Basal body

temperature (BBT)
method
What is it?
Helps identify changes
in your BBT to predict
when youll be most
fertile.

Cervical mucus (Billings) method

Calendar method

What is it?
Recognizes changes in quality and
quantity of your cervical mucus
that occur just before and during
ovulation.

What is it?
Predicts when you
are most fertile
based on counting
the days of your
menstrual cycles.

99% effective
when used
accurately!

97%
effective
when used
correctly!

How does it work?!

1. Using a basal body thermometer, take your
temperature orally at the same time each morning
before getting out of bed or eating anything.
Record on your fertility calendar.
2. By tracking your BBT each day, you will notice
that your temperatures are lower before ovulation
and higher after ovulation. Thus, you should
refrain from intercourse from the time your
temperature drops to at least 48 or 72 hours after it
increases again.

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Advantages!
Inexpensive (thermometer costs ~10-15$), convenient,
no side effects! There are also multiple free apps
available to chart your BBT!

Disadvantages?
Factors may influence temperature like stress, fatigue,
illness, alcohol, and warmth and coolness of the
sleeping environment; requires diligence; no STI
protection

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1.

Standard Days
Method (95%
effective when
used correctly!):
Use if you have regular menstrual cycles that are 26
to 32 days long
- First day of your period = Day 1
- Days 1 - 7 = safe days
- Days 8 - 19 = days of increased fertility
- Days 20 - end of each cycle = safe days
(Record on calendar as shown below or use CycleBeads
as a memory aid)

2.
How does it work?!
- Check your mucus several times each day (wiping
with tissue, putting clean fingers to check color and
texture). Do whats most comfortable for you.
- During your period: Your flow covers the mucus
signs so those are not safe days
- After your period: "dry days" without mucus may be
safe
- When an egg starts to ripen = more mucus gets
produced: Generally yellow or white and cloudy,
feels sticky or tacky
- You will have the most mucus just before ovulation:
Looks clear and feels slippery, allowing sperm to
glide more easily through the cervix like raw egg
whites = peak of your fertility
- After about four slippery days, you may suddenly
have less mucus. It will become cloudy and tacky
again. And then you may have a few more dry days
before your period starts. These are also safe days.
- Chart your mucus pattern on your calendar!

Disadvantages?
A woman's mucus pattern may be altered by
breastfeeding, cervical surgery, douching,
perimenopause, recent use of hormonal contraceptives,
spermicide, STIs, vaginitis

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Calendar Rhythm Method (91% effective when used

correctly!): Use if you have varying menstrual
cycles
- Record the number of days in each cycle for 6
months
- Subtract 18 days from the shortest cycle. This is the
estimated first fertile day.
- Subtract 11 days from the longest cycle. This is the
estimated last fertile day.
- Update the calculations each month using the 6 most
recent cycles.
(Many apps are available that can automatically do this
calculation each month)

Advantages!
No side effects. Can be used by almost all women. Can
be used by people who dont want to use contraception
due to religious beliefs or personal preference. Tracking
apps are free; CycleBeads cost $8, or you can make
your own for even cheaper.!

Disadvantages?
No STI protection. Should not be used by women who
recently gave birth, had an abortion/miscarriage, are
breastfeeding, have irregular vaginal bleeding, or are
using certain drugs.

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Coitus interruptus
(withdrawal method):
Man withdraws penis just
before ejaculation
- Setbacks: Be aware of
fluids leaking from the
penis called preejaculation that can
contain live sperm, no
STI protection, having
to rely 100% on the
male partner
- Effectiveness: 96% if
performed perfectly all the time!

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Periodic abstinence: This

practice means avoiding
intercourse on the days when
the woman is most fertile
- How does it work? Use
the symptothermal
method to estimate your
most fertile days
- Disadvantages: No STI
protection; such as stress,
medications, illness,
menopause,
breastfeeding and
whether she is just
coming off of hormonal
contraception.

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References
Lowdermilk, D. L., RNC, PhD, FAAN, Perry, S. E., RN,
CNS, PhD, FAAN, & Cashion, K., RN, BC, MSN.
(2010). Maternity nursing (8th ed.). Maryland Heights,
MO: Mosby Elsevier.

Sommer, S., Johnson, J. M., Roberts, K. K., Redding, S.

R., & Churchill, L. (2013). RN maternal newborn
nursing review module (9.0th ed.). Assessment
Technologies Institute, LLC.

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Natural Family
Planning (NFP),
Also called the fertility awareness method, is a method
of birth control that does not use any drugs or devices.

There are two main types of natural birth control that

are practiced by couples: withdrawal method (coitus
interruptus) and periodic abstinence.

These methods are assisted by fertility observation in

the form of monitoring cervical mucus, checking the
womans basal body temperature, and charting the days
of her menstrual cycles. NFP is most effective when all
of these methods are combinedcalled the
symptothermal method.

Ultimately, couples can plan when to have intercourse to

target the most fertile time to achieve pregnancy or
when to avoid intercourse to prevent pregnancy.

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Kapiolani Community College

NURS 320
Spring 2016
Michelle Liu, Ihilani Lum,
Chelsea Poligratis, & Hana Scully