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What is Natural Family Planning?

Natural Family Planning

Natural Family Planning allows couples to naturally identify the times when intercourse is more or less likely to result in pregnancy, so that they can adjust their behavior in order to either avoid or achieve pregnancy. 

Several NFP systems have developed over the past few decades. However, they’re all based on using fertility awareness as a tool for couples to guide family planning and they all use one of more of the following biomarkers to identify fertility: 

  • Cervical mucus characteristics
  • Basal body temperatur
  • Hormone levels

There is a common misconception that NFP is a “calendar” or “rhythm” method of family planning; however, none of the modern NFP methods rely on calendar dates as fertility markers. Although cycle days in reference to menstruation are still used in NFP, they are not considered biomarkers nor can they alone be used to predict fertility, since fertility does not always fall during the same cycle days for different women.

NFP is different than conventional methods of birth control in a few ways: 

  • First, it is 100 percent natural and requires no medication, so there are no risks or side effects attributed to the method itself.
  • Second, it can be used either to avoid or to achieve pregnancy. Many women like being able to apply a single tool for both of these important aspects of family planning.
  • While conventional birth control places the burden of risk and responsibility on one partner or the other (usually the woman), NFP requires communication and cooperation of both partners to perform, since timing of intercourse must be coordinated according to fertile windows.
  • While conventional birth control masks signs of ovulation and fertility, NFP reveals information about a woman’s fertility and ovulatory status, which can shed light on other health conditions.

As a medical provider, I consider NFP a worthwhile approach to family planning that every woman should consider due to a few unique benefits. Ovulation is an event often affected by medical conditions such as obesity, autoimmune conditions, endocrine disorders such as thyroid disease, and various effects of medications. A change in a woman’s fertility and ovulation can be one of the first signs of an abnormality or disease in another part of the body. Oftentimes, women who use NFP get a lot of information about their ovulation which can be a first sign that something else needs to be evaluated.

NFP is also economical. Most of the fees for education in the methods are minimal, and often become negligible over the long term since they are based on education and not medication. It is also ecological, reducing the burden of exogenous pharmaceutical hormones, which we are beginning to learn may have larger-than-expected impacts on regional and national ecosystems. Finally, users of NFP usually report that it fosters a healthy relationship because it is a cooperative effort. Several studies have actually associated NFP use with reduced rates of separation, divorce and marital discord.

Similar to conventional birth control, NFP has a risk of failure. Each birth control’s efficacy is described by failure rates with perfect use — that is, when used exactly as intended all the time — and typical use, which factors in missed doses or non-compliance. With perfect use, many NFP methods boast effectiveness of up to 98 percent. The more practical rate to consider is the typical use rate; while there is less data for this with NFP than with conventional birth control, most of the modern NFP methods maintain typical rate effectiveness of 80-90 percent (some of them higher), which is comparable to or better than most forms of conventional birth control. 

For women interested in learning more about methods of natural family planning, each method has its own website, and the Fertility Education and Medical Management system offers a user-friendly app:

  • Creighton Model (FertilityCare system)
  • Fertility Education and Medical Management
  • Billings Ovulation Method
  • Marquette Model
  • Couple to Couple League
  • Family of the Americas

In Wichita, the Catholic diocese’s Office of Marriage and Family Life is well connected with local teachers for most of these methods, and can be a good first contact for couples wanting to determine which method may be best for them.

About Jonathan Scrafford MD

I am an OB/GYN with Via Christi Clinic in Wichita, Kansas.