Which method of fertility awareness is right for me? A decision making tool

It can be hard to choose the right method for you. In this graphic, I have simplified the main signs, times of intimacy, and efficacies for the four methods that I am most familiar with.

As part of my charting journey, I have personally compared and charted with Billings, sympto-thermal, and Marquette. You can view my charting comparisons here.

The graphic is intentionally simplified. Method rules will vary, particularly if you are using a different protocol of the method or combination of signs. My Marquette example is for monitor-only rules.

Time of day for intimacy is very important to consider as a part of the decision making process. If you and your partner’s schedules don’t mix well, this may sway you towards another method!

Some couple like intimacy to feel spontaneous. If you never want to worry about time of day, Marquette is likely the best method to choose.

On the other hand, if you want your fertile window to be defined by cervical mucus, you may want to sacrifice any time of day sex for the flexibility of opening the fertile window that may come with using alternative evenings of the basic infertile pattern in Billings.

I recommend interviewing an educator and telling them your unique situation before committing to a method.

To find an instructor, I recommend using the Read Your Body Educator directory linked here. You can use it to find an instructor based on the fertility signs you want to chart, your location, price range, and more!

No dry days? You may qualify for a basic infertile pattern!

After menstruation, the majority of women will experience dry days. For these women, their basic infertile pattern is dry. Other women may experience a pattern of unchanging mucus, sensation, and discharge after menstruation. For women who experience this same UNCHANGING discharge, mucus, sensation pattern for three cycles in a row following menstruation, they may have a non-dry basic infertile pattern. The keyword here is unchanging; any changing pattern would not indicate a basic infertile pattern. This type of pattern should only be established under an instructor if someone is seriously avoiding pregnancy. For women who establish this pattern with a mucus-only instructor (either Billings or Creighton are options), this pattern has the same level of efficacy for avoiding pregnancy as a dry pattern. Some examples of this pattern may be continuous moist days, continuous sticky days, continuous white mucus, or others!

DO NOT try to use these days for unprotected sex without establishing it for a minimum of 3 cycles with an instructor (it may take longer than this). When using these days, intercourse should be rotated to every other day in the evening before bed. 

What causes this pattern? In cycles less than 35 days, it is caused by bits of the G mucus plug breaking off. While the plug is breaking off, it causes the visible mucus or sensation. However, the rest of the plug is still blocked. This means this time of the cycle can be considered infertile if an instructor works with you to make sure it is the G mucus plug breaking off. In cycles longer than 35 days, it can be caused by a combination of the G mucus plug breaking off and estrogen’s effect on the vaginal walls causing a sloughing effect. Read more about the types of mucus here.

Sympto-thermal methods like Taking Charge of Your Fertility also mention a “sticky” dry basic infertile pattern. Methods like SymptoPro claim that women do take on an elevated pregnancy risk when using these days. As sympto-thermal methods are not as strenuous on mucus observations as mucus-only, consider this risk when deciding to utilize this pattern. Again, ideally if someone is avoiding pregnancy, they should reach out to an instructor before using these.

In either of these cases, experiencing any dry days following menstruation means that you do not qualify for a basic infertile pattern of non-dry in regular cycles. This pattern needs to be re-established with an instructor following hormonal birth control usage or pregnancy. 

Irregular Cycles

For postpartum, perimenopausal, or people with cycles longer than 36 days, it is also possible to have a basic infertile pattern of non-dry after 14 days of the same UNCHANGING discharge, mucus, sensation. In addition, a combined basic infertile pattern is possible in the Billings Method. This should only be established with an instructor. For these transitions, the Billings Method is highly recommended. 

In both regular and irregular cycles, working with an instructor can help you get more safe days for unprotected sex if you are experiencing a non-dry pattern.

My Experience Becoming a Certified Billings Ovulation Method Teacher

I recently completed my teaching certification for the Billings Ovulation Method through the Billings Ovulation Method Association in the USA (BOMA). This is a cervical mucus / sensation only method that has been taught for over fifty years in over 120 countries.

