Natural Family Planning: From Prehistory to Modern Times (2019 Update)

Long before the development of the Pill -- seen as the biggest factor in women’s liberation and health -- the study of female fertility had made strides in understanding the menstrual cycle. Sadly, this history is overlooked precisely because of the industry surrounding artificial birth control, and because of this I wanted to share something that we should have made mainstream a long time ago.

Funnily enough, this particular article came about in my social sphere just a couple days after I began drafting for the original post. Regarding the sexist and racist history of birth control development, it spurred me to work even harder on sharing NFP's long history of studying and refining our understanding of our natural, God-given fertility.

Even better, this particular timeline is now updated! It’s crazy how much one can learn, even after discovering so much already. Just goes to show how underappreciated and misunderstood this topic is in modern times.

By contrasting the dark secrets of birth control history to that of NFP's enlightenment, I hope that it inspires women and couples who read this to reconsider their family planning and health options!

Prehistory

Prehistoric birth control is an under-appreciated topic, but we do have some clues as to what our foremothers and fathers used to space children. Aside from herbal abortions and alternative sex acts, families also heavily relied on breastfeeding. When breastfeeding is practiced a specific way (known as ecological breastfeeding), children can be spaced by as much as 3-5 years. This can be seen today in various hunter-gatherer societies, such as the !Kung people of Africa, or the Gainj tribe in Papua New Guinea. Breastfeeding itself is not fertility awareness, but it is likely that women saw the connection between frequent suckling of their infant/child, and their apparent inability to get pregnant.

As for objective observations of fertility signs: it is likely some societies at least understood the connection between the production of cervical mucus and pregnancy. Even today, grandmothers of the Bantu culture will teach their granddaughters about the role of the slippery secretions they make in bearing children, to better time intercourse for pregnancy. Dr. Evelyn Billings — co-creator of the Billings Ovulation Method for fertility management — also spoke of similar practices among hunter-gatherer societies, who live much the same way that their prehistoric ancestors did:

Many women around the world have discovered the significance of the mucus themselves and used it as a sign of their fertility or infertility long before scientific proofs became available. Several African tribal groups including the Taita, Kamba and Luo are known to have done so for generations; as have some Indigenous Australian communities.

This specific correlation made between secretions and pregnancy was an ancient prologue to the charting of cervical mucus as we know it today. Slippery mucus = fertility.  Not just science, but also ancient wisdom! And what a wonderful wisdom to have again after centuries of losing it.

Outside of cervical mucus, there was also the strong yet “mysterious” connection between menstruation and the ability to conceive. We often see this in cultures, both dead and alive, that celebrate a girl’s ascension into adulthood (and by default, the ability to reproduce) whenever she reaches Menarche (her first period bleed). It would make sense that our ancestors would have made this connection very early on, as is evidenced with various menstrual taboos and practices seen around the world today.

However, it would be many centuries before people better understood menstrual bleeding’s connection to female fertility and overall health, as well of that of cervical mucus and also breastfeeding.

Modern Times

Now we make a huge jump! After humans developed civilizations and gradually became more urbanized, much of our connection to our primal fertility was understandably lost. Interestingly enough, more in-depth studies of fertility -- especially that of women -- began in the 19th Century, during the Industrial Revolution. 

And even today, such study progresses. The mystery of the menstrual cycle and fertility has been uplifted, and NFP as we know it keeps getting better and better.

19th Century

1855 -- W. Tyler Smith observes that cervical mucus aids in transportation of sperm.

1868 -- J. Marim Sims first describes fertile cervical mucus as having an egg-white quality. He noted that it was crucial to study this further, so as to discern whether these secretions could affect survival of sperm within the woman’s reproductive tract.

         -- Dr W. Squire also discovers that women have biphasic temperature patterns throughout their reproductive life, as does Dr. Mary Putnam Jacobi in 1876 (A biphasic temperature pattern is when low temperatures jump up and remain high until they drop down lower again around menstruation). However, no connection was given to ovulation.

20th Century

1905 -- Dutch gynecologist Hendrick Van de Velde discovers the connection between ovulation and the biphasic temperature pattern. He also notes that the time between ovulation and menstruation is almost always consistent, no matter the length of the rest of the menstrual cycle.

