Natural Methods of Contraception

Question 1

Define natural methods of contraception

Answer 1

Methods of birth control that people can employ naturally to help prevent an unintended pregnancy

Question 2

List the 4 Natural Methods

Answer 2

Abstinence
Withdrawal method
Fertility awareness methods
Lactational amenorrhea

Question 3

Define Abstinence & give the Failure Rate

Answer 3

Failure Rate: 0%

Range b/w refraining from ALL sexual behaviour to refraining only from penetrative practices.

Requires cooperation from both partners & self-control/consistency.

Historically was probably the single most important factor in preventing pregnancy

Question 4

Give 2 alternatives names for the Withdrawal Method

Answer 4

“Coitus Interruptus” aka “Pull & Pray”

Question 5

Define the Withdrawal Method & give the Failure Rate.

Answer 5

Avg Failure Rate: 4-19%

During intercourse, the man’s penis is withdrawn from the woman’s vagina prior to ejaculation. Requires high degree of self-control.

Question 6

Does the Withdrawal Method protect against STI or pregnancy? Why or why not?

Answer 6

NO, it does NOT protect against STIs or pregnancy, as pre-ejaculate may contain STI and/or sperm

Question 7

The Fertility Awareness Methods require you to have an understanding of what?

Answer 7

The physiology of the menstrual cycle & the timing of ovulation to schedule intercourse in order to reduce or eliminate the potential for conception.

This knowledge can also be used to MAXIMIZE the potential for conception in couples who wish to conceive

Question 8

What is the difference b/w Fertility Awareness Methods & Natural Family Planning Methods?

Answer 8

Fertility Awareness Methods refers to natural contraceptive methods that also allow for the use of barrier methods, EC, & abortion.

Natural Family Planning Methods refers to natural contraceptive methods that are taught & practiced within a religious framework, usually Roman Catholic, & do not allow for the use of barrier, EC, or abortion.

Question 9

List the 3 fertility signs that the Fertility Awareness Methods rely on

Answer 9

1. Changes in cervical mucous
2. Basal body temperature
3. Cervical Position

Question 10

List 4 different Fertility Awareness Methods

Answer 10

1. Basal Body Temperature Method
2. Sympto-thermal Method
3. Calendar/Rhythm Method
4. Natural Family Planning Method

Question 11

What is the average failure rate of the Basal Body Temperature Method?

Answer 11

2-20%

Question 12

What is the Basal Body Temperature? How do you measure it?

Answer 12

BBT = lowest daily body temperature that occurs prior to rising in the morning or prior to any activity; measured w/ a basal thermometer capable of detecting small variation; temperature may be taken orally or vaginally but must be taken the same way every time

Question 13

Describe the Basal Body Temperature Method

Answer 13

Based on the observation & charting of changes in BBT, it is possible to determine fertile periods in the menstrual cycle.

12-14 hrs prior to ovulation, may be possible to detect a slight drop in BBT, which rises sharply right after ovulation in response to progesterone secreted by the corpus luteum & remains elevated for a few days.

When BBT remains elevated for at least 3 days, woman can assume she has already ovulated & intercourse for rest of cycle will not result in pregnancy.

Question 14

Basal Body Temperature Method (cont’d).

How do you determine the infertile time BEFORE ovulation?

Answer 14

Need to look at pattern of previous cycles.

Your last “safe” day is ONE WEEK before the EARLIESET recorded day of temperature rise, or 5 days after the first day of your period

Question 15

What is the average failure rate of the Sympto-thermal Method?

Answer 15

2-17%

Question 16

Describe the Sympto-thermal Method

Answer 16

This method uses all 3 fertility signs.

By recording other cyclic symptoms (cervical mucous, mid-cycle cramping, breast sensitivity, mood swings), in addition to BBT, the infertile time before ovulation can be more accurately predicted.

With careful monitoring, it is not difficult to predict the fertile period, when intercourse is to be avoided

Question 17

What is the failure rate of the Calendar/Rhythm Method?

Answer 17

5-20%

Question 18

What is the Calendar/Rhythm Method & what are its 3 assumptions? What does it rely on?

Answer 18

This is the oldest & most widely practiced method of fertility awareness methods.

Based on 3 assumptions:

1. Ovulation occurs 14 days before the beginning of menstruation, +/- 2 days
2. Sperm remain viable for up to 5 days
3. The ovum survives for 24 hours

It only relies on calculations using the calendar

Question 19

Describe the Calendar/Rhythm Method. How is the fertile period determined?

Answer 19

Women must chart menstrual calendar over several months.

Based on this method, intercourse is avoided, or another method of contraception is used, during 8-10 day periods during each cycle.

Fertile period is determined by subtracting 20 days from length of shortest cycle (to establish when fertile period begins) & subtracting 10 days from length of longest cycle (to establish when fertile period ends)

Question 20

List 3 different Natural Family Planning Methods

Answer 20

1. Billings Ovulation Method
2. Serena/Couple to Couple Methods
3. Creighton Model

Question 21

What is the failure rate of the Billings Ovulation Method?

Answer 21

3-20%

Question 22

What does the Billings Ovulation Method rely on?

Answer 22

Uses only the mucous fertility sign.

Based on the observation that, in the absence of mucous, no egg is present, & sperm cannot survive long enough for fertilization to occur after ovulation.

Volume & changes in quality of mucous are monitored to determine when ovulation occurs

Question 23

Describe a typical monthly cycle in terms of mucous production & quality. When should intercourse be avoided?

Answer 23

1. Cycle begins w/ few days of menstrual bleeding.
2. This is followed by a few “dry days” where the vagina seems quite dry
3. As ovulation approaches, more & more mucous is produced, until finally mucous becomes CLEAR, SLIPPERY, & STRETCHES W/O BREAKING (like raw egg white) - due to ESTROGENS
4. The last day of peak mucous productions right before ovulation, then come days of less mucous production. If any is noticed, it will be CLOUDY - due to PROGESTERONE

*At any time slippery, stretchy mucous is noticed, intercourse should be avoided until 2 days AFTER it is all gone (7-8 days out of each cycle)

Question 24

Briefly describe the Serene/Couple to Couple Method

Answer 24

Teach various sympto-thermal methods

Question 25

Briefly describe the Creighton Model

Answer 25

Teach different models using either mucous only or sympto-thermal methods

Question 26

What is the average failure rate of the Lactational Amenorrhea Method?

Answer 26

0.5-6%

Question 27

Briefly describe the Lactational Amenorrhea Method & what does it rely on?

Answer 27

A highly effective, temporary method of contraception via breastfeeding.

Based on physiological infertility of breastfeeding women caused by hormonal suppression of ovulation

Question 28

When can the Lactational Amenorrhea Method be used/effective? Give 3 criteria

Answer 28

1. Menses must not have returned
2. EXCLUSIVE breastfeeding 10 or more times throughout the day (NO OTHER FOODS)
3. Baby must be <6 months old

Question 29

What is an important counselling point for couples who use the Natural Family Planning Methods for contraception?

Answer 29

Should be counselled on Emergency Contraception (EC).

High probability of failure if methods are not practiced correctly & consistently