I began this certification having been quite dissatisfied with my previous certification in the sympto-thermal method. I found the sympto-thermal method inadequate for irregular cycles or postpartum cycles, as well as for any cycles with continous mucus.

This certification 100% cleared up all doubts I had about being able to teach people in these situations! I love that Billing’s motto is “Keep it simple.” Ultimately, this certification gave me the confidence to give up temperature taking as a part of my fertility awareness routine.

First Step:

Before beginning the certification, I took an introductory class with my spouse in the method. This gave me about 6 months to try to apply the principles to my charts before beginning training. I had previously certified in a “Billings-based method” but learned quickly that authentic Billings is a different creature altogether.

I recommend that anyone who is going to train in this method learn to practice it first for at least 6 to 12 cycles under the guidance of an accredited teacher. Joining this program without learning the method first is going to leave you lost on your charts – when you should be confident in your charts before helping others.

Second Step:

The class began in December 2019 and ran through September 2020. We met once a month for approximately an hour (sometimes a little more or less). Inbetween meetings, we were expected to read one to two chapters of material and complete 5 or more worksheets that included chart evaluation and quizzes.

I really appreciated the live classes because my previous certification had no live component. I’m a strong believer that synchronous connection is really important for learning something new.

During class, we were shown PowerPoints and given time to ask questions about the homework. Hearing from long-term accredited teachers about different charting circumstances did wonders for my existing knowledge base. It was incredibly valuable.

Full disclosure: It is important to know that Billings was founded by and is primarily run by Catholics. These meetings often began with prayer or referenced God. Teachers are not required to teach the religious component of the PowerPoint. That means that Billings can be presented in a secular manner. The WOOMB International head organization notably does not include religious elements in their presentation of the method. The science of the method is solid regardless of any ideology attached to it.

Third Step:

The next step after passing an exam on the material was to begin practicum. Practicum is the supervised portion of the certification where you teach 6 to 10 clients minimum in the method while submitting charts and questios to a supervisor selected for you by the organization.

This graphic is how long it took me to finish the practicum portion of the course. Most people take 1.5 to 2 years to finish the program. I went a little faster because I taught larger group classes and had clients lined up before it began.

Practicum was the most enriching part of the experience, and I recommend that anyone who does the training utilize this time to your best advantage. I learned how to help people identify complex basic infertile patterns where they never have dry days. This was not possible in my previous method. I was able to support multiple postpartum women as well as folks with PCOS or who were trying to conceive. I learned so much by meeting with my clients and sending charts to my supervisor.

The follow-ups and classes in Billings are mandatory live meetings (video calling, phone call, or in-person). The follow-ups generally last 15 to 30 minutes depending on the client and how early they are in the process. Follow-ups and classes are required to be live, and this is based on what was done to reach efficacy in the Billings studies. We generally meet with clients seven or more times in the first 6 months, and then every 1 to 3 months. Some people may have more or less follow-ups depending on when they reach autonomy and things like cycle characteristics (postpartum people tend to meet up until the third ovulatory cycle after return of fertility.)

Fourth step:

After having enough clients in different situations (postpartum, trying to conceive, trying to avoid, regular and irregular cycles), I had a final meeting with my supervisor. Before this, I had to compile a document of every client chart. This was a bit laborious as the Billings charts cannot be exported to PDF without losing part of the chart. I had to screenshot segments of the charts and then re-assemble them. This meeting with my supervisor lasted about two hours, and we discussed all of my client charts and any corrections that needed to be made.

Following that, I was recommended for the final step. I recieved a mailed in exam that involved correcting a full paper chart and writing why I made those changes and what mistakes were originally made.

I turned in this exam to two graders. They then met with me and discussed the chart and any necessary corrections. They approved my certification at the end of the meeting.

The Future

Billings Ovulation Method teachers are required to do continuing education to maintain their certification. This is an investment of approximately $300 to $600 every three years. While this is costly, it is really important to attend further training where the teacher can see more advanced charting techniques and learn about health conditions, efficacy, and more!

