This method, also known as the ovulation method or the Billings method, detects changes in the cervical mucus that occur during the menstrual cycle. The hormones that control the cycle also work on the glands of the cervix that secrete mucus, which helps to lubricate the vagina during intercourse and, depending on the time of the month, helps or hinders sperm in their journey toward the egg. Family planning clinics, including Planned Parenthood and clinics at Catholic hospitals, may be able to help you learn the method.

How does the cervical mucus change during the monthly cycle?

During the first four or five days of your menstrual period, the blood flow covers up any changes in the cervical mucus. After the bleeding stops, there are a few “dry days” when little or no mucus is present.

As an egg starts to develop within the ovary, the amount of mucus in the vagina increases and it becomes sticky, cloudy, and yellow or white in color. As ovulation approaches, the quantity continues to increase and the mucus gets clear and slippery like raw egg white. It also becomes elastic and can be stretched between the fingers. These “wet days” are your most fertile.

Four or five days later, the mucus may again become cloudy and sticky, but scantier in volume. There may be a few more dry days before your period begins again. The changes vary from woman to woman and from month to month, although the general pattern holds true.

How do you chart your cycle?

As with other methods, you note your observations every day on a calendar. Mark your menstrual period. Note which days are wet, which are dry, and when the color and consistency of the mucus change. It is wise to chart for at least a month before depending on the method, and during that month use backup contraception.

Which days are safe, using the cervical mucus method?

With this method the days of your menstrual period are unsafe, especially if you have a shorter cycle, say twenty-one or twenty-two days. It is safe to have unprotected vaginal intercourse during the dry days after your period and before ovulation if you have a long cycle. However, the safe period ends at the first sign of wetness after menstruation. Do not have intercourse during the wet period unless you want to get pregnant.

After ovulation you must refrain from sex for at least three days or until the wet days end, whichever is longer. Naturally, the longer you wait after the wet days end, the safer the method; some doctors recommend waiting three days after wetness ends. It is considered safe to have sex after ovulation when the mucus decreases in volume and becomes cloudy and sticky again. It is even safer to have intercourse on the dry days before the next menstrual cycle.

What factors can interfere with the accuracy of the cervical mucus method?

Women who don’t produce much mucus may not be able to use this method. Factors that change the natural mucus pattern make the method unreliable: douching; using contraceptive foams, creams, jellies, or suppositories; vaginal infections; sexually transmitted diseases; recent use of hormonal contraceptives (including birth control pills, Norplant, and Depo-Provera); and breast-feeding. Women near menopause may have different and unreliable patterns of cervical mucus, as may women who have had cervical surgery.

How reliable is the rhythm method?

Used conscientiously, the rhythm method and its variants (the basal body temperature and cervical mucus methods) are about 80 percent effective, which means that 20 percent of couples using the method will be pregnant within a year. This may seem like a high rate of failure, but it is a lot better than no method at all. Remember that about 85 percent of couples who use no contraception will be pregnant within a year and only about 15 percent will not.

How much does the rhythm method cost?

It is one of the least expensive methods of birth control. A thermometer costs between one dollar and twelve. Charts for graphing your cycle cost almost nothing or can be downloaded free from the Planned Parenthood site on the internet.

You may have to pay for classes in fertility awareness, though some clinics offer them free; Medicaid may cover the cost of classes in some states when they are taken at a clinic or prescribed by your doctor.

Is fertility awareness the right contraceptive choice for you?

If you and your partner are thinking about having a child maybe next year or the year after, but you really would not be distraught if you became pregnant, then the rhythm method is a reasonable choice. The method works best for women who for personal, religious, or health reasons cannot or will not use other forms of contraception, are committed to the method, and understand how it works. They must have the commitment to take their temperature every day, to keep accurate records, and, possibly, to check their cervical mucus. They should have only one sex partner, who is himself committed to the method. Both partners must have the discipline to abstain during the unsafe days (or use backup barrier-type contraception).

This method is not satisfactory if you have more than one sex partner, or if your one sex partner is not committed to the method. Nor is it advisable if you are careless about record keeping, if you don’t want to use barrier methods or abstain on unsafe days, or if you take medications that change your cervical mucus, affect body temperature, or cause irregular menstrual periods. If an accidental pregnancy would devastate you, choose another form of contraception.

What are the advantages and disadvantages of natural birth control?

It is inexpensive and does not involve last-minute contraceptive effort, but it demands discipline and interferes with spontaneity. Periods of abstention can have negative effects on a couple’s sex life, especially since many women most desire intercourse around the time of ovulation — perhaps the body’s way of ensuring a next generation.


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