Fertility Awareness Methods CEU- November 2015)

Question 1

Fertility Awareness Methods

Answer 1

• Women wishing to use fertility indicators for contraceptive purposes should receive support and instruction on the method from a trained practitioner.
• Women should be informed that combining fertility indicators is considered more effective than using single fertility indicators alone.
• Sexual intercourse on days when cervical secretions are present increases the likelihood of pregnancy. Women wishing to avoid pregnancy should not have sexual intercourse, or they should use an additional contraceptive method until three consecutive dry days
  are noted.
• Over 1 year, fewer than 1 in 100 women would be expected to fall pregnant with perfect use of the symptothermal method [monitoring of cervical secretions and basal body temperature (BBT) used with a calendar calculation].
• When sexual intercourse only occurs in the identified post-ovulatory phase, the failure rate of BBT as a single indicator is estimated to be approximately 6.6%.
• The effectiveness of changes to the cervix as a sole indicator for contraceptive purposes is unknown and therefore is not recommended.
• Women may be advised that if they are <6 months postpartum, amenorrhoeic and fully breastfeeding, the lactational amenorrhoea method (LAM) is over 98% effective at preventing pregnancy.
• Women using LAM should be advised that the risk of pregnancy is increased if the frequency of breastfeeding decreases (stopping night feeds, supplementary feeding, use of pacifiers/dummies), when menstruation returns or when >6 months postpartum.
• Women may be informed that the effect of expressing breast milk on the efficacy of LAM is not known but it may potentially be reduced.
• Barrier methods can be considered as an alternative to sexual abstinence during the fertile window of the menstrual cycle in women, provided couples have been properly instructed in their use and accept a potentially higher failure rate if using barrier contraception around the time of ovulation (peak fertile time).
• Women stopping hormonal contraception should not rely on fertility indicators until regular menstrual cycles have been established and they have had a minimum of three cycles after stopping.
• Women using drugs that are known to have a teratogenic effect should not rely solely on fertility indicators for prevention of pregnancy.
• In women for whom pregnancy poses a significant health risk, the reliance on fertility indicators for the prevention of pregnancy is not recommended. Contraceptive options should be discussed with the woman and specialists involved in the management of
  the condition.
• Withdrawal is not advised as a method of contraception on its own or as an alternative to condom use or abstinence in women using fertility indictors to avoid pregnancy.