Family Planning, Natural Family Planning, and Abortion Use among U.S. Hispanic Women: Analysis of Data from Cycle 7 of the National Survey of Family Growth
Rodriguez, D., & Fehring, R. J. (2012). Family Planning, Natural Family Planning, and Abortion Use among U.S. Hispanic Women: Analysis of Data from Cycle 7 of the National Survey of Family Growth. The Linacre Quarterly, 79(2), 192-207. https://doi.org/10.1179/002436312803571429
Rodriguez D, Fehring RJ. Family Planning, Natural Family Planning, and Abortion Use among U.S. Hispanic Women: Analysis of Data from Cycle 7 of the National Survey of Family Growth. Linacre Q. 2012;79(2):192-207. doi:10.1179/002436312803571429
Rodriguez, D., and R. J. Fehring. "Family Planning, Natural Family Planning, and Abortion Use among U.S. Hispanic Women: Analysis of Data from Cycle 7 of the National Survey of Family Growth." The Linacre Quarterly, vol. 79, no. 2, 2012, pp. 192-207.
Catholic Hispanic women report less recent abortion and more NFP use
Sexually active Catholic Hispanic women reported less recent abortion and more natural family planning use than non-Catholic Hispanic women, in a U.S. survey of 1,613 Hispanic and 5,743 non-Hispanic women. About 2 out of 3 of the Catholic Hispanic women had still ever used the Pill.
Key Findings
Among sexually active Catholic Hispanic women, 0.4% reported an abortion in the past 12 months, against 2.8% of non-Catholic Hispanic women (odds ratio 0.172, 95% CI 0.058–.515).
Ever use of natural family planning (NFP) was 4.6% among Catholic Hispanic women and 1.9% among non-Catholic Hispanic women (odds ratio 2.37, 95% CI 1.23–4.59).
Hispanic and non-Hispanic women reported similar abortion in the past 12 months: 1.5% and 1.3% (odds ratio 1.19, 95% CI 0.723–1.96).
Hispanic women had lower odds of ever using the Pill (60.6% against 73.3%; odds ratio 0.561, 95% CI 0.500–0.630) and higher odds of ever using the IUD (6.3% against 3.5%).
Among sexually active Catholic Hispanic women, ever use was 20.9% for surgical sterilization, 80.4% for the male condom, 66.0% for the Pill and 29.8% for Depo-Provera.
Interpretation
As a survey comparison of groups at one point in time, the analysis reports associations. Women self-reported abortion, and the authors name under-reporting as a known limit of the survey. About 57 percent of the Hispanic women in the survey were Catholic, while U.S. Census figures put the share of U.S. Hispanics near 68 percent, which raises a question about how well the sample represents Hispanic women. The tables list NFP as a single item. The authors conclude that Catholic faith has some influence on contraceptive, NFP and abortion patterns, and call that influence relatively minimal.
RRM Context
The survey lists NFP as one category, and the paper gives no breakdown of which fertility awareness-based methods women used. The authors cite a study in which 92 percent of nurse midwives felt minimally prepared to teach NFP. They call for NFP in medical and midwifery curricula. Restorative reproductive medicine reads a charted cycle as a record of ovulation, so this training gap reaches beyond contraception.
Our editorial summary of this paper, not the article's abstract.
Abstract
Hispanics are the largest minority group in the U.S. and they contribute to over 50 percent of Catholics under the age of 25. The purpose of this study was to determine the patterns of contraceptive use (current and ever), natural family planning (NFP), and abortion among U.S. Hispanic women between the ages of 15 and 44 years and to compare their patterns of use to non-Hispanic women of the same age range. A particular interest was to determine the influence of faith on the choice of family-planning methods among the sexually active U.S. Catholic Hispanic women. Data for this study came from the National Survey of Family Growth 2006-2008, which included 1,613 Hispanic and 5,743 non-Hispanic women between the ages of 15 and 44. Approximately 57 percent of the Hispanic women are Catholic. In general, U.S. Hispanic women had significantly less frequent use of the hormonal pill, male condom, withdrawal, and vasectomy (of male partner) but more frequent use of the IUD and Depo-Provera compared to non-Hispanic women. There was little use of NFP and no difference in the frequency of reported abortion. Catholic Hispanic women had significantly less frequent use of the male condom, the Pill, vasectomy, and abortion and more use of NFP compared to non-Catholic Hispanic women. Although there is some positive influence of faith among the sexually active Hispanic women of reproductive age, overall, the amount of ever use of sterilization (21 percent), condom use (80 percent), Pill use (66 percent), and Depo-Provera (30 percent) is remarkable. The more frequent use of Depo-Provera and the IUD might reflect the economic level of the participants and the use of federally funded family-planning services.