1923 -- Japanese doctor Kyusaku Ogino made the discovery that ovulation occurs at a relatively consistent time before a woman menstruates: meaning that menstrual periods only occurred once an egg was released.  This would lead to the development of the Calendar Rhythm Method, using past cycles to calculate future days of fertility in a woman’s cycle. (Dr. Hermann Knaus would also independently make this discovery in 1929)

1926 -- Previously mentioned, Van de Velde discovers even more details about the post-ovulation phase of the cycle (now called the luteal phase). He shows that the corpus luteum (the leftover sac that held the egg before ovulation) was responsible for causing the biphasic temperature change from low to high. He also observed the occurrence of cervical mucus and intermentstrual pain around the time of a thermal shift.

1929 -- Catholic priest and physician Fr. Wilhelm Hillebrand begins to develop a practical temperature-based method of fertility awareness for his parishioners to use in avoiding pregnancy. By 1935, he creates this new method by combining temperature-taking with Calendar Rhythm.

1930s -- Dr. Rudolf Vollman develops the “Mean Basal Body Temperature Rule”, a temperature-only method to determine when ovulation occurs.

1950s -- Dr. Jan Holt develops the concept of "the post-ovulation infertile time begins when there are three temps higher than the previous six lower ones."  Dr. Gerd Döring uses this new concept to create the "earliest Six Last Low" rule to use temperature taking as a way to determine the start of fertility as well as it's end within the menstrual cycle.

1951 -- Dr. Josef Roetzer develops the sympto-thermal method, which combines temperature taking and a crude version of mucus observation. He refines his mucus observation technique in 1965 and also incorporates the observation of vaginal sensation.

1952 -- Dr. MR Cohen develops a detailed schemata on mucus traits, and how they relate to the length of survival of sperm within the reproductive tract. This would later be used as a basis for the future mucus only method, the Creighton Model System.

1962 -- Dr. Edward Keefe publishes observations of cervical changes in relation to ovulation. This knowledge will later be refined by other NFP advocates and doctors including the Couple to Couple League, SERENA, and Dr. Josef Roetzer.

1968 -- British neurologist Dr. John Marshall does field trials of the temp shift along with other scientists (starting in the forties), but is the first to develop a practical and easy method that can be simple enough to use by the common couple to differentiate low temperatures from highs, indicating when the infertile luteal phase begins.

1969 -- Sheila Kippley publishes her book Breastfeeding and Natural Child Spacing. It delves into how ecological breastfeeding can delay the return of fertility after childbirth, and the parenting practices involved to make it happen.

1970 -- Dr. V. Insler published a system that would differentiate the varying types of cervical mucus a woman could observe in her cycle.

1971 -- The Couple to Couple League, a Catholic organization that teaches the sympto-thermal method, is founded by Sheila Kippley and her husband John Kippley. They publish their first book on the method the following year.

1973 -- Drs. John and Evelyn Billings, using a mucus rating system similar to that of Insler's, fully develop a mucus-only method of NFP called the Billings Method. Although this method came out in the 70s, they had been studying NFP since 1954.

1974 -- Louise Lacey publishes her book Lunaception, which goes over how one can use light elimination techniques to normalize the menstrual cycle in order to "make the rhythm method work". She also (inaccurately) incorporates the use of temperature-based and mucus-based methods as well, making it somewhat like the Calender-Thermal Method of the 30s but more complicated and inaccurate. Still, this was one of the earliest secular books written on natural alternatives to birth control.

1980 -- SymptoPro's instructional approach -- based on Dr. Roetzer's work -- is officially approved by the doctor himself. They had been teaching, with the doctor's permission, since 1977. (Also the organization that this blog author teaches through!)

1985 -- After studying the Billings method and forming the Creighton Model System of NFP in the late 70s, Dr. Thomas W. Hilgers opens the Pope Paul VI Institute. This establishment would be the starting point of developing medically and scientifically based alternatives to ART procedures and artificial birth control for women's health.

1990s -- Nurses and physicians at Marquette University develop a new system of NFP that utilizes hormonal fertility monitors (specifically, Clear Blue Easy) and mucus observations. Today it is known as the Marquette Method.

