DO NOT APPLY WITHOUT CONSULTING YOUR NFP PROVIDER
ACTIVITY #10:
BASIC MUCUS RULE (BMR)--INFERTILE PATTERN OF DRY
The Basic Mucus Rule: once there’s a change from dry, assume fertility until Peak Day and for 3 days
afterward. If the fourth day after Peak Day is dry, assume infertility in the evening on PEAK + 4.
Peak Day is the last day of any trait of EW-M (T, OT, G, 1") or L or non-menstrual bleeding. If no EW-M or L
could be seen or felt, Peak Day is the last day of any Sticky mucus (M) or Moist ( ) sensation.
To Avoid Pregnancy:
1.
Abstain from all genital contact on “fertile” days.
Fertile days: All days of Sticky-M, Moist ( ) sensation, EW-M, L, or Non-menstrual bleeding, and S, H, O,
W (M or EW-M) cervix until evening of Peak+4.
2. Restrict intercourse to evenings on “infertile” days.
Infertile days: All tissue-dry days (Ø), sensation dry (d), and F, L, C, Ø cervix, except those in the Peak
1.2.3 count.
Take care each day to do the tissue check before and after every voiding (day or night) and just before
sleeping, after bearing down.
If you are unsure or missed an observation, consider the day an EW-M day and count Peak+4 afterward.
If the fourth day is not dry, call your NFP Provider for further advice.
Intercourse is available in the evening of consecutive dry days only when crosschecked by the cervix as
described below.
Managing Discharge after Intercourse:
a. Alternate Dry Evenings Only: Any discharge the day after intercourse is considered fertile and charted
as observed. If you are dry the day after that, you may assume infertility again in the evening. The “Kegel
exercise” procedure described below may assist in this matter.
Kegel exercise: within an hour after intercourse, urinate (this aids against bladder infections). Then alternate
between bearing down and doing 10 to 30 Kegel exercises to force seminal fluid down. A Kegel exercise is
repeatedly contracting and relaxing the pelvic floor muscles as if one were stopping and starting urination. Wipe
away any post-intercourse discharge with tissue paper.
b. The Cervical Exam: The cervix should be checked at the end of the day and charted daily. If the cervix
is still firm, low, closed, and dry on the day after intercourse, you can assume infertility. Any discharge
should be your “same as always after intercourse” discharge.
If you are not presently cycling: these instructions may not be recommended once cycling resumes. Once you
notice a sustained temperature rise and can apply the Sympto-Thermal Rule, consult with your NFP Provider.
Example: The chart on the following page illustrates an application of Activity #10.
Activity 10: Basic Mucus Rule
This woman has long cycles and applies the Basic Mucus Rule (BMR) to the Relatively Infertile Time (RIT).
Whenever there is a change from dry, fertility is assumed. This means that whenever moistness or lubrication is
felt or mucus or egg white mucus is seen, fertility is assumed. If the cervix was charted, fertility would be
assumed with any change from F/L/C/dry to S/H/O/wet.
Fertility is assumed through the mucus episode and within the PK + 4 count. Peak is established as the last day
of the most fertile sign, crosschecking tissue and sensation. Remember that non-menstrual bleeding is treated as
EWM. If the woman is dry on PK + 4, infertility may be assumed that evening. Infertility continues, evenings
only, until the next mucus pattern is observed.
In the above example, the alternate dry evenings approach to managing seminal fluid was applied. Intercourse
may be assumed on consecutive evenings only if the cervix check is utilized and no change is observed.
When a temperature rise accompanies PK Day, the S-T Rule is given precedence over the BMR. Fertility is
assumed until the S-T Rule is fulfilled, even if the BMR is fulfilled earlier.
Directions: Use a wavy line to indicate the start of fertility. Mark in all Peak Days plus the 1.2.3.4 count
afterwards. Put a wavy line through the middle of Pk+4 to indicate that the infertile time begins that evening,
provided it is dry.
1.
When are you supposed to check
by tissue?
2.
What if you forget or just don’t
make all the tissue checks during
the day?
If you wish to avoid pregnancy,
intercourse is permitted:
___evenings only ___mornings only
___anytime
3.
4.
If you observe discharge on the tissue on the day after intercourse, how should you chart it?
5.
If you eliminate seminal fluid after intercourse (e.g., Kegel exercises), can you assume infertility the day
after intercourse if it is dry?
1.
When are you supposed to check
by tissue? Before and after urination
and bowel movements (day and night)
and just before going to sleep at night
after bearing down.
2. What if you forget or just don’t
make all the tissue checks during
the day? If you go by tissue alone, you
must chart EM-M and count PK + 4
afterward. This is a precaution in case
you missed a mucus observation.
However, if you are checking the cervix
and find it still firm, low, closed, and
dry, you could go by that and don’t
worry about having missed a tissue
check—but routine tissue checks at
every voiding, before and after, is best.
3. If you wish to avoid pregnancy,
intercourse is permitted:
/ evenings only ___mornings only
___anytime
4.
If you observe discharge on the tissue on the day after intercourse, how should you chart it? On its own
merits. Chart it “M” or “EW-M” and its traits. Don’t assume that it’s “just seminal fluid.” Tentatively assume fertility as if it were
mucus. If it’s your “typical” post-intercourse discharge, in terms of traits and time of day observed, and the day after that is again
dry, it was probably seminal fluid.
5.
If you eliminate seminal fluid after intercourse (e.g., Kegel exercises), can you assume infertility the day
after intercourse if it is dry? Intercourse is only available every other day even if dry if you are observing by tissue and
sensation. However, if you are skilled at the cervical check and find the cervix still firm, low, closed, and dry the day after intercourse,
then you can assume infertility again (you “bypass” the confusion introduced by seminal fluid).