Talk:Billings ovulation method

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[edit] Comment

The information that I started the page with is considered accurate by the Billings Organisation. Any additional information added might not be considered accurate by the Billings Organisation. I also checked the source for the use related pregnancy rates and adjusted the statement for accuracy. The other unsourced information about total pregnancy rate is unsourced and appears unsuitable for a discussion of Billings alone since it does not measure Billings separately. Wanfactor 02:24, 22 December 2005 (UTC)

[edit] Proposed Infobox for individual birth control method articles

Let's all work on reaching a consensus for a new infobox to be placed on each individual birth control method's article. I've created one to start with on the Wikipedia Proposed Infoboxes page, so go check it out and get involved in the process. MamaGeek (Talk/Contrib) 12:14, 14 June 2006 (UTC)


"No religion objects no sex at ovulation. Whats special is that one of few permitted methods by observant catholics. NB fails meet all limitations for observant Orthodox Jews (seeNiddah))"
Most Billings users live in countries where Catholicism is not a major religion. The experience of Billings International is that most religions do not have moral objections to the BOM, and that it is acceptable to most women. From my reading of the Niddah article, it appears that the Billings could be used within that context, as Billings merely provides information about fertility, and does not 'tell' people when to have relations. Wanfactor 20:47, 15 July 2006 (UTC)
Fair enough - the issue for observant Orthodox Jews is that there is a prohibition of having sex within a set time from teh end of a period - so the week of the period & week after (ie the early part of the contraceptively "safe window") is prohibited, the week around ovulation needs be avoided, which leaves very little window for full intimancy if pregnancy is to be avoided (PS condoms generally prohibited). So whilst "Billings could be used within that context", it is only small part of approach taken. Furthermore I have never heard Billings mentioned in Orthdox Jewish "lifestyle" - the term seems applied only by Catholic Christians (its not a requirement of UK Church of England Prostastant values). Whilst, I guess, similar safe-window calculation is probably also applied by strict Muslims, again is it specificaaly and precisely the "Billings Method" the method or the term that they would use/recognise ? Fertility awareness approaches are taken by these groups - I just don't see them using/recognising this specific named ("Billings") method, especially as their carefully regulated/codefied practices far pre-date Mr Billings. David Ruben Talk 00:13, 16 July 2006 (UTC)

The problem with Niddah is that on mikveh night (when the woman's period of ritual impurity ends and she immerses in a mikveh - special bath) there is a mitzvah (not exactly a commandment, but strongly recommended) of having sex. And mikveh night is almost always going to fall during the fertile period, creating somewhat of a problem if a couple wanted to use any of the fertility awareness/NFP methods (including Billings) as their sole method of avoiding pregnancy. This issue is discussed here (near the bottom of the page) and I've seen another article (can't find it now) that suggested delaying the bedikot (cloth inserted into the vagina to help determine the end of ritual impurity) to attempt to put mitzvah night in the post-ovulatory infertile period; but implied that while that would be technically acceptable, it would be somewhat frowned on. Lyrl 14:45, 16 July 2006 (UTC)

The article you point to appears to endorse the use of natural family planning.
I doubt you would find most of the methods of family planning "recognized" by religions, though some religions may ban some methods. I do not consider it a defining characteristic of Billings that Catholicism endorses it (though does not require the use of it, you will not find a specific method referred to Church Teachings); rather, that is a defining characteristic of Catholicism. Unlike the other methods of natural family planning, Billings is used primarily in underdeveloped nations, to populations that are not predominately Catholic. The overall experience of teachers is that religious beliefs do not form a barrier to use of the method. "Most religions" does not imply "all religions", for example certain Catholics believe that even learning about fertility is immoral, and/or that the use of even natural family planning is sinful.Wanfactor 15:57, 16 July 2006 (UTC)
I do see your point on the users of Billings, but the headquarters organization is strongly Catholic, and the motivation for the development of the method was driven by Catholic doctrine. On the infobox - "most religions do not have moral objections" to any method of birth control, including the pill and condoms. I don't see how that is special to Billings, either. Lyrl 17:42, 16 July 2006 (UTC)
Interestingly enough, only 2 of the 4 people who started and have done the most work on Billings are Catholic. It was also my impression from what I have read on the introduction of birth control in underdeveloped nations that artificial methods (pill, condom) are often not well accepted by the people there (who are not necessarily Catholic) but Billings does not run into the same problems. Perhaps "Usable throughout a woman's entire life, in all economic circumstances" would be more Billings specific. Wanfactor 19:29, 16 July 2006 (UTC)

