Home' Trinidad and Tobago Guardian : January 9th 2015 Contents A24
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"I can t afford to get pregnant,"
says 25-year-old Aisha Mukooza.
So every morning, for the past two
and a half years, Aisha s been strict
about taking her temperature as soon
as her alarm goes off at 6 am.
"I have my thermometer under my
pillow. I take it, and then take the
reading and put it in Kindara,"
Kindara is an app on her phone that
helps her chart her temperatures. As
Mukooza explained, "the temps, when
I ovulate, it rises."
She is part of a growing movement
of young women who are saying no
to hormonal birth control and yes to
a kind of birth control that sounds at
first like a real throwback with a little
extra high-tech twist.
These women are using Natural
Family Planning, also known as Fer-
tility Awareness Methods (FAM).
Many experts caution that this is
one of the least successful methods
to use, because it can be so compli-
cated to do correctly. But with new
technology, some women think it is
the best option for them.
While many women use these
methods to help with conception, an
increasing number are using these
same methods to avoid getting preg-
Born initially out of the Catholic
Church, FAM is starting to lose its
religious connotation as more secular
woman turn to it. Many say they are
wary of the effects of hormonal birth
According to the Centers for Disease
Control and Prevention, just between
one to three per cent of women use
FAM as a form of contraception. How-
ever, a study from the University of
Iowa found that if more women knew
about it, one in five women would
actually consider it as an option.
When Mukooza s then-boyfriend,
and now-husband, asked her to con-
sider using the pill or getting an
implant, she was vehemently against
"I wouldn t have it," she says. "I
was literally scared of hormonal birth
control. I didn t like the potential side
"I m a healthy person. I try to eat
healthy food, so the idea of being
pumped with synthetic hormones did-
n t appeal to me, in fact, it was scary,"
The pill is the most common form
of pharmacological birth control. Stud-
ies show some four out of five Amer-
ican women use them. Yet, nearly 30
per cent of all users stop using the pill
because of side effects that include
nausea, weight gain, sore or swollen
breasts, spotting and mood changes
according to research from the CDC.
One of those who users who stopped
taking the pill is 29-year-old Kacey
(she asked that we not use her last
Kacey had been on estrogen-based
birth control pills since she turned 19.
When she was 25, doctors found
that she had an increased risk for
strokes, and switched her to proges-
terone-based birth control.
"I was a mess. For two weeks, a
month, I was completely a wreck," she
Aside from just feeling emotionally
out of sorts, Kacey would have two to
three periods a month and her skin
broke out constantly.
Thinking an IUD would be a better
fit, she switched last year.
"Every symptom I had was way
more amplified," she says. She was fed
up, and three months ago she started
FAM. Last month, Kacey had the IUD
taken out. "It s worth it to not feel
like a 16-year-old all the time."
FAM is frequently referred to as the
rhythm method---a system in which
women predict their likely fertile days
based on the lengths of their cycles.
However, FAM advocates say there is
a clear distinction. This method is
much more careful.
Ilene Richman, director of the Fer-
tility Awareness Center, describes it
this way, "It s a process of becoming
aware of the signals your body is giving
you and keeping track of them."
Richman explained that after a
women ovulates, her basal body tem-
perature, the body s lowest temperature
throughout the day, would rise. In
addition, "A woman who cycles nat-
urally, is going to experience a wetness
around the time of ovulation," Richman
When women become more fertile,
their bodies produce fluids that help
give sperm their best chance at fer-
tilising the egg. Once a woman ovu-
lates, the consistency of that fluid
changes. A woman s cervix will also
change positions, based on whether
or not she has ovulated.
Charting temperatures, noting fluid
consistency, and checking cervix posi-
tion can seem overwhelming at first.
"I think it can be a little difficult to
remember it all in the beginning, but
it really isn t that difficult," explained
Kacey. "Once you get it, you fall into
The CDC and the American College
of Obstetricians and Gynecologists are
quick to point out that FAM is one of
the least-effective methods of birth
"You hear about 25 per cent, one in
four, who use it correctly can expect
to get to get pregnant." says Dr
Nathaniel DeNicola, an OBGYN with
the University of Pennsylvania Health
But FAM supporters, such as Sarah
Bly, a fertility awareness instructor,
says that number needs to be parsed
"The perfect use rate is 99.6 per
cent--99.4 per cent which is really
good," Bly says. Meaning women who
are very particular about keeping their
health statistics and not missing even
a single day. "A lot of statistics that
(the doubters quote) are typical use,
which include women taking risks,"
A German study from 2007 that
tracked 900 women over 20 years
consistently using FAM methods found
that only two per cent of those women
had an unintended pregnancy.
DeNicola agrees that it can work for some.
"For the right patient, who is really willing
to track the days, and are willing to track the
temperature," he says.
But, FAM can be a bad option for women
with more irregular bleeding or frequent
sources of infection or fever that make body
temperature difficult to track.
"Even one day (miscalculated) can result in
pregnancy," says DeNicola.
Strictly recording temperatures and noting
fluids can be tricky. But a growing number of
new apps, such as Kindara, Glow, and Ovuline
can make it a lot easier. In fact, women s health
apps have some of the highest number of sub-
scribers of all health apps.
Mukooza, who uses Kindra, says it has made
this method so much easier to keep track of
temperatures and her history. It also gives her
a community of other women using the app
for the same purpose.
Having that kind of community is important
because many of these women say they don t
feel supported by their family or friends in
their choice of birth control. (CNN.com)
For birth control, what's old is new again
Many experts caution that Fertility Awareness Methods
(FAM) is one of the least successful methods to use,
because it can be so complicated to do correctly.
YOUR DAILY HEALTH
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