Fertility awareness (natural family planning)
What is fertility awareness?
Fertility awareness is when you learn to recognise on which days of the month you are fertile and can therefore conceive a baby. It can either be used as a form of contraception or as a method to become pregnant.
It's known by different names, including natural family planning, and there are several ways of practicing fertility awareness, including the symptothermal method, the ovulation method, periodic abstinence, the mucus method, the Billings method and the rhythm method.
During your monthly menstrual cycle, you will not be able to get pregnant for about half of the month. It's possible to try to work out whether or not you are fertile by watching for signs of ovulation, including your body temperature or the amount of mucus in your vagina. If you don't have sex on these days, you reduce your chances of getting pregnant.
Fertility awareness only works as a method of contraception if you follow the instructions very carefully — and your partner agrees to follow them too. Since you can get pregnant for a few days before and after you ovulate, you need to be very careful not to have sex on these days.
The 5 days before ovulation, together with the day you ovulate, are the days when you are most likely to conceive. Sperm can live up to 5 days inside your body, so if you have sex up to 5 days before your egg is released, you can get pregnant.
After ovulation, though, your egg can only live for 12 to 24 hours. After this time is up, your time for getting pregnant has gone for now till the following month.
Is fertility awareness suitable for anyone?
Fertility awareness is not suitable if:
- you have just stopped using a hormonal method of contraception, like the pill
- you have irregular periods
- you are getting close to menopause
- your partner doesn't fully cooperate
What are the advantages of fertility awareness?
The advantages of fertility awareness are that it's a natural form of contraception with no side effects. It can be a good choice for women who can't or don't want to use other methods of contraception for religious, cultural or health reasons.
For women who follow the methods correctly and who are motivated not to get pregnant, they can be reliable. They cost nothing and they mean you get to know your body better.
What are the disadvantages of fertility awareness?
If you use fertility awareness to avoid getting pregnant, one disadvantage is that women who use fertility awareness are more likely to get pregnant than women who use other forms of contraception. It depends how strictly you follow the method. About 1 in every 4 women who use these methods will get pregnant.
It can take quite a lot of time and patience to get fertility awareness right and you need to follow instructions carefully. Even so, some women will always find it difficult to predict when they are ovulating.
Using fertility awareness methods does not protect you from sexually transmitted infections (STIs). You will need to use other forms of contraception, such as condoms, to protect against STIs.
Remember also that fertility awareness can be affected if you are ill, stressed, taking some medicines or having sex.
What are the types of fertility awareness?
There are different ways to use fertility awareness to avoid getting pregnant:
Cervical mucous method or Billings method
The mucus inside your vagina (cervical mucus) changes during the month. Right after your period your vagina may feel quite dry, then around the time of ovulation the mucus becomes clear and stretchy, like raw egg white. After you have ovulated, it becomes thicker and cloudier. You can use these changes to work out when you ovulate. You should not have sex until 3 dry days have passed.
This method isn't suitable if you have abnormal bleeding from your vagina, if you have inflammation in your cervix or vagina, or if you're taking some medicines, including antibiotics, antihistamines or thyroid medicines, which can change your cervical mucus. Getting sexually aroused or having semen in your vagina can make it harder to tell what your mucus is like.
Temperature method
Your resting temperature rises slightly after you ovulate. This method involves taking your temperature with a special thermometer before you get up every day. You need to take it in your vagina, rectum or mouth. When your temperature has risen for 3 days in a row, you can have sex for the next few days.
This method isn't very accurate because your temperature can be affected if you sleep in, drink alcohol or are stressed. It also means you can only have sex for about 12 in every 28 days.
Symptothermal method
You take your temperature in the morning and examine your cervical mucus at night to work out when it's safe to have sex.
You can also watch for various symptoms that show you are ovulating. These include some pain like period pain, spotting and tender breasts. Combining these different methods makes fertility awareness more accurate.
Calendar or rhythm method
This method can be quite unreliable. It's not suitable for women who have irregular periods. You can find more information about how to do calendar-based methods at Family Planning NSW.
Resources and support
You can find more detail on fertility awareness from these websites:
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
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Last reviewed: May 2021
