Natural Methods

 Natural methods of birth control do not involve medications or devices to prevent

pregnancy but rather rely on behavioral practices and/or making observations about a
woman’s body and menstrual cycle.
 Natural methods of birth control do not rely on the use of hormones or devices.

What is fertility awareness (FAM)?

Fertility awareness (also called natural family planning or rhythm method) is a

way to predict fertile and infertile times in your cycle. FAM is based on body
signs, which change during each menstrual cycle in response to the hormones
that cause ovulation (the release of an egg). If you use FAM and don't want to
get pregnant, you must abstain (not have intercourse at all) or use another
contraceptive during your fertile times.

What facts are Fertility Awareness Methods (FAM ) based on?

 An egg is usually released once in each menstrual cycle.

 The egg lives 12 to 24 hours.

 Sperm can live up to five to six days in the uterus, and be able to fertilize an egg
during this time.

 This means that a woman is fertile for as long as six days before ovulation and
two or three days after ovulation, a total of seven to eight days of fertility in her cycle
each month.

When does a woman normally ovulate (release an egg)?

 Ovulation normally occurs once in a menstrual cycle (between periods).

 The egg is normally released 14 days before your period starts. If a woman has
regular monthly periods (the number of days between the start of each period is exactly
the same) then ovulation will occur at the same time during each cycle.

How effective is using FAM in preventing pregnancy?

 If 100 couples use FAM for one year, an average of 25 women will become
pregnant during that time.

 If FAM is used perfectly, only 1 to 9 will become pregnant in the first year of use.
 The effectiveness depends on many factors including the regularity of the
woman's menstrual cycle and the ability to use the methods accurately and
consistently.

How do fertility awareness methods work?

Some methods depend on abstinence during fertile times, others rely on a

backup method of birth control, such as condoms and spermicide or a
diaphragm, during fertile times. Having intercourse during your fertile time, of
course, adds a risk of pregnancy since there is a chance of failure for any
method of birth control.

Also, a spermicide placed into the vagina can make it difficult for the woman to
observe mucus changes.

What are the different methods?

There are a variety of fertility awareness methods that use one or more fertility
signs.

Calendar (Rhythm) Method predicts when ovulation will happen based on

when ovulation occurred in past cycles. m

Ovulation (Mucus) Method involves watching the changes in cervical mucus.

Normal vaginal discharge changes at the time of ovulation. When you're most
fertile, there is more mucus, and it feels wet and slippery (like raw egg white).
After ovulation, there is less mucus and it's sticky, blocking sperm from entering
the uterus. Women can check their mucus daily to tell when they're most fertile.

Basal Body Temperature Method (BBT) depends on taking daily

temperature readings to determine when ovulation is occurring. There is a rise
in temperature when ovulation occurs. By taking your temperature first thing
every morning, and graphing the results, you can often tell if you've ovulated.

Symptothermal Method uses a combination of various methods that identify

symptoms of ovulation. These include the mucus method, basal body
temperature, cervix changes, and other symptoms such as breast tenderness,
abdominal heaviness, slight lower abdominal pain, or slight bleeding (spotting).
This method may work better for women with irregular or less distinct mucus
changes.

Advantages in using FAM for pregnancy prevention

 Inexpensive, no health risks and convenient (no devices or hormones to use)

 Acceptable to couples who have religious concerns.

 Can develop greater communication, cooperation and responsibility for partners

 Can be useful for determining optimum fertility time to achieve a pregnancy

 Can help a woman track and improve PMS symptoms

Disadvantages in using FAM

 High failure rate, difficulty in accurately predicting ovulation or fertile time.

 Requires commitment from both partners. Cannot be spontaneous with

intercourse.

 Provides no protection against STIs.

 Only as effective as the contraceptive used during fertile times (e.g., abstinence,
condoms)

Other considerations

 Many things can affect a woman's ovulation pattern, resulting in unintended

pregnancies.

 A woman must abstain or use another birth control method for several days
longer than the actual fertile time

 All fertility awareness methods depend both on careful, daily observation and
charting of body signs, and on the cooperation of both partners in respecting fertile
times.

 The method works best to prevent pregnancy if a couple has a stable

relationship, good communication, and strong motivation to use it correctly.

 Some couples choose FAM because it's safe, less expensive than other methods,
and requires no drugs or devices. It can be easily discontinued any time pregnancy is
wanted.

What is Abstinence?

Abstinence can mean different things for different people but strictly speaking it
means no sexual contact of any kind, especially no penis-to-vagina contact. For
a variety of reasons, many people may choose abstinence at some point in their
life.
 In terms of birth control, abstinence means not allowing sperm near the
woman's body below the waist.

