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Chapter: Obstetrics and Gynecology: Contraception

Natural Family Planning

“Natural family planning” refers to methods that seek to prevent pregnancy by either avoiding intercourse around the time of ovu-lation or using knowledge of the time of ovulation to augment other methods, such as barriers or spermicides.

NATURAL FAMILY PLANNING

 

“Natural family planning” refers to methods that seek to prevent pregnancy by either avoiding intercourse around the time of ovu-lation or using knowledge of the time of ovulation to augment other methods, such as barriers or spermicides. These methodsare safe, cost little, and may be more acceptable for couples who wish a natural method. However, the failure rate with typical use is high. For couples who are highly motivated and for women with a regular menstrual cycle, these meth-ods may provide acceptable contraception.

 

Several methods are in use, and all are based on esti-mation of the woman’s fertile period:

 

·  Calendar method

 

·  Basal body temperature method

 

·  Cervical mucus method

 

·  Symptothermal method

 

The calendar method is based on calculation of a woman’s fertile period. For a woman with a regular 28-day cycle, the fertile period would last from days 10 through 17. Additional days are added to the fertile period based on the time of shortest and longest menstrual interval. Basal body temperatures and changes in cervical mucus are used to detect ovulation. A rise in basal body temperature of 0.5°F to 1°F, or the presence of thin, “stretchy,” clear cer-vical mucus, indicates ovulation. The symptothermal method combines assessment of cervical mucus and basal body temperature methods.

 

Couples using these methods avoid intercourse until a suitable period after ovulation, that is, 2 to 3 days after temperature rise or from the first awareness of the clear, copious mucus associated with ovulation until 4 to 5 days thereafter, indicated by the appearance of the milky or opaque mucus seen in the postovulatory, or “safe,” inter-val. These methods are especially difficult to use in the postpartum period, when menstrual regularity has not yet resumed and cervical secretions are varied in appearance. Ovulation can occur as early as the fifth week postpartum. Lactation may temporarily suppress ovulation for up to six months in women who are exclusively breastfeeding. Lactation as a method of contraception is unpredictable because a woman may begin ovulation before she resumes menstruation.

 

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