Natural family planning: A review and assessment

Abstract

This article describes 3 new Natural Family Planning (NFP) methods which have taken the place of the calender rhythm method and reviews the relevant literature. 1) The basal body temperature (BBT) method relies on the womans body temperature (BT) which reflects variations in the progesterone levels during the menstrual cycle. It requires longer periods of abstinence than the other NFP methods because of the uncertainties of determining the timing of ovulation using BT. 2) The cervical mucus method based on changes in the quality and quantity of cervical mucus perceived by women uses their relation to the estrogen level to predict the timing of ovulation. It is relatively easy to learn and is the only NFP method that applies to women of all reproductive categories. 3) The symptothermal method combines the use of mucous symptoms the BBT and 2ndary signs associated with ovulation such as cervical changes abdominal pain intermenstrual bleeding and breast tenderness in its ovulation prediction. A major problem is that different signals of ovulation can sometimes be in conflict. NFP is an educational approach rather than a special technology. Training of teachers is of critical importance. Instruction in group setting is the effective approach. Self-instructional methods of training are inadequate; its users need greater motivation than artificial method users and a shared cooperative approach to family planning by partners is very important. Useful literature on the physiologic basis and psychological impact of NFP are now available for family planning counselors and other health care professionals to assist the continuing growth of both public and private sector NFP programs around the world. While the need exists for systematic research efforts concerning NFP preliminary conclusions indicate that the effectiveness of NFP methods is not as poor as often assumed but that instructional techniques and organization of NFP need further improvement.