The Billings Method of Birth Control

The Billings method is a form of natural birth control and may also be referred to as the Billings ovulation method, ovulation method, or cervical mucus method. This method of contraception (a type of fertility awareness method or FAM birth control) seeks to teach women how to recognize their own fertility patterns, so they can choose when to avoid sexual contact (to prevent pregnancy) or initiate sexual contact (in the attempt to conceive).

Pregnancy test on top of a calendar
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How It Works

The Billings ovulation method is based on your interpretation of your cervical mucus. Generally speaking, over the course of each menstrual cycle, cervical mucus changes in predictable ways. Specifically, cervical mucus often becomes clear and elastic about six days prior to ovulation (due to the influence of estrogen.) Ovulation is likely to occur on the last day that cervical mucus shows these properties.

After ovulation, cervical mucus is affected by the production of progesterone and becomes thick, sticky and opaque.

What This Method Teaches You

The Billings method teaches you how to understand your individual fertility pattern by analyzing your cervical mucus each month. This is easily done by taking a cervical mucus sample (by hand) every day and recording its quantity, appearance, and feel (as well as noting any other fertility/physical signs) on a daily chart. The appearance or feel of your cervical mucus may be described as dry, watery, sticky, creamy, watery, or egg-white like depending on where you are in your cycle.

The Billings ovulation method allows you to identify the fertile phase of your menstrual cycle by the presence of cervical mucus, and the sensation it produces at the vulva in the days leading up to ovulation.

Four Billings Method Rules

As per the Billings method, there are four rules to follow for natural contraception: three early day rules and the peak rule:

  • The early day rules have to do with the days leading up to ovulation. During this time, the cervical mucus tells you that you have begun your fertile phase. The peak rule applies once the peak day (ovulation) has been identified.
  • The peak day is often characterized by being the last day of "lubricative sensation" and occurs extremely close to the time of ovulation. According to the Billings ovulation method, you may be fertile for another three days, and menstruation should occur 11 to 16 days later.

The Billings ovulation method doesn’t require any form of rhythm counting, temperature taking, hormonal drugs, or devices, and it allows couples to share in the responsibility of natural family planning. The method's proponents say this natural birth control method can also be used from puberty to menopause, even while breastfeeding, and in women who don’t have regular menstrual cycles.

When Can't the Billings Method Be Used?

It is important to note that the Billings method cannot be used with hormonal contraception (like the pill) because these birth control methods affect the hormones that regulate natural fertility symptoms, like cervical mucus. When you begin the Billings method, it is best to abstain from sexual intercourse as you may confuse sperm and/or seminal fluid with cervical mucus.

It is essential that you have accurate knowledge and training of this natural birth method before relying on it to prevent pregnancy. The success of the Billings method is greatly dependent upon proper teaching, correct understanding, accurate cervical mucus observation and daily charting, mutual motivation, and cooperation between the couple.

It's important to note that your physician may not be familiar with this method. A 2017 study found that medical schools do not always include fertility awareness birth control methods as part of the OB/GYN curriculum, and many physicians are not confident in sharing information about these methods. You can get a better understanding and confidence by using an accredited Billings ovulation method teacher.


Not enough research has done to say for certain how effective the Billings method is in preventing pregnancy compared to methods such as birth control pills. However, according to clinical guidelines published in 2018, the unintended pregnancy rate after a year of perfect use varies in different studies from 0.4% to 5%. In common practice, though, it's 8%.

That's less effective than the pill and common methods of birth control. The authors suggested its use only in conditions where an unexpected pregnancy could be acceptable. They also instruct doctors to make sure the woman or couple is properly educated about the method and to offer reminders about methods of emergency contraception.

Bottom Line

The Billings method of birth control is a type of natural family planning that uses the evaluation of cervical mucus to predict ovulation. This and other fertility awareness method birth control can be used both to help prevent pregnancy and to predict ovulation when a woman wishes to conceive.

Methods such as the Billings method do not work for everyone and their effectiveness is dependent on careful instruction as well as motivation to accurately chart changes in your cervical mucus daily.

If it won't feel like the end of the world if you accidentally become pregnant, a strong advantage of this type of family planning is that there are no side effects, and you can use what you've learned when you wish to plan rather than prevent pregnancy.

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