Article

The modified mucus method in India

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Abstract

The modified mucus method-Prajanan Jagriti (fertility awakening) is intended to serve the cultural needs of illiterate and semilliterate women. Over 10 months, 3003 women in northern India were taught the modified mucus method. There were a total of 42 pregnancies in 24,702 cycles for a Pearl index of 2.04. High effectiveness is attributed to the support that was provided to clients by the instructor. PIP Prajanan Jagriti, a modified mucus method designed to fit the cultural needs of illiterate and semiliterate women with low status within the family, has enabled poor Indian women who cannot be reached with other methods of fertility control to plan their families. Although based on the observation of cervical mucus, this simplified method does not require its user to chart her menstrual cycle and demands fewer days of abstinence than traditional natural family planning (NFP) methods. In a 10-month period, 3003 women from North India, Uttar Pradesh, and Madhya Pradesh received structured teaching of the application of Prajanan Jagriti and supportive counseling from female village leaders. To ensure a thorough grasp of NFP concepts, only 10 women were instructed per month by each of the 37 village woman leaders, who were in turn supervised by 12 cluster coordinators from the Training and Action Pilot Project for non-Catholics. All 3003 women completed the first 3 months of training, and there were no unplanned pregnancies in the first month. In the 10 month study period, there were 42 unplanned pregnancies, for a Pearl index of 2.04. The main risk factor associated with these pregnancies was having no living child. Also contributing to method failure were cultural pressures to produce children, poor intraspouse communication, difficulties abstaining from sexual relations on the part of husbands, and the longer fertile period among younger women. Overall, however, project staff reported a high level of motivation on the part of these acceptors and a responsiveness to the shorter period of abstinence required by this modified method.

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... This comment implies that natural family planning (NFP) is an ineffective method of avoiding pregnancy. However, when used correctly by motivated couples, NFP is reported to be 97-99% effective in avoiding pregnancy (Dorairaj, 1991; European Natural Family Planning Study Groups, 1993; Fehring, Lawrence, & Philpot, 1994; Frank-Herrmann et al., 1991; World Health Organization, 198 1 b). Despite the high method or theoretical effectiveness of NFP, it is not widely used for family planning. ...
... This suggests that women of various backgrounds can understand and recognize the fertile time without difficulty. This is further supported by Dorairaj (1991), who found a 98% use effectiveness of an ovulation model used by women in India who were either not literate or semiliterate. ...
Article
Two common natural family planning (NFP) methods are the ovulation method based on characteristics of cervical mucus and the symptothermal method based on changes in cervical mucus, basal body temperature, and the cervix. Both methods are effective when used correctly. Nurses should understand the principles of NFP and introduce these methods in discussions of family planning options. Interested clients should be referred to a certified NFP instructor for education and supervision. PIP Despite beliefs to the contrary, natural family planning (NFP) methods can be 97-99% effective when used correctly by motivated couples. Lack of knowledge of different NFP methods hinders use, however, so nurses involved in family planning education should understand NFP methods and the characteristics of clients who could use NFP successfully. NFP identifies the 5-13 day fertile period that can be recognized by examination of changes in the amount and quality of cervical mucus or by changes in the cervix and in basal body temperature (BBT). During the fertile period, cervical mucus increases in amount and has the consistency of raw egg white. The risk of pregnancy is approximately 35% for 4 or more days after the last day the peak mucus appears. During ovulation, changes in the cervix, which softens and rises slightly, can be palpated. In addition, BBT increases about 0.4 degrees Fahrenheit after ovulation. The fertile period is determined to be concluded when the BBT has been elevated for 3 days. Some experts recommend the ovulation method, while others cite the benefits of the sympto-thermal method. Women must be taught how to use NFP properly through detailed instruction and supervised monitoring over an extended period of time. Women may chose to use NFP for religious, health, financial, or other reasons, and nurses should assess clients to help identify those most likely to be successful. These clients should be referred to specialists to learn NFP, and a variety of organizations (names and addresses of five are given) can refer clients to certified instructors or provide materials for correspondence study.
