Natural family planning

Definition A way of thinking and living that is adopted

voluntarily, upon the basis of the knowledge, attitude , and responsible decisions by the individual and couples , in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country

Family planning refers to that practices that help individuals or couples to attain certain objectives:

To avoid unwanted births To bring about wanted births To regulate the intervals between pregnancies To control the time at which birth occurs in

relation to the ages of the parentsTo determine the number of the children in

the family

Aim of the family planning Healthy baby and healthy mother during the

pregnancy and even after the delivery

Contraceptives methods Preventive methods to help woman to avoid

unwanted pregnancies

Types Spacing /temporary Permanent/ terminal

1. Barrier methods 1. Physical methods 2. Chemical methods 3. Combined methods

2.Intra – uterine devices

3.Hormonal methods 4.Post conceptional

methods 5.Miscellaneous/

natural methods

Male sterilizationFemale sterilization

Without identifying physiological changes

Identifying physiological changes

Without identifying physiological changes Abstinence Coitus interruptus Safe period method (rhythm method)

Identifying the physiological changes Basal body temperature methodCervical mucus methodSymptothermic method

Abstinence

Complete abstinence hard to practice If controlled for long time temperamental

changes and nervous breakdown

Coitus interruptus During sex the man withdraws his penis from the vagina before he ejaculates (cums).

Effectiveness?Depends upon the timing of withdrawing

of penis High rate of failure > 25% Even the precoital secretion may contain

sperms

AdvantagesNatural method that does not require

devices or medicine in the body.There are no known side effects.No cost.Is morally and culturally acceptable.Better than not using any birth control

method.

Disadvantages

a high rate of failureSex may not be as pleasurableNot recommended if it is dangerous for

the woman to become pregnant.No protection against sexually transmitted

infections.

Safe period Even called as calendar method/ rhythm

method

Basis of safe periodOvulation occurs 12 to 16 days prior to onset

of menstruation

Calculation of conception days Shortest cycle- 18 days 1st day of

fertile period Longest cycle – 10 days last day of

fertile period

If calculation not possible Avoid intercourse 8th to 22nd day

counting from the first day of bleeding

Disadvantage If Cycle is not regular difficult to predict the

safe periodEducated and highly motivated co-operative

and responsible couple Half a month abstinence from intercourseNot applicable during the postnatal periodFailure rate: 9 per 100

Medical complications Ectopic pregnancy Embryonic abnormalities

Identifying physiological changes

Basal body temperature method(BBT)

It depends upon the identification of the rise of the BBT at The time of the ovulation as a result of the increase in the production of the progesterone

PrincipleSame as safe periodWoman recognizes some physiological

changes relating to the ovulation and avoiding sex during that time

Rise of temperature On ovulation day BBT rises progesteroneIncrease of 0.3 to 0.5 degree CNo ovulation no rise in temperature Time to measure: before getting out of the

bed in the morning

Reliable : 3 days after the increase in body

temperature till the beginning of bleeding

Drawback:Complete Abstinence of intercourse in pre-

ovulatory phase

Cervical mucus methodEven called ovulatory method

Principle : based on the observation of changes in the characteristics of cervical mucus

At the time of ovulation watery clear resembling raw egg

white smooth slippery and profuse cervical mucus

After ovulation: Mucus thickens and lessens

Methods to assess: wiping the inner part of vagina

Lady should able to distinguish the different type of mucus

In the early non-fertile phase of a woman’s cycle, the passageway from the vagina to the uterus is closed by thick mucus. Sperm are unable to pass through the cervix.

In the fertile phase, the passageway from the vagina to the uterus is open. A slippery-type mucus assists the movement of sperm through the cervix and nourishes the sperm.

The cervix is completely open during the preparation stage of the fertile phase

After the fertile phase ends, the cervix is again closed off by a thick-mucus plug, blocking the cervical canal. Sperm are unable to pass through the cervix. This late infertile phase is followed by the menstrual phase.

It takes three days for the cervix to close completely

Once the oocyte is released, the cervix begins to close.

Role of Cervical MucusNourish sperm, that is, keep it alive. Sperm

can live up to 3-5 days in this environment. When there is no mucus, the sperm will die quickly; for they can live up to an hour without mucus.

Eliminate weaker sperm or damaged sperm. Only the best quality sperm will reach the oocyte.

Role of Cervical Mucus

• Provide transportation so they can move towards the fallopian tubes.

• Finally, to let the woman know when her fertile time starts and ends.

Symptothermic methodCombination of BBT methods, cervical mucus

methods, and calendar techniques