Fehring, R. J., & Mu, Q. (2014). Cohort efficacy study of natural family planning among perimenopause age women. Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN, 43(3), 351-358. https://doi.org/10.1111/1552-6909.12307
Fehring RJ, Mu Q. Cohort efficacy study of natural family planning among perimenopause age women. J Obstet Gynecol Neonatal Nurs. 2014;43(3):351-358. doi:10.1111/1552-6909.12307
Fehring, Richard J., and Qiyan Mu. "Cohort efficacy study of natural family planning among perimenopause age women." Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN, vol. 43, no. 3, 2014, pp. 351-358.
Women 40-55 had 6 pregnancies per 100 in a year of natural family planning
Women aged 40 to 55 had 6 unintended pregnancies per 100 in a year of natural family planning. Subset data from two prospective observational cohort studies supplied a secondary analysis of 160 such women with an intention to avoid pregnancy. They used a hormone monitor, mucus signs, or both. Correct use among online learners produced 1.5 pregnancies per 100.
Key Findings
Five unintended pregnancies occurred among 160 women aged 40 to 55, giving a typical use pregnancy rate of 6 per 100 users across 12 months.
Online learners had 1 correct use unintended pregnancy, which equals 1.5 pregnancies per 100 users across the 12 months.
Typical use rates per 100 users were 3 with the monitor alone (1 pregnancy, 35 women), 4 with mucus alone (2 pregnancies, 73 women), and 6 with both (2 pregnancies).
The mean age was 41.2 years. Fifteen of the 160 participants were 45 or older, and no pregnancy occurred in a woman older than 44.
Interpretation
The report is a secondary analysis of two prospective observational cohort studies. Researchers followed women for 12 months and estimated pregnancy rates with survival analysis. Two certified nurse teachers reviewed every pregnancy and agreed on all classifications. The authors note that diminished fertility and a strong motivation to have no more children most likely influenced the rate. They call for further study in larger, more diverse groups.
RRM Context
Restorative reproductive medicine reads the cycle for signs of health. Fertility awareness-based methods, such as the Marquette Model, use those signs to avoid or achieve pregnancy. This cohort adds data on charting in perimenopause, a life stage where little had been known about efficacy.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
To determine the efficacy of using natural family planning (NFP) methods to avoid unintended pregnancy among women of perimenopause age (i.e., age 40-55 years).
Design
A secondary analysis of subset data from two prospective observational cohort studies.
Setting
A university based in-person and online NFP service program.
Participants
One hundred and sixty couples who used either a website or an in-person NFP service to learn how to avoid pregnancy from January 2001 to November 2012.
Methods
A prospective 12-month effectiveness study among 160 women (between ages 40-55) who used NFP to avoid pregnancy. The women used either a hormonal fertility monitor, cervical mucus monitoring, or both to estimate the fertile phase of their menstrual cycles. Survival analysis was used to determine the pregnancy rate over 12 months of use.
Results
There were a total of five unintended pregnancies among the participants. The typical use pregnancy rate was six per 100 women over 12 months. The monitor alone participants (n = 35) had a 12-month pregnancy rate of three, the participants (n = 73) who used mucus alone had a pregnancy rate of four, and the participants (n = 42) who used the fertility monitor plus mucus had a pregnancy rate of six.
Conclusion
Natural family planning methods can be effective for older women to avoid an unintended pregnancy with correct use and adequate instructions. The pregnancy rate most likely was affected by diminished fertility and motivation to limit family size.
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