Thesis advisor: Corrine Y. Jurgens / Background: Infertility is a source of significant distress to women, their partners, and their families. If women are unable to identify the time in their cycle when conception is most likely (the fertile window) then they may be referred to fertility services unnecessarily, which incur costly, invasive, and risky interventions. Little is known about women’s experiences trying to conceive using fertility-awareness based methods. Objective: The purpose of this dissertation research is to examine fertility-awareness based method (FABMs) use among women seeking pregnancy, specifically as it relates to fertility knowledge, method frequency, predictors of use, and duration of pregnancy attempt. Methods: This manuscript-style dissertation will utilize multiple data sources and methods to address four major goals. First, an integrative review of peer-reviewed publications will synthesize the literature regarding fertility knowledge and fertility- awareness practices (Aim 1). Second, a secondary analysis of data from the CDC’s National Survey of Family Growth (2015-2017) will be used to identify factors that influence women’s decision to use FABMs (Aim 2). Third, an analysis of data from the Nurses’ Health Study 3 will be used to evaluate whether duration of current pregnancy attempt is associated with FABM(s) use (Aim 3). Lastly, a case study will be presented using the qualitative methodology of narrative interview to describe women’s experiences using FABMs to achieve pregnancy (Aim 4). Conclusions: Collectively, this work advances the science by providing researchers and clinicians with the knowledge to support women in their journey to natural, spontaneous conception. / Thesis (PhD) — Boston College, 2021. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.