Billings Ovulation Method

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Billings Ovulation Method

• Natural Fertility Regulation

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Billings Ovulation Method

• A natural way to
• Achieve Pregnancy
• Postpone Pregnancy
• Monitor Reproductive Health

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Billings Ovulation Method

• easy to learn
• simple to use
• no drugs or devices
• no side effects
• reliable
• morally acceptable to all cultures

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Male Fertility Sperm production begins at
puberty Production of sperm continues throughout
life
Female Fertility Begins from puberty Cyclic
potentially fertile for approx 5-7 days Finishes
at menopause


Couple Fertility
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THE FEMALE REPRODUCTIVE ORGANS
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THE OVARIES whose function is the cyclic
maturation of ova (eggs), produce hormones
oestrogen and progesterone
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FALLOPIAN TUBES tubes through which sperm cells
are assisted in their passage from the uterus to
the ovum (egg)
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FALLOPIAN TUBES the fertilized ovum (embryo)
is actively transported to the body of the uterus
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THE UTERUS - the organ of the female in which the
embryo implants and develops
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ENDOMETRIUM the inner lining of the uterus
which is shed at menstruation
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THE CERVIX the neck of the uterus which bears
the mucus-producing crypts
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THE VULVA the external parts of the female
genital organs. It is the sensing organ for
cervical mucus
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THE VAGINA the birth canal, the passage through
which the baby is deliveredThe lining of the
vagina has no glands
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POCKETS OF SHAW after ovulation, under hormonal
control, mucus is dried as it passes through the
vagina
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Keeping a Record

• Observations made at the vulva as the woman goes
  about her normal daily activities No internal
  examination
• Most fertile characteristic of day recorded each
  evening
• One or two words recorded to describe sensation
  and appearance Coloured stamps or symbols used
  on chart

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The woman will both feel and see the bleed as it
arrives at the vulva
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Sensation/Appearance of discharge
Menstruation, indicated by a red stamp or the
symbol ?
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Following menstruation cervix occluded with
thick, dense plug of mucus
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Plug prevents passage of sperm into cervix and
protects body from infection Sperm cells kept out
in vagina quickly become incapable of fertilizing
ovum and destroyed by surrounding cells
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The ovaries are quiescent Nothing leaving the
cervix, vulva feels dry
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BASIC INFERTILE PATTERN (BIP) UNCHANGING PATTERN
- DRY
DRY - nothing is felt, nothing is seen Recorded
with a plain green stamp or the symbol
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BASIC INFERTILE PATTERN (BIP) UNCHANGING
PATTERN - DISCHARGE
Discharge remains same day after day, cycle after
cycle Small fragments breaking off lower part of
plug results in discharge
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Basic Infertile Pattern of mucus remains the same
day after day, cycle after cycle.
Initially recorded with white baby stamp or the
symbol O Then recorded with yellow stamp or the
symbol when pattern is seen to be unchanging
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Basic Infertile Pattern of mucus remains the same
day after day, cycle after cycle.
Three cycles are studied in order to identify
correctly the point of change of sensation or
appearance of the mucus or both
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Basic infertile pattern of mucus remains the same
day after day, cycle after cycle.
There is no entry of sperm into the cervix
because of the plug of mucus This unchanging
pattern of infertility is common for many women
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Ovaries are active and are producing
oestrogen Cervix is stimulated fluid mucus is
produced,this frees the plug, sperm can now
enter cervix
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Change in sensation no longer dry Recorded with
white baby stamp or symbol O
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Change in vulval sensation or appearance of mucus
Ovaries are active and are producing
oestrogen Cervix is stimulated fluid mucus is
produced,this frees the plug, sperm can now
enter cervix
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CHANGING PATTERN OF FERTILITY
Changing pattern of fertility Ovaries producing
greater amounts of oestrogen Mucus progressively
changing to a wet, slippery sensation Clear
strings of mucus may be noticed
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CHANGING PATTERN OF FERTILITY
Maximum amount of mucus may diminish Slippery
sensation may continue for a day or two Last day
of slippery sensation the most fertile day of the
cycle - PEAK OF FERTILITY Very close to the time
of ovulation
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THE PEAK

• the last day of the slippery sensation
• associated with increased sensitivity and
  with swelling of the vulva

