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  • Title: More about natural family planning.
    Author: Gallagher J.
    Journal: Aust Fam Physician; 1983 Nov; 12(11):786-92. PubMed ID: 6667188.
    Abstract:
    When properly taught and practised, natural family planning can be a highly effective form of birth regulation. Recent studies indicate low failure rates of less than three pregnancies per 100 women years for couples with a strong motivation to follow the method. Studies show that pregnancy rates are high when the rules for avoiding pregnancy are not adhered to. Successful natural family planning can lead to heightened self esteem and marital enrichment. This discussion of natural family planning (NFP) reviews the basis of natural planning and discusses recognizing ovluation, determining the fertile phase, achieving pregnancy, the Billings method and symptothermal methods, the last early "safe" day, cervical palpation, application of natural methods, premenopause, the post contraceptive pill, effectiveness, continuity, and achieving autonomy. NFP for contraception appeals to those with a strong commitment to the ideals of marriage, who regard sexual intercourse as 1 of many ways to express love, and who have esthetic, health, or moral objections to other methods or found them unsuitable. NFP requires abstinence from sexual intercourse and genital contact during ovulation and on days before it when conditions at the cervix provide for sperm support and migration. The art of NFP lies in the ability to recognize the beginning and end of this fertile phase. 2 signs associated with ovulation have practical value in delineating the fertility phase. 2 signs associated with ovulation have practical value in delineating the fertile phase of the cycle: mucus detectable at the vulva which serves as a predictor of ovulation; and the sustained rise in basal body temperature after ovulation, serving as an indicator of the occurrence of ovulation. The onset of cervical mucus is detectable at the vulva by most women 4-7 days ahead of ovulation. The Billings and symptothermal methods require women to observe and record the subjective and objective features typical of estrogenic and progestogenic mucus appearing at the vulva. Using the Billings method the woman observes the conditions and observed by touch or on folded toilet paper when wiping the area before and after urinating. Rules of the method include abstinence while the woman becomes familiar with her mucus symptom, abstinence during menses, and restriction of intercourse to alternate nights in the preovulatory phase. The symptothermal method employs at least 2 of the major indicators of ovulation and fertility, using the mucus symptom and temperature shift to demarcate the fertile phase of the cycle. Breastfeeding does not guarantee infertility but usually provides an extended period of amenorrhea, especially when the only source of the baby's nourishment is breast milk. Results of the effectiveness phase of the World Health Organization 5 nation study of the Billings ovulation method, published in 1981, included an overall pregnancy rate of 22.6/100 woman years. The method related pregnancy rate was 2.8%; user related rate was 19.3%; and 0.5% were in the uncertain category. The overall pregnancy rate was 7.47 with the symptothermal method. The method related pregnancy rate was 0.93% and user rate was 6.54%.
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