St. Louis University Natural Family Planning Center. St. Louis. Missouri and Creighton University Natural Family Planning Education and Research Center, Omaha. Nebraska
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Cite this article
Hilgers, T. W., & Prebil, A. M. (1979). The ovulation method--vulvar observations as an index of fertility/infertility. Obstetrics and gynecology, 53(1), 12-22.
Hilgers TW, Prebil AM. The ovulation method--vulvar observations as an index of fertility/infertility. Obstet Gynecol. 1979;53(1):12-22.
Hilgers, T. W., and A. M. Prebil. "The ovulation method--vulvar observations as an index of fertility/infertility." Obstetrics and gynecology, vol. 53, no. 1, 1979, pp. 12-22.
Natural family planning (NFP) methods can be effective if taught well and practised by well-motivated couples. Midwives should be able to give couples an understanding of the basic principles of the methods. The observable signs of the fertile cycle are changes in basal body temperature, in the consistency of cervical mucus and in the texture and position of the cervix. Practised properly the ovulation method can have a failure rate of as little as 2.2 pregnancies per 100 woman-years. The ovulation method is a suitable method for mothers who have breastfed to detect the onset of ovulation.
A 12-month evaluation of the Ovulation Method of Natural Family Planning programme in Bangladesh is presented. Four hundred and forty-eight women entered the programme, 232 for spacing, 184 for limiting, and 32 to achieve pregnancy. Of the participating couples, 79% lived in rural areas and 20.3% were illiterate. The 416 who learned the ovulation method for avoiding pregnancy completed 2,358 months of use, with 14 unplanned pregnancies during the study period, which represents a pregnancy rate of 7.2 according to the Pearl Index. The discontinuation rate in the 12-month period was 2.4%.
Fertility AwarenessOvulation MethodAbstinence and SatisfactionNFP Effectiveness Studies
During the 13-cycle effectiveness phase of a five-center study of the ovulation method of natural family planning, there were substantial differences, particularly between the two developed and the three developing countries, in the stated degree of satisfaction with the frequency of intercourse (most couples were satisfied in Bangalore, Manila, and San Miguel, whereas one-third of the subjects and half of their partners would have preferred more frequent intercourse in Auckland and Dublin) and in expressed difficulties associated with abstinence (e.g., 62% had occasional difficulty in Auckland, 14% in Bangalore, 55% in Dublin, 28% in Manila, and 5% in San Miguel). Cumulative net probabilities of discontinuation due to pregnancy were 1.8%, 18.6%, and 54.7% for couples in whom the male partner's degree of satisfaction was described as "no difficulty," "occasional difficulty," and "always some difficulty," respectively.
Body LiteracyAdolescent ProgramsOvulation MethodAdolescent Outcomes
Fertility awareness is experiential learning about cyclic fertility. This awareness, used as a family planning method, differs from contraception because it does not isolate the procreative capacity of either partner. The acceptability and effect of teaching fertility awareness on teen sexual activity and decision making was tested in a multisite pilot program which taught fertility awareness via the prospective marker of the cervical mucus (ovulation method of natural family planning). 200 US and 35 Guatemalan volunteer women ages 15-17 in a structured 1 year curriculum, monitored cycle charting and explored the implications of experiencing one's signs of fertility. Control subjects were recruited from the general population and from family planning clinics. 9% of the US study group were sexually active prior to entry. By cycle 12, 1/2 had discontinued activity. Conception rate was 0.0044. The continuation rate dropped from 90% at cycle 7 to 71% at cycle 8 due to scheduling constraints for 2 classes and to 57% at cycle 12. Postprogram follow-up of early leavers showed only 1/3 the expected rate of onset of sexual activity and pregnancy. Parent involvement correlated positively with postponement and/or discontinuation of sexual activity. Reported movement away from peer group pressure appeared 3 months after entry.