Hesperian Health Guides

Natural Methods of Family Planning

In this chapter:


woman breastfeeding a baby while a man places a hand on her shoulder.

When a woman breastfeeds, her body produces hormones that prevent pregnancy for a few months. Breastfeeding is dependable for preventing pregnancy when:

  • The baby is less than 6 months old.


  • You are giving your baby only your breast milk, no other food or drink, and you feed your baby often, day and night.


  • You have not had monthly bleeding since giving birth.

Once you start giving your baby food or you get your period, breastfeeding will no longer prevent pregnancy.

Fertility Awareness

A woman can only get pregnant during her fertile time, when an egg comes from her ovary into her tube and womb. This time lasts for several days and happens about once a month. By avoiding sex during the fertile time, she can prevent pregnancy. (Or, if a couple is trying to get pregnant, they can plan to have sex during this time to increase chances of pregnancy.)

For this method to work, the woman must have regular menstrual cycles, and must keep good track of each stage of her cycle. The man must be willing to help make this method work too, because during fertile times, they must avoid sexual intercourse (sex with the penis inside the vagina). They can have other types of sex, like oral sex or sexual touching. Or they can use condoms during the fertile time.

This can be a good method for a woman who wants to limit the number of children she has. But sometimes the menstrual cycle changes unpredictably. People do not always keep track well so it is common to get pregnant using this method. Fertility awareness does not give any protection against STIs including HIV, which can be passed at any time of the woman’s cycle.

How to use fertility awareness

woman counting on her fingers and thinking.
I started my monthly bleeding 8 days ago so we cannot have sex today, or for the next 10 days. I better go to my sister’s.

Count the number of days of your menstrual cycle for a few months. Start counting on the first day of your menstrual period. The last day of the cycle is the last day before you bleed again. If you have about the same number of days in each cycle, and your cycles last between 26 and 32 days, this method can work.

Once you have counted your cycle for a few months and are sure your cycle is usually regular, then you can start using this method. Avoid sexual intercourse from the 8th day to the 19th day of every cycle. Or use condoms during that time. You must continue to keep good track of how many days have passed every cycle for this to work. If your cycle changes, use another method until your cycle becomes regular again for several months.

A woman’s body produces wet mucus in her vagina during her fertile time to help the sperm get to the womb. So checking the mucus every day can also help her know when she is in her fertile time.

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clear, wet, slippery mucus = fertile white, dry, sticky mucus = not fertile

Withdrawal, pulling out

When a man pulls his penis out of the woman and away from her genitals before he ejaculates (comes) they may be able to avoid pregnancy, if the man is very good at controlling himself and is committed to doing so. It does not work well for men who ejaculate unpredictably. Even if the man does pull out, some liquid that contains sperm may leak out of his penis and cause pregnancy. This method is probably not a good choice for people who are certain they do not want pregnancy. Pulling out does not protect against STIs.

Sex without intercourse

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There are many ways to be close to someone, to have sexual pleasure, and to show love besides sexual intercourse. Many couples practice oral sex: using your mouth to bring pleasure on the penis or the vulva. You cannot get pregnant this way. Sex in the anus (anal sex) also cannot cause pregnancy. But you can pass STIs, including HIV, during anal and oral sex. Using your hands to make someone feel good sexually is very safe. It cannot cause pregnancy and it cannot pass any STIs.

This page was updated:27 Sep 2018