NATURAL FAMILY PLANNING

Definition

- WHO 1982: Methods for planning or preventing pregnancies by observation of naturally occurring signs and symptoms of fertile and unfertile phases of the menstrual cycle.

- Couple abstains from coitus during fertile phases (especially when conception is an undesired effect)

- Equally effective to artificial birth control when correctly practiced

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Goals

• Ultimate goal is to improve the quality of lifeBirth spacingBirth limitationAssist infertile couples to have children

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TYPES OF NATURAL FAMILY PLANNING

A. Basal Body TemperatureB. Sympothermal MethodC. Ovulation or Cervical Mucus MethodD. Calendar MethodE. Standard Days Method F. Lactational Amenorrhea

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A. BASAL BODY TEMPERATURE• PRINCIPLE: slight increase

in body temperature, by 0.5-1˚C right after ovulation (thermogenic effect of progesterone)

• Increase in temperature is maintained until the next menstruation

• Ovulation assumed when there is rise in temperature is sustained for at least three consecutive days

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• Take temperature every morning before any activity is done

• Refrain from intercourse from end of menstruation up to 3 days after increase in temperature

• Biphasic curve• THERMAL SHIFT:

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B. SYMPOTHERMAL

• Most effective • Identify fertile and infertile days using:

changes in basal body temperature signs and symptoms of ovulation

o slippery and transparent mucus in the genital areao Swelling, tenderness, sensitivity of the breastsoDull pain the lower abdomen (Mittlschmerz)oMidcycle spotting (Klein Regal)

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• Identify the first day of fertile period by calendar method or cervical mucus method

• Advantages:permits sexual relations during the early dry days shortens the period of abstinence necessary for complete

protection when using the temperature method alone

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Ovulation / Cervical Mucus Method

• Billing’s Method• After menstruation– Cervical mucus is opaque, thick & sticky– dry days

• Ovulation– Mucus is slippery, lubricative, transparent & watery discharge– “raw egg white” – peak of ovulation

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• Klein Regal – During peak day spotting may appear– “Days of bleeding”

Ovulation / Cervical Mucus Method

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Recap

• Colour • Consistency • How stretchy it is

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• Early day Rule ( From menses to peak)COITUS IS AVOIDED ON DAYS OF BLEEDING!!

Ovulation / Cervical Mucus Method

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Three types of mucus -Odeblad

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Calendar Method

• a.k.a Rhythm Method– estimating a woman's likelihood of fertility– Basing on the past menstrual cycle for at least 6

months– Unique nature of woman’s cycle ( irregular

periods or unusual length)

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How to Calculate

• D1 (1ST day of menstrual cycle) next menstrual cycle

• Normal: 28 days ( 23-36 days)• Fertile D5- D25

To Calculate Fertile phase: subtract 18 from shortest cycle and 11 from the longest

* Shortest cycle: 23-18 = 5 (infertile phase)* Longest cycle: 36- 11 = 25 (post-ovulatory infertile

phase)17

EXAMPLE

Bechay 22y/o regular menstrual period

LMP: June 15’09June 29 – ovulation period (add 14)+/- 5 days = SAFE/ NON FERTILE

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STANDARD DAYS METHOD

• 95 % effective• Tracking of days to avoid sex to prevent

pregnancy• Beads represent the menstrual cycle• Woman can use this method if her cycles last

between 26-32 days.

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• Each bead is a day of cycle.

• Red = 1st day of the period

• White = woman can get pregnant

• Brown = Pregnancy is unlikely

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TWO DAY METHOD

• Did I note any secretions today? Yesterday?• Monitoring of each day for the presence or absence

of secretions.• Monitor secretions in the afternoon and in the

evening by sensation or observation.• Consult if secretions happens for more than 14

consecutive days.

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LACTATIONAL AMENORRHEA

• Depends on the hormones and on the act of breastfeeding.

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Prerequisites:1.Mother must feed the baby nothing but her

milk2.Breastfeeding intervals should not be longer

than 4 hours during the day and 6 hrs at night.3.The baby is also fed on demand.4. Milk can be given as a support

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• Caution: A woman might ovulate even without menstruation.

• This method is most effective during the first 6 months of exclusive breastfeeding.

• Works better in older participants.• 2 % of failure in the 1st 6 months. • If bleeding occurs the risk of failure becomes

higher.

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ADVANTAGES OF NFP• Safe-no interference with body processes, no artificila

devices used, no medical effects or allergic reactions• Inexpensive• helps women get to know their bodies and it

empowers them to cooperate with their male partners in avoiding unwanted pregnancies;

• Improves mutual relationship of couples• Allows sexual intimacy w/o interference during safe

days• Allows couples especially Catholics to remain faithful

to their religious and ethical beliefs

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DISADVANTAGES OF NFP

• They rely heavily on your ability to accurately work out your fertile periods each month.

• They are not suitable for women with irregular periods.

• Your body signs may be difficult to interpret if you are tired, stressed or ill

• They do not protect you or your partner against sexually transmitted infections,

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