Ascension Saint Agnes Natural Fertility Care
- Primary Care/Clinic
Natural Family Planning
Natural Family Planning (NFP), also known as Fertility Awareness Method (FAM), is a way of determining the fertile and infertile phases of a woman’s menstrual cycle by observing the normal, physiologic changes associated with ovulation. Changes in cervical mucous, basal body temperature and salivary estradiol levels may be tracked. Couples use NFP to achieve or avoid pregnancy.
What are the benefits of NFP?
Women learn to truly know and understand their bodies.
- SHARED RESPONSIBILITY
Family planning is equally shared between the man and woman. Both partners participate in the understanding of their naturally occurring fertility and infertility. Couples cooperate and make decisions together regarding the achievement or avoidance of pregnancy.
- ALL NATURAL
Green and organic with no hormones, side effects or risks.
Once learned, NFP costs nothing. It provides family planning throughout a woman’ s entire reproductive life.
- STRONGER RELATIONSHIPS
Helps couples to deepen conjugal love and achieve responsible parenthood.
Celebrates the gift of human sexuality and the dignity of the human person.
Who can do NFP?
Everyone! Any couple committed to sharing the responsibility of parenthood can use NFP. Women do not need regular cycles in order to do NFP effectively, and may chart when they are post-partum, nursing and perimenopausal. The most common methods of Natural Family Planning are the Sympto-thermal Method, Billings Ovulation Method, Creighton Model, and Marquette Model.
How effective is NFP for avoiding pregnancy?
When couples understand the methods and are motivated to follow them, NFP is up to 99%* successful in spacing or limiting births.
The efficacy of NFP depends upon the couple’s adherence to the rules of the method according to their family planning intention (i.e., achieving or limiting pregnancy). Those who are strongly motivated to avoid pregnancy and follow the method-defined rules are very effective in meeting their goal.
*Frank-Herrmann P. et al, HumanReprod. 2007;22(5):1310-19; Howard MP et al. Arch FamMed. 1999;8(5):391-402; Hilgers TW et al. JReprodMed. 1998;43:(495-502); Frank-Hermann P. et al. AdvContracept. 1997;13:179-189; Contraception. 1996;52(2)69-74.
Frequently Asked Questions
Is Natural Family Planning the same as the Rhythm Method?
No. It’s like the difference between Grandmom’s typewriter and your laptop.
The phrase “The Rhythm Method” was coined in 1932 when Ob/Gyn Dr Leo Latz wrote The Rhythm of Sterility and Fertility in Women.1 A few years prior, Drs Ogino and Knaus had independently discovered that ovulation occurs about 14 days before the onset of menses. With that they developed formulas which estimated the fertile window based on the lengths of a woman’s past cycles. Most couples who used the rhythm method did not actually apply the calculations developed by Dr Latz, but estimated their fertile phase based on a 28-day cycle. Only 10-15% of women have a consistent, reliable 28-day cycle, so many couples were not correctly identifying their potential days of fertility.
Modern methods of NFP use prospective biological signs to identify days of fertility and infertility.
Reference: 1. Leo John Latz, Kyusakua Ogino, and Herman Knaus, The Rhythm of Sterilty and Fertility in Women: A Discussion of the Physiological, Practical, and Ethical Aspects of the Discoveries of Drs. K. Ogino (Japan) and H. Knaus (Austria) regarding the Periods when Conception is Impossible and when Possible. (Chicago: Latz Foundation, 1932), 35.
Why have I heard that NFP has a 25% failure rate?
This statistic is based on a 1995 and 2002 survey conducted by the CDC called the National Survey of Family Growth (NSFG).2-3 While the NSFG is a rigorously designed and carefully conducted survey of Americans’ experiences with family planning, it was never a tool designed to look at the actual efficacy of any method of NFP. For the survey, women were polled by phone on the method of birth control that was used when they had an unplanned pregnancy. 86% of the women stated they were using the “calendar,” “rhythm,” or “periodic abstinence” method, which are not considered reliable, scientific forms of NFP (see FAQ 1).
Also, the survey did not measure if the participants were actually doing NFP correctly. Studies in the medical literature that look at the actual efficacy of a prospective method of NFP consistently find that the failure rate may be as low 1-2%.4-9
Reference: 2. Abma J, Chandra A, Mosher W, Peterson L, Piccinino L. Fertility, family planning, and women’s health: New data from the 1995 National Survey of Family Growth. National Center for Health Statistics. Vital Health Stat 23(19). 1997.
3. Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J. Fertility, family planning, and reproductive health of U.S. women: Data from the 2002 National Survey of Family Growth. National Center for Health Statistics. Vital Health Stat 23(25). 2005.
4. Fehring, R., Schneider, M., Raviele, K, & Rodriguez, D. Randomized Comparison of Two Internet-Supported Fertility Awareness Based Methods of Family Planning, Contraception. 2013; 88(1): 24-30.
5. Manhart MD, Duane M, Lind A, et al. Fertility awareness-based methods of family planning: a review of effectiveness for avoiding pregnancy using SORT. Osteopathic Fam Physician. 2013;5(1):2–8.
6. Frank-Herrmann P. et al, The Effectiveness of a Fertility Awareness Based Method to Avoid Pregnancy in Relation to a Couple’s Sexual Behavior During the Fertile Time: a Prospective Longitudinal Study. HumanReprod. 2007;22(5):1310-19
7. Howard MP et al. Pregnancy Probabilites During Use of the Creighton Model Fertility Care System. Arch FamMed. 1999;8(5):391-402
8. Hilgers TW et al. Creighton Model NaProEducation Technology for avoiding pregnancy. Use effectiveness. JReprodMed. 1998;43:(495-502);
9. Frank-Hermann P. et al. Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study. AdvContracept. 1997;13:179-189
Which Method of NFP should I do?
Whichever one matches your lifestyle and preferences. Creighton and Billings use only one biomarker, cervical mucus. Sympto-Thermal uses several markers like basal body temperature, mucus and menstrual history. The Marquette Model uses the ClearBlue Fertility Monitor along with mucus and/or temperature.
Does this mean we have to abstain all the time?
Of course not. Every woman’s body is different, but the fertile window lasts up to 7-8 days for all of us. While it can be challenging to identify your fertile days in the beginning, NFP allows us to really understand our bodies. What could be more empowering?
Plus, abstinence is not such a bad thing! Couples learn to express their affection in different ways, and recognize the love that’s involved with making sacrifices for the good of the other. It can also make a couple more appreciative of the times when they are able to be sexually intimate.
Is there an app I can use to do NFP?
Apps are a great way of keeping track of your biological markers, but they cannot do NFP for you. Many of the apps were designed to help with achieving pregnancy, not avoiding pregnancy. It does makes a difference! Other apps use their own algorithms for determining the fertile phase, and these have not been studied in the medical literature.
How do I learn NFP?
There are local instructors in the area who teach classes, and there are also on-line courses for the Marquette Method and the Sympto-Thermal Method (See FAQ 7). Formal instruction in-person or through an on-line course is strongly recommended to ensure that you have learned the method correctly, and that all of your questions have been answered.