Facts instead of myths: Family planning in the 21st century

Doctors in Europe and the United States are evidently skeptical as far as methods of natural family planning are concerned since only 6 to 10% of them would be willing to recommend such methods. (My guess is that Australia is similar) At the same time however, it should be noted that only half of these experts are actually adequately informed as far as the underlying scientific facts are concerned. Isn’t it time that the awareness of this subject matter is raised?
The American, Richard J. Fehring, Director of the Institute for Natural Family Planning at the Marquette University recently reported in an American journal (JOGNN, 33, 34-43) that only 2 to 3% of women between the ages of 15 and 44 use natural family planning methods. Fehring gave two main reasons for this: Firstly, that doctors and/or nurses and midwives failed to inform women about this type of method of family planning and also, they didn’t explain to them how such a method works. This is due in part to the fact that the specialists themselves didn’t know enough about the modern versions of the various methods. On the other hand, the term natural family planning still carries the label of being “unsafe”. This is, however, a prejudice which has originated from myths and is not based on scientific data.
Reduce prejudices, expand knowledge
Fehring wants to permanently change this view and is committed to making professional education on natural family planning available, which (at last) uses modern pedagogical principles, in order to make such methods of family planning easier to understand. In the end, all of the methods of natural family planning are based on a basic knowledge of the processes occurring within the body of a woman of childbearing age every month. In the ovaries, an egg becomes ripe, while at the same time the lining of the womb thickens, so that in the event that fertilization takes place, the lining of the womb is prepared. An egg is released out of its protective covering in the ovary (this generally occurs alternatively from the right and left ovaries). This process is known as ovulation and marks the middle of the female cycle.
Knowing when ovulation occurs
Without sperm, the egg cannot be fertilized and will die after 24 hours at the latest, during its way through the fallopian tubes in the direction of the womb. Ovulation is accompanied by a slight increase in the body temperature, which can easily be measured in the early morning. At the same time there is an increase in the amount of vaginal discharge since the mucus plug which usually seals the entrance of the vagina into the womb moves away, allowing the discharge to partially drain away. If the egg does not become fertilized, the hormonal state within the body changes, so that the lining of the womb breaks down, bleeding occurs and the womb lining is shed, a process known as the monthly period or menstruation. The temperature then returns to its original value, and the cycle begins once again.
Work in harmony with nature, not against it
When the order of events just described is considered, it becomes clear that a woman is not continuously able to become pregnant. Instead this is only possible within one day after ovulation. If you also consider the fact that the sperm cells can only survive for a few days after sexual intercourse, then the fertile period – which starts about five days before ovulation and ends one day after ovulation – can be calculated. It is therefore important that the day of ovulation is identified. Whether the fertile days are being calculated purely mathematically, or the mucus secretion is being observed, or the temperature measured in order to determine the day of ovulation, all of these methods are based on the fact that there are a number of infertile days in the monthly cycle of a woman which a couple can use for contraception. Conversely, this basic knowledge is at the same time a perfect support for all those want to have a child and in this way can find out when the optimum time for conception occurs.
According to Fehring, natural family planning presents a way of working in accordance with nature, rather than against it. The latest surveys show however that, of those women who chose one or another of the family planning methods available, many did not have the necessary knowledge. A lack of the appropriate knowledge can lead to errors and – together with long-standing prejudices – this may result in an incorrect estimation of the reliability of the method.
Interest in natural family planning is apparent
Besides sustained education, intense scientific research on the measurement and calculation methods needs to be carried out so that women can be advised on the basis of reliable data. Specifically, this means that the modern methods of natural family planning should be tested in a standardized way so that, for example, they can be compared on the basis of their Pearl Index*.
Such a comparison has been undertaken in the NFP (Natural Family Planning) project being carried out at the University of Düsseldorf in Germany (see addresses). In a comparative study being carried out by the NFP team, the most reliable methods were found to be those involving some form of temperature measurement. The study was however, a preliminary trial run for further clinical observation studies, with the intention that it would enable more reliable statements to be made in the future. In Europe, the interest in natural methods of family planning in any case appears to be greater than in the United States. In Europe, it is estimated that between 10 and 15 percent of women of child-bearing age choose such a natural method. In reality, the need may possibly be even greater. It has been shown that approximately 40 percent of women are interested in a natural form of family planning once they have been comprehensively informed and favorably acquainted with the method. Surveys have additionally indicated that those women who use methods of natural family planning do so because they feel that it is safe, due to the fact that it provides them with information about their own body and because of this their sexual desire increases. In future, this information should not be withheld from women during a professional consultation.
*The Pearl-Index is a measure of the reliability of a contraceptive method and indicates the statistical probability that a woman will become pregnant in 100 women years (100 women used the method in question for one year).
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