Natural Family Planning Methods Research Articles

Knowledge and Perceptions of the Billing’s Ovulation Method of Natural Family Planning among Married Women in Lagos, Nigeria

Background: Based on existing literature, it was observed that modern contraceptives are the most widely used family planning methods in Nigeria, and that they have serious side effects for their users. Despite these effects, women of reproductive age have made little or no effort to embrace Billing’s ovulation as an alternative family planning method. In order to better understand the dynamics surrounding the adoption of Billing’s ovulation method, this study examined the knowledge, perceived effectiveness, and spousal attitude toward the use of Billing’s ovulation as a method of natural family planning among married women in Lagos metropolis. Method: To accomplish this, a pure qualitative methodological approach was used, with in-depth interviews (IDI) used to collect qualitative data from (20) married women. Manual content analysis was used to analyze the collected data. Results: Findings showed that; high level of knowledge and awareness of BOM, positive perceptions of its efficacy, and a favorable spousal attitude toward BOM are indicators of the rate at which married women in Lagos metropolis use the Billing’s ovulation method as their preferred family planning alternative. Conclusion: The study then recommends that a rigorous sensitization program based on door-to-door intervention be launched to educate married women in Lagos metropolis on the need for Natural family planning as an alternative family planning method, particularly BOM, while teaching them the procedures and techniques in order to increase people’s access to natural family planning.

A cross-sectional study on Polish Medical Students’ knowledge of Fertility Awareness-based Methods

Fertility Awareness-based Methods (FAMs) observe physiological signs to determine fertile and infertile phases in a women's cycle. WHO recommends to use both natural family planning (NFP) or FAM as a synonym. They may serve as methods for family planning as well as a procreation health monitor in restorative medicine and as a useful biomarker in management of reproductive-health disorders. Unfortunately, this knowledge is marginalized during medical education. A cross-sectional study was performed among 542 Polish medical students to assess their skills in NFP. The most common NFP method indicated by 84.9% students was the Calendar Method, the one with historical value. The Billings Method and Creighton Model System were known by 42% and 14% participants respectively, while Multi Index Methods were known by 26.4%. A total of 6% of the respondents use NFP themselves. The largest group of students (42%) assessed the effectiveness of NFP in avoiding pregnancy at about 50%. The results show little interest and incomplete knowledge in up to date NFP among future medical professionals. It seems there is an urgent need to introduce this subject into medical education as a valuable tool to understand and monitor procreation health as well as family planning method.

To assess the prevalence of knowledge level and practice of Lactational Amenorrhea Method (LAM) as a method of contraception among women admitted in postnatal ward of a tertiary care teaching hospital

Background: Lactation is a natural defence against pregnancy. As long as a mother is nursing, she is delaying the return of fertility. This study aimed at evaluating the state of knowledge, among mothers of infants aged 0-6 months, on lactational amenorrhea as a contraceptive method, as well as these women's breastfeeding habitsMethods: In this study, a total of n=300 mothers were included. A questionnaire was used to interview one-on-one the mothers of infants aged 0-6 months, who had consented to such an interview. Results: Out of 300 total respondents, only 121(24%) of them had prior knowledge about LAM and 201 of them had prior knowledge about contraceptive methods. About 276(92.0%) were housewives by occupation and 24(8.0%) were working mothers. Primigravidas used contraception in the past and also had prior knowledge about LAM as compared to Multigravidas. Anganwadi workers provided knowledge to 17 of the totals, 40 of them got knowledge from relatives, Medical and paramedical workers educated 49 of them, 3 got it from the internet and 7 of them were self-acquired. Conclusion: This study although small in size localized in a particular geographical area and covering almost similar socioeconomic profile, has a strong message that if proper and sustained counselling is done the dual purpose of exclusive breastfeeding and a method of natural family planning can be achieved.

