Scarleteen

I’m a midwife in the field since 1988. I have worked in hospitals, homes, and birth centers. I’ve provided family planning to gazillions of folks: everything from fertility awareness, to placing IUD’s, to referring for sterilization. I mention this because a lot of time people think midwives “just” tend to pregnancy. Anyway, this website will become my go-to recommendation for my young clients and parents who see me for care. It’s just wonderful, and it’s teaching me lots of ways to use inclusive language around sexuality.

I was perusing your Glossary (what a smart inclusion!) and bumped into something that concerned me though. It says (maybe under “charting”, but I forget now) that Fertility Awareness Methods of natural family planning aren’t reliable for contraception because, mainly, of cycle variation. I’m really sad to see this, because on such a well-informed site this is a surprising error.

Sympto-thermal fertility awareness methods (now supported by amazing smartphone apps, at least one of which is approved in Europe as a contraceptive) are extremely effective...equal to the real-life user effectiveness of oral contraceptives. This site is so good about laying out the realities of sex, I was surprised it hedged on this subject.

Tbh, it’s not how I’d want my own teenage kid to avoid pregnancy, since the stakes are so high at this time in life. And, sadly, because people don’t always have a say in when they are placed at risk of pregnancy. BUT I always want folks to know about this very empowering option for such times in their lives when it’d be exactly right.

It matters to me that people have autonomy. Knowing when in one’s cycle to avoid (or seek!) potentially impregnating activity, simply by understanding (and carefully recording) the ebb and flow of one’s body, is profoundly empowering and liberating. It can also be a beautiful way to help the partner who doesn’t have these cycles to understand the “tides” of their partner’s cyclic experience.

I hope you wonderful educators rewrite that section with the same amount of honesty, respect, and attention to current evidence as the rest of the material on your site. Knowledge is power, and that’s what y’all are clearly here to promote!

Your work here is, in my opinion, revolutionary. Bravo to you all!

Hi Catatonk,

Thanks for your kind words.

Our main piece on fertility awareness is here and would be the main source of information for any of our users interested in fertility awareness methods. We are able to go into more depth there around how effective FAM can be when sympto-thermal methods are used perfectly, how low the effectiveness can be for all charting when used typically and also the reasons why we wouldn't recommend it to young people visiting our site.

That glossary entry may have condensed this information to focus on what is most relevant to our audience, i.e. typical usage of charting in general, not just sympto-thermal methods, in the context of being a young person with less regular cycle, and the way loose understandings of FAM can pander to stigma or avoidance around far more appropriate methods for most of our users.

We do look to the latest research as much as possible for all these things.However we will make sure we take a look at the entries above and double check we are happy with them, updating them needed.

Hey there, catatonk: I'm off today, but I just noticed this.

Thanks so much for your lovely compliments: I always feel extra good about us when we make midwives happy.
Thanks, too, for that note about the glossary definition of charting. I looked at it, and I wasn't totally happy with it either, and I don't feel it's reflective of the way we usually talk about FAM here. It did link to an excellent and supportive article we have on FAM by a FAM educator -- Get With the Flow: All About FAM. We generally do make clear to our users that FAM often isn't great or likely to be as effective as it can be for the younger of them just because it's so uncommon for many still in their teens, especially in the younger teens, to have regular cycles yet. We also always advise our users to back up every method with condom use anyway, since STIs are just as big of a risk for users in this age group as pregnancy, sometimes even greater.

But that definition wasn't how I'd like it either. Looks like it may have gotten updated somewhere alone the line and I think I may have missed the changes when it did: my apologies, and thanks so much for bringing this to our attention so I could improve it.

I also didn't think all that text was even needed to just define charting, so I edited that definition today to instead read: "Charting: Methods for keeping track of fertility and/or menstrual cycles. Charting is often used by people who are trying to conceive, by those who like to keep track of this information to help them understand their bodies or moods better, and for other reasons. Charting is also an integral part of most kinds of natural family planning methods of birth control, also called FAM or "fertility awareness."

It retains two links to two of our articles on FAM. Thanks again!