Researchers used life table rates from study and comparison groups from rural and urban areas of Cagayan de Oro City, the Philippines to test a simplified method of teaching natural family planning (NFP) defined by calendar, mucus, and cervix indicators. This method included a 6 page booklet, 2 30-minute training sessions, and a question and answer period. Fear of side effects from other contraceptive methods was the leading reason for using NFP (79.4% urban, 85.8% rural). Religious motivation and fear of side effects followed for urban couples, but the percentage was low (14.6%). In rural areas, religious motivation place 3rd (4.1%) preceded by other reasons (6.9%). User error resulted in low accidental pregnancy rates (.8%). Method failure was responsible for higher failure rates than user error, but they were still relatively low (3.4% total). In rural areas, the reason for failure was unclear in 2.6% of couples, but it was only .9% among urban couples. Rural couples who used NFP to space births (spacers) had 2 times the failure rate of those rural couples who used NFP to limit births (limiters) [69% vs. 31%]. Urban spacers had a higher failure rate than urban limiters, but the difference was smaller than it was for rural couples (54.8% vs. 45.2%). Lactation did not have a clear effect on failure rates. For example, in urban areas, partially lactating women had a lower failure rate than nonlactating women (41.9% vs. 58.1%), but in rural areas, lactation had the opposite effect (63.6% for lactating women and 36.4% for nonlactating women). Risk taking resulted in more 6 month pregnancy rates among urban couples than rural couples (12.3% vs. 8.2%). At the end of 6 months, 67.5% of all couples still used the new simplified NFP method (70.3% rural vs. 64.7% urban). Therefore the new simplified NFP method was an effective method for spacing or limiting births.
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Madigan et al. 1987, Madigan 1987
Cite this article
Madigan, F. C., Sealza, L. P., & Tabor, M. D. (1987). Can NFP be taught in two short, easy lessons? Simplified NFP for isolated and/or busy couples. Philippine population journal, 3(1-4), 51-61.
Madigan FC, Sealza LP, Tabor MD. Can NFP be taught in two short, easy lessons? Simplified NFP for isolated and/or busy couples. Philipp Popul J. 1987;3(1-4):51-61.
Madigan, F. C., et al. "Can NFP be taught in two short, easy lessons? Simplified NFP for isolated and/or busy couples." Philippine population journal, vol. 3, no. 1-4, 1987, pp. 51-61.
Fehring RJ et al., 2016·MCN Am J Matern Child Nurs
The aims of this study were to determine and compare extended use-effectiveness of an online nurse-managed fertility education service program among women (and subgroups of women) seeking to avoid pregnancy. This was a 24-month prospective study of a university-based online Web site with 663 nonbreastfeeding women using an online charting system to avoid pregnancy. Participants tracked their fertility online with either cervical mucus monitoring, electronic hormonal fertility monitoring, or both fertility indicators. Unintended pregnancies were validated by professional nurses. Participants had a mean age of 30.4 years (SD = 6.3) and mean 1.7 children (SD = 2.0). Among the 663 nonbreastfeeding participants there were 2 unintended pregnancies per 100 at 24 cycles of correct use and 15 pregnancies at 24 cycles of typical use. However, the 212 women using the electronic fertility monitor had a typical use unintended pregnancy rate of 6 at 24 cycles of use in comparison with the 118 women using cervical mucus monitoring that had a typical use pregnancy rate of 19 at 24 cycles and with the 333 women using both fertility indicators that had a pregnancy rate of 18 at 24 cycles of use. CLINICAL Use of the fertility monitor to estimate fertility among nonbreastfeeding women provides the most secure method of avoiding pregnancy.
Manhart MD et al., 2013·Osteopathic Family Physician
Each year, over three-fourths of the women of reproductive age in the United States seek family planning services from primary care clinicians. Women and their doctors should be informed of all effective family planning options and their respective effects on a woman's reproductive health. Family physicians are well-trained to support the behavior choices necessary for the successful adoption of any reversible family planning method. However, many are unfamiliar with fertility awareness-based methods (FABM) of family planning or have misconceptions about their effectiveness, complexity, or suitability for their patients. FABM teach women to observe the physical signs and symptoms that follow hormonal fluctuations throughout the menstrual cycle to identify a couple's fertile window, which can be used to avoid or achieve pregnancy. One in 5 women in the United States expressed interest in using FABM when informed about such options. When correctly used to avoid pregnancy, modern FABM have unintended pregnancy rates<5 (per 100 women years). Studies of modern FABM show that their typical unintended pregnancy rates are comparable to those of commonly used contraceptives. This article presents a review of the FABM literature to (1) familiarize the reader with the physiological basis and features of modern FABM, (2) present and utilize a framework to evaluate clinical evidence using the Strength of Recommendation Taxonomy (SORT), which supports the effectiveness of modern FABM for avoiding pregnancy, and (3) serve as a resource for health care professionals offering FABM options to their patients.
fertility-awareness/effectiveness/typical-and-perfect-usebody-literacy/patient-education/educational-materialscontraception/comparative-studies/contraception-versus-fertility-awareness
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Fehring RJ et al., 2011·J Obstet Gynecol Neonatal Nurs
To evaluate the efficacy, knowledge of fertility, and acceptability of a web-based natural family planning (NFP) education and service program.
A 6-month repeated measure longitudinal evaluation pilot study.
A university based online website. The website was piloted with 468 volunteer women seeking NFP services. Of these participants, 222 used the automatic online fertility charting system to avoid pregnancy. The 222 charting participants had a mean age of 29.9 years (SD=5.6), 2.2 children (SD=1.9), 37% were postpartum, and 47% had regular menstrual cycle lengths. Nurse-managed web-based NFP education and service program. Outcomes: Pregnancies were confirmed by an online self-assessed pregnancy evaluation form. A 10-item fertility quiz and 10-item acceptability survey was administered online. Among the 222 users avoiding pregnancy, at 6 months of use, there were two correct-use unintended pregnancies that provided a pregnancy rate of 2% and seven total unintended pregnancies providing a typical use pregnancy rate of 7%. Mean knowledge of fertility increased significantly from time of registration (8.96, SD=1.10) to 1 month of use (9.46, SD=.10), t=4.60, p<.001). Acceptability increased nonsignificantly from 1 month of use (45.6; SD=8.98) to 6 months of use (48.4; SD=8.77). The nurse-managed online NFP system seems to provide adequate knowledge of fertility and help participants meet pregnancy intentions. Acceptability of such a system of NFP is still in question.
Fehring RJ et al., 2008·MCN Am J Matern Child Nurs
To determine the effectiveness of the Marquette Method (MM) of natural family planning (NFP) as a method of avoiding pregnancy. This was a 12-month retrospective evaluation of the MM system of NFP. Two hundred and four women (mean age, 28.6 years) and their male partners (mean age, 30.3 years) who sought to learn a method for avoiding pregnancy with the MM from four clinical sites were taught to track their fertility by self-observation of cervical mucus, by use of an electronic monitor that measures urinary levels of estrone-3-glucuronide and luteinizing hormone, and by use of basal body temperature. All unintended pregnancies were evaluated by professional nurses as to whether they were intended or not. Pregnancy rates over 12 months of use were determined by survival analysis. There were a total of 12 unintended pregnancies, only 1 with correct use. The 12-month "correct use" pregnancy rate was 0.6 (i.e., 99.4% effective) and the "typical use" (total pregnancy rate) was 10.6 (i.e., 89.4% effective) per 100 users.
Clinical When used correctly, the MM system of NFP is an effective means of avoiding pregnancy. The efficacy of the MM system includes proper preparation of the professional nurse NFP teachers.