Natural Family Planning

Compiled by Reyda Cruz-Tabora, M.D.

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Natural family planning is the avoidance of pregnancy without the use of drugs, devices, or surgical procedures. It only involves abstinence from sexual intercourse during the fertile period of women. There are three methods of rhythm contraception: temperature method, mucus or Billings method, and calendar method.

Temperature Method

The temperature method involves the daily recording of basal body temperature. The temperature is obtained using an oral or axillary thermometer while in bed, right after waking in the morning. The temperature is taken and recorded daily. A rise in the basal body temperature occurs after the ovulation period.

As an indicator of fertility, the basal body temperature can detect only the end of the fertile phase because the temperature remains elevated for about three days after the shift.

When using this method, intercourse is avoided during the start of menses until three days after the temperature rise. Intercourse is allowed after this day until the start of the next menstruation.

Mucus or Billings Method

This method involves the evaluation of vaginal secretions (mucus). Safe periods (dryness) is characterized by thick, tacky and opaque secretions. Mucus of this type breaks easily when held between the thumb and forefinger and stretched. There is a sensation of dryness in the vulva.

Abstinence period (wetness) is characterized by clear, watery and abundant secretions. If held between the thumb and forefinger, it stretches for several inches before it breaks. Abstinence must be maintained throughout the time when mucus changes until three days after the peak of mucus secretion.

Calendar Method

This method involves the monthly recording of menstrual cycle length for six months to a year for prediction of fertility period, taking note of the longest and shortest cycles.

The menstrual cycle starts on the first day of menstruation and ends before the start of the next menses. Count the number of days of your cycle for 6 months (one year is better). Identify the shortest and longest cycle from your data.

To get the start of your fertile period, subtract 19 from the shortest cycle (e.g. if shortest cycle is 26 days, the start of the fertile period is 26 minus 19 or 7th day of each cycle).

To get the end of your fertile period, subtract 12 from your longest cycle (e.g. if longest cycle is 30 days, the end of the fertile period is 30 minus 12 or 18th day of each cycle).

In the above example, intercourse is avoided from the start until the end of the fertile period, between 7th and 18th day of the cycle.

Advantages of rhythm contraception

  • No drugs or devices
  • Improved communication between partners
  • Religious acceptability

Using the three methods improves the identification of fertile days and increases the efficacy of natural family planning.

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