Birth Control: Fertility Awareness as a viable form?

About a year ago, I attended a lecture on the topic of halachik birth control. It was given by a Yoetzet Halacha and prominent kallah teacher. She went through the various forms of birth control and what halachik problems they raise, how rabbis have gotten around the issue, and when they might be appropriate for women.

My biggest concern with her lecture was that up there with pills, IUDs, and condoms, she included the Fertility Awareness Method. Another article I read recently about birth control in the Orthodox community also mentioned this method as part of a list of options couples have to avoid pregnancy.

The “fertility awareness method” is a way in which women can monitor their body temperatures, vaginal mucus, and calendar days to determine when they are ovulating, and avoid sex while ovulating.

The problem is, the “fertility awareness method” is not really birth control at all!! Planned Parenthood puts the efficacy rates for the method at only 75% when used “as an average person would”, with an average amount of mistakes. When used absolutely perfectly, the efficacy rate can go up to 90%. These rates sure wouldn’t satisfy me if I was looking for a way to prevent pregnancy. In comparison, most birth control pills have a 99% efficacy rate when used “as an average person would”, and a 99.99% efficacy rate when used perfectly.

The “fertility awareness method” is even less effective than the pull-out method. Pull-out, or withdrawal, also has studies showing that the method is 77% effective with average use and 96% effective with perfect use. The numbers may seem to indicate that with perfect use, pull-out, fertility awareness, condoms, IUDs, and hormonal pills are all approximately the same amount of effective. But do a google search for any of these methods. With fertility awareness and withdrawal, you’ll find articles about the methods, but under every article, you will find many women writing “I got pregnant that way”, “yeah, me too”. You won’t find such comments with pills, IUDs, and condoms. Of course, there will be the 0.01% that get pregnant on those methods and write about it, but those types of comments or articles are few and far between.

The problem is, of course, no one is perfect!! Professionals should not be counseling women to use fertility awareness because the chances are likely that a woman using that method will become pregnant. This is how accidents happen.

The other, more systemic, problem, is that when methods like the above gain such widespread notoriety, rabbis and other religious leaders can use this information to downplay the need to find halachik methods of birth control. No, you can’t use the pill or any other birth control forms, but don’t worry, there’s still a way to prevent pregnancy, just track your menses. It is the same problem with the availablity of reconstructive therapy for homosexuality–since it’s available, rabbis can use it to downplay the problems faced by homosexual individuals. No matter that the general mental health profession has dismissed such therapy as being completely ineffective–they just haven’t found the right doctor/patient match yet.

It is also troubling to me that I heard this from a yoetzet halacha. The Yoatzot program was designed to counter the problem of uninformed men discussing and ruling on women’s issues. It’s much harder to tell if blood is menstrual blood if you’ve never experienced menstrual blood. While the Yoatzot technically have male rabbis making all the official halachick rulings, women are trained to make factual rulings. The problem is, here was a woman standing up and telling all these other women that fertility awareness is a viable method of birth control. They are making the same mistakes rabbis make when looking at the facts and not the situation as a whole.

Fertility awareness may be appropriate for those couples in very insular communities that have completely rejected all traditional forms of birth control due to halachik issues, but in a society where rabbis are willing to consider the possibility of birth control, withdrawal and fertility awareness should not even be on the list.


2 comments on “Birth Control: Fertility Awareness as a viable form?

  1. Emmy says:

    glad someone is writing about fertility awareness. It appears that you have wrong information on efficacy. You can reference Contraceptive Technology 18th Ed (resource for ob-gyns) as a reliable source. PP probably had 75% listed as an efficacy rate, not a failure rate.
    One thing to look for is whether you are quoting Correct Use efficacy or Typical Use efficacy. For example, the pill is 99% effective with Correct Use and 92% in Typical Use (real world). Most fertility awareness methods are somewhere from 95% to 97% effectiive with Correct Use, but vary in Typical Use from 88% to 75% – depending on the method.
    By the way, birth control efficacy is determined by the number of women who become pregnant in the first year of use of a method. Practice makes perfect, so the longer a woman uses a particular method, the more effective it can become – the applies to fertility awareness as well.

    Hope that helps!

    Health Counselor

  2. hannahransom says:

    I agree with Emmy, for the most part. Fertility awareness gets a bad rap because MANY forms of “birth control” are considered under the unbrella term fertility awareness (including even the rhythm method *shudder*). The sympto-thermal method can definitely be as effective as the pill. In addition, many more people accept the sympto thermal method more readily since there aren’t side effects and I think that that should play into the “effectiveness” (since when you switch around methods you have a much higher pregnancy rate due to learning something new or having a gap in birth control).
    Many people online who say they got pregnant “using” fertility awareness were 1.) intentionally breaking rules 2.) not using sympto-thermal 3.) did not have complete education.
    I’m not saying it’s for everyone, but I think that many people would love to know about it as a real alternative that works.

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