Are there contraceptives that can't be used at certain times in a woman's (reproductive) life? I suppose combined hormonal methods during breastfeeding, but nothing else comes to mind. As far as economic circumstances, I think I've read about the Two-Day Method and the Standard Days Method are being pushed for underdeveloped countries. Their teaching requirements are less than for Billings and Creighton (so less travel for students, and less money spent on facilities, teacher training, teacher pay, ongoing supplies such as charts and stamps, etc.) However, Wanfactor is right that such low-cost (especially over longer time periods) pregnancy avoidance methods are rare. Especially since it's not in the text anywhere, I'd support putting low-cost in the infobox. Then we could just avoid the religion issue altogether. Lyrl 22:36, 16 July 2006 (UTC)

I agree that we could drop the religion issue.
Billings is not unique in that it is low cost, but that it is both low-cost and universally usable. Standard Days is a variation of rhythm that works only during regular cycles, two-day method is much less effective than Billings, and also cannot be used at times of continual discharge (as far as I can tell). Most contraceptives are not usuable at all times. For example the Pill is not recommended for women with high blood pressure, the cervical cap is much less effective after a woman has had a vaginal delivery, condoms are not always available and typically cost money, IUDs cost money and should be inserted by medical personnel. If women plan to use hormonal forms of contraception, they should have access to a doctor to monitor their health and protect them from side effects. As far as paying for things, charting methods for Billings will reflect the literacy level and economic circumstances of the users. It is not necessary to purchase supplies, and the cost of training teachers is limited to the immediate costs of accomodation, travel, etc. As far as I can tell, the Billings method in unique in that it is suitable for essentially all women at all times during their lives, regardless of their personal health, access to medical services, literacy level, economic status, or what stage of their reproductive life they are in. Wanfactor 03:12, 17 July 2006 (UTC)

[edit] History

I spoke to Dr. Billings a number of years ago, I think it was in the 90's. He said that he got the idea for his method in 1950 and started research in 1951. I spoke to him at a pro-life meeting in the San Jose area. It was close to the Great America theme park. He had just finished a talk in one of the lecture rooms of the fancy hotel where the conference was being conducted.

Richard Bruce 00:58, 28 July 2006 (UTC)

The information in the history section is sourced from an article that Dr. Billings authored. I wouldn't be comfortable with putting in statements that he related orally that contradicted what he wrote. Lyrl Talk Contribs 02:13, 28 July 2006 (UTC)

[edit] Historical use of mucus by African tribes?

I've seen references online that the book by Evelyn Billings says that three African tribes and one Austrailian Aborigines tribe was discovered to have known the fertility significance of cervical mucus. This seems of historical interest, but I don't have the book and the online references are pretty disjointed, so I would be hesitant to write anything based off of them. I thought I'd put the suggestion here in case anyone has the book. Lyrl Talk Contribs 21:29, 12 August 2006 (UTC)

[edit] Billings As not "Natural Family Planning"

In accordance with WOOMB preference, I have changed the description from Natural Family Planning to Natural Fertility Regulation. This is beneficial for a couple of reasons 1) Not all BOM users are using this information to 'plan a family' and 2) the wikipedia entry on Natural Family Planning is not descriptive or relevant to the Billings Ovulation Method. I have also removed the paragraph on Natural Family Planning for the same reason.

18:20, 5 March 2007 (UTC)

[edit] Categorization - what articles should this one be grouped with?

This article has been categorized with other methods of fertility awareness since July 2006. It was recently re-categorized with coitus interruptus and sexual abstinence (diff). The old Category:Periodic abstinence has been nominated for deletion.

