An overview on the effectiveness of natural family planning

What Do Social Media Influencers Say About Birth Control? A Content Analysis of YouTube Vlogs About Birth Control

Youth get their sexual health information from social media, often from social media influencers (SMIs) or microcelebrities with large followings. Previous research suggests that SMIs have powerful persuasive effects on attitudes and behaviors. Thus, it is important to examine the ways in which sexual health information, such as birth control, is conveyed by SMIs. Using framing theory as a theoretical framework, this study examines characteristics of SMIs and their shared experiences pertaining to birth control. A content analysis of YouTube vlogs (n = 50) posted from December 2019-2021 was conducted on SMIs who talk about their experiences using hormonal and non-hormonal birth control. SMI status was determined based on the number of people subscribed to the YouTube channels. Results suggest that SMI YouTube videos are primarily about the discontinuation of hormonal birth control and may provide inaccurate sexual health information. Reasons for discontinuation of hormonal birth control provided by the SMIs are discussed. Future research should explore the effects of influencer sexual health messaging on beliefs, attitudes, and behaviors.

The Use of NFP When Pregnancy Is Contraindicated?

The Sacred Congregation for the Doctrine of the Faith has declared the moral liceity of hysterectomy when certain medical criteria are met but does not exclude other options, "for example, recourse to infertile periods or total abstinence." Consequently, there may be couples who prefer to use natural family planning (NFP) methods. We shall refer to these in this article. The efficacy of NFP methods is determined by knowing the day of ovulation. To that end, three parameters are used: the presence and consistency of cervical mucus, measurement of the basal body temperature, and the determination of particular hormones in urine. Of the NFP methods used, the so-called sympto-thermal method seems to be the most effective. It has been concluded that the postovulatory or luteal phase of the female menstrual cycle is the safest time to avoid pregnancy if the couple has sexual intercourse during this period. Nevertheless, the use of NFP methods has limitations if the length of the cycles varies, there are fluctuations in the basal temperature, or when there are vaginal infections. Urinary hormone levels can also be altered by the use of antibiotics or psychotropic drugs. In general, however, it can be concluded that NFP methods, if used in the conditions mentioned herein, offer a high degree of reliability, similar to that of artificial contraceptive methods. Accordingly, if pregnancy must be avoided in the medical circumstances to which the Congregation for the Doctrine of the Faith refers, NFP methods can effectively replace hysterectomy, thereby circumventing the medical difficulties of this practice.

Summary

The Sacred Congregation for the Doctrine of the Faith has declared the moral liceity of hysterectomy when certain medical criteria are met but does not exclude other options, "for example, recourse to infertile periods or total abstinence." Consequently, there may be couples who prefer to use natural family planning (NFP) methods. We shall refer to these in this article. In general, it can be concluded that NFP methods, if used in the conditions mentioned herein, offer a high degree of reliability, similar to that of artificial contraceptive methods. Accordingly, if pregnancy must be avoided in the medical circumstances to which the Congregation for the Doctrine of the Faith refers, NFP methods can effectively replace hysterectomy, thereby circumventing the medical difficulties of this practice.

An inexpensive smartphone-based device for point-of-care ovulation testing

The ability to accurately predict ovulation at-home using low-cost point-of-care diagnostics can be of significant help for couples who prefer natural family planning. Detecting ovulation-specific hormones in urine samples and monitoring basal body temperature are the current commonly home-based methods used for ovulation detection; however, these methods, relatively, are expensive for prolonged use and the results are difficult to comprehend. Here, we report a smartphone-based point-of-care device for automated ovulation testing using artificial intelligence (AI) by detecting fern patterns in a small volume (<100 μL) of saliva that is air-dried on a microfluidic device. We evaluated the performance of the device using artificial saliva and human saliva samples and observed that the device showed >99% accuracy in effectively predicting ovulation.

Efficacy of the new TwoDay Method of family planning

OBJECTIVE

To test the efficacy of the TwoDay Method, a new fertility awareness-based method of family planning that provides women with simple instructions to identify the days each cycle when they are most likely to become pregnant. Users avoid unprotected intercourse on days when cervical secretions are present on that day or on the day before, to prevent pregnancy.

DESIGN

Prospective, nonrandomized, multicenter study.

SETTING

Five culturally diverse sites in Guatemala, Peru, and the Philippines.

PATIENT(S)

Four hundred fifty women, aged 18-39 years, wishing to use a fertility awareness-based method to prevent or delay pregnancy.

INTERVENTION(S)

Study participants were followed for up to 13 cycles of method use.

MAIN OUTCOME MEASURE(S)

Life table pregnancy rate.

RESULT(S)

The first-year pregnancy rate was 3.5 (pregnancies per 100 women/years) with correct use of the method (pregnancies and cycles with no intercourse on identified fertile days), 6.3 with use of a backup method on the fertile days, and 13.7 including all cycles and all pregnancies in the analysis.

