Several years ago, a colleague began developing a historical timeline of fertility awareness research findings, technologies, and publications. What started as a personal project grew and she solicited feedback from several FABM professionals, myself included. I understood the importance of such a timeline and its contribution to furthering awareness about the benefits of fertility awareness among both health professionals and consumers alike. While the original document is available and accessible online, I felt that there were still gaps in the history being told.
What follows is a timeline that has been expanded from the original, with additional research, as well as information and events relevant to Hebrew speakers in Israel (Any item marked with an asterisk [*] in the Line # column refers to milestones that have either been added or modified from the original).
I felt inspired to expand on the original outline for a number of reasons. First and foremost, most people, including medical professionals, are not aware of the historic and scientific development of FAM and other Sympto-Thermal Methods. It will surprise many to learn that FAM/STM variations are not something new and that they are based on research that has evolved during the past 160 years! The timeline provides a valuable context for understanding the progression and accumulation of knowledge about the human body, hormones, the menstrual cycle, and fertility potential over a wide stretch of time. The scientific journey is far from over, as researchers, for example, continue to discover new hormones and their connections to a vast array of functions in the human body.
The bottom line is this: We have an extensive body of knowledge that both clarifies and confirms the science behind FAM and other STMs while conferring its credibility as a legitimate tool for those interested in natural, evidence-based approaches to fertility planning.
| Line # | Year | Milestone/activity description |
| 70* | 2020 | Richard J. Paulson writes an editorial in Journal of Fertility and Sterility, Fertility Awareness 2020, advocating for the inclusion of fertility awareness education in all health curriculum. In the same issue, Diana Rudick advocates for the medical community to move from a “sex-ed” to a “fertility-ed” holistic approach to reproductive education. |
| 69* | 2020 | The second edition of Taking Charge of Your Fertility and Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body by Toni Weschler were translated into Hebrew (Israel). |
| 68 | 2019 | A prospective study of the family planning app Dot for pregnancy prevention finds that the app is as effective as other modern methods of contraception. “Their study, published in the European Journal of Contraception and Reproductive Healthcare, is the first to test a fertility app using best-practice guidelines for assessing the effectiveness of family planning methods. (13-cycle Perfect and Typical-use Effectiveness of the Dot Fertility App; Results From a Prospective Contraceptive Trial).” |
| 67 | 2018 | “Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review” is published. Their conclusion is that “[s]tudies on the effectiveness of each fertility awareness-based method are few and of low to moderate quality. Pregnancy rates or probabilities varied widely across different fertility awareness-based methods (and in some cases, within method types), even after excluding low-quality studies. Variability across populations studied precludes comparisons across methods.” |
| 66 | 2018 | The FDA allows the marketing of the first direct-to-consumer smartphone application (Natural Cycles) for contraceptive use to prevent pregnancy. |
| 65 | 2018 | A study out of India concludes that study participants were able to accurately identify their fertile window through salivary ferning tests with a basic microscope. |
| 64 | 2016 | Researchers at Columbia University Medical Center review 108 free menstrual tracking smartphone apps and conclude that 95% “of (these) apps for patient use are inaccurate. Few cite medical literature or health professional involvement.” |
| 63 | 2013 | Tempdrop, the first wearable BBT sensor, is founded and sold commercially. |
| 62 | 2013 | FAN is re-organized and re-branded as the Association of Fertility Awareness Professionals (AFAP). It is a membership organization for Fertility Awareness professionals who teach in secular contexts, as well as other people who support the work. |
| 61 | 2013 | Ida Tin, founder and CEO of Clue, coins the term “femtech” (a portmanteau of “female technology”) to describe the rising market sector of wearable gadgets, applications, and other technology designed for women’s health monitoring. |
| 60* | 2011 | The first edition of Taking Charge of Your Fertility is published in Hebrew (Israel) |
| 59 | 2011 | Sarah Bly, through Grace of the Moon, begins offering a two-year FABM teacher training. It is the first AFAP-recognized teacher training program in the United States. |
| 58 | 2010 | Dr. Marguerite Duane connects with Dr. Bob Motley to start the Fertility Appreciation Collaborative to Teach the Science (FACTS), an initiative dedicated to teaching healthcare professionals about FABMs and the science behind them.