I feel this new grouping is less useful. Someone unfamiliar with methods of fertility awareness could previously read the intro paragraph to fertility awareness and then have a good idea what all articles in Category:Periodic abstinence were about ("determin[ing] the fertile and infertile phases of [the] menstrual cycle" and timing unprotected intercourse based on that information). I believe the new categorization scheme is not as useful as the old one - it only offers the information to the navigator that behavior modification is involved, like that involved in coitus interruptus. Nothing about fertility or the periodicity of the behavioral aspects. What do others think? Lyrl Talk C 20:19, 13 May 2007 (UTC)

There seems to be a rough consensus at Categories for discussion to put this article into a new Category:Fertility awareness. I'll leave this notice here for a couple of days, and if there are no objections, go ahead and create the new category. Lyrl Talk C 01:42, 22 May 2007 (UTC)

[edit] See also - Toni Weschler

Why is Toni Weschler listed in the "see also" section? I understand her book has greatly promoted fertility awareness - but, so did Pope Paul VI (author of Humanae Vitae, which declared "medical science should by the study of natural rhythms succeed in determining a sufficiently secure basis for the chaste limitation of offspring." ). Why should Weschler be listed and not others important to the spread of FA (such as John Billings)? Lyrl Talk C 03:03, 19 May 2007 (UTC)

Toni Weschler is primarily notable for teaching fertility awareness for over twenty years. Weschler's Taking Charge of Your Fertility is a groundbreaking reference manual for learning fertility awareness methods. Many people consider TCOYF to be the definitive manual on FA methods. Weschler didn't give a brand-style name to the methods she described in her book which is why there is no link to "her method" as with Billings et al. The reason we don't list John Billings is that the Billings ovulation method is linked. You haven't demonstrated that Weschler is not immediately relevant to various fertility awareness methods. Weschler has made fertility awareness methods her life's work. There is no reason not to link to her article from articles on fertility awareness methods. Joie de Vivre 03:27, 19 May 2007 (UTC)
Weschler did give a brand-style name to her sympto-thermal system (Fertility Awareness Method or FAM). I disagree that either making fertility awareness one's life work or being groundbreaking in the field of fertility awareness warrants a link in the see also section. But I see that Weschler has done both, and so does have a higher level of relevance than other possible topics/people. Lyrl Talk C 19:43, 20 May 2007 (UTC)

[edit] Prominence of Creighton Model in the text

I find it odd that the Creighton Model is presented in the introductory paragraph. To me, both the high-level placement of the text and the wording "developed from" imply that Creighton superseded or is otherwise better than Billings. I realize Creighton thinks their method is better than Billings, but there is actually significant dispute over this claim [1]. I would rather see a less prominent placement of the Creighton Model, and wording along the lines of "variation of" or "modification of" that does not imply sequential order as "developed from" does. Lyrl Talk C 19:51, 20 May 2007 (UTC)

I actually didn't know that, that Creighton thinks their method superior. I only meant to convey the chronological order, not that the newer method was superior. Frankly I tend to think that the Billings' had a better grasp on the concept than "the new guy" who made up a lot of silly words with odd capitalization and italics (NaProTECHNOLOGY, FertilityCare) to describe his method. I tried changing the wording but feel free to change it. Joie de Vivre 22:40, 20 May 2007 (UTC)
I like the new wording. I would like to see it in a subsection rather than the intro, but it doesn't really fit into any of the current sections. It should be fine like it is now.
I think Billings and Creighton just have different audiences - Billings worked with impoverished people in the third world - so things needed to be as simple as possible - focusing on pregnancy avoidance and simple infertility problems better timing could "cure". Creighton focused on the medical world in America, trying to make the method accepted to doctors who are impressed by such things as odd capitalization, and working on more complex infertility (and other cycle-related) problems that have nothing to do with poor timing. Lyrl Talk C 23:54, 20 May 2007 (UTC)
Good, I'm glad you like the wording. I was surprised to see that the CrMS requires the user, (this is a bit graphic) among other things, to do Kegels to physically expel semen. The Billings method seems more holistic in nature. Thanks for sharing the BOM comparison paper, it was very informative and it clarified the differences for me a good deal. Perhaps we can incorporate a contrasting description of these two mucus methods at some point. Joie de Vivre 00:18, 21 May 2007 (UTC)
Weschler recommends the Kegels, too. I agree it would be good to work up a contrasting description at some point. Lyrl Talk C 00:23, 21 May 2007 (UTC)

[edit] Recent changes to lede

I don't like the new changes. "Determining a woman's fertility or infertility" sounds like it is determining whether she is fertile at all, not where she is in her cycle. The de-emphasis on its historical roots as Catholic NFP do a disservice to the article. I would like to hear arguments for keeping these changes otherwise I think a revert is in order. Joie de Vivre 02:31, 23 May 2007 (UTC)

