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  • Title: Fertility awareness as a component of sexuality education. Preliminary research findings with adolescents.
    Author: Roth B.
    Journal: Nurse Pract; 1993 Mar; 18(3):40, 43, 47-8 passim. PubMed ID: 8459941.
    Abstract:
    Fertility awareness refers to the observation and interpretation of cervical mucus, often called vaginal discharge. A woman's cervical-mucus pattern indicates the time of ovulation and differentiates the fertile and infertile phases of the menstrual cycle from each other. Fertility awareness enables a woman to know when pregnancy can and cannot occur on a daily basis during each menstrual cycle. There has been, to date, almost no exploration of the appropriateness of fertility-awareness instruction for adolescents. A review of the literature on adolescent cognitive development, sexual activity, knowledge of fertility and contraceptive risk-taking behavior is presented. Based on the literature review, a theoretical rationale for fertility-awareness instruction as a unique sex-education curriculum for adolescents is proposed. The content and teaching techniques of a fertility-awareness presentation for teenagers is described. Directions for future research in fertility-awareness instruction for teenagers, and the need for long-term follow-up to assess the effects of such education on teenagers' sexual activity and contraceptive use are discussed. Most adolescents know little about the menstrual cycle and human fertility, resulting in contraceptive risk taking behavior. Both male and female adolescents tend to believe that girls cannot get pregnant. Each time girls do not use contraception and do not become pregnant reinforces the incorrect assessment that pregnancy cannot take place. Lack of knowledge about the menstrual cycle and inability to correctly identify the fertile and infertile phases of the cycle directly encourages contraceptive risk taking behavior. If adolescents were able to correctly identify the fertile phase, they could contraceptive decisions based on actual risk of pregnancy and would increase contraceptive compliance. Application of theories of adolescent cognitive and social development to sex education results in personalized, concrete, entertaining instruction which supports the peer group structure. Fertility awareness instruction educates teenagers about the timing of ovulation and the fertile and infertile phases of the menstrual cycle. In the 1991-1992 school year, inner city middle school students in New Haven, Connecticut, underwent 2 hours of such instruction during an ongoing reproductive health course. The class presented basic anatomy and physiology of both reproductive systems. The instructor used 2 dried figs for tests and an upside down pear over the pelvis for the uterus to discuss fertilization. The instructor broke open a raw egg to depict the consistency and appearance of cervical mucus when women are most fertile. Other audiovisual materials (e.g., posters) explained the menstrual cycle. The instructor stressed the importance of condom use during every act of intercourse to prevent transmission of sexually transmitted diseases and HIV. Appropriate contraception and appropriate health care and family planning services were also emphasized. The mean fertility awareness scores improved (pretest 29% and post-test 74%). Median scores also increased (25-80%). The students evaluated the instruction in a positive manner. Some students even said that they would change their sexual or contraceptive behaviors accordingly.
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