... The start of the fertile interval generally corresponds to a signi®cant rise in estrogen levels, which results in the secretion of estrogenic cervical mucus and characteristic changes in vaginal discharge (Billings et al., 1972; Insler et al., 1972; Katz et al., 1997). Although monitoring of these changes has long been used as a marker of the fertile interval (Billings et al., 1989; World Health Organization, 1983; Dorairaj, 1991; Hilgers and Stanford, 1998; Sinai et al., 1999), the extent to which mucus characteristics predict the day-speci®c probabilities of conception within the fertile interval is not known. Because properties of cervical mucus determine whether sperm will be capable of survival and transport to the ovum (Moghissi, 1973; Yudin et al., 1989; Katz, 1991; Kunz et al., 1997), we hypothesize that mucus characteristics on the day of intercourse provide a clinically important predictor of the probability of conception independent of the timing relative to ovulation. ...
Article
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Intercourse results in a pregnancy essentially only if it occurs during the 6-day fertile interval ending on the day of ovulation. The strong association between timing of intercourse within this interval and the probability of conception typically is attributed to limited sperm and egg life times. A total of 782 women recruited from natural family planning centres in Europe contributed prospective data on 7288 menstrual cycles. Daily records of intercourse, basal body temperature and vaginal discharge of cervical mucus were collected. Probabilities of conception were estimated according to the timing of intercourse relative to ovulation and a 1-4 score of mucus quality. There was a strong increasing trend in the day-specific probabilities of pregnancy with increases in the mucus score. Adjusting for the mucus score, the day-specific probabilities had limited variability across the fertile interval. Changes in mucus quality across the fertile interval predict the observed pattern in the day-specific probabilities of conception. To maximize the likelihood of conception, intercourse should occur on days with optimal mucus quality, as observed in vaginal discharge, regardless of the exact timing relative to ovulation.
... Pro podmínky rozvojových zemí byla vyvinuta "modifikovaná hlenová metoda" (Modified Mucus Method; Dorairaj, 1991) a "metoda TwoDay" (Sinai, Jennings, & Arévalo, 1999). ...
... The ovulation method depends only on changes in cervical mucus as an indicator to predict and detect ovulation, whereas the symptothermal method uses various indicators of ovulation, including changes in the cervix, cervical mucus, and basal body temperature. Like the ovulation method, the modified mucus method is based on changes in cervical mucus but has different criteria for determining fertile and infertile days (Dorairaj, 1991). Eighteen of the studies used life-table analysis to determine use effectiveness, and five used the Pearl index. ...
Objective: To determine the use effectiveness of the Creighton model ovulation method in avoiding and achieving pregnancy. Design: Prospective, descriptive. Setting: A natural family planning clinic at a university nursing center. Participants: Records and charts from 242 couples who were taught the Creighton model. The sample represented 1,793 months of use of the model. Main outcome measure: Creighton model demographic forms and logbook. Results: At 12 months of use, the Creighton model was 98.8% method effective and 98.0% use effective in avoiding pregnancy. It was 24.4% use effective in achieving pregnancy. The continuation rate for the sample at 12 months of use was 78.0%. Conclusion: The Creighton model is an effective method of family planning when used to avoid or achieve pregnancy. However, its effectiveness depends on its being taught by qualified teachers. The effectiveness rate of the Creighton model is based on the assumption that if couples knowingly use the female partner's days of fertility for genital intercourse, they are using the method to achieve pregnancy.
... Another version of the mucus method is the Creighton model (Hilgers, 1991). For conditions of developing countries a "Modified Mucus Method" (Dorairaj, 1991) and a "TwoDay method" (Sinai, Jennings, & Arevalo, 1999) have been developed. ...
Article
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1st ed. Nad názvem: Masarykova univerzita, Fakulta sociálních studií, Institut pro výzkum dětí, mládeže a rodiny 200 výt.
... 11 We ranked three studies of the mucus-based Modified Mucus Method or variants low quality. 29,30,60,79 We ranked one moderate quality; in this study, both the Modified Mucus Method and a simplified local variant of the Modified Mucus Method were assessed, 79 but pregnancy probabilities among new users were not provided. Among experienced users, the pregnancy probabilities were 10.3 (95% CI 6.0-14.6) ...
