One book states that periodic abstinence was recommended "by a few secular thinkers since the mid-nineteenth century," but the dominant force in the twentieth century popularization of fertility awareness-based methods was the Roman Catholic Church. In 1905 Theodoor Hendrik van de Velde, a Dutch gynecologist, showed that women only ovulate once per menstrual cycle.
In the 1920s, Kyusaku Ogino, a Japanese gynecologist, and Hermann Knaus, from Austria, independently discovered that ovulation occurs about fourteen days before the next menstrual period.
In 1930, John Smulders, Roman Catholic physician from the Netherlands, used this discovery to create a method for avoiding pregnancy.
Smulders published his work with the Dutch Roman Catholic medical association, and this was the first formalized system for periodic abstinence: the rhythm method. ===Introduction of temperature and cervical mucus signs=== In the 1930s, Reverend Wilhelm Hillebrand, a Catholic priest in Germany, developed a system for avoiding pregnancy based on basal body temperature.
In the early 1950s, John Billings discovered the relationship between cervical mucus and fertility while working for the Melbourne Catholic Family Welfare Bureau.
Two speeches delivered by Pope Pius XII in 1951 gave the highest form of recognition to the Catholic Church's approval—for couples who needed to avoid pregnancy—of these systems.
Evelyn Billings, studied this sign for a number of years, and by the late 1960s had performed clinical trials and begun to set up teaching centers around the world. ===First symptoms-based teaching organizations=== While Dr.
In the 1970s they modified the method to rely on only mucus.
Billings is now known as the World Organization Ovulation Method Billings (WOOMB). The first organization to teach a symptothermal method was founded in 1971.
The next decade saw the founding of other now-large Catholic organizations, Family of the Americas (1977), teaching the Billings method, and the Pope Paul VI Institute (1985), teaching a new mucus-only system called the Creighton Model. Up until the 1980s, information about fertility awareness was only available from Catholic sources.
The first secular teaching organization was the Fertility Awareness Center in New York, founded in 1981.
Toni Weschler started teaching in 1982 and published the bestselling book Taking Charge of Your Fertility in 1995.
Justisse was founded in 1987 in Edmonton, Canada.
Although the Catholic organizations are significantly larger than the secular fertility awareness movement, independent secular teachers have become increasingly common since the 1990s. ===Ongoing development=== Development of fertility awareness methods is ongoing.
In the late 1990s, the Institute for Reproductive Health at Georgetown University introduced two new methods.
Toni Weschler started teaching in 1982 and published the bestselling book Taking Charge of Your Fertility in 1995.
This is similar to failures of barrier methods, which are primarily caused by non-use of the method. ==To achieve pregnancy== ===Intercourse timing=== A 2015 review found insufficient evidence to draw any conclusions about the effect of timing intercourse on the rate of live births or pregnancies, compared to regular intercourse. A study by Barrett and Marshall has shown that random acts of intercourse achieve a 24% pregnancy rate per cycle.
In 2019, Urrutia et al.
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