Use of fertility awareness-based methods of contraception: Evidence from the National Survey of Family Growth, 2013-2017

Contraception. 2021 Aug;104(2):183-187. doi: 10.1016/j.contraception.2021.03.014. Epub 2021 Mar 21.


Objectives: Fertility awareness-based methods (FABMs) of contraception are rarely studied, although their use has increased in recent years. The objective of this study was to examine the sociodemographic characteristics, contraceptive histories, and prospective fertility intentions of FABM users.

Study design: We used data from the 2013-17 National Survey of Family Growth (NSFG) to examine FABM use among female contraceptive users aged 15 to 44 (N = 6195). We conducted logistic regression analyses to evaluate the demographic characteristics associated with FABM use and whether FABM users differed from users of other contraceptive methods in their contraceptive histories and fertility intentions.

Results: Among this sample of contracepting women, 176 respondents (or, 3.4%) were FABM users. FABM users significantly differed from users of other contraceptive methods in their relationship status, education, parity, health insurance status, and religious affiliation. Controlling for relevant sociodemographic factors, FABM users had lower odds of ever using the pill (OR = 0.40, 95% CI = 0.23, 0.67), higher odds of discontinuing the pill due to dissatisfaction (OR = 1.68, 95% CI = 0.99, 2.84), and higher odds of expressing intentions to have (more) children (OR = 2.69, 95% CI = 1.31, 5.53) compared to users of other contraceptive methods.

Conclusions: Efforts to address the healthcare and contraceptive needs of individuals should consider the demographic characteristics, contraceptive histories, and fertility intentions of FABM users.

Implications: With growing rates of FABMs of contraception in the United States, better understanding FABM users is imperative for researchers and clinicians, alike. Advancing research on FABM use allows clinicians to better meet their patients' diverse health care and contraceptive needs.

Keywords: Contraception; Contraceptive history; Demographic characteristics; Fertility awareness-based methods; Fertility intentions.

MeSH terms

  • Child
  • Contraception Behavior
  • Contraception*
  • Contraceptive Agents, Female*
  • Family Planning Services
  • Female
  • Fertility
  • Humans
  • Pregnancy
  • Prospective Studies
  • United States


  • Contraceptive Agents, Female