Advantages
Natural family planning methods are generally the preferred contraceptive method for women who do not wish to use artificial methods of contraception for reasons of religion, or who, due to rumors and myths, fear other methods.
Disadvantages
Natural family planning methods are unreliable in preventing unwanted pregnancy.
It takes time to practice and use them properly, which adds to their unreliability.
Additionally, natural family planning methods do not protect against sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV). Effectiveness
The effectiveness of any method of natural family planning can vary from couple to couple and all these methods are less effective for couples who do not follow the method carefully.
Types of natural family planning methods
There are three major classifications of natural family planning methods:
1 Periodic abstinence (fertility awareness) method
2 Use of breastfeeding or lactational amenorrhoea method (LAM)
3 Coitus interruptus (withdrawal or pulling out) method
PERIODIC ABSTINENCE (FERTILITY AWARENESS) METHODS
During the menstrual cycle, the female hormones oestrogen and progesterone cause some observable effects and symptoms. Oestrogen produces alterations in the cervical mucus, which changes from thick, opaque and sticky to thin, clear and slippery as ovulation approaches. Progesterone produces a slight rise in basal body temperature (temperature at rest) after ovulation. Otherwise, the function of progesterone on the cervical mucus is just the opposite effect of oestrogen — it makes the cervical mucus thick, opaque and sticky. Observation of these changes provides a basis for periodic abstinence methods. There are three common techniques used in periodic abstinence methods, namely:
1 Rhythm (calendar) method
2 Basal body temperature (BBT) method
3 Cervical mucus (ovulation) methods
CALENDAR OR RHYTHM METHOD
This method is the most widely used of the periodic abstinence techniques.
The calendar method is a calculation-based approach where previous menstrual cycles are used to predict the first and the last fertile day in future menstrual cycles. This method requires a good understanding of the fertile and infertile phases of the woman’s menstrual cycle. It is based on the regularity of the menstrual cycle and the fact that an ovum (egg) can only be fertilized within 24 hours of ovulation.
It is important for you to know that before relying on this method a woman needs to record the number of days in each of her menstrual cycles for a period of at least 6–8 months (remembering that the first day of menstrual bleeding is always counted as day 1)
Advantages of the calendar or rhythm method
This method does not require daily monitoring of fertility indicators.
Disadvantages of the calendar or rhythm method
It is associated with a high failure rate and can be difficult to use in the case of irregular menstrual cycles.
It also takes a long time to learn and use it properly.
Effectiveness of the calendar or rhythm method
This method is about 95% effective if a woman uses it correctly
BASAL BODY TEMPERATURE (BBT) METHOD
The basal body temperature method is based on the slight increase in the body temperature of women at rest by about 0.3–0.5°C during and after ovulation, due to the action of an increased level of progesterone secreted by the corpus luteum. The rise in body temperature sustained for three consecutive days indicates that ovulation has occurred, and it remains at this increased level until the start of the next menstrual cycle. In this section you will learn about when the rise in body temperature occurs, and what women need to know in order to use this method properly.
PROCEDURE
Take temperature in the morning before getting out of bed and before eating or drinking anything or putting anything in the mouth (after at least three hours of sleep)
Take temperature at the same time every morning, in the same way, either orally, rectally or vaginally, orally for 5 minutes, vaginally for 3 minutes and rectally for 2 minutes
Record the reading at the level the mercury stops
If mercury stops in between two readings take the lower reading as your temperature
Record reading on a temperature chart
Abstain from intercourse from the first day of your period until after the third consecutive day of rise in the body temperature( use a back up or abstain)
Do not use this method if you are breast feeding (temperature may not rise during this period)
Request client to repeat instructions and demonstrate charting of temperature on the chart.
Advantages
No side-effects for this method.
Encourages discussion about family planning between couples
Disadvantages
High failure rate if the couple does not clearly understand the method.
Requires several days of abstinence
Needs a longer duration to practice, understand and use properly.
False interpretation or indications in the case of fever, as this may mislead the result of BBT.
A special thermometer may be required.
