North American Registry of Midwives (NARM) Practice Exam

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In the Billings method, how many days after ovulation are counted as fertile days?

  1. Five days

  2. Three days

  3. Seven days

  4. Ten days

The correct answer is: Three days

In the Billings method of natural family planning, the fertile phase is determined by observing changes in cervical mucus and is primarily centered around ovulation. The principle behind the method is that cervical mucus alters in consistency and volume in relation to hormonal fluctuations throughout the menstrual cycle. After ovulation, the cervical mucus typically changes and becomes less hospitable to sperm. Studies indicate that the sperm can survive in the female reproductive tract for up to five days, but the highest fertility window is usually within three days following ovulation. This is primarily because ovulation itself marks the peak of fertility, and the days immediately afterward are when the conditions align best for achieving conception. Therefore, the fertile days counted are three days after ovulation, during which the chances of conception are highest due to the presence of fertile cervical mucus and the viability of sperm. This is why this particular option is aligned with the principles of the Billings method.