Natural Family Planning

What is natural family planning?

Natural family planning is a term used for methods of birth control that do not involve the use of any drugs or devices. It is also called the rhythm method, fertility awareness, or periodic abstinence. If you do not want to get pregnant, you should not have sex during the fertile days (days you are more likely to get pregnant) of your menstrual cycle.

When is a woman fertile?

An average menstrual cycle lasts approximately 26 to 32 days. Normally during each menstrual cycle an egg is released from one of your ovaries. The release of an egg is called ovulation. The egg travels through a fallopian tube to the uterus. The egg can be fertilized by sperm as it travels to the uterus. If the egg is not fertilized after it leaves the ovary, it is absorbed by the body, or your body gets rid of it during the monthly period. It is during this time that you are fertile.

Sperm can live inside your body for 3 days after you have sex. This means that you can get pregnant up to 3 days after you have sex if you ovulate during that time.

How do I use natural family planning?

Natural family planning birth control methods are based on calculating when your fertile days will occur. You should not have sex during your fertile days if you do not want to get pregnant.

There are 6 types of natural family planning methods:

• Basal body temperature
• Cervical mucous or ovulation
• Symptothermal
• Calendar
• Standard days
• Lactational amenorrhea (breastfeeding).

Other changes, such as pain in the area of the ovaries, low backache, breast tenderness, and bloating also may be used to help you know which days you are fertile.

The length of the menstrual cycle varies from woman to woman. It can also vary month to month. Natural family planning methods depend on accurately recording information about your menstrual cycle and calculating safe days for sex. These methods require a strong commitment from both partners. Usually women between 20 and 40 years-old have more regular menstrual cycles. For this reason, natural family planning is more effective for women in this age group.

If you choose to use natural family planning birth control, you should use a barrier and spermicide method of birth control until you and your partner are aware of your most likely ovulation days. Barriers (such as diaphragms or condoms) and spermicides will not affect your natural family planning measurements. You and your partner should be comfortable with the natural family planning method that you choose before using it as your only method of birth control. Women who should not get pregnant for health reasons should not use natural family planning as a method of birth control.

How do I use the basal body temperature method?

Basal body temperature is the lowest body temperature of a healthy person. You will need to measure your temperature with a special, basal body thermometer right after you wake up, before you get out of bed, eat, drink, smoke, or have sex. This type of thermometer can detect small changes in temperature. You can buy one at a drug store. Your body temperature will rise about 0.5 to 1°F (0.5°C) just after you ovulate. It will stay at this higher level until your next menstrual period starts. Write down your temperature every day on a calendar.

When you use this method of birth control it is important to remember that illness and any drugs, including alcohol, can raise your body temperature.

How do I use the cervical mucous or ovulation method?

Cervical mucus is a jellylike vaginal discharge that comes from the cervix. The cervix is the opening of the uterus into the vagina. The cervical mucous is thick and sticky during most days of the menstrual cycle. It becomes clear, thin, and watery (like uncooked egg white) on days about 4 days before ovulation. Sometimes the mucous may then look white or yellowish instead of clear and watery.

You can check the cervical mucus with your finger or a piece of toilet paper. When the mucus is clear, thin, and watery, these days are called wet days. If you do not want to get pregnant, you should not have sex from the time the wet mucous appears until 4 days after the mucus becomes thick, sticky, and smaller in amount. Be careful that you don't confuse wet day mucous with semen that leaves your vagina after intercourse.

You may also buy over-the-counter ovulation kits at a pharmacy, which can show you exactly when you ovulate.

How do I use the symptothermal method?

The symptothermal method uses a combination of the basal body temperature and cervical mucous methods to determine the most likely time you can become pregnant. You will need to check your temperature and cervical mucus every morning.

How do I use the calendar method?

The calendar method is also called menstrual charting. You must keep track of your menstrual cycles for 8 cycles. The time that you are most likely to become pregnant is measured by subtracting 18 days from the number of days of your shortest cycle, and subtracting 11 days from the number of days of your longest cycle. For example, if the shortest number of days in your menstrual cycle is 28 days (28 - 18 = 10), and the longest number of days in your menstrual cycle is 32 days (32 - 11 = 21), then the most likely time for you to become pregnant is between days 10 and 21 of your menstrual cycle. If you do not want to get pregnant, you should not have sex during this time.

How do I use the standard days method?

Standard days is a method which uses a string of 32 beads. Each bead stands for one day in the menstrual cycle. The string of beads starts with a red bead, which stands for the first day of your menstrual cycle (the day your menstrual period starts). A rubber ring is moved to the next bead each day. Brown beads stand for days when you are not likely to get pregnant. White beads stand for days when you are more likely to get pregnant. If you do not want to get pregnant, do not have sex on days when the rubber ring is on a white bead (days 9 through 18).

How do I use the lactational amenorrhea method?

Lactational amenorrhea means that you do not have a menstrual period or ovulate while you are breastfeeding. You may only use this method if you are breastfeeding, and your infant is not taking any other foods or formula. You must breastfeed at least 8 to 10 times per day, with no more than 6 hours between feedings if you do not want to get pregnant. You should not use this method of birth control if you are not breastfeeding this often, if your infant is taking other foods or formula, or if you begin to have menstrual bleeding.

How effective is natural family planning?

Natural family planning methods of birth control can be 97 to 98% effective (2 to 3 pregnancies per 100 couples) when they are used correctly all of the time. However, if you do not follow the instructions completely, or if you have irregular menstrual periods, these methods will be much less effective, and they will be less reliable than some of the other forms of birth control.

What are the benefits?

The advantages of natural family planning are:

• You can have some control over when you have children without using drugs or devices.
• You can enjoy sex without the interruption or discomfort of barrier methods of birth control, such as condoms or diaphragms.
• You can avoid the health risks of some methods such as birth control pills and the IUD.
• It costs very little.

What are the disadvantages?

Natural family planning has several disadvantages, which include:

• If it is not practiced carefully, the failure rate can be 20 to 30%. This means 2 to 3 of every 10 women get pregnant during 1 year of use.
• There are days every month when you should not have sex.
• It requires time, energy, commitment, and careful record-keeping.
• It does not protect against sexually transmitted diseases, including AIDS.

How can I learn more about natural family planning?

Classes are available for couples who choose to use natural family planning methods. This form of birth control should not be attempted until both partners have had the class and are comfortable with using this method.

For more information on family planning, contact your healthcare provider or the following organizations:

• National Women's Health Information Center sponsored by the US Department of Health and Human Services at http://www.4woman.gov or call (800) 994-WOMAN
• EngenderHealth, a nonprofit organization dedicated to making reproductive healthcare accessible to women and men around the world, at http://www.engenderhealth.org.