Natural Birth Control Methods

Natural family planning, or fertility awareness, involves timing your sexual activity to avoid a woman's most fertile time.

Birth control is the use of practices, medications, or devices to prevent pregnancy. Natural birth control methods, or natural family planning, are a type of birth control that relies on observations about the woman's body and menstrual cycle. Natural birth control methods include fertility awareness methods.

Examples of natural birth control methods include:

• Calendar rhythm method
• Basal body temperature method
• Cervical mucus examination

Natural methods of contraception are considered "natural" because they are not mechanical or a result of hormone manipulation. Instead, natural birth control methods to prevent pregnancy require that a man and woman not have sexual intercourse when an egg is available to be fertilized by a sperm.

The fertility awareness methods (FAMs) are based on knowing when a woman ovulates each month. To use an FAM, it is necessary to watch for the signs and symptoms that indicate ovulation has occurred or is about to occur.

• On average, the egg is released about 14 (plus or minus 2) days before a woman's next menstrual period.
• Because the egg survives 3 to 4 days (6 to 24 hours after ovulation) and the sperm can live 48 to 72 hours (up to even 5 days in fertile mucus), the actual time during which a woman may become pregnant is measured not in hours, not in days, but in weeks.

FAMs can be up to 98% effective, but they require a continuous and conscious commitment with considerable monitoring and self-control. Although these methods were developed to prevent pregnancy, they can equally be well used by a couple to increase fertility and promote conception.

Natural forms of birth control are typically very inexpensive compared to other birth control methods unless a woman chooses to purchase ovulation test kits.

Advantages of natural birth control

• Natural birth control methods may align with personal or religious beliefs that prioritize avoiding chemical contraception.
• A woman does not need to take medication or use hormonal manipulation.
• No procedures or fittings by a physician are required.

Disadvantages of natural birth control

• It can be difficult to estimate or know precisely when a woman is fertile, allowing increased chances for unplanned conception.
• Natural birth control methods are not as effective as some forms of contraception.
• Ovulation test kits are used by some couples using natural methods of contraception, and the cost of these kits is another potential disadvantage.
• Being unable to have intercourse at certain times of the month is a disadvantage for some women.

The calendar rhythm method, a type of natural birth control, relies upon calculating a woman's fertile period on the calendar. Based upon her 12 previous menstrual cycles, a woman subtracts 18 days from her shortest menstrual cycle to determine her first fertile day, and 11 days from her longest menstrual cycle to determine her last fertile day. She can then calculate the total number of days during which she may ovulate. If a woman's menstrual cycles are quite irregular from month to month, there will be a greater number of days during which she might become pregnant.

The calendar method is only about 80% effective in preventing pregnancy, and when used alone, it is considered outdated and ineffective.

The basal body temperature (BBT) method is a natural birth control approach based on the fact that a woman's temperature drops 12 to 24 hours before an egg is released from her ovary and then increases again once the egg has been released. Unfortunately, this temperature difference is not very large. It is less than 1 degree F (about a half degree C) when the body is at rest.

The basal body temperature method requires that a woman take her temperature every morning before she gets out of bed. A special thermometer that is more accurate and sensitive than a typical oral thermometer must be used, and the daily temperature variations carefully noted. This must be followed every month. Online calculators are available to help a woman chart her basal body temperature.

To use basal body temperature as a natural birth control method, a woman should refrain from having sexual intercourse from the time her temperature drops until at least 48 to 72 hours after her temperature increases again.

Another natural birth control method is mucus inspection, which depends on the presence or absence of a particular type of cervical mucus that a woman produces in response to estrogen. A woman will generate larger amounts of more watery mucus than usual (like raw egg white) just before the release of an egg from her ovary. This so-called egg-white cervical mucus (EWCM) stretches for up to an inch when pulled apart. A woman can learn to recognize differences in the quantity and quality of her cervical mucus by examining its appearance on her underwear, pads, and toilet tissue; or she may gently remove a sample of mucus from the vaginal opening using two fingers.