[It is important to note that, while FACTS presents itself as evidence-based and uses secular language in its materials, FACTS is ideologically aligned with natural family planning – specifically, the Creighton Model. Dr. Duane, herself, is a certified Creighton Model practitioner and is an associate scholar with the Charlotte Lozier Institute and a speaker for the Catholic Information Center. The reason why FACTS is included in this document is because it is the only organization that advocates for FAM education and training for medical students and -professionals in the United States.] |
| 57* | 2010 | Gunther Freundel (Germany) publishes Efficacy of Natural Family Planning Methods, a literary and historical review of the development of methods of contraception and natural family planning. |
| 56 | 2009 | A pilot study is published that suggests that healthy individuals with regular cycles can accurately observe their cervical pupil (os) and thereby determine their fertile window. The observed fertile window was, on average, three days long, “which is significantly shorter and more consistent than when defined on the basis of the vulvar mucus method.” |
| 55* | 2008 | Ovulation is captured on camera for the first time in a British hospital |
| 54* | 2008 | Piper and Knight publish Fertility Awareness Methods of Family Planning for Achieving or Avoiding Pregnancy, an article that comprehensively reviews natural methods of contraception and conception |
| 53 | 2007 | “The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: a prospective longitudinal study.” is published. Referred to as the Frank-Hermann study, it is considered a methodologically strong, moderate quality examination of the effectiveness of the symptothermal method for pregnancy prevention. |
| 52 | 2006 | Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body, by Toni Weschler, is published. It is the first commercially published resource on secular fertility awareness for teenagers. |
| 51 | 2005 | Michal Schonbrun founds Poriutivit (“Natural Fertility”) 20 years after her teacher training, which becomes the first AFAP-recognized teacher training program in Israel. |
| 50 | 2004 | The Garden of Fertility: A Guide to Charting Your Fertility Signals to Prevent or Achieve Pregnancy – Naturally – and to Gauge Your Reproductive Health, by Katie Singer, is published. |
| 49 | 2004 | A Cochrane Systematic Review is published, stating that “The comparative efficacy of fertility awareness‐based methods of contraception remains unknown. Despite intensive training and ongoing support, most participants in these trials discontinued prematurely. Contraceptive methods should be properly evaluated, preferably in randomized controlled trials, before adoption and dissemination.” |
| 48 | 2003 | Following the publication of their first book (Patterns, in 1982), Barbara Kass-Annese and Hal C. Danzer publish Natural Birth Control Made Simple. |
| 47 | 2002 | The New No-Pill No-Risk Birth Control, by Nona Aguilar, is published. |
| 46 | 2001 | Barbara Feldman passes away, and Ilene Richman becomes the director of the Fertility Awareness Center. |
| 45 | 2001 | Georgetown University’s Institute for Reproductive Health validates the Two-Day Method of natural family planning. |
| 44 | 1999 | Georgetown University’s Institute for Reproductive Health introduces the Standard Days Method (SDM). SDM designates “a fixed set of days in each menstrual cycle” wherein someone could become pregnant if they had unprotected intercourse. (Today, SDM is taught and practiced through the use of CycleBeads, CycleBeads Online, and CycleTel.) |
| 43 | 1999 | Georgetown University’s Institute for Reproductive Health introduces the “TwoDay Algorithm,” the precursor to what will become the Two Day Method of natural family planning. |
| 42 | 1995 | Taking Charge of Your Fertility (first edition) by Toni Weschler, is published. |
| 41* | 1994 | Erik Odeblad publishes an article on the discoveries of the molecular structure of natural secretion and defines 7 types of natural secretions in the cervix. The study began in 1959 and was published in 1994. |
| 40 | 1990 | A group of American and Canadian women organize themselves into the Fertility Awareness Network (FAN) as a way to build community, share knowledge, and develop the professional field of secular fertility awareness educators. |
| 39 | 1987 | Fertility: A Comprehensive Guide To Natural Family Planning, by Elizabeth Clubb and Jane Knight, is published. |
