[Final report: overall study of the Billings Ovulation Method]

In 1974-75 the Canadian natural family planning organization SERENA conducted an evaluation of the Billings ovulation method of family planning with a view to its possible incorporation into the SERENA program. The various phases of the study were intended to satisfy 6 SERENA objectives and were carried out through various means including use of the method by 34 couples between October 1974-December 1975 and completion of questionnaires by 32 of the 34 couples. Recruitment of couples to test the method was difficult partly because of the demanding record keeping requirements and partly because the couples recruited were satisfied with the symptothermal method and unwilling to substitute a new and unproven method for it. 16 of the 34 couples were 20-29 years old and 16 were 30-39. 7 couples participated for 4 or fewer cycles while 19 did so for at least 9 cycles. Many of the women reported difficulty in distinguishing between wet and dry days identifying the "peak" day identifying the type of mucus. 11 of 30 women reported they had still not overcome all their problems by the end of the study. The first objective was to verify that all participants understood the teaching of the Billings method. The second objective was to develop a French vocabulary for the method terminology. It was concluded that further experience with teaching and use of the method would be necessary before the adequacy of the provisional terminology could be definitely assessed. Study participants sent information on their cervical mucus and thermal shifts for 259 cycles which allowed comparison of the various symptoms of ovulation. Mucus was observed in 287 of 290 cycles studied suggesting that it is a common symptom most women could observe. Participants were able to distinguish sensations of wetness or lubrication during the stage of ovulatory mucus in 245 of 285 cycles. Very little difference was found in the length of the infertile period according to the Billings or the symptothermal method. The 4th objective verifying the efficacy of the Billings method could not be attained due to the small number of couples (9) who actually relied on the method. The 9 couples had 2 unplanned pregnancies 1 of which seemed to be due to method failure. The 5th objective that of informing participants of medical research on symptoms of ovulation was carried out throughout the study period by means of a monthly newsletter. The final objective was to determine what place if any the Billings method should have in SERENA activities. It was concluded that the method should be available in future programs but that it should be taught by couples not already committed to the symptothermal method.