Effectiveness of BBT
BBT is about 98% effective if the woman uses the method correctly. But it’s still important to realise that of 100 women using this method in any one year, two will become pregnant. Its effectiveness will decrease dramatically to 80% if the woman does not use the method correctly. Effectiveness is greatest when the couple limits unprotected sexual intercourse to the period after ovulation.
CERVICAL MUCUS METHOD (CMM)
The cervical mucus method (or Billings method) is based on the recognition and interpretation of changes in cervical mucus and sensations in the vagina, due to the effect of changes in oestrogen levels during the menstrual cycle. This method is also an ovulation method used by women trying to get pregnant and have a child.
Mechanism of action of cmm
You may remember from the description of natural family planning methods, that the rise in the level of oestrogen during the menstrual cycle influences the cervical gland to secrete mucus that changes from a sensation of dryness in the vagina (characterised by thick, viscous and sticky mucus), to a sensation of wetness in the vulva (characterised by thin, white, slippery and stretchy thread-like, transparent strands — similar to uncooked egg white), during ovulation. Using this method, these are the times when it is safe to have sexual intercourse:
. After menstruation ends the dry days (absence of cervical secretions) will start, and during these days it is safe to have sexual intercourse every other night until a woman starts to feel wet in her vagina. Every other night is suggested, as it will help women from confusing semen with cervical mucus.
. It is also safe from the evening of the fourth day after the peak day, to the beginning of the next menstruation. Once a woman has ovulated, her cervical mucus will begin to dry up, so the peak day is the last day of cervical or vaginal wetness.
In cervical mucus method (cmm) the client should
Abstain from intercourse during menstruation
Feel the vagina daily for mucus
Record findings daily on appropriate chart
Have sexual intercourse during the ‘dry’ days when no mucus appears
Abstain from intercourse once mucus appears and continue abstinence until four days after mucus has ceased to be felt
Do not douche, as this alters the nature of the cervical mucus
Abstain from intercourse whenever there is inter-menstrual bleeding
Abstain on alternate days, during the learning phase, prior to onset of the feeling or observation of mucus. This is to reduce the confusion that may arise as a result of the presence of seminal fluid
Effectiveness of CMM
The effectiveness of the cervical mucus method is about 97% if women use it correctly
Advantages of CMM
The advantages of this method are similar to those associated with the use of the basal body temperature method.
Disadvantages of CMM
CMM has a high failure rate because it needs several days of abstinence and a lot of experience in using the method to be effective. It is also difficult to use this method in the case of vaginal infections, as the cervical mucus secretions may be misleading.
CYCLE BEADS METHOD
This also called a standard day method, and it is a natural Family Planning Method. It is based on the knowledge that the menstrual cycle is made up of a fertile phase preceded and followed by infertile days. The cycle beads helps users of the SDM to identify the fertile and infertile days of their cycle and also monitors cycle length. Based on physiological evidence that a woman’s fertile phase starts five days before ovulation and lasts through the day of ovulation, the SDM allows women with cycles 26 to 32 days long to prevent pregnancy by avoiding unprotected intercourse during their fertile window—days 8 through 19 of their menstrual cycle. The couple uses cycle beads, a colour-coded string of beads that indicates fertile and non-fertile days of a cycle, as a memory aid.
Cycle beads has 32 beads, each bead represents a day of the menstrual cycle. The red bead represent first day of menstruation and of the cycle and white beads represent days when a woman can get pregnant
Who can use cycle Beads
Women who usually have cycles between 26 and 32 days long
Couples who can avoid unprotected sex during the woman's fertile days
Who cannot use Cycle Beads
Women who have irregular menstrual cycles
Couple who cannot avoid unprotected sex during fertile days
How to use Cycle Beads
Move the black ring onto the red bead the first day of menstruation
Move the ring to the next bead the next day and continues to move the ring one bead per day throughout.
When the beads are on any of the brown beads pregnancy is not likely to occur.
When the ring is on any of the white beads pregnancy is likely to occur if she has unprotected sex.
If the woman gets her period more than once before she gets to the dark brown bead within a year, the method may not be very effective for her. If she doesn’t see her period before she gets to the last brown beads more than once within a year, the method may not be very effective for her.
Effectiveness
Cycle beads method is 95% effective with perfect use.