Article
Objective: To summarize best available prospective data on typical and perfect use effectiveness of fertility awareness-based methods for avoiding pregnancy. Data sources: We conducted a systematic review of studies published in English, Spanish, French, or German by June 2017 in MEDLINE, EMBASE, CINAHL, Web of Science, and ClinicalTrials.gov. Methods of study selection: We reviewed 8,755 unique citations and included 53 studies that contained 50 or greater women using a specific fertility awareness-based method to avoid pregnancy, calculated life table pregnancy probabilities or Pearl rates, and prospectively measured pregnancy intentions and outcomes. We systematically evaluated study quality. Tabulation, integration, and results: Of 53 included studies, we ranked 0 high quality, 21 moderate quality, and 32 low quality for our question of interest. Among moderate-quality studies, first-year typical use pregnancy rates or probabilities per 100 woman-years varied widely: 11.2-14.1 for the Standard Days Method, 13.7 for the TwoDay Method, 10.5-33.6 for the Billings Ovulation Method, 4-18.5 for the Marquette Mucus-only Method, 9.0-9.8 for basal body temperature methods, 13.2 for single-check symptothermal methods, 11.2-33.0 for Thyma double-check symptothermal methods, 1.8 for Sensiplan, 25.6 for Persona, 2-6.8 for the Marquette Monitor-only Method, and 6-7 for the Marquette Monitor and Mucus Method. First-year perfect use pregnancy rates or probabilities among moderate-quality studies were 4.8 for the Standard Days Method, 3.5 for the TwoDay Method, 1.1-3.4 for the Billings Ovulation Method, 2.7 for the Marquette Mucus Method, 0.4 for Sensiplan, 12.1 for Persona, and 0 for the Marquette Monitor. Conclusion: Studies on the effectiveness of each fertility awareness-based method are few and of low to moderate quality. Pregnancy rates or probabilities varied widely across different fertility awareness-based methods (and in some cases, within method types), even after excluding low-quality studies. Variability across populations studied precludes comparisons across methods.
Article
Background There are numerous natural family planning methods (FAM), which differ considerably in efficacy, practicability and acceptance by the user. Aim Aspects crucial for assessing the usefulness of a FAM are presented, thus, facilitating the identification of the most appropriate contraceptive method. Materials and methods Results of our studies (Natural Family Planning) in the last 20 years and peer-reviewed scientific publications, concerning efficacy and acceptance, were evaluated. The data are predominantly derived from prospective cohort studies of several European and American databases and from a World Health Organization (WHO) database. Results With modern FAM, users monitor changes in their body during their current cycle. Therefore, they must no longer depend on a regular cycle. The old calendar methods are obsolete, at least in the European context. Information on contraceptive efficacy, acceptance and the probability of conception within the fertile phase permit the correct evaluation of a FAM. It was found that many FAM methods do not meet the standards required for effective and sensible family planning. Conclusions Of the different FAM, the Sensiplan method is the only one that is currently recommended because it has been scientifically validated and can be assigned to the category of a very effective FAM (method-related efficacy of Sensiplan 0.4 pregnancies/100 women–years). For developing countries and communities with other cultural backgrounds, more scientific research must be performed regarding efficacy and acceptance of FAM.
Article
Recent years have witnessed important developments in natural family planning (NFP), which is based on the observation of fertile and infertile periods of the menstrual cycle, so that the couple is able to know when sexual intercourse may lead to a pregnancy. A review of the main studies regarding the effectiveness of NFP showed a decrease in the Pearl Index and life table values from the early 1980s to date, indicating that progress both in the teaching and in the application of these contraception, methods has been achieved. The main cause of lack of success seems to be the misapplication of NFP rules, whereas the errors due to the method itself are few. Furthermore, it seems that the symptothermal method might give better results than the ovulation method, even though no comparative study has been carried out, and that the first studies on the lactational amenorrhea method show encouraging results. Finally, it seems that NFP is best suited for 'spacers' of pregnancies, rather than for 'limiters'. Indeed, the former are more likely to show good compliance, since the sexual abstinence periods are limited and an unwanted pregnancy is not regarded as a completely negative event.
Article
During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and colleagues first described the cervical mucus symptoms associated with ovulation natural family planning has incorporated these symptoms and advanced considerably. Ultrasonography shows that the symptoms identify ovulation precisely. According to the World Health Organisation, 93% of women everywhere can identify the symptoms, which distinguish adequately between the fertile and infertile phases of the menstrual cycle. Most pregnancies during trials of natural family planning occur after intercourse at times recognised by couples as fertile. Thus pregnancy rates have depended on the motivation of couples. Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had a pregnancy rate approaching zero. Natural family planning is cheap, effective, without side effects, and may be particularly acceptable to the efficacious among people in areas of poverty.
