Last week, our new fertility thermometer, Wink, was featured in a blog post on Gizmodo.com called: “These New Thermometers Make an Unreliable Birth Control Method Less Sketchy.” If you’ve been reading Kindara’s blog for any length of time, you can imagine why the title didn’t exactly make a good first impression on us. While I appreciate the angle this blogger was coming from, she presented a lot of misinformation as fact.
We happily acknowledge that the Fertility Awareness Method (FAM) is not the ideal birth control method for everyone. Birth control is not one-size-fits-all, and we know that there are a number of valid reasons FAM might not suit every single woman’s particular needs. To name a few: FAM does not protect against STDs, requires occasional abstinence or barrier use, and requires daily observation of fertility signs. These are examples of potentially good reasons not to choose FAM as a birth control method if a woman deems these facts unacceptable for her particular circumstances.
Unfortunately, there are also a lot of bad reasons to reject FAM as birth control floating around. These ‘bad reasons’ take the form of misinformed claims about the practicality or efficacy of FAM as birth control. The article in question made two factual errors in particular that really need to stop circulating.
Claim #1: “Fertility signs are subjective.”
The four rules of the fertility awareness method call for daily observation of two primary fertility signs: cervical fluid and basal body temperature. On the surface, it seems (somewhat) reasonable that women might make mistakes identifying their cervical fluid, since cervical fluid’s qualities must be assessed by personal observation and humans are not perfect data-gathering robots. However, it’s fallacious to assume that the observational nature of cervical fluid data means that women aren’t capable of doing it correctly.
This study taught 869 women to evaluate the qualities of their cervical fluid for the purposes of contraception. They found that 91% of women in the trial had an excellent or good understanding of the method after 1 cycle, 94% after 2 cycles, and 97% after 3 cycles. With a cycle or two of practice and educational support, the vast majority of women are very capable of learning to recognize the qualities of their cervical fluid. The investigators themselves commented: “Perhaps the most unequivocal conclusion is that almost all the women entering the study were indeed able to identify the fertile period by self-observation of the cervical mucus symptom.”
The article also called basal body temperature into question as “subjective,” owing to morning grogginess or accidental errors, such as mistaking an 8 for a 0 when entering your temperatures. Again, this seems somewhat reasonable in a hypothetical world. However, when we examine the data about how many errors women actually make, we get a different story.
Another FAM study compared cervical fluid and temperature shifts recorded by a cohort of women to their ultrasound-detected ovulation times. They found that the ovulation time observed by the women themselves correlated very closely to their true ovulation day (within 1 day in 89% of the 62 cycles).
I’d also like to briefly point out that a simple way of avoiding morning grogginess errors is to record your temperature into the app later in the day after you’ve truly woken up (or consider purchasing Wink, which automatically syncs your basal temperatures and the time your temperature was taken to the Kindara app). Most basal body temperature thermometers store at least one temperature in memory which can be accessed later.
Putting aside the overwhelming evidence that women are very capable of reading their own fertility signs, the Fertility Awareness Method also has built-in safeguards on either side of the fertile window in order to compensate further for possible mistakes. For example, the method requires that women observe at least three elevated temperatures and four days without egg-white (or watery) quality cervical fluid before they are safe to have unprotected sex. The result is a safe margin of error and evidence-based confidence that ovulation has indeed passed before the light is green for unprotected sex.
Claim #2: “Fertility awareness is an unreliable method of birth control.”
We’ve said it before and we’ll say it again: the Fertility Awareness Method is a very effective method of birth control. When practiced perfectly, FAM is over 99% effective – the same as the hormonal contraceptive pill. I won’t belabor this point too much because this is something that has been discussed several times on this blog alone, and it has been studied extensively in scientific literature (for more scientific evidence, please see here, here, and here).
Instead, I’d like to briefly discuss the damage that this kind of misinformation can have both on prospective fertility-charters and women who already practice fertility charting. As I mentioned before, there are undoubtedly some good reasons for certain women not to choose FAM as birth control. If she needs STD protection or does not wish to observe her fertility signs every day, then FAM is not a good choice for her. But to say that FAM isn’t for her because it’s not effective, or because she can’t trust herself to read her fertility signs correctly, is blatantly and demonstrably false.
Women are not prone to making mistakes about their fertility signs. In fact, if you practice fertility awareness as birth control, the single-most likely cause of unintended pregnancy is knowingly breaking the four FAM rules (having intercourse during your fertile phase) rather than misunderstanding, forgetting, or misreading your fertility signs. So if you know that you and your partner won’t consistently follow the four FAM rules, that’s a good reason to choose a different birth control method. But if you avoid FAM because someone told you you’re not capable of doing it right, they’re just plain wrong.
Trust yourself. And if you have questions, ask us. We’re here to help!