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Natural Family Planning (NFP)

Natural Family Planning refers to a variety of methods used to plan or prevent pregnancy, based on identifying the woman's fertile days. For all natural methods, avoiding unprotected intercourse during the fertile days is what prevents pregnancy. Natural methods are sometimes called Fertility Awareness-Based methods

What is Natural Family Planning?
Natural Family Planning refers to a variety of methods used to plan or prevent pregnancy, based on identifying the woman's fertile days. For all natural methods, avoiding unprotected intercourse during the fertile days is what prevents pregnancy.
more below...

New Simple Methods of Natural Family Planning
The Standard Days Method is a new simple fertility awareness-based method which relies on a "standard rule" or a fixed "window" of fertility that makes it easy for women to know when they are likely to become pregnant. The TwoDay Method relies on a simple algorithm to help women identify when they are fertile, based upon the presence or absence of cervical secretions. more below...

Other Natural Family Planning Methods
Other methods include the the Ovulation Method, Basal Body Temperature (BBT) Method and Symptothermal Method. more below...

Effectivess of Natural Family Planning Methods
Successful use of NFP methods to prevent pregnancy depends upon: 
the accuracy of the method in identifying the woman's actual fertile days; a couple's ability to correctly identify the fertile time; and the couple's ability to follow the rules of the method they are using. more below...

 

Advantages of Natural Family Planning Methods
Women and couples using NFP frequently cite advantages including:
increased self-awareness and knowledge of their fertility; increased reliance on their own resources rather than a family planning program or other sources of contraception. more below...

What is Natural Family Planning?

Natural Family Planning refers to a variety of methods used to plan or prevent pregnancy, based on identifying the woman's fertile days. For all natural methods, avoiding unprotected intercourse during the fertile days is what prevents pregnancy. Natural methods are sometimes called fertility awareness-based methods.

The effectiveness and significant advantages of NFP address the needs of diverse populations with varied religious and ethical beliefs. They also provide an alternative for women who want to use natural methods for medical or personal reasons.

Of married women worldwide using some form of family planning, approximately 15% claim to use a form of periodic abstinence. Yet a very small percentage of these couples actually are using a natural method correctly.

New Simple Methods of Natural Family Planning

The Standard Days MethodTM
The Standard Days Method is a new simple fertility awareness-based method. It relies on a "standard rule" or a fixed "window" of fertility that makes it easy for women to know when they are likely to become pregnant.

The fact that it involves no calculation or observation makes the Standard Days Method easy for service providers to teach and for women to learn and use. To avoid pregnancy, the woman should not have unprotected intercourse during the fertile window.
 

Field trials conducted in Bolivia, Peru, and the Philippines determined the effectiveness of the Standard Days Method. It is more than 95% effective when used correctly.

Analysis of a large data set of women's menstrual cycles from a World Health Organization study reveals that the fertile window is on days 8 to 19 for women whose cycle lengths range from 26 – 32 days. 


CycleBeads™
 

A color-coded string of beads, called Cycle Beads™, are used to help women keep track of the days of their menstrual cycle and see which days they are likely to get pregnant if they had unprotected intercourse.

The TwoDay Method™
The TwoDay Method is a new simple approach to NFP. It relies on a simple algorithm to help women identify when they are fertile, based upon the presence or absence of cervical secretions.

If the woman notices any secretions on the current or previous day, then she is probably fertile and should not have unprotected intercourse to avoid pregnancy.

If she notices no secretions on either day, then she is not fertile.  

Analysis of a large data set of women's menstrual cycles from World Health Organization indicate that the TwoDay Method would be a highly effective approach to avoid pregnancy.

The effectiveness of the TwoDay MethodTM is being studied in Bolivia, Guatemala and the Philippines.


Other Natural Family Planning Methods

The Ovulation Method
The Ovulation Method, also call the Billings Method, is based on understanding and interpreting changing cervical secretions that are produced at the neck of the uterus (cervix). At the time of greatest fertility, these secretions become clear, stretchy, slippery and wet. 

Couples who wish to avoid pregnancy abstain from intercourse from the onset of cervical mucus symptom until three days after the last day of fertile-type secretions.

Basal Body Temperature (BBT)
Women using the Basal Body Temperature (BBT) Method identify their fertility by observing their body temperature each morning before beginning any activity. 

The body temperature is lower before ovulation and rises slightly to about .2 degrees Celsius or .4 degrees Fahrenheit after ovulation.

Couples who wish to avoid a pregnancy abstain from intercourse from the onset of menses until three days after the woman's basal body temperature has risen, to about .2 degrees Celsius or .4 degrees Fahrenheit, signifying the end of the fertile phase.

Symptothermal Method
The Symptothermal Method involves observing changes in the cervical secretions, along with changes in the basal body temperature, and the position and feel of the opening of the cervix. Other fertility signs such as mid-cycle pain or bleeding may accompany ovulation.

Couples who wish to avoid pregnancy abstain from intercourse during the fertile period identified by all of the fertility indicators. 

Effectiveness of Natural Family Planning Methods

Successful use of natural methods to prevent pregnancy depends upon: 

  • The accuracy of the method in identifying the woman's actual fertile days 

  • A couple's ability to correctly identify the fertile time 

  • The couple's ability to follow the rules of the method they are using

The concept of unintended pregnancy, which is basic to the study of effectiveness of any family planning method, has been much debated by NFP experts. While there is clearly a range of opinion on the validity of differentiating between intended and unintended pregnancies, identifying a couple's reproductive interaction is essential for studying and providing accurate information about NFP. 
 

Unintended pregnancies among women practicing natural methods are primarily related to user error. A sizable but unknown portion of the unintended pregnancies is attributable to improper teaching and poor use of the methods. Experts at the World Health Organization (WHO) suspect that among users of NFP, sexual-risk taking during fertile days--that is, having intercourse even when they know the woman is fertile--accounts for more unintended pregnancy than does inability to accurately identify the fertile time. 

Couples who use natural methods correctly to prevent pregnancy have only a 1% to 9% chance of becoming pregnant during one year of use, depending on which method they use.

Couples who do not use their method correctly—that is, they have intercourse on days when the method's guidelines tell them that the woman is fertile—-have a much greater chance of unintended pregnancy.

The following is the probability of pregnancy for women using natural methods: 

Standard Days Method
During the first year of use, the probability of pregnancy is about 5%. During typical use, i.e., using the method correctly during some cycles but having unprotected intercourse during the woman's fertile time in other cycles, the probability of pregnancy is about 12%

BBT Method
Among perfect users, the first-year probability of pregnancy is only about 2%. During typical use the probability of pregnancy is about 20%.

The Ovulation Method
The first-year probability of pregnancy for methods based on using only cervical secretions to identify the beginning and end of the fertile time is about 3% among perfect users and 20% among typical users. 

Symptothermal Method
The first-year probability of pregnancy among couples who use two or more fertility indicators are about 2% to 3% among perfect users and as high as 13% to 20 % among typical users.

Advantages of Natural Family Planning Methods

Women and couples using NFP frequently cite advantages including:

  • increased self-awareness and knowledge of their fertility

  • increased reliance on their own resources rather than a family planning program or other sources of contraception

  • increased independence from costly or distant medical services

  • freedom from artificial substances and the side effects or potential medical risks of other methods

  • reduced re-supply costs associated with commodity-based methods

  • Enhanced communication and intimacy

  • For some, the ability to adhere to religious and cultural norms.

Last updated: 1-30-03

Copyright 2002 Institute for Reproductive Health and Georgetown University
 

 

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