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Article
There is agreement in the correspondence on R. E. J. Ryders review of natural family planning (NFP) at least among the letters by those who are able to be objective that the method works among motivated people who can abstain from sexual intercourse during the fertile phase impossible or unnatural though this may seem to many. What comes through vividly however is the chasm that exists between the primal sexual philosophy that Ryders detractors represent and the more sublime ideals that aficionados of NFP champion. The sexual sensitivities of the two camps differ greatly. This is highlighted by the term "periodic abstinence" with its emphasis on the loss of intercourse--a description of NFP that its practitioners never use. N. Hampton and D. Mansour refer to baboons and chimpanzees as role models for human sexual behavior. They argue that artificial feeding and artificial contraception are morally symmetrical and should both be condemned or both be endorsed. As it is commonly accepted that artificial feeding is inferior to breast feeding they should have no difficulty denouncing artificial contraception. There is no doubt and on this both sides concur that monkeys cannot use NFP. NFP is alien to those for whom abstinence is a forgotten experience. Couples who use NFP are committed to sexual discipline in a value system that has its origins and its aspirations in God; they choose to live by their fertility rather than to override it. Incidentally neither St. Augustine nor his putative belief that sexual intercourse is good only for procreation is mentioned in Humanae Vitae. Instead this document contains the unequivocal statement that the sexual act has both unitive and procreative meanings and indicates that the Catholic church considers recourse to the infecund periods to be licit. This shows that the church accepts that sexual intercourse has to do not only with procreation but also with the deepening of love. (full text)
Article
PIP Natural family planning (NFP) tends to be considered as a matter of chance resulting in unplanned pregnancies and large families. A World Health Organization (WHO) multicenter trial of the ovulation method of NFP was undertaken during 1975-79 with the primary objective of determining what proportion of women of many different cultures could be taught to recognize changes in the cervical mucus around the time of ovulation. The conclusions were that: a) irrespective of cultural, educational, or economic background, over 95% of fertile women could recognize the mucus signs of fertility; b) the fertility rate was 22.6 pregnancies per 100 woman years; c) the preovulatory and postovulatory days designated by the ovulation method of NFP rules as infertile were indeed infertile, as the pregnancies in this phase were 4 per 1000 acts of intercourse. The knowledge gained through the WHO trial and subsequent experience has given NFP organizations and teachers a much greater understanding of the fertile and infertile phases, so that total pregnancy rates have been steadily falling. Of the 11 NFP studies so far reported in the 1990s, the 3 that had total pregnancy rates greater than 5 per 100 woman years were trials of atypical NFP approaches or teaching methods. The results can be compared with reported pregnancy rates of between 0.18 and 3.6 for artificial contraceptive methods in well-motivated couples. One criticism of NFP is that the necessary periods of abstinence may be detrimental to the marital relationship. It is suggested that the sexual revolution of the last 20-30 years has caused marital and family breakdown on a massive scale, thus NFP might be the antidote. Since women are potentially fertile for no more than 6-8 days in the cycle, these easily recognized symptoms empower women through the knowledge they impart regarding their state of fertility. All women are entitled to this simple and fundamental information.
Article
Numerous studies have been conducted to assess the use-effectiveness of natural family planning. However, because of imprecise definitions of terms, these studies show noncomparable results. Special effort is required to study natural family planning use-effectiveness by the same criteria as other family planning methods. PIP There is a 10-15-year time lag between scientific evaluation of medical contraception and measurement. As a result, NFP has been relegated to a subordinate status in the family planning field. Although NFP researchers can benefit from the time lab by adapting the data collection techniques and statistical approaches refined through decades of studies of modern contraceptive effectiveness, there are selected issues that only NFP research can resolve. For example, it must be determined whether an NFP client becomes a study subject at registration, when she is taught the method, when she begins to chart her cycles, or after she has had several months of experience with the method's use. Such clarification is especially important to the calculation of drop-out rates. Methodological problems in measuring use-effectiveness have led to noncomparable results for the same NFP method from country to country. An examination of NFP effectiveness studies conducted from 1981-90 reveals a median rate of 13/1, with a low of 2.5 for an ovulation method study conducted in Indonesia in 1990 and a high of 27.9 for an ovulation method study conducted in New Zealand in 1981. Studies completed after 1988 tend to document pregnancy rates lower than the median, presumably reflecting both improved methodology and NFP program development.