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THE PEAK
The ovary is now producing progesterone,preparing
follicle to shed ovum (ovulation)
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RECOGNISING THE PEAK
Peak is recognised on the day of change No longer
any lubricative sensation at the vulva Peak is
marked with a cross on the record
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Ovulation occurs on Peak day or days 1 or 2 after
Peak The ovum can live for up to 24 hours
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DAY 1 to 3 PAST PEAK
Cervix gradually closes with thick plug of
mucus Small channels remain through which sperm
can travel
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DAY 1 to 3 PAST PEAK
The three days following the Peak are markedwith
a numbered green or yellow baby stamp ora
numbered symbol or
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THE LUTEAL PHASE
From the fourth day past Peak, cervix is
closed Sperm cannot enter If not fertilized, the
egg will have disintegrated
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THE LUTEAL PHASE
Plain yellow or green stamps are now used or the
symbols for discharge or for dry
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MENSTRUATION
Occurs 11-16 days after ovulation Plug has left
the cervix allowing flow of blood Start of next
cycle
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Billings Ovulation Method
4 Rules
3 Early Day Rules Peak Rule
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Early Day Rule 1
Avoid intercourse on days of heavy bleeding
during menstruation.
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Early Day Rule 1
Reason
Ovulation might occur quite early in the cycle
and menstrual bleeding could obscure mucus
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Early Day Rule 1
Ovulation can occur as early as day 5 Menstrual
bleeding would obscure beginning of fertile phase
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Early Day Rule 2
Alternate evenings are available for intercourse
when these days have been recognised as
infertile. (Basic Infertile Pattern)
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Early Day Rule 2
Reason
Seminal fluid on the day following intercourse
could obscure the mucus. It is important to allow
time for the seminal fluid to disappear and to
confirm the BIP is still present by avoiding
intercourse on consecutive evenings.
If the woman is lying down the fluid mucus that
leaves the cervix in the beginning of the fertile
phase, collects in the upper part of the vagina.
The woman needs to be in an upright position for
a few hours for this cervical mucus to make its
presence felt at the vulva.
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Early Day Rule 2
Alternate evenings are available for intercourse
when these days have been recognised as
infertile. (Basic Infertile Pattern)
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Early Day Rule 2
Alternate evenings are available for intercourse
when these days have been recognised as
infertile. (Basic Infertile Pattern)
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Early Day Rule 3
Avoid intercourse on days of discharge or
bleeding which interrupts the Basic Infertile
Pattern.
Allow 3 days of BIP afterwards before intercourse
is resumed on the fourth evening. Rule 2
continues
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Early Day Rule 3
Reason
Waiting will enable the woman to either recognise
the Peak in which case the Peak Rule is
used.
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Early Day Rule 3
Waiting will enable the woman to either recognise
the Peak in which case the Peak Rule is used, or

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Or when the change is an interruption of the BIP
caused by raised oestrogens, the hormonal level
will return to a basic low level and the woman
will recognise a return of the BIP.
She counts 3 days to enable the oestrogens to
settle at the basic low level, before resuming
intercourse applying Early Day Rule 2
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Early Day Rule 3
or when the change is an interruption of the BIP,
caused by raised oestrogens Allow 3 days of BIP
before intercourse is resumed on 4th evening
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Peak Rule
From the beginning of the 4th day past the Peak
until the end of the cycle, intercourse is
available every day at any time.
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Peak Rule
From the beginning of the 4th day past the Peak
until the end of the cycle, intercourse is
available every day at any time.
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Billings Ovulation Method
Observation of Patterns Fertility Changing,
developing pattern of variable length Infertility
Unchanging pattern
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Rules for achievement of Pregnancy

• Apply the Early Day Rules
• Postpone intercourse until the slippery
  sensation occurs
• Intercourse should occur over the time of
  the slippery sensation and for one or two days
  after

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Rules for postponement of Pregnancy

• Apply
• The Early Day Rules
• The Peak Rule

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Billings Ovulation Method
4 Rules
3 Early Day Rules Peak Rule
Can be used throughout all stages of reproductive
life
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Billings Ovulation Method
Effectiveness Recent trials have reported
effectiveness greater than 99 when the Method
guidelines were followed for avoidance of
pregnancy
Indian Council of Medical Research Task Force on
NFP (1995) Jiangsu Family Health Institute,
China (1997)
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Billings Ovulation Method

• Requirements
• Accurate Observations
• Accurate Charting
• Motivation
• Loving co-operation

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Billings Ovulation Method

• Benefits
• Accurate, scientific, simple method of
  regulating fertility
• Increases knowledge, understanding and of
  respect for fertility
• Joint responsibility
• Does no harm
• Develops couple communication and
  relationships

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Billings Ovulation Method
Research began in 1953. Ongoing research has
confirmed validity of this safe, effective and
reliable method
Drs John and Evelyn Billings