Editor's Note: We believe that virginity, birth control, and sex are still opaque topics here in the Philippines. A discussion about these things with our parents mostly involves them telling us never to have intercourse or get pregnant until we're married. However, that is hardly a deterrent for women to make unwise choices. At Project Vanity, our ultimate goal is to empower women by providing them information about their own bodies so they feel more confident navigating their world.

In The Sex Talk, a new section here at PV, we aim to consult with doctors and experts about common questions we feel should be answered by women, for women.

I always knew I wanted to have kids. No specifics on how many, what gender, and when, though. Whenever I would hear the phrase “family planning” it just went over my head, my brain stamping it with “N/A” and going on with my life. So I had a bit of a panic attack when I found out I was pregnant, a mere two months after I got married. I never thought I’d get preggers so soon! I felt very unprepared, and wished desperately that I had paid attention to the required pre-wedding seminar on birth control.

Don’t get me wrong—I don’t regret for one moment conceiving and giving birth to my beautiful babies. Still, I had thought my husband and I would enjoy at least a year or two of just being newlyweds. I realized with guilt that I had given more thought to planning our wedding than making specific plans for our marriage.

Here at PV, we want women to be informed of their options on this critical issue. Since we already talked about artificial birth control, let’s have a look-see at natural options. I sat down with Dr. Cecilia Vicencio, head of the Department of Obstetrics and Gynecology at The Medical City, for the low-down on natural birth control, and her expert opinion on its merits and disadvantages. We hope this article can give you the basic facts you need and encourage you to consult with your own doctor before you decide whether or not this is for you and your partner.

First things first

Natural birth control methods are also known as fertility awareness-based methods for good reason. All of these methods involve pinpointing dates when one is likely to get pregnant and avoiding unprotected sexual contact on those times. It comes as a bit of a shock but Dr. Vicencio reveals, “You are actually only fertile one day in a month, so that’s just 12 days in a year!”

Although the egg cell is viable for only 24 hours each cycle, sperm cells live for an average of 3 to 7 days, with the most tenacious ones surviving for up to 8 days in the womb. So it’s unsafe to have sex about a week before the egg drops, and until after the egg exits the body through menstruation. The key to success is accurately predicting when you will ovulate, since not all women get their menstrual cycles within regular intervals. There are several methods that medical practitioners recommend.

Rhythm Method

Also known as the calendar method, this is probably the most commonly known and used natural method for birth control. It has been around since the 1930s, and just requires a calendar and basic arithmetic to use. To make this work, you’ll need to keep a log of your menstrual cycles for the past six months at least, and then use simple math to chart days when you’re likely to be fertile. Here’s the formula, as quoted from WebMD:

“Subtract 18 from the number of days in your shortest cycle.
Count that many days after you start your period. That’s your first fertile day.
Subtract 11 from the number of days in your longest cycle.
Count that many days from the start of your period. That’s your last fertile day.
Don’t have sex on or between your first and last fertile days.”

Advantages: You won’t need to spend much--all you’ll need is a calendar or journal. There are also free apps available to help you track your cycles. Once you know which days are “unsafe”, just avoid having sex on those dates. On the flipside, you can also use this same knowledge if you’re trying to get pregnant.

Disadvantages: The rhythm method assumes that your period follows a strict schedule. If your cycles is irregular though (as women who have polycystic ovary syndrome can sometimes experience), it’s hard to accurately predict your ovulation. It can work but it’s not completely fail-safe method for preventing pregnancy, and if you don’t use this method together with artificial birth control, it can drastically diminish sexual contact between partners.

From top: Day 1 (sticky and a little slippery = safe), Day 3 (cloudy and stretchy = not safe), Day 5 (clear, wet and stretchy = fertile), Day 7 (white and tacky = safe)
Images via readytogroove.com

Cervical Mucus Method

Also known as the ovulation method or Billings method, this involves checking the mucus from the cervix. On fertile days, there are detectable differences. Dr. Vicencio explains that as you reach your peak fertility, your cervical discharge becomes clear, thin, slippery, and spinnable. She demonstrates by putting her index finger and thumb together and slowly pulling them apart--the mucus feels more wet and stretchy.

You can check your discharge by wiping with a tissue, from front to back. Take note of the appearance (white, clear or cloudy), texture (clumpy and thick, or smooth and sticky), and feel (wet, dry or slippery). Like the rhythm method, it’s best to log these observations over a few months.

Advantages: There are no expenses involved with this method. Plus, if you track these changes and see a regular pattern, you can predict your fertile days for future cycles.

Disadvantages: Breastfeeding, menstrual flow, use of vaginal products like douches and spermicide, as well as certain medical conditions (like having PCOS or an infection) can affect cervical discharge, preventing an accurate interpretation. Some women also don’t produce enough mucus daily.

Temperature Method

Monitoring your basal body temperature (BBT) is another way to check for your fertile days. To measure this accurately, you have to check your temperature immediately upon waking up. An oral thermometer will do but a rectal one gives a more accurate reading. There will be a slight rise in your body temperature (about 1 degree Fahrenheit) when the egg drops into your uterus and falls again just before menstruation. Usually, you reach your peak fertility 2 to 3 days before the increase in your body temperature.

Advantages: Anyone with a thermometer can use this method. You can use this in tandem with other natural birth control methods.

Disadvantages: The differences in temperature can sometimes just be a fraction of a degree from day to day, so this is not an ideal method if you don’t have a large-scale thermometer that can track slight variances. Of course, you won’t get accurate results if you have a fever. Stress, excessive physical exercise, drinking alcohol, and an irregular sleeping schedule can also affect your BBT.

Helpful tools and aids

Practicing natural birth control takes quite a bit of effort and diligence but there are tools that can help you stay on course and get more accurate readings. A basal thermometer provides a more specific thermal reading compared to regular thermometers. Dr. Vicencio shares that there is a vaginal thermometer with a matching app that charts the results straight to your smartphone (but it’s not available locally). There’s also a gadget that can check for ferning patterns (due to crystallization of sodium chloride) in your saliva.

It may be easy to get data for these methods but the true challenge lies in faithful tracking and accurate interpretation. Cycle beads can be used to track the days in one’s cycle while doubling as either a bracelet or a necklace.

Whether you’re practicing natural birth control or not, it’s a good to get a period tracker app for your phone. There are many free options for both iOS and Android such as Maya, Clue, Eve and SpotOn. Some even offer features like sending reminders before you get your period (so you can stock up on supplies!) and taking notes for temperature, cervical mucus, mood, etc.

Should you go natural?

Dr. Vicencio’s explained that natural birth control options are the safest ways to prevent pregnancy. There are no side effects, unlike hormone-based pills and IUDs, patches, and injectables. There are no major expenses involved, too. Should a couple change their mind and opt to conceive, there is no waiting period, plus they can continue using these methods to determine fertile days.

Although these are big reasons to consider a natural option, Dr. Vicencio admits that it is the least effective of birth control methods. Natural birth control has relatively high failure rates, though it helps if you use all three methods to boost efficacy. Women whose menstrual cycles are outside the normal range (21 to 35 days, or even up to 38) will have a challenging time making the rhythm method work. It’s also not for women who have uncooperative partners. To be candid, it takes a lot of work and advanced planning for both parties to use fertility awareness-based methods to prevent pregnancy.

Again, please see your OB before deciding to go for natural family planning. It’s best to do this with your partner, since it involves his willingness and cooperation to make it work. Even if you do decide that this birth control method is not for you, we hope it encourages you to be more attuned to your body, and how your menstrual cycles might be affecting your everyday life.

Supplementary sources: WebMD, Planned Parenthood

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