Article
Modern fertility awareness-based methods (FABMs) of family planning have been offered as alternative methods of family planning. Billings Ovulation Method, the Creighton Model, and the Symptothermal Method are the more widely used FABMs and can be more narrowly defined as natural family planning. The first 2 methods are based on the examination of cervical secretions to assess fertility. The Symptothermal Method combines characteristics of cervical secretions, basal body temperature, and historical cycle data to determine fertility. FABMs also include the more recently developed Standard Days Method and TwoDays Method. All are distinct from the more traditional rhythm and basal body temperature methods alone. Although these older methods are not highly effective, modern FABMs have typical-use unintended pregnancy rates of 1% to 3% in both industrialized and nonindustrialized nations. Studies suggest that in the United States physician knowledge of FABMs is frequently incomplete. We review the available evidence about the effectiveness for preventing unintended pregnancy, prognostic social demographics of users of the methods, and social outcomes related to FABMs, all of which suggest that family physicians can offer modern FABMs as effective means of family planning. We also provide suggestions about useful educational and instructional resources for family physicians and their patients.
Chapter
The term Natural Family Planning is used for methods of contraception based on the biological fact that women are only fertile for a short time during the menstrual cycle. Accordingly, this method depends on the ability of the couple to identify the fertile phase in each menstrual cycle and the couple’s motivation and discipline to practice abstinence when required [9].
Chapter
Die historische Entwicklung der Natürlichen Familienplanung führte von den Anfängen der Kalendermethode zu den Selbstbeobachtungsmethoden mit Temperatur- und Zervixschleimparameter. Im Rahmen des technologischen Fortschritts erfolgte als nächster Entwicklungsschritt die Unterstützung der Zyklusführung und –auswertung via Smartphone-App und neuerdings auch die Automatisierung der Temperaturmessung. Daneben gab es durch alle Epochen hindurch die Suche nach neuen, aussagekräftigen und einfach zu bestimmenden Zyklusparametern. Einen problematischen Rückschritt stellen jene zahlreichen Zyklus-Apps dar, die – wie einst die Kalendermethoden – die fruchtbare Zeit nur berechnen und nicht im aktuellen Zyklus bestimmen.
Article
Es gibt 3 Methoden, die entsprechend der Begriffsdefinition der WHO als Methoden der natürlichen Familienplanung bezeichnet werden können: die Temperaturmethode, die Zervikalschleimmethode und die symptothermale Methode. Die Kalendermethode nach Knaus-Ogino gehört im strengen Sinne nicht dazu, da sie die fruchtbare Zeit berechnet und nicht durch Selbstbeobachtung im aktuellen Zyklus bestimmt. Im Hinblick auf die Sicherheit für die Anwenderin steht die symptothermale Methode an erster Stelle. Diese Methode wurde von der Arbeitsgruppe NFP – durch wissenschaftliche prospektive Untersuchungen begleitet – weiterentwickelt, wobei das Prinzip der doppelten Kontrolle eine wesentliche Rolle spielt. Heute können wir eine Methode anbieten, die eine Gebrauchssicherheit von 2,2 Pearl-Index und eine Methodensicherheit von 0,3 Pearl-Index (kein Verkehr in der durch die Methode definierten fruchtbaren Phase) aufweist. Überprüfte Lehrmaterialien liegen vor, ein Beraternetz, auf das jeder Arzt zurückgreifen kann, existiert in Deutschland. Als anwenderabhängige Familienplanungsmethode hängt die Sicherheit der Verhütung auch vom Sexualverhalten ab: die Anwender können ein kontrolliertes Risiko eingehen. Durch die sog. „Neuen Technologien“ in der NFP werden die Beobachtungen der Frauen durch Geräte ersetzt, die in der Lage sind, direkte oder indirekte Veränderungen in Körperflüssigkeiten oder an der Körperoberfläche zu messen, die während Follikelreifung, der Ovulation oder postovulatorisch ablaufen. Ausreichend prospektiv untersucht ist heute nur das Hormonmeßsystem im Urin. Seine Anwendersicherheit liegt im mittleren Bereich. Die Sicherheit der Basaltemperaturcomputer sollte in prospektiven Gebrauchssicherheitsstudien geprüft werden. Originäre NFP und neue Technologien stehen nicht in Konkurrenz, sondern ergänzen sich, da die Anwenderprofile für beide unterschiedlich sind.
