Duane, M., Motley, R., & Manhart, M. (2013). Physicians need more education about natural family planning. American Family Physician, 88(3), 158-159.
Duane M, Motley R, Manhart M. Physicians need more education about natural family planning. Am Fam Physician. 2013;88(3):158-159.
Duane, Marguerite, et al. "Physicians need more education about natural family planning." American Family Physician, vol. 88, no. 3, 2013, pp. 158-159.
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Natural family planning effectiveness varies by method, letter says
A 2013 letter to the editor says individual natural family planning (NFP) methods ranged from 85.8% to 98.4% effective with typical use in good-quality studies. The authors say a widely quoted 76% rating pools all methods. In their survey of 120 family medicine residency programs, more than half of women's health faculty were not familiar with modern NFP methods.
Key Findings
The authors surveyed 120 family medicine residency programs. They report that more than half of faculty members in women's health were unfamiliar with modern natural family planning methods.
The letter reports that 25% of the surveyed programs do not include natural family planning in their women's health curriculum.
The letter says the 2012 article's 76% user-effectiveness rating comes from surveys of women with unintended pregnancies, pools all natural family planning methods, and adjusts for underreporting of abortion.
The letter cites 2002 National Survey of Family Growth results: 86% of surveyed NFP users named calendar rhythm, which it calls much older and less effective, as their primary contraception.
The authors' review of peer-reviewed natural family planning studies since 1980, using the Strength of Recommendation Taxonomy, reports typical-use effectiveness from 85.8% to 98.4% for individual methods in good-quality studies.
Interpretation
The letter replies to a 2012 article on natural family planning (NFP) in the same journal. The authors cite a survey, national data, and a review that used the Strength of Recommendation Taxonomy to examine published NFP studies. Among couples who are well instructed and motivated, the authors say NFP effectiveness is comparable with generally accepted methods of contraception, based on NFP model-specific data. The author of the 76% estimate has acknowledged that pooling masks differences between methods. The letter ends by saying physicians best serve patients interested in NFP by learning more about the research.
RRM Context
Restorative reproductive medicine is informed by cycle charting. Fertility awareness-based methods teach couples to chart signs of the ovulatory event and potentially fertile days, which they use to avoid pregnancy or to conceive. Clinicians can read the same chart to look for the cause of a cycle or fertility problem. Residency training bears on how many clinicians learn to read charts.
Our editorial summary of this paper, not the article's abstract.
Clinician-reviewed comparison of fertility awareness-based methods (Billings, Creighton, Sensiplan, Marquette, Standard Days, apps). Every effectiveness figure cited and labeled by metric.
Clinician Education and Training › Clinician Training › Curriculum and Competencies · Fertility Awareness › Effectiveness › Typical and Perfect Use · Ethics and Policy › Advocacy and Public Understanding › Public Awareness
Marguerite Duane, Robert Motley, Michael Manhart
M Duane, Bob Motley, Rob Motley, Bobby Motley, R Motley, Mike Manhart, M Manhart
PMID 23939690 23939690 Duane et al. 2013, Duane 2013
