Next month is my FAMiversary. I will have been charting my cycles for 6 years. In that time, things have changed. Some for the better, some for the worse. But I'm an optimist - I think Fertility Awareness Methods are on the up!
The number one thing that I cared about? Efficacy. I wanted to know, explicitly, does this method work to prevent pregnancy. The conclusions online were murky. It seemed like I needed a PHD to wade through the research, anecdotes, and biases. I could write a whole other blog post on the confusion surrounding efficacy rates of women using FABM. I'll just leave it at this: for women who are just starting to enter the world of fertility awareness, there isn't one pretty chart that will tell you a method will definitively work for you 99.37% of the time like that cute t-shaped piece of metal. Then again, should we even be trying to compare the two? Aren't they kind of apples and oranges? Another post for another time.
I'd like to think research is up and coming - people who crunch numbers for a living like Chelsea Polis PhD are working hard to bridge the gap. But the fertility awareness world is still not unified. There's no one overarching committee (although AFAP is doing hard work to aim for this) to rule over the research and literature. Not to mention, differing values have made it hard for NFP and FAM to come together on much. I'm hoping in the next 6 years, we'll see more numbers about fertility awareness. The groundwork is being layed down. In 2016 Marguerite Duane MD of FACTS published a comparative study of FABM and hormonal contraception. In 2014, the use of OPKs was researched in conjunction with using a fertility awareness based method.
And more than just efficacy - studies are coming out about the usefulness and successful implementation of fertility awareness based methods. in 2017, Pilar Vigil, in conjunction with FEMM published Ovulation, A Sign of Health, which confirmed the importance of monitoring ovulation in a woman's cycle. The year before, A Qualitative Study of the Barriers and Enablers to Fertility Awareness Educaiton in General Practice came out, exploring how to break down the barriers for women to learn FABM, either inside or outside their doctor's office.
Since 2012, there have been a few landmark studies regarding hormonal contraception. In 2017, a Danish study confirmed a link with hormonal contraception and breast cancer. In 2016, research officially connected a link with hormonal contraception and depression. The numbers are happening. But often, before the research world (and accordingly its funding), can get to something, the media grasps on it first.
From what I've seen, since 2012, there's been a media explosion of content for fertility lovers. Sites just like this have popped up left and right. From Fifth Vital Sign, to Beauterus, to Body Language Life, to Ovary.Co, to Fearless Fertility, there's a whole host of homes for FAM content. This simply didn't exist a decade ago. I think it's great that newcomers to the fertility awareness world can find relatable, casual, informal information about charting. It's not so crazy anymore to get in a conversation with someone and say, "Well I use fertility awareness." and they chime in, "Me too!" It just doesn't feel as uncommon as it used to, finding a fellow FAM enthusiast. And it's increasingly more common to read about those finding fault with hormonal contraception.
Last week, the New York Times Op-Docs aired Sindha Agha's "Birth Control Your Own Adventure", a quirky and fun short film exploring the filmmaker's obstacle laden journey with different types of birth control. Sure, after someone broadcasts their unpleasant experiences with hormonal contraception on the web, there's usually a wave of criticism lashing back (isn't there always though?) of people alarmed and panicked that someone is denouncing the holy hormonal grail of family planning - but that just comes with the territory. Our political climate is...precarious at best.
That's another thing that has changed dramatically in the last 6 years I've been charting - our political climate. These days, fertility awareness advocates often find themselves in a pickle - wanting to make clear the factual risks of hormonal contraception without limiting access to them. Late in 2017, a report came from the White House that more funding would be put into Fertility Awareness Based Methods. Sounds great - sign us up! But there may be an agenda behind the reports that many FAM advocates can't get behind.
It remains to be seen how our current administration will affect women's health in coming years. Without delving too much into it (dinner party rules, right?) it's safe to say the FAM scene has become a little more tricky to navigate.
Someone once told me that technological advances often supersede political change. That has certainly been true in the FAM world. When I first started charting, I had my little thermometer from CVS and a few apps to choose from. Kindara was fairly new to the market. But they didn't have an app for android, which I was using at the time. Now there are hundreds of fertility charting apps (although the distinction should be made between observational charting apps vs rhythm method apps), and a whole blossoming FEMMEtech industry.
Ultimately, I think FAM is headed in the right direction. It's far less obscure than it used to be. I'd love to see fertility awareness in every sex ed class across the nation but Rome wasn't built in a day. I feel mostly positive about the growth and change I've seen. When did you start charting? Have you seen the FAM field change since then? I'd love to hear your thoughts!