Contraception and the effectiveness of the ovulation method in India.

PIP: The Billings Ovulation Method was studied in India -- a method whereby a woman observes, records, and interprets her physiological sensations and symptoms during her menstrual cycle and thus is aware of the periods of her fertility or otherwise. The basis of the study was the evaluation of 3530 acceptors over the January 1975 through December 1977 period. The Centers participating in the study were located in several states of India, giving a varied picture of all cultures and socioeconomic classes. Evaluation of the program was carried out through aggregate and average woman months of use, net cumulative continuation rates and Pearl's pregnancy rates/life table pregnancy rates. 499 of the 3530 women discontinued the method at various points. The aggregate woman months of use was found to be 39,967 yielding an average of 11.3 months per woman. At the end of the 6th month, the continuation rate was 88.5, and at the cut-off point 80% of the women were continuing in the program. There were 176 pregnancies among the acceptors of this method during the study period. The Pearl's pregnancy rate was found to be 5.3 for all pregnancies. The life table pregnancy rate was found to be 5.7 at the end of 1 year.^ieng

The ovulation method in developing countries with special reference to India.

PIP: Time may prove that no equal exists to natural family planning (NFP) methods in regard to safe and wide applicability without much sacrifice of reliability, especially in developing countries because of its inexpensiveness and dependence on the couple rather than doctors or paramedical staff. In India, for example, the vast majority of Indians, regardless of caste of religion, are indoctrinated to practice abstinence of various kinds: fasting for either religious or social reasons, abstinence from sleep, abstinence from speech, sexual abstinence during Ramzan (Muslims) and Adimasam (South Indians). With this background, there is great scope for wider use of the Ovulation-Method (Billings). NFP helps in the establishment of a "self-energized family," which is the aim of community health workers in developing countries. A World Health Organization (WHO) study conducted in India, Philippines, and El Salvador revealed some salient findings: the days of menstruation were only 4.4 days (5.6 days in developed countries); and the fertile period, defined as days of sticky mucus plus slippery mucus (3 days), averaged 8 days (10.6 days in developed countries). In 149 women there was only 1 day of mucus before the peak day (PD); there were 2 days of mucus in 479 women (7%); and there were days of mucus in 649 (10%). Illiteracy, poverty, and marital problems were encountered in many couples. Continuation rates were significantly high in the WHO study (1979) and the Karnataka State Study (1981). Friction caused by abstinence was experienced by only 1.7-4.6% of husbands in the Karnataka Study of 2790 couples with detailed records on this aspect. In developing countries where the dignity of a woman needs to be raised, an educational method that lends itself to the integrated teaching of health, hygiene, and nutrition concepts and practices is appealing. The responsible behavior of the husband together with the wife's effort in recording her fertility creates a marital partnership with the woman sharing on an equal basis with her husband.^ieng