The opening paragraph was phrased quite awkwardly, and I consider the changes an improvement - though the wording could be tweaked in "Determining a woman's fertility or infertility".
The wikipedia article on Natural Family Planning uses a definition which does not correspond to the actual/historical use of the term Natural Family Planning by the Billings. In fact, over 80% of "NFP" users use Billings, and not necessarily for the religious reasons in the wikipedia NFP article - for example the studies in India have less than 30% of users as Catholic. It is thus inaccurate to describe the BOM as primarily a form of NFP by the restrictive and unrepresentative definition of NFP espoused in the wikipedia article. If you do a bit more research you will find that WOOMB itself calls BOM Natural Fertility Regulation. In addition the history of BOM is properly discussed in the History section, in which a discussion of John Billings' Catholicity is more appropriate. It is difficult to see why a method of fertility education can be properly termed "Catholic", since it is not a theological proposition, but a scientific and natural investigation of fertility. Wanfactor 17:10, 23 May 2007 (UTC)
OK. I tried to incorporate your points. Let me know what you think. Joie de Vivre 19:24, 23 May 2007 (UTC)
Billings uses the term vaginal discharge, since not all discharges are cervical mucus. It is important to note that the method is not primarily observation of 'biological signals', but is a way to interpret of the pattern of vaginal discharge or vuval dryness to determine when a woman is fertile or infertile. Wanfactor 04:45, 24 May 2007 (UTC)
The Billings literature extols at length the relevance of cervical mucus to fertility, not "vaginal discharge". The non-fertile days are called "dry days" because there is no discharge of mucus at that time. It is true that ailments like BV can cause discharge but these aren't the indicators that the method detects. If anything "vaginal discharge" is just a euphemism, people might not like the term "mucus" but it is more accurate. Joie de Vivre 05:04, 24 May 2007 (UTC)
Cervical mucus is what is created by the cervix and is responsible for fertility but other than through microscopic analysis, the woman might not know if there is 'actual' cervical mucus in it. Most women will experience a number of different vaginal discharges, including menstrual flow, vaginal secretions, seminal fluid, etc. To say that BOM observes only cervical mucus is inaccurate. Also, users do not detect the "length" of the fertile time, but identify times of potential fertility. As I stated at the top of the discussion, all the information (including phrasing) that I originally started the article with is considered accurate by WOOMB, and I would discourage you from changing their approved material without first contacting them. Wanfactor 14:43, 24 May 2007 (UTC)
OK. I have left the phrase "vaginal discharge" but specified that cervical mucus is of particular importance. I have also rephrased "fertile and infertile times during each menstrual cycle", because to say "fertile times (plural)... during each menstrual cycle" is not accurate. There is only one fertile period per cycle. I have changed the wording slightly, take a look. Joie de Vivre 14:53, 24 May 2007 (UTC)
Cervical Mucus should be discussed in the "how the method works" section, as it is a large topic all its own. Cervical mucus is always present (please refer to Odeblad's work on the multiple types of cervical mucus), it is the pattern of sensation/discharge that indicates fertility or infertility. Now, to get into some intensive talk about fertility, multiple "fertile" times during a single cycle may be identified because follicular activity does not always lead to ovulation (please refer to Dr. Brown's work on waves of follicular activity). Technically, because only ovuluation only occurs once per cycle it is true to say that a woman is only fertile at one time during her cycle, but in practice it is impossible to predict ovulation since the ovulatory process may be interrupted. In particular, long cycles, possibly during breastfeeding and peri-menopause, may have multiple waves of follicular activity that do not result in an adequate ovulation, leading to the identification of multiple periods of potential fertility and infertility in the same cycle, (possibly but not necessarily interrupted by non-menstrual bleeding). It is thus most accurate to talk of times of infertility and potential fertility. Wanfactor 15:41, 24 May 2007 (UTC)

[edit] sperm cultured with human oviductal epithelial tissue

Why is this information in this article? From my reading of the article in the link, some scientists stuck some cells together in a petri dish and decided the sperm cells were still viable several days later. This appears to (maybe, depending on its credibility) belong in an article about sperm. Numerous studies of the BOM have found sperm survival to be limited to 5 days, with no evidence to support longer longevity. Until such evidence is found, please recall that we are talking about how long sperm survive within a woman's reproductive tract, not a petri dish. Wanfactor 18:42, 27 May 2007 (UTC)