Bouchard TP et al., 2026·Journal of ovarian research·Free to read
Reproductive hormones of the fertile window are often referenced to women in regular cycles, but this may not be representative of the hormonal profiles of women in different circumstances like polycystic ovarian syndrome, the postpartum period, and the perimenopause transition. This observational cohort study sought to identify the variability in the reproductive hormones in various clinical circumstances and to establish potential thresholds for each category based on hormone measurements with the Mira urinary hormone monitor. A total of 57 women (ages 22-51) in various circumstances (regular cycles, polycystic ovarian syndrome, postpartum and perimenopause) tracked Mira urine hormone measurements (estrone-3-glucuronide, luteinizing hormone, pregnanediol glucuronide), contributing 444 cycles of data. Using additive mixed models, hormone values were stratified by the four different reproductive categories. The perimenopause and polycystic ovarian syndrome groups demonstrated relative hypoestrogenic states, while the perimenopause group showed low luteal pregnanediol glucuronide and the polycystic ovarian syndrome/polyendocrine metabolic ovarian syndrome (PCOS/PMOS) group showed high luteal pregnanediol glucuronide. The perimenopause group had significantly higher luteinizing hormone values throughout the whole cycle. The fertile window hormone thresholds vary depending on a woman's specific reproductive category. Women in different circumstances should not necessarily use the same hormonal thresholds for the fertile window and ovulation. A larger dataset with ultrasound correlation to ovulation is required to delineate the fertile window with more precision. Hormone differences across the menstrual cycle could be used for targeted treatments in polycystic ovarian syndrome and perimenopause women.
Malliou-Becher MN et al., 2026·Human reproduction (Oxford, England)
What are the variations in ovulation time and menstrual cycle characteristics among and within various individuals over the course of 12 menstrual cycles? There are considerable variations in both cycle length and ovulation time, with pronounced intra-individual variability over a 12-cycle observation period. Although it is commonly believed that healthy women have regular cycles with a predictable mid-cycle ovulation, more recent research shows a significant variation in cycle length and ovulation time. Previous studies have focused only on cycle length, often excluding cycles outside the 25-35-day range, thus limiting the understanding of natural variation; they have also lacked precise ovulation diagnostics or included small sample sizes, making it difficult to capture the full scope of cycle and ovulation variability. Similarly, a recent big data study, while valuable, was limited by a self-selected group and the absence of accurate ovulation diagnostics, reducing its generalizability. STUDY DESIGN, SIZE, This study was designed as a prospective long-term observational study, which involved collecting data from 1923 women with a total of 43 999 menstrual cycles from January 1985 to July 2019. After fulfilling the inclusion criteria, the main group consisted of 1051 women, all of whom contributed data for 12 cycles (12 612 cycles), including 420 conception cycles. PARTICIPANTS/MATERIALS, SETTING, Participants in the study were between 18 and 44 years of age at study entry and did not take any reproductive hormones. Women who were postpartum, breastfeeding, amenorrheic, or within a 3-month period after stopping hormonal contraception were excluded. Participants agreed to keep cycle records according to the symptothermal method, 'Sensiplan'. Ovulation time was determined using an evidence-based algorithm based on evaluating cervical mucus patterns and basal body temperature shifts, with ovulation time defined as the day before the temperature rise. Data analysis was descriptive, using absolute and relative frequencies, standard deviation, percentiles, and ranges. Age dependency was assessed using unpaired sample t-tests and one-way ANOVA. Linear regression was used to assess long-term trends. MAIN In 62.4% of women, cycle lengths varied by 1 week or more within 12 cycles. Accordingly, the time of ovulation varied by 1 week or more within 12 cycles in 54.8% of women, with 96.5% experiencing fluctuations of 4 days or more over the 12 months. The median spontaneous cycle length was 28 days, with a mean of 29.66 days (SD = 7.55). Only 52.7% of women consistently had cycle lengths between 23 and 35 days across all 12 cycles. Ovulation occurred most frequently between Days 12 and 16, with almost half of conceptions (45.7%) occurring after Day 16. A one-way analysis of variance revealed a significant reduction in mean cycle length with increasing age (P < 0.001), showing the shortest median cycle length of 27 days being in women aged 40-44 years. Age also impacted ovulation time, with women aged 35-39 years showing more stable ovulation patterns compared to younger women. Over the 34-year study period, average cycle length increased slightly but significantly (β = 0.0161, P = 0.0306), corresponding to approximately half a day. Intra-individual variability also showed a slight, but non-significant, upward trend (β = 0.0262, P = 0.2173). LIMITATIONS, Comorbidities such as hyperprolactinemia, obesity, and PCOS were not systematically excluded. However, by including only women with at least 12 cycles, the study largely avoided severe hormonal disorders. This study highlights the considerable individual variation of ovulation time and cycle length over 12 menstrual cycles. These findings contribute to a better understanding of fertility awareness, and highlight the implications for family planning and reproductive health management. STUDY FUNDING/COMPETING INTEREST(S): The authors declare no conflicts of interest. No funding was provided. N/A.
