Is “Natural Family Planning” a Good Idea?

Non-hormonal birth control methods like tracking your cycle and taking your base body temperature have always existed. Do they work?

Natural family planning, sometimes known as fertility awareness methods, is a form of birth control that relies on knowing when you’re ovulating and avoiding unprotected sex during that time. It’s also trending. On TikTok, the hashtag #naturalbirthcontrol has 34.6 million views and is filled with young people—largely people in their 20s and early 30s—explaining how they don’t use hormonal birth control and instead rely on “natural methods.”

“Basically, [natural family planning] requires a knowledge of your own menstrual cycle, and the length and timing of ovulation in that cycle,” explains Ashley Waddington, associate professor of obstetrics and gynecology at Queen’s University. This involves tracking your cycle, either with a good ol’ calendar, an Excel sheet, or an app (though, in regards to that last one, as abortion has been banned in some American states, reproductive health experts are concerned that the data from common apps could be used to prosecute users who seek out an abortion); examining your cervical mucus (it changes in consistency throughout your cycle, like when you ovulate); and taking your basal body temperature once a day (you’re slightly warmer once you ovulate and during your luteal phase). “It requires a pretty intensive understanding of your own body,” says Waddington. Plus, it requires you to have the luxury of time to do all this measuring and recording, as well as a willing and supporting partner since this method really takes the full cooperation of two to work.

And that’s just it—these methods can work (natural planning is about 76 to 88 percent effective), but it’s hard to get right. Take tracking your cycle, for example. Most people don’t have a perfect 28-day cycle, and that cycle also tends to shift. So even if you think you ovulate around, say, day 15, that might change from cycle to cycle.

While natural family planning isn’t perfect, it’s interesting that so many young people are turning to it. Maybe they’ve been burned by the side effects of hormonal birth control, or maybe they’ve suffered through a painful IUD insertion. Or maybe it’s just their choice and they’re comfortable with the risk of pregnancy. But it’s important to remember that it is not as effective as an IUD, the pill, the patch, or condoms—and online creators who say that it is should be scrutinized. “You have to accept that there’s going to be a higher failure risk because it’s so hard to do well,” says Waddington.

Next: The Pill Is Good. Why Isn’t It Better?

Originally Published in Best Health Canada