Johnson, J. H., & Reich, J. (1986). The new politics of natural family planning. Family Planning Perspectives, 18(6), 277-282. https://doi.org/10.2307/2134959
Johnson JH, Reich J. The new politics of natural family planning. Fam Plann Perspect. 1986;18(6):277-282. doi:10.2307/2134959
Johnson, Jeanette H., and Julie Reich. "The new politics of natural family planning." Family Planning Perspectives, vol. 18, no. 6, 1986, pp. 277-282.
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RRM Academy Synopsis
US natural family planning funding grew with high dropout, report says
Critical to restorative reproductive medicine
A 1986 Family Planning Perspectives report by Johnson and Reich says US funding for natural family planning (NFP) grew in the early 1980s and recruitment is hard. In a 5-country WHO study, 17% of women quit during training. The report also summarizes questions from an international NFP congress.
Key Findings
AID, the US Agency for International Development, lifted NFP spending from US$0.8 million to US$7.8 million over 1981-85, after the Roman Catholic Church and other groups friendly to NFP pressed for it.
AID excused NFP providers in 1985 from offering direct or referral services for other methods. AID repealed that exemption in 1986.
In a WHO study across 5 countries, 17% of women left during training, and 36% stopped using the method in the year after.
Speakers at an IFFLP congress (International Federation for Family Life Promotion) stressed the lack of NFP prevalence data broken down by NFP type.
The report says NFP advocates often omit couples who "break the rules" from their count of acceptors, and that excluding them makes the method look much more effective.
Interpretation
The source for this synopsis is the published abstract only. The abstract describes an overview of US policy developments and of discussions at a congress. The abstract reports no data collected by the authors. The dropout figures come from a WHO study the report cites, and the abstract gives that study's design and populations no detail. Congress questions, such as aged gametes and sex selection, appear as questions raised, with no evidence given either way.
RRM Context
The abstract puts several charting methods under one NFP label. Cycle charting is a principle of restorative reproductive medicine, and here the methods serve family planning. The abstract covers funding, dropout and how effectiveness is counted. It has no content on evaluating a couple's fertility or treating a cause of infertility.
Our editorial summary of this paper, not the article's abstract.
Abstract
There has been an increase in interest in natural family planning (NFP) in recent years. The Roman Catholic Church and other groups sympathetic to NFP philosophy have pressured the US Agency for International Development (AID) to increase emphasis on NFP, and AID has responded by increasing funding devoted to NFP from US$0.8 to US$7.8 million from 1981-85. In 1985, AID exempted NFP providers from the requirement of providing direct or referral services for other methods, but repealed the exemption in 1986. Several methods fall under the NFP umbrella: rhythm, the estimation of ovulation time by the counting of days elapsed in relation to menstruation; and the more precise cervical musus; basal body temperature; and sympto-thermal methods. Because NFP requires considerable training, recording, and willingness to abstain, recruitment is difficult and dropout rates high. A 5-country World Health Organization study found that 17% of women dropped out during training, and 36% discontinued during the following year. At the 4th International Congress of the International Federation for Family Life Promotion (IFFLP), it was stressed that data on NFP prevalence classed by type of NFP are lacking. Questions raised included whether populations of countries that have achieved or hope to achieve a low birth rate will be interested in NFP; whether NFP can increase the risks of birth defects through fertilization by "aged gametes;" and whether NFP is capable of helping couples to select the sex of the child. The implications of the contraceptive effects of breastfeeding were reviewed. Some problems arise concerning evaluation of effectiveness: NFP advocates often do not consider couples who "break the rules" as acceptors, and when these couples are excluded from data the method appears much more effective. Traditionalists emphasize the increased quality that NFP brings to a marital relationship. Some participants maintained that rigid moral advocacy would deter many couples.