Bouchard TP et al., 2025·Preprints.org·Free to read
Background/Objectives: Quantitative urine monitors are increasingly being used for a personalized approach to improve menstrual cycle knowledge and to manage fertility. Although several studies have evaluated urine fertility monitors in regular cycles, there is limited research in the use of quantitative monitors in reproductive disorders, such as polycystic ovarian syndrome (PCOS). Urine hormone data was collected with the Mira monitor from 20 participants, 10 of whom had PCOS and a matched group who had regular cycles. The main aim of this study was to evaluate the levels of luteinizing hormone (LH), estrone-3-glucuronide (E13G), and pregnanediol glucuronide (PDG) in PCOS menstrual cycles compared to regular cycles. Women with PCOS had higher BMI than regular cycling women (p=0.02). PCOS cycles were longer (p<0.05), peak day was later in the menstrual cycle (p<0.001), and luteal length was shorter (p < 0.01) compared to regular cycles. In whole cycle comparisons, E13G was found to be lower in PCOS cycles (p<0.01) and PDG was found to be higher in PCOS cycles (p<0.05). E13G was also lower in the follicular phase of and late luteal phase of PCOS cycles (p<0.00001). The results of this study demonstrate the feasibility of detecting hormonal differences in PCOS compared to regular cycles with at-home measurements with the Mira monitor. The metabolic dysregulation of PCOS is a possible factor in these hormone changes. Larger studies with different sub-types of PCOS will be needed to further clarify these changes and to understand the pathophysiology behind these hormonal changes.
Manhart MD et al., 2025·Linacre Q·Free full text on PubMed Central
A one-day meeting was held as a pre-conference to the Catholic Medical Association Annual Educational event in 2024. A panel of eighteen physicians, scientists, and researchers involved in NFP work was convened to review the available evidence in four topical areas: (i) evidence for effectiveness of NFP methods to postpone and achieve pregnancy, (ii) evidence for effectiveness in the postpartum and perimenopause transition periods, (iii) evaluate the current state of technology in NFP (specifically app and quantitative hormone monitoring), and (iv) evidence examining the impact of NFP on marital relations. In each topical area, the panel worked to reach a consensus opinion on the currently available evidence and identified priorities for further research. Results from these discussions and a set of priorities for further work are presented here.
An expert panel was convened to review the current evidence supporting use of NFP in various settings, utilization of new technology, and the impact of NFP on marital dynamics. Results from these discussions and a set of priorities for further work are presented here.
Related research
Family Planning Use and Attitudes · Attitudes and Acceptability
We performed a cross-sectional survey of 357 reproductive-aged women, mostly Hispanic (81.8%), presenting for ambulatory and hospital reproductive care in Phoenix, AZ, about their interest in natural family planning (NFP). Participants completed questionnaires, and responses were analyzed to determine predictors of interest in NFP. Sixty-one percent stated that they were likely or very likely to use NFP to avoid pregnancy, and 50% would use NFP to achieve pregnancy. Of factors studied, Hispanic ethnicity, lower level of acculturation, less education and recent use of condoms or withdrawal were independently associated with interest in using NFP to avoid pregnancy. Younger age and desire for future pregnancy were independently predictive of potential NFP use to achieve pregnancy. This study suggests that Hispanic women find NFP to be an appealing family planning alternative.