CONCLUSION(S)

The TwoDay Method offers a valuable addition to the services that reproductive health and other programs can offer. Its efficacy compares well with that of other coitus-dependent family-planning methods; it is easy to teach, learn, and use; and it can address the need of women for simple, accurate instructions for identifying their fertile days.

Using complete breastfeeding and lactational amenorrhoea as birth spacing methods

The aim of this study was to evaluate the effectiveness of lactational amenorrhoea and to determine the relationship between extended breastfeeding and the return of fertility. Breastfeeding pattern, basal body temperature, cervical mucus, salivary ferning, vaginal blood discharge, frequency of sexual intercourse, and the presence of ovulation in the first cycle after the resumption of menses with ultrasonography were evaluated in 40 women. All subjects completed the study with only one case of incomplete breastfeeding. No pregnancies were observed. The mean number of feeding sessions and mean interval between sessions decreased significantly (p <0.01) during the first six months postpartum (7.5 +/- 1.3 after 60 days postpartum vs. 5.7 +/- 2.1 after 180 days, and 3.6 +/- 0.8 vs. 5.1 +/- 0.9, respectively). Eight women (20%) menstruated before weaning, but none had an adequate thermal shift, while 32 (80%) had their first vaginal bleeding after weaning with 12 (37.5%) registering an adequate thermal shift. Both basal body temperature and salivary ferning proved to be suggestive of ovarian activity, while mucus characteristics were not reliable in identifying fertile periods. Our study showed that breastfeeding associated with lactational amenorrhoea proved to be a good method of postpartum fertility control. Since the importance of supplementation is still debated, it is recommended that a "complete" breastfeeding program be used.

The importance of user compliance on the effectiveness of natural family planning programs

Nowadays, there is an increasing interest in natural family planning methods. The biological basis for the application of natural family planning methods is the recognition of ovulation and, more extensively, of the fertile period. Several studies in the past decade have shown the efficacy of these methods and that the main cause of failure was either a conscious departure from the rules of the method or erroneous application of the method. Another problem affecting natural family planning that has been highlighted is the relatively high discontinuation rate. These features are probably due to low compliance in applying the natural family planning rules, which may be too demanding for a number of couples. In this review, there are comments on the application of natural family planning methods, the discontinuation rates and the failure of the method due to mistakes in the studies carried out in the past 15 years. Steps that can be taken to limit mistakes and discontinuity are also addressed.

Efficacy of methods for determining ovulation in a natural family planning program

OBJECTIVE

To evaluate the efficacy in ovulation detection of methods used in natural family planning in comparison with pelvic ultrasonography.

DESIGN

Prospective analysis of ovulation detection by natural family planning methods and ultrasonography.

SETTING

Natural family planning clinic, Department of Obstetrics and Gynecology, University of Naples "Federico II".

PATIENT(S)

Forty healthy women who were highly motivated to use natural family planning.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Transvaginal ultrasonographic findings, urinary LH levels, salivary beta-glucuronidase activity, salivary ferning levels and characteristics of cervical mucus, and BBT.

RESULT(S)

Urinary LH level determination yielded a 100% correlation with the simultaneous ultrasonographic diagnosis of ovulation. Mucus sensations and characteristics yielded a 48.3% correlation when simultaneously evaluated with ovulation. Beta-glucuronidase levels yielded a 27.7% correlation. The salivary ferning test had a 36.8% ovulation-detection rate the day of ovulation, but 58.7% of results were uninterpretable. Body temperature measurements yielded a 30.4% correlation with the simultaneous ultrasonographic diagnosis of ovulation.

CONCLUSION(S)

Measuring urinary LH levels is an excellent method for determining ovulation. Although variations in mucus characteristics and basal body temperature correlate somewhat with ovulation, the length of the fertile period is overestimated with these methods. The salivary ferning test and measurement of beta-glucuronidase levels are not good methods for home ovulation testing.

The TwoDay Algorithm: a new algorithm to identify the fertile time of the menstrual cycle

Women who monitor their fertility signs and recognize when they are fertile can use this knowledge to conceive or to avoid pregnancy. Studies have shown that there is a rather small fertile window of several days during each menstrual cycle. Established methods of identifying the fertile window, such as the Ovulation and the Symptothermal methods of Natural Family Planning, can be very effective in helping couples avoid pregnancy. A new algorithm for identifying the fertile window has been developed, based on monitoring and recording of cervical secretions. The TwoDay Algorithm appears to be simpler to teach, learn, and use than current natural methods. A large existing data set from a World Health Organization study of the Ovulation Method, along with Natural Family Planning charts from women using the Ovulation Method and the Symptothermal Method, were used to determine the potential effectiveness of the TwoDay Algorithm in identifying the fertile window. Results suggest that the algorithm can be an effective alternative for low literacy populations or for programs that find current Natural Family Planning methods too time consuming or otherwise not feasible to incorporate into their services. Further studies are needed to determine the efficacy of the TwoDay Algorithm in avoiding pregnancy and to assess its acceptability to users and providers.