Chapter
Die Anwendung von Familienplanungsmethoden hat in den letzten 20 Jahren auch in den Entwicklungsländern deutlich zugenommen. Dennoch ist das Bevölkerungswachstum, insbesondere in den ärmsten Regionen der Welt, bisher nicht wesentlich aufzuhalten. Aufgrund ihrer Einstellung zu Kind und Großfamilie empfinden viele die Geburtenkontrolle für sich selbst als überflüssig, mehr noch, sie widerspricht ihren Zielen. Schwangerschaft und Kinderreichtum gelten weiterhin als Beweis für Weiblichkeit bzw. männliche Potenz. Nicht selten sind mit diesem Thema ängste und Aberglaube verbunden. Erschwerend kommt bei der NFP hinzu, dass der zeitweilige Verzicht auf Sexualverkehr in manchen Gesellschaften als unakzeptabel gilt.
Chapter
Durch Planung des Sexualverkehrs wird bereits seit dem Altertum versucht, die Schwangerschaftswahrscheinlichkeit zu maximieren oder zu minimieren. Zur genauen Lage der fruchtbaren Tage im Zyklus gab es jedoch die unterschiedlichsten Vorstellungen. Der jüdische Gelehrte Maimonides (12. Jahrhundert n. Chr.) war der einzige, der ein halbwegs zutreffendes Konzept entwickelte, das die fruchtbare Zeit auf den 14. Zyklustag festlegte.
Article
Inherent inter- and intra-individual variation in the length of the menstrual cycle limits the accuracy of predicting days of peak fertility. To improve detection of days of peak fertility, a more detailed understanding of longitudinal changes in cervicovaginal fluid (CVF) biomarkers during the normal menstrual cycle is needed. The aim of this study, therefore, was to characterize longitudinal changes in CVF proteins during the menstrual cycle using a quantitative, data-independent acquisition mass spectrometry approach. Six serial samples were collected from women (n = 10) during the menstrual cycle. Samples were obtained at two time points for each phase of the cycle: early and late pre-ovulatory, ovulatory and post-ovulatory. Information-Dependent Acquisition (IDA) of mass spectra from all individual CVF samples was initially performed and identified 278 total proteins. Samples were then pooled by time of collection (n = 6 pools) and analyzed using IDA and information-independent acquisition (SWATH). The IDA library generated contained 176 statistically significant protein identifications (P < 0.000158). The variation in the relative abundance of CVF proteins across the menstrual cycle was established by comparison with the SWATH profile against the IDA library. Using time-series, pooled samples obtained from 10 women, quantitative data were obtained by SWATH analysis for 43 CVF proteins. Of these proteins, 28 displayed significant variation in relative abundance during the menstrual cycle (assessed by ANOVA). Statistical significant changes in the relative expression of CVF proteins during pre-ovulatory, ovulatory and post-ovulatory phases of menstrual cycle were identified. The data obtained may be of utility not only in elucidating underlying physiological mechanisms but also as clinically useful biomarkers of fertility status. Copyright 2015 by The Society for the Study of Reproduction.
