Cephalad shift of the cervix uteri sign of the fertile time of women. International Review of Natural Family Planning 1: 55, 1977.
Controlling their fertility by selective abstinence, a couple ask the question, in short, "Is it safe - today?" The answer, signs, will be "Yes", "No", or "Maybe". "Yes" days are those when it is certain ovulation will not occur before deposited sperm will have lost their fertility. "No" days are those when ovulation seems soon to occur "Maybe" days are those when it is uncertain whether ovulation is soon to occur or may have just occurred; in retrospect they will often have been "Yes" days.
The cervix is a built-in bioassay for estrogen and progesterone to answer the question stated above of the relative likelihood of a given day being fertile. A domestic chemical assay "to predict ovulation", moreover, is a futile dream because experience of 20 years with selfexamination of the cervix has shown that the daily progression toward ovulation is often erratic and varies from cycle to cycle and from woman to woman.
To reach her cervix, the woman passes two fingers through the vagina and presses down on the body of the uterus through the abdominal wall with her other hand if necessary. She observes the status of the cervix and collects a sample of the current secretion in the os between her fingers.
"Yes" days follow an ovulation up to the sixth day after the onset of menstruation, and even longer depending on the signs. On "Maybe" days, whether the couple allow coitus is determined by: (1) length of the fertilizing life of the sperm in a favorable cervical environment (as yet unknown), (2) need to avoid a pregnancy, (3) sexual drive of the marital partners, (4) skill in examination and interpretation of the signs, (5) variability of signs from cycle to cycle, (6) confidence of the couple in the method.
One can not measure effectiveness of cervical examination statistically because it is used not in isolation but with temperatures and consideration of previous "cycle-patterns"; moreover the couple is permitted to apply abstinence with variable care on "Maybe" days. However the examination is gaining popularity, especially in the "special conditions", postpartum, lactation, and the climacteric.
Most women when they realize the usefulness of self-examination overcome their fastidiousness about it. The attitude of a teacher influences its acceptance. Sometimes the husband makes the examination and the couple share responsibility for interpreting the signs.
by Edward F. Keefe, M.D.
Edward F. Keefe M.D. has promoted control of fertility by selective abstinence since 1948 when he developed an open-scale thermometer for women and began to teach the role of cervical mucus as a guide to fertile time. Since 1958 he has taught the changes in the cervix itself and direct collection of mucus from the cervix.
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