1995 -- Toni Weschler, MPH, would start a secular grassroots movement for fertility awareness when publishing her first edition of Taking Charge of Your Fertility. Today many non-Catholic NFP groups and movements point to her book as their inspiration or starting point, although her methodology is not as accurate.

21st Century

2000s — Still, Weshcler’s work spurred other secular groups such as Red Tent Sisters and Fertility Friday to form up and spread fertility awareness to women at large. Other organizations, such as FEMM Health and Justisse sprang up to teach variations of the mucus only methods.

Around the second decade of the new millennium, many apps began coming out into the market relating to tracking periods and -- you guessed it -- charting menstrual cycles. Some predict fertility for you, some have the option of predicting it, and others are bonafide, digital charting. Most NFP organizations offer charting apps, or charting online, with a way to contact your instructor there should there be any questions.

Another great step forward with fertility awareness as a whole, was the development of fertility monitors. Clear Blue Easy is the most well-known brand for helping show when ovulation is approaching through hormone levels in urine, but as of late a few independent start ups have gone above and beyond that. I actually made a post here about the various fertility monitors on the market or those about to be. They go from simple to complex, and each are unique to what fertile sign they track and how. Even now, I keep seeing ads for new fertility tech I have never heard of before!

The 21st Century has also seen the spread of pro-fertility medicine, such as Natural Procreative Technology (as developed by Dr. Hilgers); more women seek natural options for their reproductive health as well, seeking out the aid of herbalists, naturopathic doctors, Traditional Chinese Medicine, and more. Women want more than just artificial hormones, IVF, and hysterectomy to help them with their ailments and demand better care.  Organizations -- such as The Guiding Star Project, Natural Womanhood, and FACTS about Fertility -- help with the spread of these wholesome options that seek to nourish fertility and work with NFP as a diagnostic tool, rather than to override or belittle normal health.

It seems then, that our present is focused on sharing this knowledge and making it more accessible as well as working to make it the new normal. We have our NFP methods and ways to use it for health: now it's all about reminding people that these (much better) options exist!

The Future

From lactating and child spacing to using apps and fertility monitors to track our cycles, humanity has made large strides in recent history to better understand and even appreciate fertility. This has reached even the medical sphere, giving women truly wholesome and respectful healthcare whether for infertility treatment, or for overall body literacy. Also, as stated above, NFP advocacy is gaining ground and working hard to spread awareness of these amazing choices.

So where do we go from here? 

Personally, I believe the next step is not just to educate the adult masses: but to make NFP the cultural norm for future generations. NFP should be as well known as birth control; fertility awareness should be body literacy shared and encouraged in basic health education; doctors should know just as much about charting as they do about putting in an IUD. Fertility awareness needs to be the basis for women’s and men’s health, to better serve people in their quest for safe and effective family planning, as well as informing them of their needs and options concerning reproductive health.

From what I have experienced and seen, we need to start passing the torch not just to younger adult advocates, teachers, and doctors: but to our very children.  As we work to teach adults about their options, we must work so that the youth already know of these options once they are of reproductive age. Imagine a world where a teen girl can bring in a simple chart to her doctor for her check ups, where a teenage boy can understand how his own fertility is a huge responsibility in the act of pregnancy: where a man or woman living on their own for the first time already know what so many older adults today do not!

In short, humanity's future needs what NFP can offer: and NFP's future within humanity relies on people speaking up for this reality as a normal part of our culture.

We've got the know how, we've got the tech, and we've got the voice. Let's make some use of it.

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References

(Note: you may have to google some organizations mentioned as I did not find it necessary to link directly to them)

Books:

A Couple’s Guide to Fertility (Chapter Seven: Background Information)

Taking Charge of Your Fertility (Epilogue)

The NaProTechnology Revolution (Chapter 1: Dissent and Discovery)

Lunaception: A Feminine Odyssey

Breastfeeding and Natural Child Spacing

The Seven Standards of Ecological Breastfeeding

Prehistory of Sex

The Billings Method: Using the body’s natural signal of fertility to achieve or avoid pregnancy (chapter 1)

Studies:

Gainj Women and Child-Spacing

!Kung Women and Child-Spacing

Cervical Mucus in Infertile Women

Online Sources:

SymptoPro's History Page

Fertility Friend’s “A brief history of fertility charting”

The Development of Natural Family Planning