| 38 | 1987 | Geraldine Matus, PhD, develops the Justisse Method, a symptothermal FABM. Justisse Healthworks for Women – the non-profit organization that teaches the Justisse Method – is the first AFAP-recognized teacher training program in Canada. |
| 37 | 1986 | Valley Electronics GmbH is established in Murnau, Germany, and begins selling the Lady Comp (billed as “the first family planning computer in the world”). |
| 36* | 1984-5 | Toni Weschler and Michal Schonbrun train as FAEs at the former Los Angeles Regional Family Planning Council. |
| 35* | 1982 | An analysis of the use-effectiveness of fertility awareness methods of family planning among clients in a San Diego, California, clinic reveals a 12-month failure rate (life-table method) of 13·2 failures per 100 women. This is comparable to results from previous studies of the use of fertility awareness methods (as defined by the sympto-thermal method) in developed nations. Also consistent with previous studies is the finding that fertility awareness method users tend to be young and well-educated. Motivational factors are identified as being most closely associated with successful use of this method of family planning.
Patterns – The Fertility Awareness Book, by Barbara Kass-Annese and Hal Danzer, is published in June. |
| 34 | 1981 | “A New View of a Woman’s Body” is published by the Federation of Feminist Women’s Health Centers (Los Angeles). It includes discussion about FAM in the chapter on birth control. The booklet also illustrates the full clitoris, something that was only verified in the scientific research literature year later, around 2007. |
| 33 | 1981 | Barbara Feldman founds the Fertility Awareness Center in New York City. She is credited as one of the first teachers of secular fertility awareness in the United States. |
| 32 | 1981 | The Malteser Arbeitsgruppe NFP is established in Germany. |
| 31 | 1980 | Sister Hanna Klaus establishes TeenSTAR (Sexuality Teaching in the context of Adult Responsibility), an adolescent sex education program that teaches NFP. |
| 30 | 1980 | The Creighton Model (FertilityCare) is developed and publicized by Dr. Thomas Hilgers, “the founder and director of the Pope Paul VI Institute.” The Creighton method is a cervical-fluid-only method of natural family planning. |
| 29 | 1979 | A Cooperative Method of Natural Birth Control, by Mary Nofziger, is published. |
| 28 | 1975 | Lunaception, by Louise Lacey, is published. |
| 27* | 1970s | Dr. Anna Flynn, one of the founders of the NFPTA in England and the NFPTAI in Ireland, develops the double-check method. |
| 26* | 1971-
1975 |
Thima recommends the dual test method, which monitors both temperature and changes in cervical fluid to determine the beginning and end of the fertile period. |
| 25 | 1971 | The first edition of Our Bodies, Ourselves is published by the New England Free Press. 250,000 copies are sold, advertised primarily through word-of-mouth. |
| 24 | 1971 | The Couple to Couple League (a natural family planning organization that teaches the sympto-thermal method) is founded. |
| 23 | 1968 | Humanae Vitae, an encyclical on family planning by Pope Paul VI, is issued. |
| 22 | 1968 | Dr. Konald A. Prem uses a 19-day rule for women with regular cycles and a 21-day rule for women with irregular cycles. He later used only the 21-day rule and dropped the 19-day rule completely because of a few surprise pregnancies with [the previous rule]. |
| 21* | 1962 | Dr. Hartman discovers that sperm survives in a woman’s body for 3 days and the egg survives only a day. |
| 20* | 1960s | Austrian physician Dr. Josef Roetzer continues to develop the sympto-thermal method. |
| 19 | 1955 | Serena Canada (a sympto-thermal method of NFP/NFP organization) is founded by Gilles and Rita Breault. |
| 18 | 1953 | Drs. John and Evelyn Billings develop and begin teaching the Billings Ovulation Method (BOM) in Australia. The BOM is a cervical-fluid-only method of natural family planning. |
| 17* | 1949 | Kieff emphasizes the importance of combining temperature measurements and observations of secretions. |
| 16 | 1945 | A birth control calculator called the “Rythmeter” is produced by Gilmore Lee Tilbrook. The Rythmeter and its accompanying instructional booklet reflect a better understanding of the menstrual cycle and was used to help people calculate their fertile period. |
| 15 | 1941 | W. W. Greulich becomes one of the first to provide usable data on the time of ovulation in relation to the basal body temperature through performing and observing operations on the ovary and reporting the microscopic observation of excised corpora lutea. |
| 14* | 1932 | The Rhythm of Sterility and Fertility in Women, by Dr. Leo Latz, is published.