Article
Since 1989 an international multicenter prospective study to evaluate the effectiveness and acceptability of natural family planning (NFP) methods in Europe has been conducted by the NFP Research Center at the University of Düsseldorf in collaboration with the European Zone of the International Federation for Family Life Promotion (IFFLP). Fourteen NFP-organizations from nine European countries participate in the study. Cycle data from women in the fertile age group are transferred to a special standard computer sheet by the respective organizations and forwarded at three-monthly intervals to the study center for analyses. To date, 10 045 cycles from 900 women aged between 19 and 54 years have been analyzed. This paper presents the pregnancy rate for the women aged between 19 and 45 years of age, who contributed 9284 cycles. In the analyses the cycles were subdivided into two categories consequent to sexual practices during the fertile phase: group I (NFP only-4277 cycles) use only NFP to avoid a pregnancy; group II (FA/mix-5007 cycles) where barrier methods or coitus interruptus during the fertile phase, at least in some cycles, were used to avoid a pregnancy. The women used different clinical indicators such as basal body temperature during the fertile phase, at least in some cycles, were used to avoid a pregnancy.The women used different clinical indicators such as basal body temperature (BBT), cervical mucus, calculations, cyclical cervical changes or combinations of these to determine the beginning and the end of the fertile phase necessitating a further division into four subgroups, A, B, C, D, and different efficiency rates for each of these groups.
Chapter
Durch Planung des Sexualverkehrs wird bereits seit dem Altertum versucht, die Schwangerschaftswahrscheinlichkeit zu maximieren oder zu minimieren. Zur genauen Lage der fruchtbaren Tage im Zyklus gab es jedoch die unterschiedlichsten Vorstellungen. Der jüdische Gelehrte Maimonides (12. Jahrhundert n. Chr.) war der einzige, der ein halbwegs zutreffendes Konzept entwickelte, das die fruchtbare Zeit auf den 14. Zyklustag festlegte.
Chapter
Die Anwendung von Familienplanungsmethoden hat in den letzten 20 Jahren auch in den Entwicklungsländern deutlich zugenommen. Dennoch ist das Bevölkerungswachstum, insbesondere in den ärmsten Regionen der Welt, bisher nicht wesentlich aufzuhalten. Aufgrund ihrer Einstellung zu Kind und Großfamilie empfinden viele die Geburtenkontrolle für sich selbst als überflüssig, mehr noch, sie widerspricht ihren Zielen. Schwangerschaft und Kinderreichtum gelten weiterhin als Beweis für Weiblichkeit bzw. männliche Potenz. Nicht selten sind mit diesem Thema Ängste und Aberglaube verbunden. Erschwerend kommt bei der NFP hinzu, dass der zeitweilige Verzicht auf Sexualverkehr in manchen Gesellschaften als unakzeptabel gilt.
Chapter
Die Anwendung von Familienplanungsmethoden hat in den letzten 20 Jahren auch in den Entwicklungsländern deutlich zugenommen. Dennoch ist das Bevölkerungswachstum, insbesondere in den ärmsten Regionen der Welt, bisher nicht aufzuhalten. In den Entwicklungsländern ist der Schwerpunkt für eine erfolgreiche Anwendung einer Familienplanungsmethode von der Sicherheit hin zur Akzeptanz verschoben. Eine Methode, die von den Anwendern akzeptiert und praktiziert wird, wird die Kinderzahl einer Familie signifikant reduzieren, auch wenn sie nur im mittleren Sicherheitsbereich liegt und kann somit als Erfolg gewertet werden. Für die Entwicklungsländer wurden stark vereinfachte Varianten der NFP-Methoden entwickelt: Dabei wird auf Thermometer und eigene Zyklusaufzeichnungen verzichtet. Im Rahmen der Primary Health Care werden einfache Zervixschleimregeln gelehrt oder festgelegte Zyklustage als fruchtbar definiert oder neuerdings mit der Unterstützung von Zyklus-Apps Kalendermethoden verbreitet.
Atlas of the ovulation method
  • Billings Jj Catarinich
Billings EL, Billings JJ, Catarinich M. Atlas of the ovulation method. 4th ed. Melbourne, Australia: Advocate Press 1980.
Teaching natural family planning: a guide for field workers
  • K Dorairaj
  • Deepika
Dorairaj K, Deepika C. Teaching natural family planning: a guide for field workers. New Delhi: Indian Social Insti-tute, 1980.
Teaching fertility awareness to illiterate women. New Delhi, Natural Family Planning Association of India
  • K Dorairaj
Dorairaj K. Teaching fertility awareness to illiterate women. New Delhi, Natural Family Planning Association of India, 1986.
Training village women leaders to teach fer-tility awareness and its use. New Delhi: Natural Family Planning Association of India
  • K Dorairaj
Dorairaj K. Training village women leaders to teach fer-tility awareness and its use. New Delhi: Natural Family Planning Association of India, 1987.