Natural methods of family planning.

ABSTRACT

PIP: Recent scientific discoveries about the mechanisms of reproduction as well as growing concern about the adverse effects of modern contraceptive techniques have contributed to increased interest in natural family planning methods. Natural family planning encompasses both fertility awareness and the application of this knowledge to fertility control. Fertility detection can be achieved through biochemical methods, biophysical methods, or clinical indicators. In addition, there are several multiple index methods. Prospective studies aimed at assessing the efficacy of natural family planning have reached 3 general conclusions: 1) method-related failure rates are substantially lower than use failure rates; 2) the chances of an unplanned pregnancy are greatly reduced when intercourse is limited to the postovulatory infertile phase; and 3) all variations of the sympto-thermal method appear to have a significantly lower failure rate than the cervical mucus method. These studies further point to the importance of good quality teaching to the efficiency of natural methods. Postpartum women who select natural family planning should be alert to changes in the cervix rather than mucus to predict the return of ovulation. An inexpensive chemical kit to test urine to detect the changing concentration of estrogen and progesterone at the beginning of the fertile phase would make natural family planning more widely acceptable. New scientific techniques of this type are under development and can be expected within the next couple of years.