Natural family planning (NFP) methods are effective for contraception with proper and consistent use. However, only 1% of patients at federally funded Title X family planning clinics select NFP as a contraceptive method. The goal of this study was to understand from clinicians' perspectives the barriers and facilitators to providing NFP methods.
Methods
Six telephone focus groups were conducted with 29 clinicians from Title X clinics across the United States and Puerto Rico. A hermeneutic method was used to analyze data for related themes.
Results
The overarching theme from the study was that participants had a strong desire to teach their patients how their bodies work and to empower them to learn to control fertility. Four subthemes emerged: patient misinformation and misunderstanding about fertility; provider ideas about ideal types of candidates for NFP; inconsistent patient teaching strategies; and lack of time to teach NFP methods.
Discussion
There is a need for increased NFP training for providers and efficient NFP patient teaching strategies to meet the needs of patients with limited knowledge about fertility.
natural family planning Title X clinics clinician perceptions, NFP barriers facilitators family planning provider perspectives, clinician attitudes natural family planning federally funded clinics, fertility awareness methods provider training patient education, Title X clinic NFP contraceptive method selection barriers, natural family planning patient teaching strategies empowerment, focus group study clinician NFP provision challenges, body literacy fertility education underserved women clinics, provider knowledge gaps natural family planning methods, Kelly Witt NFP Title X clinician focus groups
PMID 22251910 22251910 DOI 10.1111/j.1542-2011.2011.00107.x 10.1111/j.1542-2011.2011.00107.x Kelly et al. 2012, Kelly 2012
Cite this article
Kelly, P. J., Witt, J., McEvers, K., Enriquez, M., Abshier, P., Vasquez, M., & McGee, E. (2012). Clinician perceptions of providing natural family planning methods in Title X funded clinics. Journal of midwifery & women's health, 57(1), 35-42. https://doi.org/10.1111/j.1542-2011.2011.00107.x
Kelly PJ, Witt J, McEvers K, Enriquez M, Abshier P, Vasquez M, et al. Clinician perceptions of providing natural family planning methods in Title X funded clinics. J Midwifery Womens Health. 2012;57(1):35-42. doi:10.1111/j.1542-2011.2011.00107.x
Kelly, Patricia J., et al. "Clinician perceptions of providing natural family planning methods in Title X funded clinics." Journal of midwifery & women's health, vol. 57, no. 1, 2012, pp. 35-42.
Keywords
Adult, Ambulatory Care Facilities/economics, Attitude of Health Personnel, Education, Continuing, Family Planning Services/economics/methods, Female, Fertility, Financing, Government, Focus Groups, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Natural Family Planning Methods, Patient Education As Topic/methods, Puerto Rico, Sex Education/economics/methods, United States
Delbaere I et al., 2020·Ups J Med Sci·
Open Access
Delayed childbearing is currently a major challenge in reproductive medicine as increased age has an important impact on successful conception, both in natural and in assisted reproduction. There is a lack of knowledge about the impact of age on fertility, even in highly educated populations. A number of initiatives have been taken to increase fertility awareness. Health care providers have been encouraged to talk with patients about their reproductive life plan (RLP) for almost a decade based on recommendations from the Centres for Disease Control and Prevention. This concept has been explored successfully in Swedish contraception counselling. A growing number of online interventions aim to raise fertility awareness. These websites or interactive tools provide relevant information for individuals and couples as they consider whether they want children, when they should have them, and how many they may wish to have. These interventions are important, because research depicts that knowledge helps people in their decision-making process. With new fertility preservations such as egg freezing now available, additional education is needed to be sure that women and couples are well informed about the cost and low success rates of this intervention.
Diagnostic Criteria and Classification · Terminology and Definitions
Teede HJ et al., 2026·Lancet (London, England)·
Open Access
Polyendocrine metabolic ovarian syndrome (PMOS), previously named polycystic ovary syndrome (PCOS), affects one in eight women. However, the term PCOS is inaccurate, implying pathological ovarian cysts, obscuring diverse endocrine and metabolic features, and contributing to delayed diagnosis, fragmented care, and stigma, while curtailing research and policy framing. Building on an international mandate for change, we outline an unprecedented, rigorous, multistep global consensus process for the name change. Funding and governance were established with engagement of 56 leading academic, clinical, and patient organisations. Using iterative global surveys (with responses from 14 360 people with PCOS and multidisciplinary health professionals from all world regions), modified Delphi methods, nominal group technique workshops, and marketing and implementation analyses, we identified principles prioritising scientific accuracy, clarity, stigma avoidance, cultural appropriateness, and implementation feasibility. An accurate new name was prioritised over retaining the PCOS acronym or a generic name. Implementation approaches prioritised evolution rather than transformation. Preferred terms were polyendocrine, metabolic, and ovarian, reflecting the condition's multisystem pathophysiology, and polyendocrine metabolic ovarian syndrome was the consensus new name. Accuracy was improved by omitting cysts and by capturing endocrine, metabolic, and ovarian dysfunction. A co-designed global implementation strategy, including a transition period, education, and alignment with health systems and disease classification, is under way.
