FAM path.
So what is Fertility Awareness Method?
Well first let me tell you what its not. It not the "rhythm method." Its not assuming you ovulate on day 14, or have a regular cycle. FAM is a way for a woman to know each day whether she's potentially fertile by observing two basic fertility signals: basal body temperature and cervical fluid.
And the elevator pitch of how to do it?
To practice FAM, a woman takes her temperature before getting out of bed every morning, and takes note of her cervical fluid changes a few times a day. She records this info on her chart (either a paper chart or more commonly a fertility charting app). She can then apply a few simple rules to determine with accuracy when she's fertile. Its really about living with your fertility every day and knowing what's going on.
Why can FAM be a big asset to actually achieving pregnancy?
Many women don't actually ovulate on day 14, or have regular cycles, so being able to time sex correctly makes a big difference. If you are ovulating, your temperature is lower in the first half of your cycle and your cervical fluid increases. Right before ovulation, there's often a dip in the temperature and a peak in fertile cervical fluid (think eggwhites) that let you know when it’s best to plan sex. After ovulation, the temperature remains high for the rest of the cycle. If the temperatures don't, this could mean there's a problem with progesterone or with ovulation.
When a woman comes to me who have been unsuccessfully trying to conceive for several months, her chart can helps us determine what imbalances might be going on so she knows what to work on. And women who have charted their cycles over many years can often spot and correct subtle shifts in their fertility well before they become a problem.
What abot using FAM as postpartum birth control?
I'll be honest, its not a great time to start FAM. Irregular sleep patterns can make it difficult to chart waking temperatures accurately, and postpartum hormones will affect cervical fluid, especially when breastfeeding.Women who do want to start at that time really should seek the guidance of a certified FAM teacher to help learn the method. That said, many women do learn FAM during that time and use it effectively. It’s really a personal preference -- no birth control is perfect.
How effective is FAM?
Studies showing the efficacy of FAM as birth control vary. Perfect use is often as high as 97-99%, on par with the pill. Typical use may drop to 85%. The biggest efficacy risk is the commitment it takes to act in accordance with information your chart gives you. One of the benefits of FAM is that many women find it puts them in touch with their libido, but as nature would have it, you want to have sex most when you are most fertile. So if you want to avoid getting pregnant, you have to be 100% committed to using another form of birth control during that time, or avoiding intercourse and getting creative. Still for many women, avoiding side effects of other forms of birth control or gaining an understanding of their hormonal health is worth the extra effort and attention it takes to practice FAM effectively.
Give us the 3-step plan to get started using FAM.
- Download an App. Kindara is my favorite charting app by far, and it has a great online resources to help you learn how to chart, you can even reach an expert through the app when questions come up. Then get a basal body thermometer (you can order WINK which syncs with your phone through Kindara or a regular basal body thermometer on amazon).
- Learn the method. There are two great books that I recommend: Katie Singer's the "Garden of Fertility," and Toni Weschler's "Taking Charge of your Fertility." We are also lucky to have the Fertility Awareness Center here in NYC so women or couples wanting to take a class can contact them.
- Chart your fertility signals for at least 3 cycles. Then find a teacher or someone to discuss your charts with so you know you understand them before deciding if its right for you as birth control. If you are breastfeeding, coming off the pill, have just been pregnant, or are approaching menopause it may take some time for you to be able to chart accurately enough to use the method as birth control, but you can learn a lot about your body in the process and that alone is worth the effort!
(Note: If you are on hormonal birth control of any kind, you aren't cycling so you need to come off if it before you start charting.)
Photography by Christina Emilie for Well Rounded NY.