Sperm get inside a woman's reproductive tract by traveling through the cervical mucus in the cervix. Once in there, they go to the fallopian tube and attach to the tube wall. Fertile mucus is critical for sperm to get inside the reproductive tract (1-45 minutes after ejaculation), but once they're in there the mucus has nothing to do with sperm survival. The interaction between the sperm and the epithelial tissue of the fallopian tube is what's critical at that point.
Because the sperm are actually attached to the tube wall, even washing the reproductive tract and examining the fluid for sperm will not give a good indication of sperm life - growing the fallopian tube tissue in the lab at body temperature and seeing how long sperm stay motile when exposed to it is the best study, to my knowledge, that's been done so far.
From the summary of the BOM study in Austrailia [2]: Indications were that sperm survival in one case was 5-6 days, 6-7 in two cases and 7-8 on one other. A sperm survival time of up to five days is credible in the presence of adequate amounts of fertile mucus, but present scientific knowledge does not allow a clear statement about sperm viability for longer than this. Considering that comment from WOOMB I'm not inclined to believe the organization has an official statement that sperm life of longer than five days is not possible, ever, under any circumstances. Unlikely, rare, something to be skeptical about - yes. Impossible - no. Lyrl Talk C 19:20, 27 May 2007 (UTC)
(Some) sperm remain locked in the cervix in the days leading up to ovulation, and are released at the right time to fertilize the ovum. Every description of the very complex interactions within the reproductive organs is a simplification, so the claim that sperm live 3-5 days in fertile mucus is accurate and simple, without contradicting the more complex reality.
You will note that I said evidence of longer survival. All scientific findings are subject to discreditation. However, as I said before, that has not yet happened, thus the statement that sperm live 3-5 days remains accurate, especially in regards to the BOM. The application of this lab research to the established observational findings would constitute original research, something which does not belong in a wikipedia article. Additionally, I am unconvinced that the research on other factors in sperm survival has gone beyond the preliminary stages. The study that you cite did not grow fallopian tube tissue - it cultured a particular type of cell. Wanfactor 22:32, 28 May 2007 (UTC)
The Couple to Couple League does not teach that five days is an absolute maximum for sperm life, and they have reviewed all the same studies Billings has. I do not believe that five days as an absolute maximum for sperm life is an accepted finding in the scientific community.
From Dr. Joanna Ellington, a sperm physiologist [3]: "The sperm that penetrate into the cervical mucus begin to do so within 1.5 min, and they are pretty much done by 30 minutes, with no gain in sperm numbers in... Fallopian tubes after 45 min from intercourse." From the first question on that page [4]: "The "cervical reservoir" of sperm is not an actual pool of fertilizing sperm."
From the same Q&A page [5]: "Some men have almost no sperm attaching and they die quickly within hours, while some men have a very high attachment rate and survival rate with sperm living attached to the tubal cells for up to 9 days in the laboratory. This correlates with what has been in seen in women with live sperm found in one woman’s tubes 21 days after intercourse!" Dr. Ellington also explains that sperm survival in the female reproductive tract is what she did her PhD on, so I believe that her explanation is the most recent research. Dr. Ellington's experiments with sperm and tubal cells sound exactly like the study I linked to with sperm and tubal cells. The "particular type of cell" they cultured was the cell type that lines fallopian tubes, so I don't understand how that statement supports the claim they "did not grow fallopian tube tissue".Lyrl Talk C 23:09, 28 May 2007 (UTC)
Your quotes are from a site selling a commercial product, not from an actual study. Dr. Ellington (in your quote) extrapolates (ie. steps outside what the limits of her research) that what she believes happens with stallions will happen with men as well. This sounds like a prediction, not established science. She has made assertions that are not supported by hers or others research out there, ie. that pregnancy can result from acts of intercourse longer than 5 days before ovulation. Anecdotal reports can be a starting point for scientific investigation, but they do not subtitute for it.
The fallopian tubes are an organ, and are part of the reproductive system of the woman. You could culture cells from the cervix as well, but it would not tell you what the cervix does, only what that particular cell does. Culturing a single type of cells may give you some insight into the function of that cell, but it hardly compares to a full investigation of the organ.
Taking snippets of this and that from unrepeated and/or non-published, non-peer reviewed research does not compare in credibility to the extensive amount of research that lies behind the BOM. Like I said before, there is no scientific evidence that sperm survive for longer than 5 days in the presence of fertile cervical mucus. When/if such evidence is found, then it would be appropriate to update that information. In the context of the sources you cite, it has not been established that there have been pregnancies resulting from acts of intercourse more than 5 days before ovulation so I don't think you have a case for claiming that sperm survive and are viable for longer than 5 days. If you wish to include 'bleeding edge' research about sperm life (unrelated to actual pregnancies) it belongs in the sperm article. Wanfactor 04:15, 29 May 2007 (UTC)
From page 88 of the The Art of Natural Family Planning by the founders of the Couple to Couple League:
Can sperm ever live longer than five days? In very rare cases it is possible for sperm to live six days or more, but pregnancies caused by such extended sperm life are extremely rare, perhaps about like the chances of winning a huge lottery.
I believe Dr. Ellington's research and knowledge of other recent research supports the possibility of pregnancy from intercourse more than five days before ovulation, but even without any of that, you have not presented any evidence that five days is the absolute limit to sperm life other than "WOOMB says so". As I said before, the Couple to Couple League has reviewed all the same studies as WOOMB has. Lyrl Talk C 21:41, 29 May 2007 (UTC)
Couple to Couple League is an NFP organisation; not a member of the scientific community, and their book is not a scientific document. The preponderance of evidence suggests that pregnancy does not result from sperm "survival" longer than 5 days. This is an issue that can be answered by science; reducing it to a he said/she said dispute is not appropriate to the question. When/if such evidence is found, then it would be appropriate to update that information.Wanfactor 23:37, 29 May 2007 (UTC)
The current reference for five day sperm life being an absolute maximum is Dr. Evelyn Billings' book. Do you consider this a "scientific document"? Or do you have some other source for this claim? Lyrl Talk C 01:10, 30 May 2007 (UTC)
The claim in the Billings book is sourced, but moving back two layers in sourcing is not a good idea without having first checked the original source, so I will see if something closer to actual/original research can be found. Wanfactor 18:42, 30 May 2007 (UTC)
Any idea how long that will take? I know some older articles are available online in scanned forms, but often only for those with appropriate subscriptions. Looking through Evelyn Billings' book, the only relevant reference I came across was a 1962 book by Carl Hartman, which certainly isn't available online. I'm curious what you will find and want to allow plenty of time, but I don't know if this is something you have relatively quick access to (days) or if we're talking more like interlibrary loan and 3-5 weeks. Lyrl Talk C 19:32, 30 May 2007 (UTC)
I doubt anything online will be found. The internet is rarely a good resource for good information. I have asked WOOMB to provide references to research, and will post them when they get back to me. Wanfactor 23:11, 1 June 2007 (UTC)
Any word on those references? It's been about five weeks, which was the longest I expected to wait (as mentioned in my previous statement). I understand if the references are going to take longer to find, but would greatly appreciate a timetable for their arrival. LyrlTalk C 17:08, 7 July 2007 (UTC)
Wanfactor has become busy with personal matters. In addition, the WOOMB international staff have no doubt become busy with reorganization after the death of John Billings. 198.53.160.251 17:12, 25 July 2007 (UTC)
I appreciate the update.
Since it appears the claimed citations are on hold indefinitely, I'm going to go ahead and modify the article to reflect the citations we currently have access to. LyrlTalk C 21:06, 25 July 2007 (UTC)