To assess the prevalence of knowledge level and practice of Lactational Amenorrhea Method (LAM) as a method of contraception among women admitted in postnatal ward of a tertiary care teaching hospital

Background: Lactation is a natural defence against pregnancy. As long as a mother is nursing, she is delaying the return of fertility. This study aimed at evaluating the state of knowledge, among mothers of infants aged 0-6 months, on lactational amenorrhea as a contraceptive method, as well as these women's breastfeeding habitsMethods: In this study, a total of n=300 mothers were included. A questionnaire was used to interview one-on-one the mothers of infants aged 0-6 months, who had consented to such an interview. Results: Out of 300 total respondents, only 121(24%) of them had prior knowledge about LAM and 201 of them had prior knowledge about contraceptive methods. About 276(92.0%) were housewives by occupation and 24(8.0%) were working mothers. Primigravidas used contraception in the past and also had prior knowledge about LAM as compared to Multigravidas. Anganwadi workers provided knowledge to 17 of the totals, 40 of them got knowledge from relatives, Medical and paramedical workers educated 49 of them, 3 got it from the internet and 7 of them were self-acquired. Conclusion: This study although small in size localized in a particular geographical area and covering almost similar socioeconomic profile, has a strong message that if proper and sustained counselling is done the dual purpose of exclusive breastfeeding and a method of natural family planning can be achieved.

The Association of Family Planning Methods With the Odds of Divorce Among Women in the 2015–2019 National Survey of Family Growth

ABSTRACT We sought to determine the influence of the most common methods of contraception and natural methods of family planning (NFP) on the odds of divorce among women of reproductive age. The influence of use of family planning methods and other factors on risk of divorce was examined in 5,403 ever-married women from the National Survey of Family Growth (2015–2019). Chi-square and relative risk odds ratios (ORs) of divorce were calculated for the family planning predictor variables (ever-use vs. never-use). Logistic regression analysis examined the influence of family planning methods relative to other known influencers of divorce (income, education level, etc.). Chi-square analysis revealed significant (p < .01–p < .001) ORs for ever-use of the hormonal pill (OR = 1.54), female and male sterilization (ORs = 1.78 and 2.02, respectively), male condoms (OR = 1.67), and natural methods of family planning (OR = 0.66, 0.53). Logistic regression indicated ever-use of contraception was associated with increased odds of divorce, from 30% to 200%, whereas ever-use of NFP was associated with 31% lower odds. Poverty level and education levels did not meaningfully influence divorce odds. In conclusion, ever-married women who have ever used NFP have lower odds of divorce, whereas those who have ever used most the common contraceptives have higher odds of divorce. Further research is needed to understand how and why choices in family planning affect stability of marriage.

Natural Family Planning, An Option in Reproductive Healthcare: A Qualitative Study on Clinicians' Perceptions.

Natural family planning (NFP) empowers women to control their reproductive health and approach fertility as a normal biological process. Although substantive literature supports their comparative effectiveness with contraceptive methods, there is a paucity of this knowledge amongst clinicians and users. This study aimed to understand clinicians' perceptions regarding offering NFP to patients as part of reproductive health care. It explored clinicians' knowledge of NFP, described their perceptions of their effectiveness, and identified enabling and deterring factors to their use. Basic Interpretive qualitative research design was appropriate in obtaining an in-depth description of this phenomenon. It was conducted in 2018 in two hospitals and clinics in Ekurhuleni health district, located East of Gauteng Province, South Africa. Fifteen doctors and nurses from diverse cultural and educational backgrounds were purposefully selected and interviewed. Transcribed data were analyzed, coded, and recurrent themes identified. Training that empowers clinicians on NFP methods and their effectiveness will improve their willingness to advocate for it and promote patient autonomy by providing comprehensive counseling on family planning methods. Further, a pro-NFP policy would drive training in undergraduate and postgraduate programs and increase public awareness, including early education of male and female children.