This book describes for the first time the Catholic Safe Days method as a method of family planning. The use of the term “safe days” is first described and Ogino’s theory that ovulation always occurs about two weeks before menstruation is verified by Dr. Latz. During this time, the church opposed the idea that a woman should have control over her body to prevent pregnancy, believing that “it is impossible to play with a higher power.” |
| 13 | 1930 | The calendar-based Rhythm Method is created by Dutch neurologist John Smulders. He publishes his work with the Dutch Roman Catholic medical association. |
| 12* | 1924 | Van der Wald discovers that the cause of the increase in body temperature after ovulation is the corpus luteum. |
| 11* | 1923 | German researcher Knaus discovers that ovulation always occurs about two weeks before menstruation. |
| 10 | 1923 | Japanese gynecologist, Dr. Kyusaku Ogino, publishes his research on ovulation, asserting that the duration of fertility was the day of ovulation plus the preceding three days, except when there was a rare case of more extended sperm life. |
| 9 | 1919 | The Sex Side of Life: A Guide for Young People, by Mary Ware Dennett, is published. |
| 8 | 1905 | “Theodoor, Hendrik Van de Velde, a Dutch gynecologist, publishes a series of biphasic charts and notes that the length of elevated temperatures prior to menstruation is independent of the length of the menstrual cycle, thus demonstrating that the luteal phase is constant. He also makes the connection that the upward thermal shift is related to ovulation.” |
| 7 | 1897 | It is discovered that “ovarian extract” can be administered to postmenopausal individuals to alleviate hot flashes. This is considered the first reported use of hormonal therapy. |
| 6 | 1877 | “The Question of Rest for Women during Menstruation,” is published by Dr. Mary Putnam Jacobi. It won the Boylston Prize at Harvard University in 1876 and was published in 1877. For this study she had women record a number of physical items including their pulse rate and temperatures. Her paper showed that menstruation was not a sickness. |
| 5* | 1868 | Dr. J. Marion Sims compares the properties of cervical mucus with the properties of egg white by torturing enslaved black women and conducting surgeries on them without their consent. |
| 4 | 1868 | W. Squire first notes that basal body temperature shows a two-stage cycle pattern. |
| 3 | 1855 | ‘Dr. W. Tyler Smith, a member of the Royal College of Physicians in London, describes cervical mucus: “The use of the cervical mucus is probably twofold. In the first place, it closes the cervix uteri and defends the cavity of the fundus from external agencies as completely as though it were a shut sac.” That would be during the infertile times. Dr. Smith then continues to describe this mucus during the fertile phase of the cycle. “In the second place, it appears to afford a suitable medium for the passage of the spermatozoa through the cervix uteri into the uterine cavity.’ (Jan Mucharski, History of the Biologic Control of Human Fertility with a Foreword by Edward F. Keefe, MD, FACOG, 1982, 90.) |
| 2 | 1854 | “An English physician named George Drysdale correctly teaches his patients that the days near menstruation are the least fertile. [This is] the minority view for the remainder of the 19th century.” |
| 1* | 1837- 1847 | Observations concerning changes in cervical mucus secretions were published by French gynecologists Don (in 1837) and Pushe (in 1847). |
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איגוד המנחות העולמי לשיטת המודעות לפוריות
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