Introduction
During the days leading up to ovulation, cervical mucus leaves
the vagina when the woman is in the upright position and as she
moves about. The mucus is observed at the vulva:
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By the changing sensations of the vulva over the whole day.
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By direct inspection of visible mucus from time to time.
The recording of these observations is made at the
end of each day. The record reveals the patterns of infertility
and fertility.
The pattern of fertility is a changing pattern. The pattern
of infertility is an unchanging pattern. Both of these patterns
follow the hormonal patterns which control sperm survival and conception
and therefore provide reliable information for achieving or postponing
pregnancy.
The anatomy of the female reproductive system is illustrated in
Figure 1. Features worthy of note are:
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the cavity of the uterus where the baby develops for 9 months;
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the cervix which produces the mucus which is responsible for
the vitality and health of the sperm cells;
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the vagina; the Pockets of Shaw;
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the vulva which senses the presence of mucus as it flows from
the vagina;
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the ovaries which contain the full complement of egg cells.
The follicles in the ovaries produce the hormones which are
responsible for the growth of the endometrium and its preparation
for pregnancy, the activation of the cervix and the production
of the mucus, and the cyclical changes in the function of the
vagina and the fallopian tube.
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The requirements of fertility are:
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A satisfactory ovulation.
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Healthy fallopian tubes which allow the passage of sperm cells
to meet the ovum and then nourish and assist the embryo to proceed
to the cavity of the uterus for implantation.
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A healthy endometrium for implantation.
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An adequate cervical function to produce mucus which will enable
healthy sperm cells to navigate the genital tract.
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Emotional harmony between husband and wife facilitates conception.
Figure 1. The female reproductive organs.
Keeping a Record
A daily record of observations made
at the vulva is essential for the Billings Ovulation Method. The
recording is made in the evening of the most fertile characteristics
noticed throughout the day. The first record, which is begun immediately,
is usually of 2 - 4 weeks duration and is made without any genital
contact so that the observations will not be confused by any secretions
due to intercourse or contact. The resulting chart provides information
for the husband and the opportunity for communication and decisions.
There must be no internal examinations made as these will be confusing.
Coloured stamps or symbols are used to make the recordings and underneath
each stamp one or two words are written, if the woman is literate,
which describe the sensation at the vulva and the appearance of
the mucus.
A helpful question to an anxious woman is to ask her how she knows
when menstruation begins. She will readily admit that she both feels
and sees the bleeding as it arrives at the vulva. The event is recorded
with a red stamp or the symbol
(Figure 2).
The recording of sensation and appearance will then be made of
all other observations the woman makes at the vulva. As the days
go by she will recognize her patterns of fertility and infertility,
according to the patterns of discharge.
Figure 2. Menstruation, (i) indicated by
a red stamp, (ii) indicated by the symbol
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Wet |
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Sticky |
Dry |
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Following menstruation the cervix is occluded with a thick, dense
plug of mucus which prevents the passage of sperm cells into the
cervix and which also protects the body from infection. The sperm
cells which are kept out in the vagina very quickly become incapable
of fertilizing the ovum and are destroyed by surrounding cells.
The ovaries are quiescent at this stage. There is nothing leaving
the cervix and the vulva feels dry. Nothing is felt and nothing
is seen. The recording of this observation is made with a plain
green stamp or the symbol 
(Figure 3).
Figure 3. Basic Infertile Pattern of dryness.
There is no entry of sperm into the cervix because of a thick dense
plug of mucus
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Wet |
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Dry |
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Following intercourse, the discharge of seminal fluid from the
vagina may last for 24 hours and be felt as a wetness at the vulva.
This seminal fluid contains no live sperm cells. They will
have been destroyed within an hour or two in the vagina when the
cervix prevents them from entering the uterus. |