Impact of coronavirus 19 pandemic on contraception in Jordan

The coronavirus 19 (COVID-19) pandemic has negatively impacted family planning services worldwide. There are no published reports from Jordan on the impact of COVID-19 pandemic on family planning methods. This was a web-based cross-sectional study between September and December 2020 with 519 participants; of these 43.5% did not use any method. The most used methods were intrauterine devices, coitus interruptus and male condoms. Furthermore, 38.2% of women changed methods due to limited access to services and non-availability of methods. While 82.1% of women preferred modern methods before the pandemic, 79.7% became more acceptant of traditional methods. Moreover, 35.3% of women got pregnant during the curfew, and 90% were unplanned with a statistically significant higher rate in women who changed their routine method, accepted traditional methods, have been married for less than 10 years and multiparous women. National health policy makers should consider the impact of large-scale pandemics on family planning services. IMPACT STATEMENT What is already known on this subject? Family planning services in Jordan have improved significantly over the last decade because of accessibility and availability of a wide range of contraceptive methods. Available methods are either traditional or modern. Because of the high failure rates of traditional methods, public health family planning programmes promote modern methods. What do the results of this study add? There are no published reports from Jordan on the impact of COVID-19 pandemic and curfew on family planning methods. This study aims to report on what family planning methods women used during the pandemic, reporting if women changed their preferred methods and the reasons, assess women's knowledge about the natural methods of family planning which is probably an alternative method in situations where services and accessibility to more effective methods are limited and estimate unplanned pregnancies. What are the implications of these findings for clinical practice and/or further research? National health policy makers should consider the impact of large-scale pandemics on family planning services. Additionally, the implementation of telehealth and home delivery of self-administered methods should be considered. Natural methods of contraception may be an option when access and availability to modern methods is limited.

Trend natural family planning – an online survey to assess attitudes towards NFP among German-speaking women

Purpose To study trends regarding the use of contraceptive methods and digital health modalities and to identify target groups of natural family planning (NFP). Material and methods Using an online questionnaire specifically developed for this study in German (utilizing the online tool at 'www.surveymonkey.com’), we analysed the attitude towards NFP -methods and -apps, the need for contraceptive effectiveness in general, the perceived contraceptive effectiveness of NFP methods, and differences between NFP users and non-NFP users among 779 sexually active German-speaking women of fertile age (18–50 years) from November 2019 to October 2020. Results and conclusions Participants used NFP more frequently than they did five years ago. Women aged 30 years and older, with higher levels of education, who are living with a partner and have children, seem to be the target group for NFP methods. Concerning the wish for contraceptive effectiveness we found significant (p < .001) differences between NFP and non-NFP users. Furthermore, an increasing number of women wants to use NFP-methods and -apps for contraception; thus, non-hormonal contraceptive options should be offered. The majority of current NFP users stated that the handling and effectiveness of NFP have been improved by digitalisation.

Quantitative versus qualitative estrogen and luteinizing hormone testing for personal fertility monitoring

ABSTRACT Background A new fertility monitor is now available that provides quantitative measurement of urinary hormones, but clinical use requires validation against an established fertility monitor that provides only qualitative results. Research design and methods Two fertility monitors were compared using daily first morning urine samples over 3 cycles of use in 21 women users with experience using a fertility monitor with the Marquette Method of Natural Family Planning. Results Women were aged 33.4 ± 5.5 years and had menstrual cycles ranging between 23 and 41 days. The quantitative Mira Monitor estimates of ovulation were highly correlated with the qualitative ClearBlue Fertility Monitor (CBFM) estimates of ovulation. Both monitors provided an accurate estimate of the fertile window. Conclusions In this preliminary trial, the Mira monitor was shown to be effective at delineating the fertile window and ovulation. We demonstrated the feasibility of applying the Marquette Method algorithm with the use of the Mira monitor. Satisfaction differences between the two monitors did not reach statistical significance. We anticipate that quantitative fertility monitoring will give couples and health-care providers new and unprecedented insights into the menstrual cycle and fertility.