Advocacy and Public Understanding · Public Awareness
Parnell TA et al., 2026·Journal of Restorative Reproductive Medicine
This study examined public attitudes toward restorative reproductive medicine (RRM) and in vitro fertilization (IVF) using secondary analysis and comparative reporting of two independent surveys conducted in the United States. It also explored preferences among individuals with fertility issues and the general population’s views on treatment options. A secondary analysis was conducted using data from two nationally representative online surveys, designed and administered by organizations independent of the researchers, whose samples demographically reflected the U.S. adult population. The surveys—conducted by J.L. Partners (N=1002) and McLaughlin & Associates (N=1000)—assessed familiarity, acceptance, and attitudes toward IVF and RRM. The J.L. Partners survey focused on IVF, including medical risks, creation and use of embryos, preimplantation genetic testing, arguments for government oversight of IVF, and overall attitudes toward IVF. The McLaughlin survey focused on comparative descriptions of IVF and RRM. Pearson’s Chi-Square tests of independence were used to assess differences in response distributions across demographic subgroups and between survey items of interest. Findings: Overall, there was strong consistency of responses to items that were similar in the two surveys. Approximately 80% supported IVF initially, although both surveys found respondents to have limited knowledge about IVF procedures. In contrast, 33% supported RRM initially, with 43% having never heard of RRM. After learning more about the characteristics of RRM and IVF approaches, as presented within the surveys, preference shifted toward approaches consistent with RRM (e.g., 69% preference for an approach for natural fertilization in a woman’s body vs. 17% for fertilization in a lab). Respondents prioritized baby health (74%) over cost (13%) and time to conceive (6%). Many IVF patients were concerned about undiagnosed health issues and being rushed into IVF. Overall, 70% wanted treatments that addressed underlying causes; nearly half were unaware of any medical risks of IVF. Stated support for IVF declined by 10% overall after presentation of medical risks, questions about the creation and use of embryos and genetic testing, and arguments to support government oversight of IVF. Both surveys showed strong support for patient access to full information about treatments and treatment processes. While IVF is widely accepted, these national survey data suggest preferences for fertility treatments that prioritize diagnosis and restoration of natural reproductive health, which is the focus of restorative reproductive medicine. Comprehensive assessment, restoration of healthy function, transparency regarding treatment processes, and sensitivity to ethical concerns in patient care reflect important public values. Greater awareness and public education, improved consent, more research, and ongoing surveys are needed to inform public health strategies and meet patient needs in fertility care.
Measurement and Statistics · Instrument Development and Validation
Global fertility rates are declining. In China, the total fertility rate dropped sharply from 5.59 in 1971 to 1.15 in 2021. Chinese university students often lack adequate fertility awareness, yet no validated instrument exists to assess this construct in this population, despite its recognized importance for informed reproductive decision-making. The Fertility Awareness Scale for University Students (FASUS) was developed through literature search, semi-structured interviews, and two rounds of Delphi expert consultation. Psychometric properties were tested using exploratory and confirmatory factor analysis, Cronbach's α, split-half reliability, and test-retest reliability. A cross-sectional survey of 750 students examined fertility awareness levels and influencing factors via univariate analysis and multiple linear regression. The final FASUS Scale consisted of 22 items across three dimensions: fertility-related knowledge, reproductive health attitudes, and reproductive health skills, with a cumulative variance contribution rate of 67.952%. The scale demonstrated strong reliability (Cronbach's α = 0.97, split-half reliability = 0.885, test-retest reliability = 0.981). A survey of 750 students revealed an average fertility awareness score of 78.01 ± 16.44, indicating a low to moderate level. Key influencing factors included gender, ethnicity, education level, only-child status, and prior fertility knowledge education. This study utilized a self-developed scale to assess fertility awareness among Chinese university students. The results showed that the fertility awareness level of Chinese university students was generally low. We suggest that health care institutions implement targeted intervention measures to improve reproductive health outcomes.