Natural family planning

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Natural Family Planning (NFP) is a religiously-motivated set of methods which help women to achieve or avoid pregnancy by identifying times of infertility and potential fertility. NFP excludes the use of artificial birth control methods and orgasmic acts outside of marital intercourse. Several NFP methods fall under the category of fertility awareness.

Though many people assume the Rhythm Method is the only form of NFP, it is generally considered obsolete as a primary method, since most other types of NFP have much lower correct-use failure rates - as low as 1% per year.[1] Methods of NFP include methods which track indicators of fertility (eg. Sympto-Thermal, Billings, Creighton), methods which make statistical estimates as to when a woman is fertile (eg. Rhythm, Standard Days Method), and methods which help identify and/or encourage breastfeeding infertility.

Contents

Users[edit]

NFP and total abstinence are the only contraceptive methods permitted by the Roman Catholic Church. Worldwide, many Catholics use NFP in obedience to church teaching. The practice of NFP among Catholics in developed countries, however, is rather low. In 2002, 24% of the U.S. was Catholic.[2] Of sexually active Americans avoiding pregnancy, 1.5% were using NFP.[3]

NFP is also practiced by many Protestant Christians. Some find the Roman Catholic rationale convincing, and others use it for their own reasons.

Rationale[edit]

Catholic doctrine holds that God created the marital act to be both unitive and procreative. Deliberately altering fertility or the marital act with the intention of preventing procreation is considered to be a grave sin. Thus, artificial birth control methods and orgasmic acts outside of full marital intercourse are forbidden. Not having sex at all (abstinence) can be considered moral. Having sex at an infertile time in a woman's life (such as pregnancy or menopause) can also be moral since the infertile condition is considered to be created by God, rather than as an act by the couple intended to frustrate fertility.

Thus, it is considered morally acceptable to abstain during the fertile part of the woman's menstrual cycle. Increasing the infertile period through particular breastfeeding practices — the Lactational Amenorrhea Method — is also considered a moral way to space a family's children.

The benefits of spacing children are recognized by the Catholic Church, and use of Natural Family Planning for this reason is encouraged. Humanae Vitae cites "physical, economic, psychological and social conditions" as possibly compelling reasons to avoid pregnancy. Couples are warned, however, against using NFP for frivolous, selfish, or materialistic reasons. Many Catholic sources extol the benefits children bring to their parents, their siblings, and society in general, and couples are encouraged to have as many children as their circumstances make practical.

Benefits[edit]

Proponents of NFP say it increases marital satisfaction and helps lower divorce rates. The honeymoon theory holds that the scheduled abstinence encourages couples to express love in non-genital ways, and to have a greater appreciation for intercourse when it does happen. Fertility awareness forms of NFP (which require daily charting of fertility signs) can result in couples communicating more about their bodies and sexuality; this is said to improve communication skills throughout the entire marriage.

Anecdotal evidence and small studies[4] are put forth in support of this view. One study involving 505 women using NFP found a correlation between lower divorce rates and the use of NFP.[5] To date, no studies exploring a cause and effect relationship between the use of NFP and lowered divorce rates have been performed.

NFP has no proven side effects, unlike chemical and hormonal contraceptives. It also does not interfere with the spontaneity of intercourse as barrier methods sometimes do.

Disadvantages[edit]

Some fertility awareness forms of NFP require observation or touching of cervical mucus, an activity some women find distasteful. Some drugs, such as decongestants, can change cervical mucus. Women may not be able to rely on these forms of NFP while taking these drugs.

Some fertility awareness forms require tracking of basal body temperatures. Because irregular sleep can interfere with the accuracy of basal body temperatures, shift workers and those with very young children, for example, might not be able to rely on those methods.

The fertility awareness and statistical forms of NFP require periodic abstinence, most commonly 8-10 days of each menstrual cycle. Some couples find the woman only enjoys intercourse on these days (when she is fertile); prohibiting intercourse on those days is problematic for the sexual part of their relationship.

Couples seeking the lowest risk of pregnancy (less than 1% per year) may be required to abstain for more than half of each menstrual cycle.

The NFP methods that encourage breastfeeding infertility can only be used until the woman's first post-partum menstruation. Even the most strict form results in average return of menses at 14 months post-partum, and menstruation can return as early as 6 weeks post-partum.

Some schools of NFP teach that orgasmic acts outside of intercourse are incompatible with the correct practice of NFP. Some couples are not comfortable with this restriction.

It has been suggested that unprotected intercourse in the infertile periods of the menstrual cycle may still result in conceptions, but create embryos incapable of implanting.[6] It has also been suggested that pregnancies resulting from method failures of NFP are at increased risk of miscarriage and birth defects due to aged gametes at the time of conception.[7] The most recent research, however, suggests timing of conception has no effect on miscarriage rates.[8]

References[edit]

  1. ↑ Comparison of Birth Control Effectiveness see "Fertility Awareness-based methods". Accessed December 6, 2005.
  2. ↑ Largest Religious Groups in the USA. Accessed November 13, 2005.
  3. ↑ National Survey of Family Growth Use of Contraception and Use of Family Planning Services in the United States: 1982-2002. Advance Data No. 350
  4. ↑ Marital Duration and Natural Family Planning. Accessed October 2005.
  5. ↑ Divorce Rate Comparisons Between Couples Using Natural Family Planning & Artificial Birth Control
  6. ↑ Luc Bovens (2006). "The rhythm method and embryonic death". Journal of Medical Ethics 32: 355-356.
  7. ↑ Gray, RH. Aged gametes, adverse pregnancy outcomes and natural family planning. An epidemiologic review.] Contraception. October 1984. 30(4):297-309. PMID 6509983.
  8. ↑ Gray RH, Simpson JL, Kambic RT. Timing of conception and the risk of spontaneous abortion among pregnancies occurring during the use of natural family planning. Am J Obstet Gynecol 1995;172(5):1567-72. PMID 7755073.

External links[edit]


Birth control edit
Sterilization: Tubal ligation, Vasectomy, Essure
Post-intercourse: Emergency contraception • Abortion: Surgical, Medical, Herbal/Drug
Intra-uterine: IUD, IUS (progesterone)
Anti-estrogen: Ormeloxifene (a.k.a. Centchroman)
Hormonal: Combined: COCP ('the Pill'), Patch, Nuvaring

Progestogen only: POP mini-pill, Depo Provera, Norplant, Implanon

Barrier: Condom, Diaphragm, Shield, Cap, Sponge, Spermicide
Behavioral: Coitus interruptus, Fertility awareness, Rhythm Method, Lactational

Avoiding vaginal intercourse: Anal sex, Oral sex, Outercourse, Masturbation, Abstinence

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