The Centers for Disease Control (CDC) revised the statistics it presents on Fertility Awareness Based Methods of contraception (FABMs) earlier this year. The change is a significant improvement that more accurately reflects the failure rates for various FABMs, including the Symptothermal Method that many AFAP-certified instructors teach.
The Association of Fertility Awareness professionals ( AFAP) is very pleased to have been in correspondence with the CDC in the months leading up to the revision. The CDC is a federal agency in the US and the leading national health institute there. Its influence is global as it works closely with the World Health Organization and other international groups.
Previously, the CDC had characterised FABMs as having a failure rate of 24%, which is the rate often cited for the Calendar Rhythm Method. Now, the CDC cites a range of failure rates, 2-23%, and on its infographic (which you can download here) specifically names the Symptothermal Method, Standard Days, and the app Natural Cycles as “newer methods” that may be “easier to use and consequently more effective.” The old statistics are still widely cited in many CDC and government documents and web pages. However, the revised citation on the primary “Contraception” page of the CDC website is an important change that, with time, may permeate additional government-provided resources and other authoritative documents.
In March 2018, AFAP submitted a detailed, evidence-based letter urging the CDC to review and revise the information it presents about FABMs, which was delivered by Chelsea Polis, Ph.D., a member of the committee that drafted the letter. The CDC’s appreciative response noted that the “CDC does not produce estimates of contraceptive effectiveness, but rather uses published national estimates, which are periodically updated.” As the CDC predicted in its letter to AFAP, the new statistics on the webpage reference two sources: “Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review” and the updated chapters on contraceptive effectiveness and FABMs in the 21st edition of Contraceptive Technology.
Our letter was delivered after other organizations began a petition campaign to change the statistics, a petition that AFAP declined to endorse for a variety of reasons noted here.
In the current political and cultural environment in which provocative social media posts and click-bait headlines can drive conversations (often in less than productive ways), AFAP strives to provide evidence-based information accessible to all. We are gratified to have been heard by the CDC and will continue to look for opportunities where our voice and expertise can help people who cycle, and the providers who care for them, separate fact from fiction about FABMs.
The Association of Fertility Awareness Professionals Board of Directors
Anna Churchill, FAE
Lisa Leger, HRHP, FAE
Ilene Richman, MSW, FAE
Rosemary Roberts, MSc, FAE
