Family Planning, Post-TEOTWAWKI, by Lisa F.

Bring to mind one of the post-TEOTWAWKI scenarios you most frequently imagine, be it the after-effects of a worldwide flu pandemic, series of natural disasters, economic collapse, or nuclear war.  Is this a world into which you’d want to bring children?  At least for the short-term aftermath, I bet you wouldn’t.  Not while you may be on the move or actively defending your retreat or community from danger.  However…”birds do it, bees do it, even educated fleas do it”…c’mon, sing along with me and Cole Porter…”let’s do it, let’s fall in love!”  As the song says, love is natural and often accompanied by relations that can result in babies being born.  What if the methods of contraception you had long taken for granted were not readily available?  If your bunker isn’t well-stocked with condoms, you’re probably out of luck.  Prescription contraception?  Won’t be available.  Medical or surgical interventions (think IUD or vasectomy) won’t be worth the risk, in the absence of ongoing qualified medical care, even if they are available. 

Of course, the best way to prevent unwanted pregnancy is abstinence.  But assuming that abstinence is not the preferred option, how can heterosexual couples engage in sexual intimacy including intercourse and prevent ill-timed pregnancy without contraception?  By observing the woman’s body’s natural function over time and planning intercourse during the days when she is not ovulating, that’s how.  Conveniently, this method also helps couples plan the optimum times to conceive a child as well.  Also known as Natural Family Planning (NFP) or the Rhythm Method, the essence of this approach is that women and their loving menfolk track the ovulation cycle and avoid intercourse or make sure to use a barrier method of contraception (diaphragm, vaginal sponge, condoms, all of which should be used with spermicide to be most effective) when the woman is ovulating.  How does one do that?

The first requirement for an ovulating woman is to understand your monthly fertility pattern or menstrual cycle.  (Men are fertile from birth, but women only become fertile after achieving sexual maturity, usually around age 12-13 and lasting until menopause, which may start between the ages of 40 and 60.)  Days of the cycle may be divided as follows:

  • days when you are fertile (able to get pregnant)
  • days when you are infertile
  • days when fertility is unlikely, but possible

Day 1 of the cycle is the first day of a woman’s menses, or period; the average cycle lasts 28 days, but a healthy cycle might last from 12 to 35 days and vary throughout a year or over a number of years.  The amount of time in the cycle before ovulation–crucial information for pregnancy planning,–aries from woman to woman and sometimes monthly for the same woman.  The period always starts (unless a woman is pregnant) in 14 to 16 days.  The period is the shedding of the blood and uterine lining that will not be needed, as there is no fertilized egg present.

Women with a regular menstrual cycle, which means they menstruate for the same duration each month with about the same number of days between the first day of once cycle and the next, have about nine or more fertile days each month. Should you not want to get pregnant, do not have intercourse on the days you are fertile or use a barrier method (condoms, diaphragm with spermicide, etc) of birth control (this could be a way of conserving your limited supply of barrier contraception, if you have any.)

The knowledge of when you are definitely or likely to be fertile is essential both for pregnancy planning and natural avoidance.   There are three ways to track fertility; they involve monitoring:

  • basal body temperature
  • the monthly calendar
  • cervical mucus

The most accurate method is to combine all three approaches.

Basal body temperature

The average human body temperature is 98.6 degrees, and most people have a consistent body temperature that is close to 98.6 degrees. Basal body temperature is your temperature when you first wake in the morning, before you start moving around a lot.  During ovulation, a woman’s body temperature rises, though usually by less than a degree.  By monitoring body temperature over time, a woman can learn what her basal body temperature is and be able to note when it rises.  This method requires a special thermometer, available at most drug and grocery stores; if you aren’t currently using one, you may consider adding it to your preparedness supplies.  Remember, ” two is one and one is none”, so think about purchasing a few.  Illness, alcohol consumption, or getting out of bed and moving around can all raise basal body temperature.

Most women have ovulated within 3 days of the temperature spike; you’re most likely to get pregnant 2-3 days before the temperature spike and 12-24 hours after ovulation.  This gives an average 6-day window of likely fertile days.  Sperm can live inside a woman for up to three days, which extends the window to 9 days.

Calendar Method

This method involves recording your menstrual cycle over a period of time, at least 6 months, to determine the pattern.  Projecting into the future, you may calculate the days you’ll be most fertile by subtracting 18 from the total number of days in your shortest cycle (for example, 26 days.) Take this number (in our example, it would be 8) and count ahead that many days from the first day of your next period, once you get it. Mark that date on your calendar; it is the first day you’re likely to be fertile.  Then subtract 11 from the total number of days in your longest cycle (for example, 32 days.) Count ahead that many days (in our example, it would be 21) from the first day of your next period. Mark this date on your calendar. The time between the two dates is your most fertile window and the time when you would want to abstain from intercourse or use a barrier method of contraception.  In our example, the window is 13 days, which is long but possible.

This method is the least reliable, so you should always use it in combination with the basal body temperature or cervical mucus method.

Cervical Mucus

A woman’s cervix, which is the portion of the uterus where is joins with the vagina, produces mucus; the presence or quality of this mucus is an indicator of ovulation. The menstrual cycle is driven by hormones, and the same hormones change the quality and quantity of this mucus.   For a few days after a woman’s period, there is no cervical mucus present.  As the egg starts to mature in the ovaries (this happens monthly for a fertile woman), cervical mucus increases and appears at the vaginal opening, cloudy and sticky.  Just before ovulation, the mucus become more copious, clear, and slippery (think egg whites.)  This is when you are most fertile.  About four days later, it should change again.  This method (really all three methods) requires the use of a calendar to record your observations.  Label each day “sticky”, “dry”, or “wet.”  You are most fertile at the first signs of wetness after your period ends.

Many couples who are trying to conceive purchase ovulation kits or fertility monitors from drugstores. These kits detect surges in luteinizing hormone, which triggers ovulation.  You could store some of these kits in your cache, but they are more for people who are trying to conceive than for people who are trying to prevent pregnancy.

Of course, times of significant stress (i.e. TEOTWAWKI) may disrupt a woman’s regular menstrual and ovulation cycle, so this method may not be 100% reliable.  The Center for Disease Control describes it as being 75 – 99% effective at preventing pregnancy (compare with condom use, generally accepted as being 85 – 98% effective); of course, natural family planning will not prevent sexually transmitted infections.  It is also worth noting that chances of conceiving or of  carrying a pregnancy to term diminish after age 35.  According to the National Institute of Health, “For women aged 35-39 years the chance of conceiving spontaneously is about half that of women aged 19-26 years.” (“ABC of Subfertility”, 2003.) Postmenopausal women are not able to become pregnant.

If the anticipated circumstances of your survival situation make it absolutely undesirable to encourage pregnancy (hopefully for a limited time), you will want to include a great number of condoms in your cache.  They take up little space but should be rotated like other perishable items; over time, latex breaks down and loses its strength and flexibility.  Condoms have expiration dates on the packaging.

Besides pregnancy planning and/or prevention, there are a number of other sexual health topics commonly covered in advanced first aid training that are beyond the scope of this article.  A crucial part of preparedness is training and practice; consider taking an advanced first aid or first responder course.  If your natural family planning doesn’t work, then you may need to know how to safely deliver a baby!