Natural family planning (sympto-thermal method) is as effective as the pill if used correctly, according to research at the University of Heidelberg, Germany. A 2007 study assessed the efficacy of STM in a data sample of 900 women. They found the lowest rates of pregnancy amongst women who followed STM (avoiding sex during their fertile window) and a rate of 0.4 pregnancies per 100 women each year. Lead researcher Dr Petra Frank-Hermann told the BBC 'We maintain that the efficacy of STM is comparable to the effectiveness of modern contraceptive methods such as the oral contraceptive, and it is an effective and accurate method of family planning.'
So why is it not widely used as a form of contraception? Possibly because there is a misconception that it's not as reliable as other forms of birth control. It's not taught in school and doctors don't really discuss it because it's not a paid-for (profit-making) form of contraception. Fertility UK has a list of local teachers as lessons are recommended for the first few months but teachers aren't in every town. I have to travel 30 miles to find my nearest one in Brighton. So, it's not as convenient as popping a pill but I think the positives outweigh the negatives. This is a rewarding and empowering method of birth control that all women should know about.
Types of Natural Family Planning
There are two types of natural family planning:
- The sympto-thermal method, which involves observing physiological changes during the menstrual cycle so that a woman can pinpoint when she is ovulating. This can help her to plan or prevent pregnancy.
- Lactational amenorrhoea - this can be used in the first six months after childbirth if a woman is breastfeeding exclusively and her periods haven't restarted. It's the body's natural way of contraception so that we don't get pregnant again too quickly.
When am I Fertile?
A 1993 WISE Report by Unipath carried out in six European countries found limited knowledge of the facts about fertility, pregnancy and menstruation. A third of women thought that ovulation occurs during menstruation and 21% of women in the UK thought that there were more than 21 fertile days in the menstrual cycle, when it's actually 8-9 days. An egg can live for up to 24 hours and sperm up to a week, hence the need for a longer period of contraception. Women ovulate mid-cycle, on around day 14, which is 12-16 days before their next period.
Pros and Cons of NFP
The sympto-thermal method requires organisation, discipline, commitment and a regular menstrual cycle. It takes between three and six cycles to get an accurate picture of your fertility so it's not a quick fix but it is rewarding and will put you (and your partner) in touch with your body. In that sense, it encourages you to talk about sex and to share the responsibility of contraception, which will increase intimacy. It can also stop resentment building up if the woman usually takes responsibility for contraception.
How to do it
Keep a record of the following indications for at least three months to get an accurate picture of your fertility cycle:
- Your body temperature rises slightly when you ovulate and stays at a higher rate until your next period. Use a digital thermometer for accuracy and take your temperature at the same time each day, before you get out of bed in the morning.
- Cervical secretions indicate when you are ovulating. After a period the vagina is drier and doesn't secrete fluid. A week before ovulation you may notice a sticky, moist or cloudy fluid, which signals that you are about to ovulate. This becomes slippery and wet (like stretchy egg white) four days before ovulation. Keep a diary to help you become aware of the changes.
- The length of your cycle is also important. Ovulation occurs 12-16 days before your period starts (usually around day 14 of a 28-day cycle) so NFP is easiest to monitor when you have a regular cycle.
- Breast or abdominal pain is a sign that your period is about to start or that you are ovulating mid-cycle (some women experience a dull ache around one ovary).
Ovulation Prediction Kits
There are various ovulation kits on the market that will do the hard work for you. Persona (Swiss Precision Diagnostics) is the most widely used in the UK to help women prevent and plan pregnancy. It monitors the level of luteinising hormone in your urine, which rises one to two days before ovulation so you know when it's safe to have unprotected sex. It's not as cheap as the DIY approach but it can help alongside NFP for the first few months to give you a bit of confidence in monitoring your fertility cycle.
Natural family planning is something that all women should be educated about and have the chance to try. It puts women in control of their bodies and avoids the potential risks associated with taking artificial hormones long-term. It doesn't impact on your libido or affect fertility. You still need to use a barrier method during your fertile window or with a new sexual partner to prevent STIs but this is a small sacrifice for the long-term benefits that NFP can bring to a relationship.
Sources
- Patient UK: 'Natural Family Planning' (accessed 27th May 2011)
- NHS Choices: 'Natural Family Planning' (accessed 27th May 2011)
- Fertility UK - find a local NFP teacher, fertility chart, DVD's and further resources.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Nicci Talbot - Nicci Talbot is a journalist and author specialising in sex, health & wellbeing. She edits Rude Magazine, an online resource for better ...
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