Implementing a Natural Family Planning Program: The Case of The Metropolitan Archdiocese of Cagayan De Oro

Implementing a Natural Family Planning Program: The Case of The Metropolitan Archdiocese of Cagayan De Oro

Natural Family Planning and Marital Chastity: The Effects of Periodic Abstinence on Marital Relationships

This study showed that ever-use of natural family planning (NFP) among ever-married women was associated with 58 percent lower odds of divorce than among women who never-used NFP. Ever-use of contraceptive methods was associated with two times the odds of divorce and four times for cohabitation compared to those women who never-used those methods. Use of periodic abstinence with NFP is the practice of marital chastity and is thought to strengthen the marital relationship.

'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea.

This article reviews the competition of two natural family planning methods in the mid-1970s when the Catholic Natural Family Planning program was underway in Korea. The Catholic Church, emphasizing the natural law, has recommended Natural Family Planning (NFP), a method of regulating childbirth by abstinence during the fertile period, since the mid-twentieth century. However, a group of gynecologists working at St. Mary's Hospital, a Catholic general hospital in Korea, questioned the utility of NFP. As an alternative, they proposed the method of Ovulation Regulation (OR), which regulates the menstrual cycle by inducing ovulation with steroids agents. This seemed to be no different than contraception with oral contraceptives disapproved of by the Catholic Church, but many doctors who advocated OR thought that this could be a new 'natural' family planning method to replace NFP. What is noteworthy here is the fact that not only NFP advocates, but also OR advocates attempted to justify their methods based on the authority of the 'nature.' In the debate over natural family planning methods, nature's legitimacy was given premise, not the object of doubt. Rather, the issue was the definition of nature. First, 'nature' in NFP signifies 'innate nature,' which excludes human intervention. According to this point of view, OR with steroids agents could not be natural. On the contrary, a group of doctors who advocated OR considered nature 'primal completeness.' If the natural order of the menstrual cycle could be restored, the artificial intervention of the administration of steroids was not a problem. Thus, both groups defended their arguments by redefining nature, rather than raising an issue of nature itself. The competition between 'innate nature' and 'complete nature,' a proxy war between NFP and OR, resulted in the victory of the former as the meaning of nature became fixed. Advocates of NFP pointed out that OR inhibits other physiological functions in the process of inducing ovulation, suggesting that the idea of 'complete nature' could never be achieved. The meaning of nature could no longer be controversial. Since the intervention was unnatural, nature meant innateness, the absence of intervention. Accordingly, the Catholic Bishops of Korea approved the Billings Method, a kind of the NFP, as the official family planning method, and gynecologists at St. Mary's Hospital of Korea also focused on the development and supplementation of the Billings Method. In short, the debate over the methods of natural family planning in mid1970s Korea was a clash of 'innate nature' and 'complete nature.' As a result, this confirmed the limitations of medical practice and reconfirmed the power of magisterium, the church's authority over medical practice.

The impact of disturbancesin natural conception cycles.

Many physiciansand other healthcare professionals are often asked questions on interfering factors for conception by couples with a desire for children. Such possible disturbances include, for example, the very common minor diseases, stress and also sexual intercourse during the suspected implantation period. Non-scientifically based statements about disturbances in conception cycles, as found in many layman publications and on the internet, can strongly unsettle couples with a desire for children and force them into corset of rules of conduct. Therefore, a systematic scientific evaluation of the impact of disturbances on conception is urgently needed. A search for possible disturbancesin natural conception cycles together with up to three of the respective pre-cycles in a large cycle database from users of the symptothermal method of natural family planning in Germany was performed. Disturbances were qualified by scientific panel decision and analysed statistically with their effects on the chances of spontaneous conception. Mixed logistical regression models and survival time analyses were used. A total of 237 women with a total of 747 cycles could be included in the analysis. In 61% of all 237 conception cycles, disturbances occurred. The statistical analysis shows that disturbances in natural conception cycles unexpectedly increase the likelihood of pregnancy by an overall factor of 1.32 (95% CI 1.04-1.70). Sexual intercourse in the window of implantation does not decrease the chances of conception. Relaxation states at the time of ovulation and/or during the implantation period have no representable effect and do not increase the chance of pregnancy. Couples trying to conceive should at least be informed that disturbances in conception cycles, such as minor diseases, stress or sexual intercourse during the implantation period do not interfere with conception. Relaxation has no effect in favour of success. This takes away the guilty feeling of couples, fearing that they possibly did something wrong in cycles without the desired pregnancy.