She may choose to have intercourse between the time of her last menstrual period and the time of change in the cervical mucus. During this period, it is recommended that she have sexual intercourse only every other day because the presence of seminal fluid makes it more difficult to determine the nature of her cervical mucus. If the woman does not wish to become pregnant, she should avoid sexual intercourse for three to four days after she notices changes in her cervical mucus.

The symptothermal method is a natural birth control approach that combines certain aspects of the calendar, basal body temperature tracking, and mucus inspection methods to identify fertile days. Not only are all these factors taken into consideration, but also are other symptoms, such as slight cramping and breast tenderness. Some women experience lower abdominal discomfort (in the area of the ovaries) during the release of an egg (ovulation).

A woman can use an ovulation prediction kit as a natural birth control tool to determine when she is most likely to ovulate. This special kit measures the amount of luteinizing hormone (LH) in the urine. Because luteinizing hormone promotes the maturation of an egg in the ovary, the amount of LH usually increases 20 to 48 hours before ovulation. This increase is called the luteinizing hormone surge, which can then be detected in a woman's urine 8 to 12 hours later. The ovulation prediction kit is designed to measure the amount of luteinizing hormone in the urine.

There are several ovulation prediction kits sold at pharmacies that range from simple to complex. In the simplest kits, the woman urinates onto a test stick and the amount of luteinizing hormone is indicated by a color change. The intensity of the color is proportional to the amount of luteinizing hormone in her urine. A woman should begin testing her urine two to three days before she expects to ovulate based on the dates of her previous monthly cycles.

The optimum days for fertilization are the two days before ovulation, the day of ovulation, and the day after ovulation. The greatest chance of becoming pregnant is if intercourse occurs within 24 hours after the luteinizing hormone surge. Ovulation prediction kits are used primarily to increase the chance of a woman becoming pregnant, but they can also be utilized as a natural birth control tool. They indicate when a woman is about to ovulate, allowing her to take appropriate contraceptive precautions.

In the withdrawal method, the man withdraws his penis from a woman's vagina before he ejaculates so that the sperm released from his penis does not enter her vagina. Withdrawal is also called coitus interruptus.

There are problems with using withdrawal as a natural birth control method. First, a man may release small amounts of sperm before actual ejaculation. Secondly, a man needs self-control and a precise sense of timing to be able to withdraw his penis from the woman's vagina before he ejaculates. Because this can be difficult for the man to complete successfully, the withdrawal method is only about 75%-80% effective in preventing pregnancy.

Lactational infertility is a natural birth control method based on the idea that a woman cannot become pregnant as long as she is breastfeeding her baby. Indeed, a woman may not ovulate quite as soon after giving birth as she would if she were not breastfeeding. Women who are breastfeeding usually start ovulating again between 10 and 12 weeks after delivery.

However, this natural birth control method is not considered appropriate as a sole contraceptive measure. A nursing mother may start ovulating again and not realize she is fertile, as ovulation can occur before the return of her menstrual period. If this happens and the mother has unprotected sexual intercourse, she can become pregnant while still breastfeeding her baby. If a nursing mother does not wish to become pregnant again, she must start to use an appropriate method of contraception.

Vaginal douching is the use of a liquid solution to wash out mucus and other types of bodily debris from a woman's vagina. Many women choose to make regular douching a part of their routine for maintaining vaginal hygiene. However, most doctors and the American College of Obstetricians and Gynecologists (ACOG) do not recommend the practice.

Regardless of whether a woman does it for hygienic reasons, vaginal douching does not work as a natural birth control method. During intercourse, active sperm can reach a woman's cervix and even the upper part of her uterus within five minutes of ejaculation. Douching after intercourse cannot be done soon enough to have any contraceptive benefits, and the douching could even force sperm higher up into the uterus. In addition, if a woman douches within 6-8 hours after using a spermicide, she may reduce the effectiveness of this contraceptive method.

