Natural Family Planning Safe and Effective? Underappreciated tool in Global Environmental Concerns?

Birth Control Quiz Q: How many methods of birth control/family planning are 100% effective? (effective in avoiding pregnancy?) A: (Three) TOTAL abstinence TOTAL abstinence Castration Castration Total hysterectomy (removes ovaries) Total hysterectomy (removes ovaries)

Birth Control Quiz Q: What are reasons a sexually active couple would NOT use artificial birth control? A: Some include: Religious (RC, Islam) Religious (RC, Islam) Allergic to latex! Allergic to latex! Health risks assoc. with hormonal methods Health risks assoc. with hormonal methods $$$! $$$! Availability! Availability! Desire children!! Desire children!! Others? Others?

Biology Basics I Length of female’s hormonal cycle = 28 days (“Textbook” only) Length of female’s hormonal cycle = 28 days (“Textbook” only) “Day 1” = First day of menses “Day 1” = First day of menses Life of sperm (3 -5 days) Life of sperm (3 -5 days) Life of ovum (36 hours) Life of ovum (36 hours) Day of ovulation = “Day 14” Day of ovulation = “Day 14” HA!! HA!! Safe day for intercourse? (All couples; all cycles) Safe day for intercourse? (All couples; all cycles)

Natural Method I: Calendar Rhythm Q: What do you call people who practice calendar rhythm? A: Parents! Strategy: Assume woman always ovulates on Day 14 Assume woman always ovulates on Day 14 Abstain from intercourse a couple of days before & after Abstain from intercourse a couple of days before & after

Biology Basics II Certain hormonal changes occur in EVERY WOMAN, EVERY CYCLE * Exponential growth of estrogen Exponential growth of estrogen PEAK level of estrogen  Triggers LH surge  triggers ovulation!!!!! PEAK level of estrogen  Triggers LH surge  triggers ovulation!!!!! Progesterone released (from “empty egg house”) AFTER ovulation Progesterone released (from “empty egg house”) AFTER ovulation * (Assuming ovulation occurs!) * (Assuming ovulation occurs!)

Biology Basics II Fertility Signs: Rising level of estrogen Rising level of estrogen  Increases female’s receptiveness to sperm  Fluid cervical mucus High Levels of progesterone (an anabolic steroid) High Levels of progesterone (an anabolic steroid)  Increase in basal body temperature

Natural Method II: Sympto-Thermal Strategy: Monitor woman’s fertility signs  Major: cervical mucus, cervical position, basal temperature  Minor: ovulation pain, other cyclic indicators Use information to avoid or achieve pregnancy

Natural Method II: Sympto-Thermal Effectiveness? WHO study on 20,000 Indian couples All couples lived in poverty All couples lived in poverty All were uneducated All were uneducated All received GOOD NFP instruction All received GOOD NFP instruction Pregnancy Rate: Approached Zero! (<.2%!!!!) “NFP is cheap, effective, and without side effects…” BMJ, 1993

Perspectives Health: No health risks to male or female user Health: No health risks to male or female user Feminist perspective Feminist perspective Does not suppress woman’s cycle; works with her natural cycle Does not suppress woman’s cycle; works with her natural cycle Only method (other than condoms) in which male is involved Only method (other than condoms) in which male is involved Ecological Perspective Ecological Perspective Does not pollute Does not pollute Always available, to even poorest couples, if proper training has occurred Always available, to even poorest couples, if proper training has occurred Effectiveness: Extremely effective, if couple is properly trained & desires effectiveness; is also effective to achieve pregnancy Effectiveness: Extremely effective, if couple is properly trained & desires effectiveness; is also effective to achieve pregnancy

References & Resources 1993 WHO study: WHO study: Fun fertility self quiz: Fun fertility self quiz: Couple-to-Couple League, based in Cincinnati, Ohio Couple-to-Couple League, based in Cincinnati, OhioBooks: Merryl Winstein, Your Fertility Signs, Using them to avoid or achieve Pregnancy Naturally #reader-link #reader-link Kippling, John & Sheila, The Art of Natural Family Planning