My Final Thoughts

I would recommend this certification program to anyone who is interested in having an in-depth understanding of cervical mucus charting. The Billings Method teaches about things like the “pockets of shaw” and the cervical mucus crypts. My previous certification did not include close study of the patterns of cervical mucus. This program fundamentally changed my thinking about temperatures always being a necessary part of charting. I ended up dropping temperatures completely after 3 years of using basal body temperature.

Billings allows teachers to order all supplies, including digital materials, for clients. This means I do not have to produce my own materials, and it is super useful for quickly mailing clients what they need.

To make the most of out of this program, I recommend also reading the scientific studies on the side. Unfortunately, the program did not go into a lot of depth on the previous research studies. As someone in academia, I really like understanding all the different correct use and typical use statistics. I’m often questioned about efficacy, and I want to be able to answer people’s questions. If this also describes you, I recommend the following articles:

The Discovery of the Different Types of Cervical Mucus

Use-effectiveness and client satisfaction in six centers teaching the Billings Ovulation Method.

Field trial of billings ovulation method of natural family planning.

A prospective multicentre trial of the ovulation method of natural family planning

A Trial of the Ovulation Method of Family Planning In Tonga

A Response: In Defense of Truth in the Science of the Billings Ovulation Method

Misrepresentation of contraceptive effectiveness rates for fertility awareness methods of family planning

A Day in the Life of a Billings Ovulation Method User

Have you ever wanted to know what it is like to chart with the Billings Ovulation Method? This blog attempts to give an overview of what it is like for one individual to chart with the Billings Ovulation Method (BOM) over a single cycle. I go through each day of the cycle and explain my overall charting habits. All times are just approximate. I get personal and discuss some challenges I experience with natural family planning. BOM involves tracking sensation felt at the vulva along with the visible appearance of cervical mucus as a person goes about their day to day activities.

Day 1: Record heavy bleeding. Heavy bleeding feels wet. Done! Users are not allowed to use heavier days in the Billings method when avoiding pregnancy. This is a true day one of a cycle because it was preceded by a Billings peak day.

Day 2: Record heavy bleeding. Heavy bleeding feels wet. Done!

Day 3. Record medium bleeding. Medium bleeding feels wet. Done!

Day 4: Very light bleeding. It is now possible to observe my basic infertile pattern of dry.

8am: I feel dry and see a small amount of blood.

10am: I still feel dry.

8pm: I still feel dry. I see no mucus. Sex is allowed in the evening of this day. We use this day.

Day 5: Extremely light bleeding. Technically this day is not allowed for intercourse since I used the day before and Billings method rotates alternative evenings. We use this day anyway #rulebreaker

Day 6: I feel dry. I do not see anything. I record this day as “possibly fertile” since I broke a rule and used the day before. Every day after intercourse gets this white stamp in the pre-ovulatory time of the cycle.

Day 7: My basic infertile pattern of dry is still there! I notice nothing the entire day in the bathroom and my vulva sensation is dry. Sex is allowed in the evening. I consider my evening 8pm because I go to bed around 9pm on average. We use this day.

Day 8: I feel dry all day and see nothing. However, this day is not allowed since Billings alternates days. We skip this day.

Day 9: I feel dry all day and see nothing. However, we do not use this available day because we are both tired. It happens!

Day 10:

9am: I feel a bit moist. I don’t see anything when wiping in the bathroom.

11am: Still feel moist. I do not see anything in the bathroom.

2pm: Still feel moist. I do not see anything.

4pm: Still moist. Nothing seen.

4:45pm: Walking to my car from work. Still moist!

8pm: Overall observation for the day is moist. I record it. The fertile window has opened. This is known as the point of change.

Day 11:

7am: I feel moist as soon as I walk to the bathroom. I see very scant clear mucus on the tissue.

I do not see or feel anything for the rest of the day.

8pm: Overall observation for the day is “moist, clear”

Day 12:

7am: I feel moist, but see nothing.

10am: I feel moist, but see something white.

8pm: The feeling remains the rest of the day. I record “moist, white” for the day.

Day 13:

7am: I feel dry.

11am: I still feel dry.

1pm: I feel wet sensation when walking to my office. This is a change, so I keep that in mind.