The Use of NFP When Pregnancy Is Contraindicated?

The Sacred Congregation for the Doctrine of the Faith has declared the moral liceity of hysterectomy when certain medical criteria are met but does not exclude other options, "for example, recourse to infertile periods or total abstinence." Consequently, there may be couples who prefer to use natural family planning (NFP) methods. We shall refer to these in this article. In general, it can be concluded that NFP methods, if used in the conditions mentioned herein, offer a high degree of reliability, similar to that of artificial contraceptive methods. Accordingly, if pregnancy must be avoided in the medical circumstances to which the Congregation for the Doctrine of the Faith refers, NFP methods can effectively replace hysterectomy, thereby circumventing the medical difficulties of this practice.

Anthropological and Methodical Differences of Natural Family Planning and Fertility Awareness-based Methods.

The term natural family planning (NFP), both in the scientific terminology and in the practical language of health policy, is often referred to as natural contraception or fertility awareness-based methods (FABM). The World Health Organization's (WHO) is the directing and coordinating authority on international health within the United Nations' system. WHO family planning recommendations present FABM as one group of contraceptive methods For these obvious reasons the article mostly concentrates on the WHO definition of FAMB. The article presents the anthropological and methodological differences between NFP and FABM and, through comparative analysis, determines that NFP is synonymous with neither FABM nor any of the methods of this group but is rather a distinct group of family planning methods.

A Comparison of User Behaviors for a Fertility-Tracking App: Does Training in an NFP Method Improve Persistence and Use?

"CycleProGo™ users with NFP training were more persistent and diligent about daily data input than those without training."

A Quantitative Self-Assessment of Seminarians' Response to a Curriculum Addition on Marriage, Sexuality, FertilityCare, and Naprotechnology: The Kenrick-Glennon Experience (2006-2015).

This is an evaluation of a ten-point, seven-question questionnaire that was utilized at the beginning of a course at Kenrick Seminary in Marriage, Sexuality, Creighton Model and NaProTECHNOLOGY. The same questionnaire was given to the students at the beginning of the course and then two to three months later at the conclusion of the three-credit course. The results show that there is a significant improvement in the seminarians' knowledge and general attitude about natural methods of family planning and suggests that such courses would be beneficial to establish in seminaries throughout the country.

Response of One Man of Science to Humanae Vitae.

The understanding of the full truth and beauty of the marital relationship has developed from a remedy for concupiscence (cf. 1 Cor 7:9) to "a sacrament of mutual sanctification and an act of worship" (St. John Paul II). With this development came a realization of the need to respond to the dilemma of couples who legitimately and responsibly wanted to avoid pregnancy but in fidelity to the Church's consistent teaching against contraception. In the middle of the last century, Dr. John Billings undertook to assist in the quest to find a reliable means of preventing pregnancy, which was in accord with natural moral law. He was aided in this quest by his wife Dr. Evelyn Billings and the many couples who contributed to the research. Their discovery formed the basis of all modern methods of natural family planning. "[T]he difference, both anthropological and moral, between contraception and recourse to the rhythm of the cycle…is a difference which is much wider and deeper than is usually thought.…The choice of the natural rhythms involves accepting the cycle…and thereby accepting dialogue, reciprocal respect, shared responsibility and self-control.…In this context the couple comes to experience how conjugal communion is enriched with those values of tenderness and affection which constitute the inner soul of human sexuality, in its physical dimension also". Nontechnical Summary: Pope Saint Paul VI's magnificent but much misunderstood encyclical "Humanae Vitae" called on men of science "to labour to explain more thoroughly the various conditions favouring a proper regulation of births." To doctors he asked that they "persevere in promoting on every occasion the discovery of solutions inspired by faith and right reason". Dr John Billings and his wife, Dr Evelyn Billings, devoted their lives to answering these calls which the Holy Father also made to them in person some years after he gave his encyclical to the Church.

