Periodic abstinence in developing countries: an assessment of failure rates and consequences

It is estimated that 27 million couples, representing 2.6% of all couples in the reproductive span, use periodic abstinence (PA). Using data from 15 national surveys in low and middle-income countries, this article assesses characteristics of PA users, knowledge of the fertile period, accidental conceptions while using PA and the reproductive consequences of these conceptions. Current users of PA (predominantly the simple calendar variant) tend to be more educated and urban than users of other methods. The method is preferred by young single women and older married women. The proportion of users with correct knowledge of the timing of ovulation ranges from 8% to 91%, with a median value of 62%. The median 12-month gross failure rate was 24 per 100 episodes. Net of other predictors of failure, correct knowledge of the timing of ovulation was associated with a 12% decrease in failure probabilities. Couples who experienced PA failure were more likely than couples who experienced failure with another method to carry the pregnancy to term. Nevertheless, PA still contributes to one-sixth of all abortions (or miscarriages) following contraceptive failure.

Characteristics of women associated with continuing instruction in the Creighton Model Fertility Care System

Effective use of natural family planning is strongly dependent upon adequate instruction. The Creighton Model Fertility Care System (CrMS) has a standardized protocol for instruction of new users that includes individual follow-up visits in the first year of use. This study evaluated the number of follow-up visits completed by new CrMS users from eight CrMS centers in the United States. Four follow-up visits were completed by 75.7% of women. Women who continued instruction were more likely to be educated, Catholic, and white, and to have a more challenging reproductive status (discontinuing oral contraceptives, or breastfeeding). These results suggest that the number of follow-up visits needed varies among new CrMS users. Future research should address the optimal length of instruction for adequate use of the CrMS by women with different characteristics and needs.

Efficacy studies in natural family planning: issues and management implications illustrated with data from five studies

Studies of method effectiveness must be carefully assessed for comparability of findings. Several parameters are identified that are important in the assurance of comparable results. This article discusses these issues with the use of data from previously published studies and emphasizes the management implications of use-effectiveness data.