To equip the reader with the tools necessary to evaluate studies of natural family planning (NFP) effectiveness found in the literature and to make recommendations for future NFP effectiveness studies.
Design
Current standards to evaluate contraceptive method effectiveness are reviewed. A framework for evaluating reports on NFP is presented.
Results
Most NFP studies found in the literature are flawed in design and do not calculate pregnancy rates correctly. The results from the few well-designed studies are presented.
Discussion
Many factors influence NFP effectiveness, and these factors must be considered when evaluating published studies and designing future studies.
natural family planning effectiveness study evaluation, NFP pregnancy rate calculation methodology, Trussell natural family planning effectiveness review, contraceptive effectiveness study design standards, NFP study design flaws pregnancy rates, evaluating published reports contraceptive effectiveness, natural family planning method effectiveness comparison, Lamprecht Trussell NFP effectiveness evaluation framework, life table analysis natural family planning, fertility awareness based methods effectiveness research methodology
PMID 9288333 9288333 DOI 10.1023/a:1006595703472 10.1023/a:1006595703472
Cite this article
Lamprecht, V., & Trussell, J. (1997). Natural family planning effectiveness: evaluating published reports. Advances in contraception : the official journal of the Society for the Advancement of Contraception, 13(2-3), 155-165. https://doi.org/10.1023/a:1006595703472
Lamprecht V, Trussell J. Natural family planning effectiveness: evaluating published reports. Adv Contracept. 1997;13(2-3):155-165. doi:10.1023/a:1006595703472
Lamprecht, V., and J. Trussell. "Natural family planning effectiveness: evaluating published reports." Advances in contraception : the official journal of the Society for the Advancement of Contraception, vol. 13, no. 2-3, 1997, pp. 155-165.
Related articles
Fertility AwarenessUrinary Hormone AssaysNatural Family PlanningHome-Based Immunoassays
It is now well accepted that a woman can conceive from an act of intercourse for a maximum of only about 7 days of her menstrual cycle. The reliability of natural family planning depends on identifying this window of fertility without ambiguity. Several symptomatic markers, cervical mucus and basal body temperature, have been used extensively and with considerable success in most women but failures occur. Ovarian and pituitary hormone production show characteristic patterns during the cycle. Urinary estrogen and pregnanediol measurements yield reliable information concerning the beginning, peak, and end of the fertile period, provided that the assays are accurate and performed on timed specimens of urine. We have developed such enzyme immunoassays for urinary estrogen and pregnanediol glucuronides that can be performed at home. In the early versions of the assays, enzyme reaction rates were measured by eye, but more recently, a simple photoelectronic rate meter has been used. The final problem to be solved is not technologic but whether women are sufficiently motivated to expend the same time and effort each day for 10 days a month, with less cost, on fertility awareness as they spend on making a cup of tea.
Fertility AwarenessProvider Perspectives and BarriersNFP in Family PlanningNFP Service Expansion
Despite the recognized benefits for clients and programs of providing natural family planning (NFP) services, few family planning programs offer NFP and few provide fertility awareness education. Furthermore, many non-governmental organizations (NGOs) that provide only NFP actually reach a very small percentage of the potential NFP users in the areas they serve. This paper discusses the results of interviews with selected family planning providers that were conducted to explore reasons why NFP and fertility awareness education are not offered in their programs, and with NFP providers to get their opinions on how to improve service delivery. The interviews were structured around some of the lessons learned from the successful incorporation of the lactational amenorrhea method (LAM) into several multimethod family planning programs. There is agreement that the need for NFP services* is far from being met and that most clients lack the information and skills they could learn through fertility awareness education. The providers interviewed also acknowledged that offering these services would improve the quality of reproductive health services in general. Presented here are some ideas about why these services are not offered, as well as suggestions for integrating NFP and fertility awareness education into existing family planning programs.
Body LiteracyReproductive Health AwarenessBody KnowledgeCommunication Skills
To protect and advocate for their own reproductive health, people of all ages can greatly benefit from enhanced body/self awareness and strong interpersonal communication skills. Body/self awareness and interpersonal communications, along with gender awareness and the integration of sexuality, are the fundamental components of a new approach to obtaining high quality health called reproductive health awareness.
Body LiteracyBehavior ChangeSocial MarketingReproductive Health Awareness
Social marketing applies commercial sector ideas to programs to change behavior. It involves a mindset that is customer-focused; a process that starts with customers and continually returns to them for validation; and concepts to make change happen. Customer behavior models guide strategy. One useful model is based on stages of change perceived benefits, perceived costs, the influence of others, and perceived behavioral control.