If you only rely on this method for a few days each month immediately after the end of menses, the chances of it failing are MUCH lower than if you rely on it for a week prior and a week after menses.
That said, wiki claims[1] that the latter approach is >95% effective in perfect use, and 88% effective in typical use.
Compare this to withdrawal[2], which wiki claims is 96%/78% effective respectively.
[1]: https://en.wikipedia.org/wiki/Calendar-based_contraceptive_m...
> "fertility awareness" (on its own) is a less reliable means of contraception than most other options
You're absolutely correct, of course - but some people's situations don't require such a high level of reliability. For instance, my wife and I used the rhythm method for four years after marriage without incident, until we decided to try for our first child.
During that time an unexpected pregnancy would not have been unwelcome. We weren't where we wanted to be financially, but we would have been fine. Our ballpark assumption of a 10% chance of conception per year was an acceptable level of risk to outweigh the negatives of a barrier method or hormone-based option.
People capable of passing high school biology should also grasp the concept of a) "whoops!" and b) sex being enjoyable enough to risk even if ovulation is possible.
http://www.patheos.com/blogs/lovejoyfeminism/2012/11/lets-ta...
> According to the Guttmacher institute, the typical use failure rate of NFP is around 25%. Of course, Catholics have taken issue with this number, insisting that it is way too high. So I looked around and another number sometimes used for NFP’s typical use failure rate was 12%. One Catholic writer suggested that it was 2% to 5. Note that even that last number shows that the typical use failure rate for NFP is higher than IUDs and implants.
[1] http://www.contraceptivetechnology.org/wp-content/uploads/20...
That means fertility awareness has worse odds than Russian roulette.
I'm not the slightest bit interested in perfect use failure rates, because humans are rarely perfect (especially not the ones who think they are), and the consequences of a whoops are pretty immense, both for the couple and for the unwanted child that results.
Meanwhile, an implant has a 0.05% typical use failure rate, and an IUD 0.2%. I'm not taking any chances - I'm infertile, have had a vasectomy, and my wife has an IUD. My current set of twins (via donor sperm) are plenty of work for my liking.
But what other people do is of no interest or consequence to me. I know what I do, thus I am interested in perfect use rates. Which are better than condoms.
According to actual studies rather than people trying to push an agenda, failure rate is comparable to condoms: https://en.wikipedia.org/wiki/Comparison_of_birth_control_me...
http://www.cdc.gov/reproductivehealth/contraception/unintend...
Condoms are also pretty crappy in typical use, so I wouldn't consider that a success even if the number lined up. IUDs and contraceptive implants are massively more reliable than either in typical use.
That is because they are dishonestly presenting the data on the rhythm method and fertility awareness combined as fertility awareness. That is obviously silly, as one method is significantly more reliable than the other.
>Condoms are also pretty crappy in typical use
Typical use matters for population control, not for a responsible individual's personal use. I know if I am putting a condom on or not. The large percentage of people who do not put one on despite relying on them as their sole contraceptive does not lower the failure rate for me, it merely brings down the average failure rate across the population. Other people's failures do not cause me to fail.
Hormones cloud all sorts of otherwise reasonable judgement as well - I'm guessing if you pay attention, you'll notice it in yourself as well.
In addition, this can be dangerous for those that shouldn't get pregnant for health reasons, yet can't get sterilized (there are many doctors that won't sterilize childless people, nor folks that are young - and it is often not a covered procedure).
Folks that have reasonable intelligence, pass high school biology, and have a reasonable understanding of health should understand these down sides. A bit of understanding of risks and statistics would probably lead the person to assume it is a lesser risk to use another form of contraception or two.
there are many doctors that won't sterilize childless people, nor
folks that are young - and it is often not a covered procedure
I know it wasn't covered by insurance when I was younger (I'm in my late 30's), though I didn't know it would be somewhat risky for me to be pregnant at the time, if it is possible at all. I've simply never wanted children, and the procedure wasn't covered by insurances let alone finding a doctor that would do it. I don't know if they became something covered under the recent health care changes as I don't live in the states any longer. I'd often not been able to pay the copayment anyway, unfortunately.
From an insurance perspective, the cost-effective and less risky option is to do birth control, either pills, shots, or IUD's to prevent such a thing from happening, I'd think.
You don't need to have regular periods, I am not talking about the rhythm method, I am talking about fertility awareness. You accurately detect the hormonal changes which precede ovulation. It does not matter if you ovulate early or late, because you are detecting the changes that precede it, not guessing when it will happen based on days passed.
And there is absolutely no doctor who will refuse to sterilize a woman whose life would be at risk from pregnancy.