FEMM calls the spectrum of hormonal health The Continuum. It goes all the way from pre-puberty, into cycling, pregnancy, breastfeeding and past menopause. The phases are all part of the continuum but everyone's journey looks a little different. It might be completely normal for a woman to not ovulate or have irregular periods during a certain season. But what I like most about this concept is that it makes no assumptions about where a woman is and accounts for the fluidity of hormonal health.
I like to think of Family Planning intentions as a continuum, too. Sure, for some women, deciding whether or not to have a baby may be a definitive yes or no. But for many, it's more complicated than that. In the world of fertility charting you may have seen the acronyms (among many others) TTA and TTC. Respectively, trying to avoid (pregnancy) and trying to conceive. But a new acronym is finding its way into FAM bedrooms - TTW. Or trying to whatever.
I have seen the fear based contraceptive culture that got us here - you can get pregnant anytime, anyway, anywhere - carried over into many fertility awareness discussions. Women get scolded in support groups for using a low risk day. (A day that is considered 100% fertile for TTA women, but only a little fertile for TTW women.) Any deviation from the strict rules of charting is paraded as an invitation for an unplanned pregnancy. And that's simply bad press, we can't have that. But are we in a place to judge a couple's decision to engage in risky days? Do we really know the full story?
Consequently, efficacy rates of FABM are tricky to talk about.
With pharmaceutical contraception, and particularly LARCs, your uterus is pretty well turned on or off. But Fertility Awareness methods are so much more nuanced than that. Using FAM allows you to be tuned in to the many factors that go into deciding (or not) to procreate. During a certain season of your life, you might not necessarily be aiming for a perfect efficacy rate.
Baby making is biological, hormonal, situational, economical, and cerebral. In cases of difficulty conceiving and miscarriage, we don't always have complete control over our family planning. Do we allow for that fluidity in our discussions on birth control? I have wanted a baby so badly, been anxiety ridden during the two week wait (What was I thinking? A baby??) only to be crushed to find my period grace me with its presence. It's complicated. Boiling down the drive to procreate to an on/off button does a huge disservice to women and simplifies something that is anything but.
Over the years I've practiced FAM, I've learned to be ok fluctuating on the spectrum. Communication with my partner (and myself to be honest) is uber crucial. Sincere, clear, down to the gut communication.
But that can be difficult. It's easy to communicate "Yes, I'm fertile today." "No I'm not." What's not so easy to talk about is, "It's a low fertility day. What do you think? Are we ready to take that risk?" If it's a knee jerk reaction "Heck no," that's one thing, but the grey area often proves to be a challenge.
In this sense, a couple using the fertility awareness method gets an opportunity for a valuable communication workout. In my work as a fertility awareness educator, I try to encourage this workout. It takes 2 to make a baby and there's 2 people with varying factors going into each cycle. If you don't get it out in the open to the other person, who might I add, has no other way of knowing what's going on - it might come out in another way. This isn't exactly the case for other forms of family planning and I think it's an important distinction to make.
So wherever you are on the spectrum, be there. And there. And there, too. Process it, write about it, But most importantly, talk about it with the person who might be the other half of the decision. This makes using FAM different from other forms of family planning, but I have been pleasantly surprised by this element. Without it, I'm fairly certain I wouldn't have my daughter.
This article was originally posted on 5/12/17 on Appleseed Fertility.