[edit] Category move

This article has been moved to Category:Fertility tracking as part of a planned deletion of Category:Periodic abstinence, Category:Fertility awareness, and Category:Natural family planning. Please bring up any concerns at Category talk:Periodic abstinence. If there are no objections within four days, these three categories will be tagged for speedy deletion. Lyrl Talk C 21:07, 7 June 2007 (UTC)

NOTICE: The old discussion at Category talk:Periodic abstinence is now located at Category talk:Fertility tracking/Periodic abstinence. Joie de Vivre 11:30, 13 June 2007 (UTC)


[edit] Pictures of mucus

I will start off by saying that I do realize that this picture is in the Billings book. However, there are reasons that it would be better that the article not include pictures of mucus.

1) The Billings' have been trying for years (unsuccessfully) to have the pictures of mucus removed from the Billings Ovulation Method book.

2) The BOM is about women's own observations of their sensation and discharge, without comparison to the visual characteristics of other women's mucus, and with an emphasis on sensation rather than appearance.

3) The fingers in the photo may cause people to associate the Billings Method with touching mucus, which is not part of the method.

Perhaps a picture of mucus would be more appropriate in an article about cervical mucus, or one about a method which emphasizes the visual and *felt* characteristics of mucus. Wanfactor (talk) 18:50, 25 February 2008 (UTC)