Factors affecting uptake of natural family planning methods among clients at the reproductive health clinic of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Background: The use of natural family planning (NFP) methods is low worldwide with few existing data. Aim: The aim of the study is to determine the factors affecting the use and discontinuation of NFP methods in our setting. Methodology: In this descriptive cross-sectional study, 302 clients who presented at the Reproductive Health Clinic of Ahmadu Bello University, Zaria, were interviewed, with the aid of pretested questionnaires. Sociodemographic variables, reasons affecting the use, and discontinuation of NFP methods were recorded and analyzed using SPSS software version 15. Results: Among the 302 clients interviewed, 88.1% (266) had used a form of family planning method: 38.4% (116) used NFP, 49.7% (150) used artificial methods, whereas 37.1% (43) discontinued the NFP methods. Major factors hindering the use of an NFP method include lack of awareness (24%), been single (17%), unknown reason (17%), irregular menstrual cycle (10%), and fear of method failure (8%). Major factors for discontinuing the NFP methods include high failure rates (21%), irregular menstrual cycle (18%), introduction to other methods (14%), want of conception (12%), and fear of pregnancy (12%). Conclusion: The most common factor affecting the uptake of NFP was lack of awareness. Failure rates and irregular menstrual cycles were the common denominators, affecting both the use and discontinuation of NFP methods.

The State of the Science of Natural Family Planning Fifty Years after Humane Vitae: A Report from NFP Scientists' Meeting Held at the US Conference of Catholic Bishops, April 4, 2018.

A one-day meeting of physicians, professional nurses, and scientists actively involved in Natural Family Planning (NFP) research was held to review the state of the science of NFP and consider future priorities. The meeting had four objectives: (i) determine the gaps in research evidence for secure methods of NFP among women of all reproductive categories, (ii) determine the gaps in the research and development of new technology for providing NFP services, (iii) determine the gaps in the research that determine the benefits and challenges with use of NFP among married couples, and (iv) provide prioritized ideas for future research needs from the analysis of evidence gaps from objectives above. This article summarizes the discussion and conclusions drawn from topics reviewed. While much has been accomplished in the fifty years since Humane vitae, there are still many gaps to address. Five areas for future research in NFP were identified as high priority: (1) well-designed method effectiveness studies among various reproductive categories including important subpopulations (postpartum, perimenopause, posthormonal contraceptive), normally cycling women (especially US women), and comparative studies between NFP methods; (2) validation studies to establish the benefit of charting fertility signs (both currently known and potential new indicators) as a screening tool for women's health issues; (3) ongoing independent evaluation of fertility monitoring apps to provide users perspective on the relative merits of each and to identify those most worthy of further effectiveness testing; (4) studies evaluating the impact of new technologies on NFP adoption, use, and persistence; and (5) creation of a shared database across various NFP methods to collaborate on shared research interests, longitudinal studies, and so on. This summarizes a meeting to review the scientific and medical progress related to natural family planning made in the 50 years since Humane Vitae and to define priorities for future work. Areas reviewed included the evidence for avoiding pregnancy in normally cycling, postpartum, and perimenopausal women, the impact of new technology, including fertility charting apps, on NFP, and the impact on relationships and personal well-being from use of NFP. Five priority focus areas for future research were also identified.