Some women used to think that standing up and urinating immediately after sexual intercourse might reduce the chances of them becoming pregnant. They hoped that gravity might make it more difficult for sperm to swim "uphill" to the uterus and that the stream of urine running over their vaginal area would wash away sperm, similar to the process of douching. However, just like douching, urination after intercourse does not have any contraceptive value.

Abstinence from sexual activity as a natural birth control method means not having any sexual intercourse at all. No sexual intercourse with a member of the opposite sex means that there is no chance that a man's sperm can fertilize a woman's egg.

A man or a woman can practice abstinence from sexual activity for a specific period, or continuously throughout one's lifetime. Abstinence is 100% effective in preventing pregnancy. Another significant benefit of abstinence is that it markedly reduces the likelihood of contracting a sexually transmitted disease (STD).

In this context, abstinence means refraining from vaginal, anal, and oral sexual activity because sexually transmitted infections can be passed from one person to another in any of these ways. It should be noted that sexual activity such as mutual masturbation and touching of the other partner's genitals can, in some instances, transfer sperm during heavy mutual foreplay, possibly leading to pregnancy.

Apart from effective natural birth control methods, there are other safe options, which vary based on individual health and risk factors. Nonhormonal options are often considered among the safest. The copper intrauterine device (IUD) is highly effective and hormone-free, making it a low-risk choice for many. Condoms also provide protection against both pregnancy and sexually transmitted infections without affecting hormonal balance. Both methods generally have fewer side effects compared to hormonal contraceptives. However, the best option depends on personal health, lifestyle, and preferences. It is essential to consult a health care provider to determine the safest and most effective birth control method for your individual needs.

The most effective birth control methods offer high pregnancy prevention rates with minimal user intervention:

• Copper IUD: Over 99% effective, the copper IUD provides long-term contraception for up to 10 years without hormones. It creates a hostile environment for sperm, preventing fertilization.
• Implant: Over 99% effective, the implant is a small rod inserted under the skin that releases hormones to prevent ovulation, offering protection for 3-5 years.
• Contraceptive injections: Approximately 94% effective, these injections deliver progestin to prevent ovulation and need to be administered every 3 months.
• Contraceptive pills: About 91% effective with typical use, these pills contain hormones that inhibit ovulation and alter the uterine lining. Consistency in taking the pill is crucial for maintaining effectiveness.

Consulting a health care provider is essential to select the method best suited to individual health and lifestyle needs.

• What can I use instead of birth control pills? Alternative options to birth control pills include hormonal options such as patches, rings, or injections, as well as nonhormonal options such as condoms or devices such as copper intrauterine devices (IUDs). Additionally, natural birth control approaches can also be considered. These include fertility awareness, which tracks menstrual cycles, basal body temperature, and cervical mucus to avoid intercourse during fertile periods, and the withdrawal method, which involves withdrawing before ejaculation to reduce sperm entry. For personalized recommendations, it is best to consult a health care provider to determine the most suitable method.
• What is the safest birth control without hormones? The safest nonhormonal birth control options include condoms and the copper IUD. Both methods effectively prevent pregnancy without hormones. The copper IUD also offers long-term protection.
• What is the healthiest form of birth control? The healthiest form of birth control varies based on individual health and lifestyle. Apart from effective natural birth control methods, nonhormonal options such as condoms and the copper IUD are generally considered low-risk and suitable for most people.
• What foods act as natural birth control? There are no foods that serve as reliable natural birth control methods. While some foods may influence hormonal balance or fertility, they cannot effectively prevent pregnancy. For effective contraception, use scientifically validated methods and consult with a health care provider.
• What is the least harmful form of birth control? The least harmful forms of birth control generally include nonhormonal methods such as condoms and the copper IUD, as they pose minimal risk and avoid hormone-related side effects. These methods are effective and suitable for many individuals seeking to avoid hormonal interventions. Additionally, natural birth control methods such as fertility awareness involve tracking your cycle and have no physical side effects.