I’ll never forget their conversation on that car ride home. I was driving back from a nationally recognized nursing research conference with graduate nursing students in my research group. I was horribly intimidated by their knowledge of research methods and how they could tear apart a study in minutes. They knew so much more about research than I could fathom!
As I was falling asleep in the back, the two most senior graduate students were talking over the various research posters they had seen. “Did you see that only about perimenopausal women and natural family planning? His sample size was so small.”
“Yeah, that guy is crazy. I’ve seen his stuff at conferences before. That natural stuff is hokey witchcraft, not science.”
Their words stung. As a senior in nursing school, I was struggling to understand how to balance the demands of my Catholic faith to avoid contraception and the science of fertility. I recently opened myself up to the idea of fertility based awareness methods (FABMs), the very thing they were mocking.
As I eventually examined the science of it myself over the course of the next year, I found faith and science beautifully converged in FABMs and could brush doubtful comments off. However, those graduate students would not be the first nor the last to express doubt about the scientific validity of natural family planning methods. Many in the medical community do. I hear it at work as a nurse frequently, and I hear my friends who use FABMs vent their frustrations about their unsupportive provider. My love of FABMs has always felt like a dirty little secret.
I have been using the Creighton Model, a cervical mucus FABM for over 4 years. Like most women I have met who use FABMs, I love understanding my natural cycle. I’m very happy to be avoiding the side effects and risks of hormonal oral contraceptives. I am a fan of the universality of describing mucus so my charts can be used as a diagnostic tool using NaPro Tehcnology.
The science of the Creighton Model and other FABMs are cutting edge. A quick search on reputable medical journal websites will bring you the latest studies. However, like most FABMs, Creighton’s delivery is stuck in the past. Creighton uses paper charts and stickers to track cycles, and their website reminds me of a MySpace page. It’s looks ancient compared to the sleek ads and websites for contraception.
This is why I am so excited for the web and phone applications for FABMs. Though science has been backing them for decades, my hope is that evidence-based phone and web applications will give FABMs the public validation they deserve. and 21st century makeover it greatly needs.
Internet headlines have lately been touting Sweden physicist Elina Berglund Scherwitzl’s phone-based Natural Cycles. For those of us familiar with FABMs, her technology is nothing new. The app uses basal body temperature like the sympto-thermal method, a kind of FABM that uses both basal body temperature and cervical mucus to predict fertility. The app has a separate thermometer for purchase that links daily basal body temperature to the app and uses an algorithm to predict fertility. [1]
A team of researchers sponsored by the Fertility Appreciation Collaborative to Teach the Science (FACTS) studied 40 fertility-based phone apps available on iTunes, Google, and Google Play was published in the Journal of the American Board of Family Medicine. [2] Only 6 of the apps were found to be evidenced-based and highly effective in predicting fertile days. The team found Natural Cycles was not its most effective app. It was accurate in measuring fertile days but found it difficult to assess the patented algorithm, asking for further validation and independent study [2].
Natural Cycles and other fertility-based phone apps are not necessarily perfect in predicting fertility and do not rely enough on the decades of science behind FABMs. However, what continues to feel like my dirty little secret now has Facebook ads and is available for download on app stores. These sleek apps and websites validate that FABMs are normal, socially acceptable, and even cool.
I hope these apps are a start to the 21st century makeover that makes FABMs appealing to my generation of millennial women.
 
1 – Berglund Scherwitzl, E., Lindén Hirschberg, A., & Scherwitzl, R. (2015). Identification and prediction of the fertile window using NaturalCycles. The European Journal of Contraception & Reproductive Health Care, 20(5), 403-408.
2 – Duane, M., Contreras, A., Jensen, E. T., & White, A. (2016). The performance of fertility awareness-based method apps marketed to avoid pregnancy. The Journal of the American Board of Family Medicine, 29(4), 508-511.