The 28-year-old used to take hormones but dumped them because they made her moody and because her Catholic faith opposes birth control. Now, the Ogden woman and her husband practice a natural method to track when she can conceive and when she can't. And she's much happier.

"You're prescribed medication when you're sick," she said. "Fertility is not a sickness. It's a healthy part of your reproductive life."

Utah health officials are starting to promote natural family planning, hoping to reach similar women who don't want to use hormones or other artificial methods to control their fertility. Also called "fertility awareness," the natural route works by educating women about their menstrual cycles so they can avoid sex or use protection during the days they are most likely to conceive if they don't want to get pregnant.

The push is prompted by the steady rate of unintended pregnancies in the state - and a recent surprise about why some Utah women aren't using any form of birth control.

Health officials thought women avoided it because they couldn't afford it. Instead, surveys showed some either don't understand their fertility cycles or don't want to use birth control. At the same time, some Utah men and women reported wanting to learn about natural options.

"We had always thought if we could just increase insurance access then all our problems could be solved," said Lois Bloebaum, reproductive health program manager at the Utah Department of Health. "This was an ah-ha moment for us."

Couples working together: Every year, the health department randomly surveys women who have recently given birth. In 2005, almost 34 percent of women, or about 17,500, said their pregnancies weren't planned.

Utah's rate is much lower than the national average of near 50 percent, but is still troubling. Such pregnancies are associated with poor prenatal care and low birthweight babies.

Of the women who said their pregnancies weren't planned in 2004, almost 60 percent said they were using contraception, which tells Bloebaum that not all the couples really were using it or they used it incorrectly.

Around 40 percent of the women who weren't using birth control said they had thought they couldn't get pregnant at the time they conceived.

Another 13 percent said they didn't like the side effects of their current method.

The survey also found that of the small percentage of women who said they weren't using birth control after they gave birth - officials say it's best for pregnancies to be spaced about two years apart - almost 31 percent said it was because they didn't want to.

Proponents of natural family planning say it is a viable alternative. There are no side effects, it is inexpensive and it works: The method the state is promoting, called Standard Days, has a failure rate that is higher but still close to the pill, condoms and diaphragms.

Another benefit: "It gives a different approach to sexuality where the couple is working together," said Joe Stanford, a University of Utah professor of family and preventive medicine.

He is helping the health department promote the technique, which uses a ring of CycleBeads to help women track their fertile days (explained in the accompanying graphic), and notes it traditionally receives little attention because no pharmaceutical company can make money on it.

"It just deserves a lot more exposure," he said. "A lot more people would indeed use it if they knew about it."

Hormone backlash: It could also be a good option for poor women, who have a higher rate of unintended births. Those who receive prenatal services through Medicaid lose coverage two months after they've given birth, limiting their access to contraceptives. In addition, Utah, unlike many other states, doesn't put money into family planning services and it has more stringent requirements for who can qualify for Medicaid.

Anecdotally, health-care providers say more women are showing an interest.

Stanford, who also runs a nonprofit group that educates women about natural methods, said the group has grown from one teacher in 1993 to six today.

Some of the appeal could be due to a backlash against hormones after studies revealed the risks of hormone replacement therapy. It could also be a part of a larger natural movement as customers demand organic foods and natural products for their homes. Other women seek it out because they have experienced side effects from birth control.

"A lot of people are really turned off by care providers who push so much chemical and technological birth control," said Heather Johnston, a midwife who helps women give birth at home. With natural birth control, "What you're relying on is knowledge of your own body and own body signals. Some people find that really, really empowering."

She was one of the 30 providers the health department trained in April on natural planning.

The health department has also contracted with a Midvale health clinic to work with the Latino community, which has a higher rate of unwanted pregnancies, at nearly 40 percent. Comunidades Unidas will teach 50 to 60 women a month about natural options along with other birth control methods starting in July.

A tool for conception: Diane Heubusch, a certified nurse midwife at Mount Olympus Obstetrics and Gynecology, also attended the state training. She said she's been providing information about natural methods for years and finds her patients also use it to try to conceive.

Amy Toone got pregnant with her third child by naturally tracking her menstrual cycle. The Ogden 33-year-old uses what's called the Creighton model.

"It makes you listen to your body and watch what your body is doing," she said. "The pill, it's almost, 'Well, I don't care what my body is doing, I'm going to force it to do this thing.' "

Holm watched her cycle to avoid getting pregnant in the year after she had her first child because she had a Cesarean section.

The health department's Bloebaum said natural methods aren't for everyone. Women who need protection from sexually transmitted diseases or who don't have supportive partners willing to abstain certain days of the month shouldn't use it.

"Each woman has to look at her lifestyle and her values and decide for herself what's the best option," she said.

hmay@sltrib.com