Family Planning Use and Attitudes · Method Use and Prevalence
This study examined the characteristics and attitudes of 132 married couples who had received training in use of the symptothermal method of natural family planning (NFP). 61% of respondents were 20-30 years of age and over 2/3 had completed college; 59% were Catholic. The largest group of subjects (35%) became aware of NFP through friends, neighbors, and relatives. 71% said they were drawn to NFP because it represented a safe and healthy alternative to other methods of birth control; only 17% gave moral or religious reasons for learning about NFP. 42% of the sample were using NFP at the time of the survey, 32% had discontinued use, and 25% were using fertility awareness in conjunction with barrier methods (combination-continuers). There was a significant difference between these 3 groups in church attendance: 48% of combination-continuers and 67% of continuers compared with 41% of discontinuers attended church once a week or more. The combination-continuer group had more Catholics (50%) than the discontinuer group (37%) but less than the continuers (76%). No significant differences were found between the 3 groups in terms of age, education, or regularity of menstrual cycle length. Over 3/4 of continuers had been married for less than 5 years compared with about 1/2 of those in the 2 other groups. 69% of continuers believed that NFP is extremely effective compared to 13% of discontinuers and 40% of combination-continuers. Spouses encouraged each other in the use of NFP in 88% of combination-continuer couples and 86% of continuer couples, but only about half of discontinuers received such encouragement. Although most NFP advocates emphasize a nonsexual form of abstinence during the fertile period, the vast majority of respondents in this study defined abstinence to include the possibility of orgasm. Combination-continuers, positioned between continuers and discontinuers or both dissatisfaction with other methods and with abstinence, warrant more attention in future NFP research.
Family Planning Use and Attitudes · Attitudes and Acceptability
A discrepancy exists between the interest in modern methods of natural family planning (NFP) and their actual use in developed countries. To explore reasons for this discrepancy, we analyzed data from a questionnaire administered to postpartum women in Berlin (n = 223) and Cracow (n = 233). Knowledge of NFP, past use of NFP and expected effects of abstinence on the partnership were independently associated with interest in using NFP, but not the choice to do so among those interested. Desire for future pregnancies, importance of religious belief and location in Cracow were independently associated with the choice to use NFP among those interested. Perceived accuracy of observation to identify the fertile time and acceptance of own body were independently associated with both interest in and choice to use NFP. Frequency of intercourse had no effect on interest. These results suggest that increased access and cultural support would likely lead to a higher prevalence of NFP use in developed countries.
Comparative Studies · Contraception Versus Fertility Awareness
Fehring RJ et al., 2021·Linacre Q·Free full text on PubMed Central
Marital chastity is the practice of periodic abstinence with use of natural family planning (NFP). The purpose of this study was to determine the influence of the most common methods of contraception (female sterilization, oral contraceptive pills, and condoms) and NFP on divorce/separation and cohabitation rates among reproductive age women. The study involved an extensive review of the literature on the effects of practice of NFP on marital dynamics and a statistical analysis of 2,550 ever-married women in the (2015-2017) National Survey of Family Growth data set. Importance of religion and frequency of church attendance were included in the analysis. With ever-use of NFP, 14 percent were divorced or separated, and 27 percent to 39 percent were divorced or separated with ever-use of oral contraceptive pills. Stepwise logistic regression indicated that ever-use of contraception was associated with increased odds of divorce or separation (odds ratio [OR] = 2.05; confidence interval [CI]: 1.96-2.49) and cohabitation (2.95, CI: 2.20-3.95). Ever-use of NFP yielded 58 percent lower odds for divorce or separation. Frequent church attendance was associated with lower odds of divorce or separation and cohabitation. Although there are lower odds of divorce among NFP users, the reason might be due to their religiosity.
This study showed that ever-use of natural family planning (NFP) among ever-married women was associated with 58 percent lower odds of divorce than among women who never-used NFP. Ever-use of contraceptive methods was associated with two times the odds of divorce and four times for cohabitation compared to those women who never-used those methods. Use of periodic abstinence with NFP is the practice of marital chastity and is thought to strengthen the marital relationship.
Contraception › Family Planning Use and Attitudes › Method Use and Prevalence · Ethics and Policy › Reproductive Ethics › Conscience Protections
Richard J Fehring, Dana Rodriguez
Rick Fehring, Dick Fehring, Rich Fehring, R Fehring, D Rodriguez
PMID 30082968 30082968 DOI 10.1179/002436312803571429 10.1179/002436312803571429 Rodriguez et al. 2012, Rodriguez 2012
Cite this article
Rodriguez, D., & Fehring, R. J. (2012). Family Planning, Natural Family Planning, and Abortion Use among U.S. Hispanic Women: Analysis of Data from Cycle 7 of the National Survey of Family Growth. The Linacre Quarterly, 79(2), 192-207. https://doi.org/10.1179/002436312803571429
Rodriguez D, Fehring RJ. Family Planning, Natural Family Planning, and Abortion Use among U.S. Hispanic Women: Analysis of Data from Cycle 7 of the National Survey of Family Growth. Linacre Q. 2012;79(2):192-207. doi:10.1179/002436312803571429
Rodriguez, D., and R. J. Fehring. "Family Planning, Natural Family Planning, and Abortion Use among U.S. Hispanic Women: Analysis of Data from Cycle 7 of the National Survey of Family Growth." The Linacre Quarterly, vol. 79, no. 2, 2012, pp. 192-207.
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