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The Billings ovulation method is a form of natural family planning. Users track fertility by paying attention to the sensation at the vulva and the appearance of any vaginal discharge. This information can be used to achieve or avoid a pregnancy by choosing when to have intercourse and when to abstain. There are no harmful side effects, and it uses no drugs or devices. Women can use this method during regular or irregular cycles, breastfeeding, or peri-menopause.
In trials method related pregnancy rates have ranged between 0% to 2.9%. In a recent trial in China 992 couples using the Billings Method were compared to 662 couples using the IUD. The method-related pregnancy rate amongst Billings users was zero and the total pregnancy rate was 0.5%. In studies up to the 1980's teaching related pregnancies ranged between 0% to 6%. Total pregnancy rates vary between 1 and 25%.. Reasons for a higher total pregnancy rate include misunderstanding the method, risk taking, ambivalence toward pregnancy, and deciding to become pregnant.
History
The first recorded observations of the relationship between cervical mucus and survival of spermatozoa come from the mid-19th century. The topic was not systematically studied, however, for almost another century. In 1948, Erik Odeblad was studying mycoplasms in the female genital tract. During the course of his studies, he noticed that cervical mucus changed in a predictable pattern through the course of a woman's cycle. He continued his study of the cervix.
Independently in 1953, Dr. John Billings discovered the relationship between cervical mucus and fertility while assisting the marriage consultant for the Melbourne Catholic Family Welfare Bureau. Some of the couples he worked with had serious reasons to postpone pregnancy, and followed the Catholic Church's teachings of only using natural methods of pregnancy avoidance. While Dr. Billings was familiar with the Rhythm and Basal Body Temperature methods, he felt there was a need for something more flexible and more reliable. He embarked on a study of medical literature, and found the mid-19th- and early-20th-century references to cervical mucus and sperm survival. He instructed women using the Rhythm method to avoid intercourse also on all days, and for a few days after, they noticed vaginal discharge. This resulted in a dramatic decrease in unintended pregnancies among these couples.
In the early 1960s, Dr. James Brown took a position at the Royal Women's Hospital in Melbourne, Australia. Dr. Brown had earlier developed the first tests to measure oestrogen and progesterone, and he used these tests to assist Dr. Billings in further study of the relationship between cervical mucus and fertility. Dr. Evelyn Billings joined the research team in 1965. By the late 1960s, the rules for identifying fertile days had been established and teaching centers began to be set up around the world. The method was called the Ovulation Method, to emphasize that the central feature of a woman's fertility cycle was ovulation, rather than menstruation. In the 1970s, a committee of the World Health Organization renamed it the Billings Ovulation Method.
Scientific verification of the Billings Method is ongoing. Dr. James Brown continued to study ovarian activity until his retirement in 1985. Dr. Erik Odeblad was acquainted with the Billings Ovulation Method in 1977, and reported that his research into the activity of the cervix confirmed all the conclusions made by Dr. Billings. Dr. Odeblad's research into the cervix and cervical mucus also continued for many decades.
Fertility
- A woman ovulates at only one time during her cycle, and an ovum can survive for only 12-24 hours.
- Cervical mucus enabling healthy sperm cells to navigate the genital tract is necessary for fertility
- Spermatozoa have an average life of only 3 days in the presence of fertile mucus, with survival of longer than 5 days being rare.
- Menstruation will occur about 2 weeks after ovulation.
How the method works
In the days leading up to ovulation the cervix responds to oestrogen by producing mucus capable of sustaining sperm survival. This mucus leaves the vagina as the woman is in an upright position. The mucus is observed through the sensation at the vulva and by looking at any discharge. Daily charting of these observations will reveal either an unchanging pattern indicating infertility or a changing pattern of sensation and discharge indicating fertility. Both of these patterns follow the hormonal patterns which control sperm survival and conception.
Billings Method teachers help women recognize and understand their signs of fertility. This can help in the early diagnosis and treatment of gynaecological disorders, and can contribute to a woman's reproductive health.
Notes
- Trials of the Billings Ovulation Method The Billings Method, Dr. Evelyn Billings & Ann Westmore, 2000, pg 215.
- Evaluation of the Effectiveness of a Natural Fertility Regulation Programme in China: Shao-Zhen Qian, et al. Reproduction and Contraception (English edition), in press 2000.
- Contraceptive effectiveness rates: James Trussell et al. (2000). Contraceptive Technology — 18th Edition, New York: Ardent Media. On-press.
- THE QUEST - leading to the discovery of the Billings Ovulation Method, Billings, J., Bulletin of Ovulation Method Research and Reference Centre of Australia, Vol 29 No.1 March 2002, pp18-28.
- The Discovery of Different Types of Cervical Mucus, Erik Odeblad, Bulletin of the Ovulation Method Research and Reference Centre of Australia, Volume 21 No.3 September 1994, pp3-35.
- Ovarian Activity and Fertility and the Billings Ovulation Method: Dr. James B. Brown, 2000.
- Cervical Mucus and their functions, Erik Odeblad, Journal of the Irish Colleges of Physicians and Surgeons, Vol. 26 No.1 January 1997.
- Teaching the Billings Ovulation Method, Dr E. L. Billings AM, MB BS, DCH (London), 2001.
- Part. 2 Variations of the Cycle and Reproductive Health, Evelyn L. Billings and John J Billings.
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