NFP Feb 2011

 Despite the progress that has been made over the years to provide adequate family planning methods, over 120 million women worldwide do not have access. Reasons ranging from lack of education about contraceptive methods, lack of access to supplies, fear of side effects to fear of social, cultural or religious disapproval. Natural Family Planning Also called fertility awareness method/ periodic abstinence.  Methods for planning or avoiding pregnancy by observation of the natural signs and symptoms of the fertile and infertile periods of menstrual cycle. NFP is not a contraception. NFP gives couples a way to space out child births and limit the total number of children but does not give the couple complete control over procreation. Couples using NFP simply abstain from sexual intercourse during the fertile period when avoiding pregnancy but have vaginal sex at this time when want to achieve pregnancy .

NFP Feb 2011

Pre 20th Century St. Augustine wrote on periodic abstinence(In the yr 388 ) Roman Catholics first recorded Official statement on periodic abstinence(.1853 Ruling). Reaffirmed in 1880. Early 20th Century In 1905 Theodore Van de Velde( 1x ovulation/cycle in women) . Kysusaku Ogino, Herman Kuaus(Austria) Discovered that ovulation occurs about 14days before next cycle. Ogino used this discovery to develop a formula for use in aiding infertile woman to time intercourse to achieve pregnancy. In 1930, John Smulders( Roman catholic physician) used Kuaus and Oginos discoveries to create a method for avoiding pregnancy. In 1932 a catholic physician published a book titled the Rhythm of Sterility and Fertility in women describing the method. Late 20th Century 1950s: Dr Billings discovered the relationship between cervical mucus and fertility while working for the Melbourn Catholic family welfare Bureau setting up teaching centers around the world in the 60s.
NFP Feb 2011

2 3% of the worlds reproductive age population relies on periodic abstinence for pregnancy prevention. Breastfeeding believed to reduce worlds fertility rate by 30 45%. In Brazil NFP : 3rd most popular FP method. Safe period method : most common FP method in India Use of NFP in developed countries is low even among Catholics.( In the US Catholics(24%) of reproductive age population using birth control only 1.5% were using periodic abstinence in 2002)

  

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Depends on the user Risk of pregnancy greatest when have unprotected vaginal sex during fertile periods. Commonly used; 25 pregnancies per 100 women. Correct and consistent use vary for different types of NFP methods In General abstinence during fertile periods more effective than using other methods No side effects Fertility returns immediately after NFP is stopped Health benefits; prevents pregnancy

 

  
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No side effects Requires no procedures or supplies Helps women learn about their bodies and fertility Allows some couples to adhere to their religious or cultural norms about contraception. Can help achieve or avoid pregnancies

NFP Feb 2011

 Calendar Based Method (CBM)

Standard Days Method (SDM) Calendar Rhythm Method (CRM)

Symptoms-Based Method (SBM)

Two Day Method (2DM) Basal Body Temp (BBT)

Symptothermal Method (SM) Withdrawal Method (WM) Lactational Amenorrhea Method (LAM)

NFP Feb 2011

Calendar Based Methods(CBM)

Standard Days Method
   Can use if most of her menstrual cycle are between 26-32 days long in a year Less effective if has more than two longer or shorter cycles within a year Fertile period days; days 8-19 of every cycle avoid unprotected vaginal sex or use barrier method. Cycle Beads (Memory Aid)

NFP Feb 2011

Calendar Rhythm Method

   Record length of menstrual cycle for at least six months Subtract 18 for the shortest cycle and 11 from the longest cycle fertile period Update calculation each month always using the 6th most recent cycle. Eg Longest Cycle 32 day; shortest cycle 27 days; 27-18 = 9. Day 9 beginning of fertile period. 31-11 =20. Day 20 end of fertile period.

NFP Feb 2011

Symptom Based Method

  All women can use SBM No medical conditions prevent the use of these methods, but some conditions can make them difficult to use effectively. Therefore, delay their use of use with caution.

Use with Caution  Recently had an abortion/miscarriage  Menarchy/Perimenopause/Irregular menstrual cycle  Chronic condition that body temp. (For BBT and symptothermal methods) Delay Use  Recently gave birth/ Breastfeeding; 6months (for breastfeeding mother and 4weeks for non breastfeeding woman till the normal secretions have returned). After several months of regular cycle use with caution.  Acute conditions that increase body temp.  Irregular vaginal bleeding  Abnormal vaginal bleeding
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Delay Use / Use with Caution  Mood altering drugs Methods  Two day method  BBT. Basal Body Temp ( 0.2 0.5C)

NFP Feb 2011

Ovulation Method In the presence of vaginal infection or another condition that changes cervical mucus makes its use difficult

NFP Feb 2011

Symptothermal Method
   Identify fertile period and fertile period by combining BBT and ovulation method instructions May also identify fertile period by other signs such as breast tenderness and ovulatory pain. Avoid unprotected sex between first day of monthly bleeding and either the forth day after peak cervical secretion or third day post increase in BBT which ever happens later.

NFP Feb 2011

Withdrawal Method (WM)

    Other Names Coitus Interuptus or Pulling Out Always available in every situation Requires no supplies, pharmacy or clinic visits to do that One of the least effective contraceptive methods Protects male involvement and couples communication

Effectiveness  Depends on user  Commonly used; 27 pregnancies per 100 women whose partners used that method over the first year.  Correct use with every act of sex is 4 pregnancies per 100 women whose partners used that method over the first year.  Instant return of fertility after stopping  No protection against STIs  All men can use this method

NFP Feb 2011

Lactational Amenorrhea Method (LAM)

    Family planning method based on breast feeding Can be effective up to 6 months post partum Require breastfeeding often, day and night. Works primarily by preventing ovulation

Three Conditions Required  The mothers monthly bleeding has not returned  The baby is fully or nearly fully breastfed and is fed often, day and night  The baby is less than 6 months old

NFP Feb 2011

Effectiveness  Depends on the user  Risk of pregnancy greatest when not fully breast feeding nor nearly fully breast feeding  Commonly used 2 pregnancies/100 Women  Correct use 1 pregnancy/100 women in the first 6months postpartum  Return of fertility after LAM depends on how much the woman continues to breast feed No protection against STIs Health Benefits  Protects against risk of pregnancy  Encourages the best breastfeeding patterns with health benefits for both mother and baby  No known health risks

NFP Feb 2011

Who can use LAM All breastfeeding women except in the following circumstances:  In HIV and AIDS  Taking certain medication during breastfeeding( mood altering drugs, high doses of Corticosteroid, Bromocriptine, Radioactive drugs, Lithium and certain anti coagulant drugs)  Newborn having a condition that makes it difficult to breast feed.

NFP Feb 2011

NFP provides methods for planning or avoiding pregnancy by observation of the natural signs and symptoms of the fertile and infertile periods of menstrual cycle. It is preferred by many because it has no side effects, respects cultural and religious beliefs, inexpensive, and this method can be used to prevent or achieve pregnancy. The effectiveness of NFP depends on the user because there are several methods as mentioned; which have different requirements.

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(2007) Family Planning: A Global Hand Book for Providers: A WHO Family Planning Cornerstone The American congress of Obstetrics and Gynecology http://www.acog.org/publications/patient_education/bp024.cfm (2000-2011) American Pregnancy Association http://www.americanpregnancy.org/preventingpregnancy/fertili tyawarenessNFP.html Google Images: www.google.com

NFP Feb 2011

Summary

NFP Feb 2011