In terms of STI protection, abstinence also means no oral-genital, anal-genital, or

intimate skin-to-skin contact.

How effective is it?

If used consistently, abstinence is 100% effective in preventing pregnancy and

STIs.

Advantages

 Abstinence is free, available to all, and can be started at any time in one's life

 Abstinence may encourage people to build relationships in other ways - there are
ways to be intimate with someone that don't involve sexual activity

 Abstinence may be the course of action which you feel is right for you and makes
you feel good about yourself

 There are no medical or hormonal side effects

Disadvantages

 If you are counting on abstinence and change your mind in the heat of the
moment, you might not have protection handy.

 Choosing abstinence does not mean that your sex drive (libido) goes away and
you may need to find other ways to redirect your sexual energy.

Important points to think about

 There are many reasons people choose abstinence; it is important to make your
decision for yourself and define what abstinence means to you and, if you are in or
beginning a relationship, what it means to your partner.

 You don't have to be a virgin to practice abstinence - many people abstain from
sex at different times, and for different reasons.

 Find someone that you trust, respect and feel safe with to discuss your decision.

 Have barrier methods handy 'just in case' you change your mind

 Seek emergency contraception if intercourse occurs without contraception

 What is lactational amenorrhea?

This is a temporary contraceptive method that relies on exclusive breast

feeding. It can be used from birth up to six months afterwards.

Producing milk is called lactating and not having a period is called amenorrhea,
hence this method of birth control is called lactational amenorrhea (or LAM).

How does this method work?

If a woman exclusively breastfeeds her baby for six months, the hormones that
produce the breast milk will also work to stop the ovaries from releasing an egg
(that is, there will be no ovulation) for the first six months after the baby is born.
A woman doesn't get her period during this time.

For this method to work, the following three conditions must be met.

1. The baby must be under six months of age AND

2. The woman must not have had a period AND

3. The baby must be exclusively breastfed (no formula or pablum with breast
feeds at least every four hours during the day and at least every six hours at
night).

How effective is it?

 Lactational amenorrhea is between 98% and 99.5% effective in preventing a

pregnancy.

 If any of the criteria changes, such as you get your period or you start feeding
your baby formula or pablum, then you need to assume the LAM is no longer working
and you need to use another form of birth control. It is useful to have some condoms to
use in case one of the criteria changes.

Advantages

 It costs nothing

 Easy to use

 No clinic visits or external drugs required

 No hormones that interfere with breast feeding

 Does not interrupt intercourse

Disadvantages

 It only lasts for six months after your baby is born

 It is not reliable if your baby is fed any pablum or formula

 It is difficult to predict if your ovaries are ready to start releasing an egg

(ovulating). However, as soon as you have a period, you should use another method of
birth control, if you have not already done so.

 Requires frequent breastfeeding (see above) which may be difficult for some
women

 Does not protect against STIs

Additional information

 LAM helps the woman's body return to its pre-pregnancy state

 Helps the woman to return to normal weight

 Vaginal dryness related to breastfeeding can be improved by using water-based

lubricant

 Women who are HIV+ should discuss the risks and benefits of LAM with their
physician

What is withdrawal?

The man removes his penis from the vagina before he comes so that ejaculation
takes place outside the vagina. Usually, no other protection methods are used
with the withdrawal method. Experience and practice helps men develop the
skill to use this method effectively.

How effective is it as a contraceptive?

 Withdrawal is 73% (typical use) - 96% (perfect use) effective.

How effective is it at preventing STIs?

 There is a greater risk of contracting sexually transmitted infections (STIs)

because there is no protection (barriers) between partners and body fluids.
 Advantages

 Withdrawal is free and always available

 No clinic visits necessary

 No equipment or supplies needed

 No side effects

 Method does not rely on woman using contraception

 Method can be used with other methods of contraception

Disadvantages

 May be difficult for some men to know when they need to withdraw before the
point of ejaculation

 There may be increased anxiety for both partners around withdrawing in time.
This worry may decrease their enjoyment of sex.

 Poor to no protection against sexually transmitted infections including HIV and

AIDS

 Sperm may be present in the clear fluid that comes out of the penis before
ejaculation; so pregnancy might still be possible.

 How to use the withdrawal method

1. The man must rely on his own sensations to determine when he is about to
ejaculate.

2. He must then withdraw his penis prior to ejaculation and move away from the
female genitalia.

3. If another act of intercourse takes place, the man must urinate and wipe off the
tip of his penis to remove any sperm remaining from the previous ejaculation.