We were so thrilled when NYC’s very own Well Rounded asked Katinka to be featured in a piece to cover Fertility Awareness. Katinka has been an avid promoter of FA based methods of family planning for years and has a mission to shed light on what fertility awareness can offer!
Here is the full interview.
Photo by Christina Emilie
How did you personally get into Fertility Awareness Method? What was your own awakening?
I was thinking of going to Med School after college and was interning with a holistic Doctor. There was a sign in her office that said “Come learn how your cycle works.” I was intrigued and signed up for the class. It was life changing. I couldn’t believe I was a 22-yr old woman and I didn’t know when I was ovulating, or that it was possible to have regular periods without ovulating, or that fertility awareness could be used effectively as birth control. I just kept thinking “How has no one mentioned this to me!”
Why did you start building it into your practice? Why do you feel it’s so important to help/guide women as they embark on this?
In my practice, I see women of all ages with all kinds of health and hormonal issues. A woman might come to me and tell me her blood work is normal, or that her Doctor can’t find a problem, but she’s having trouble getting pregnant, or having horrible cramps. I learned over the years that her fertility chart could give a more accurate picture of her overall pattern. FAM is not just about birth control or conceiving, it can be incredibly useful for identifying imbalances like sub-clinical thyroid problems, or too much stress impacting relative progesterone levels. I also noticed that for some women connecting with their cycles and becoming more aware of how their lifestyle impacted their symptoms was really empowering. We all know stress or diet can affect our hormones, but seeing your cycle lengthen change after increasing sleep, or cutting back foods with too many chemicals, is really powerful. It gives a woman a much deeper understanding of her body and how everything is connected.
Give us the basics of FAM. The elevator pitch of how to do it?
Well first let me tell you what its not. It not the “rhythm method.” Its not assuming you ovulate on day 14, or have a regular cycle. FAM is a way for a woman to know each day whether she’s potentially fertile by observing two basic fertility signals- basal body temperature and cervical fluid. To practice FAM, a woman takes her temperature before getting out of bed every morning, and takes note of her cervical fluid changes a few times a day. She records this info on her chart (either a paper chart or more commonly a fertility charting app). She can then apply a few simple rules to determine with accuracy when she’s fertile. Its really about living with your fertility every day and knowing what’s going on.
Why can FAM be a big asset to actually achieving pregnancy?
Many women don’t actually ovulate on day 14, or have regular cycles, so being able to time sex correctly makes a big difference. If you are ovulating, your temperature is lower in the first half of your cycle and your cervical fluid increases. Right before ovulation, there’s often a dip in the temperature and a peak in fertile cervical fluid (think eggwhites) that let you know when its best to plan sex.
After ovulation the temperature remains high for the rest of the cycle. If the temperatures don’t this could mean there’s a problem with progesterone or with ovulation. When I first started charting, my temperatures didn’t go from low to high each month. To my surprise, that I wasn’t ovulating, even though I was having regular periods. I was able to use that information to rebalance my system. I shifted my diet to include more health fats, and started to sleep more. Within some months I was ovulating again. When women come to me who have been unsuccessfully trying to conceive for several months, her chart can helps us determine what imbalances might be going on so she knows what to work on. And women who have charted their cycles over many years can often spot and correct subtle shifts in their fertility well before they become a problem.
What about using as postpartum birth control? is this a particularly good — or bad — time to start it?
I’ll be honest, it’s not a great time to start FAM. Irregular sleep patterns can make it difficult to chart waking temperatures accurately, and postpartum hormones will affect cervical fluid, especially when breastfeeding. Women who do want to start at that time really should seek the guidance of a certified FAM teacher to help learn the method. That said, many women do learn FAM during that time and use it effectively. Its really a personal preference, no birth control is perfect.
How effective is FAM, and what are the efficacy risks?
Studies showing the efficacy of FAM as birth control vary. Perfect use is often as high as 97-99%, on par with the pill. Typical use may drop to 85%.
What’s interesting is that the biggest efficacy risk is the commitment it takes to act in accordance with information your chart gives you. One of the benefits of FAM is that many women find it puts them in touch with their libido, but as nature would have it, you want to have sex most when you are most fertile. So if you want to avoid getting pregnant, you have to be 100% committed to using another form of birth control during that time or avoiding intercourse and getting creative. Still for many women, avoiding side effects of other forms of birth control or gaining an understanding of their hormonal health is worth the extra effort and attention it takes to practice FAM effectively.
How has the public perception changed about FAM over the time you’ve been exploring this area?
There’s a lot of interest! The increase in period tracking apps (there are over 100 on the itunes app store) means more women are used to charting their menstrual cycles, and many are deciding to chart their fertility signals too. There’s also a bigger cultural shift happening. While the pill was once considered a symbol of feminist freedom, many women now find a deeper sense of independence and control in knowing how their body works and not relying on a pharmaceutical company to navigate their fertility.
Give us a 3 step plan to get started using FAM.
(Note: If you are on hormonal birth control of any kind, you aren’t cycling so you need to come off if it before you start charting)
1. Download an App: Kindara is my favorite charting app by far, and it has a great online resources to help you learn how to chart, you can even reach an expert through the app when questions come up. Then get a basal body thermometer (you can order WINK which syncs with your phone through Kindara or a regular basal body thermometer on amazon).
2. Learn the method: There are two great books that I recommend -Katie Singer’s the “Garden of Fertility,” and Toni Weschler’s “Taking Charge of your Fertility.” We are also lucky to have the Fertility Awareness Center here in NYC so women or couples wanting to take a class can contact them.
3. Chart your fertility signals for at least 3 cycles: Then find a teacher or someone to discuss your charts with so you know you understand them before deciding if its right for you as Birth Control. If you are breastfeeding, coming off the pill, have just been pregnant, or are approaching menopause it may take some time for you to be able to chart accurately enough to use the method as birth control, but you can learn a lot about your body in the process and that alone is worth the effort!
Happy Charting! Look out on the blog here for future Fertility Awareness events hosted by Earth + Sky. And don’t forget that we offer one on one instruction and support for anyone interested in learning the Fertility Awareness Method.