I feel damp the rest of the day. I never see anything in the bathroom. I record “wet” as the most fertile sensation that day.

Day 14:

6:30am: I immediately feel moist.

9am: I see long clear strings when wiping in the bathroom.

11am: I have a wet sensation when walking around.

3pm: I walk around my work place. I still feel moist.

5pm: I see clear strings again.

8pm: I record “wet, clear strings” on my chart.

Day 15:

7am: I feel a gush as soon as I wake up. I do not see anything in the bathroom.

9am: I see scant, clear mucus on the tissue when wiping.

11am: I feel very wet walking around my work place.

1pm: I do not see anything on the tissue.

3pm: I do not see anything on the tissue.

5pm: I feel wet sensation while making dinner.

8pm: I record “wet, clear” as my observation for the day.

Day 16:

7am: I do not feel or see anything when waking up.

9am: I still do not feel or see anything.

12pm: I go for a 20 minute walk. When I get back, I feel slippery sensation. I go to the bathroom and see copious amounts of long, clear mucus.

8pm: I felt slippery the rest of the day. I record “slippery, long clear” on the chart.

Day 17:

6am: I feel dry when waking up.

8am: I don’t see anything or feel anything.

11am: I don’t see anything or feel anything.

8pm: The day was nothing felt, nothing seen all day. I record dry. This means yesterday was my peak day because it was a changing and developing pattern ending in slippery followed by an abrupt dry up to no longer wet or slippery.

Day 18 and Day 19:

I have the same experience as day 17. I pay attention all day and observe no mucus or sensation.

Day 20:

Ovulation is expected to be over and the cervical mucus plug has re-closed for the cycle. Sex is available any time for the rest of the cycle until day one of menstruation occurs. I can chart, but it is not necessary to wait until the evening and observations are less important as sex may interfere at any time.

Day 28: I record heavy bleeding and the rules restart.

Real Talk: Diffulties / Obstacles With Billings Not Seen on the Chart

These are things that I find can be difficul in my own personal experience. I know that people in really long cycles or with other irregularities may have different issues than me.

Challenge One: Alternative evenings only can be a struggle, and it seems even harder for me right before the fertile window opens due to my mood at this time of the cycle. This follicular phase is much longer for me than my luteal phase on average, and this means alternative evenings is the rule for most of my cycle. If someone has a partner with a conflicting schedule, this can especially be offputting. I think anyone who is going to practice this method should consider whether this is practical for their lifestyle.

Challenge Two: Expected abstinence in Billings can be hard, and I have fairly short fertile windows on average. I originally practiced sympto-thermal, and I switched to Billings when I realized that overall consecutive abstinence was much less overall (for my own cycle, Billings: 9 days, Sympto-Thermal: 14+ days). I tend to break some rules still, but this is much more suitable for my fertility intentions level than sympto-thermal.

Look out for my next blog on “A Day in the Life of a Marquette User.”

Disclaimer: Do not try to learn how to chart from this post. Everyone has their own unique cycle and this is just an example of charting with Billings in a regular cycle. Please reach out to me if you would like to learn this method with me as your guide. Alternatively, you can find a teacher here.

Why did I choose to become a fertility awareness instructor?

Why did I choose to become a fertility awareness educator?

Fertility awareness is the sex education I wish I learned in middle school.

When women actually learn how their fertility works, they learn that getting pregnant is not as easy as the drop of a hat. We learn to appreciate and live with rather than work against our fertility.

Almost every person who I’ve seen read #takingchargeofyourfertility or take a FAM class comes out of the experience saying, “Why have I not always known this information? I wish I could have known this when I was younger!” Learning fertility awareness changed my life, and I know it can change yours too.

Do I believe FAM is the right method of birth control for every woman?

No, it is probably not.

But I do believe that every woman should be taught how to understand her own body. What she does with that information is up to her.

Fertility awareness gave me the ability to avoid pregnancy on my own terms. It gave my spouse more knowledge about my body and the changes I experience during my cycle. It has strengthened my relationship in more ways than I can name.

If you want to learn FAM, I suggest getting an instructor. Check out this website for a list of instructors.