There is a good chance you have seen a bit of news floating around this past week about fertility awareness. WHAT?! There is never news about fertility awareness! Hallelujah!
However, you may have also noticed that it was pretty negative news. Many articles stated that a memo that was leaked from the White House was talking about replacing birth control access with fertility awareness education. Fertility awareness is already something that tends to be jumped all over negatively, but when you add in the tendencies of the media + the current administration any suggestion of fertility awareness is going to take gunfire.
Fertility awareness in the news generally goes something like this:
- It’s sooooo ineffective. YIKES. (reality: efficacy varies between different methods and what’s most important to is have a user that is very sure about what their family planning goals are)
- It’s basically impossible to do unless you are pretty much a brain surgeon/rocket scientist. (reality: It’s pretty simple, but it DOES have a learning curve and you need to be more consistent than you would with something like an IUD)
- STDs for everyone YAY. (reality: Obviously it does not protect against STDs! The only birth control method that does is the humble condom)
So what’s the truth about this memo and the plan for fertility awareness and what would it be like if fertility awareness WAS taught to teens?
This is what I see specifically IN the memo, posted on crooked media:
Teen Pregnancy – needs to be defunded as it has not worked, there is no positive evidence and some negative evidence. Instead we should work with adolescents on sexual risk avoidance and fertility awareness methods.
To begin at the beginning, I would say we can’t even be sure what “sexual risk avoidance” means. Condoms? That would be FANTASTIC. In addition, though I don’t want to see title X (which is more than just birth control and for more than just teens!) funding cut, I don’t think that it is inherently wrong to promote sexual risk avoidance to teens. That just needs to be one part in the arsenal of a full and comprehensive sexual education. Overall, this snippet of text is vague.
But what would it be like to teach fertility awareness to teens? Is that something that should be supported by those who tend to be on the more liberal end of the spectrum, even though they are currently vehemently opposed? I’d give a big, huge, resolute YES.
It would obviously be quite silly to tech teens to use fertility awareness and remove their access to other birth control methods because, just like all birth control methods, it’s not going to be the right method for everyone. Also, teens, in general, are not going to be the ideal user of such method for various reasons. They often are not going to be diligent enough in charting, they haven’t matured their prefrontal cortex and are going to be more susceptible to risky behavior, even if they know logically what they “should” do, their lifestyle might not have the consistency needed to easily chart, and more.
While I don’t believe that we should teach teens to use fertility awareness as their only birth control option (and actually would be hesitant to teach most teens how to use the method as birth control AT ALL), the amount of information women get about their bodies from learning a symptom-based rather than calendar-based fertility awareness method is invaluable (more on the difference below). With that information teens can feel more self assured about their bodies, detect hormonal issues, learn more about their sexuality, and learn more about fertility and how it works.
“Fertility awareness” is quite a broad term that generally is not referring to the (very ineffective) calendar/rhythm method. Most modern fertility awareness methods take into account symptoms (temperature and cervical fluid) based on what’s going on with your hormones real time and are VERY effective birth control methods when learned correctly and practiced correctly. 99.6%.
Teens are a likely population to misuse a birth control method, so it’s definitely not a bad idea to use typical use statistics. Unfortunately, fertility awareness based methods are used with such a small population of women that typical use statistics are not differentiated between different fertility awareness based methods despite the fact that they vary wildly. The calendar method? Not so hot. The sympto-thermal method? The best study we have suggests that the typical use failure rate is quite low. Probably due to the motivation of the population in the study.
The population in that study could have been inherently motivated to avoid pregnancy and been equally as fabulous at typical use with any method, but it’s also possible that the mere act of learning about and understanding their fertility and their risk of pregnancy at any given time was a strong motivation in and of itself. It’s completely anecdotal, but I do find that when learning fertility awareness women generally become very diligent in their birth control, whether that is with a barrier during the fertile period or abstaining from penis-in-vagina sex during any potentially fertile time. I would love to see more studies on whether a deeper understanding of fertility is, in fact, linked to greater motivation in perfect use of the chosen birth control method for those strictly trying to avoid pregnancy. If more body education did lead to less birth control risk taking (regardless of method used), we would do very well if it was taught to teens. Perhaps just omitting the information about the nitty gritty rules to make it a birth control method.
To be clear, I don’t believe there are no teens who can or should use fertility awareness, more that it shouldn’t be taught as a birth control method in an environment like a school because it would be too difficult to make sure it was understood correctly and to make sure those who wished to use it were good candidates.
The information contained in a fertility awareness education is so much more than just birth control, and we don’t know a whole lot about how far reaching the implications of having that education as a youngster really is. Unfortunately, most grown women do not understand a lot of the inner workings of their own bodies even though they could, especially if exposed at a younger age. I would LOVE to see tweens and teens learning about fertility awareness as both an integral part to understanding their body and fertility and, perhaps, as one more option in the full arsenal of birth control choices.