TYPES OF NATURAL METHODS OF FAMILY PLANNING
LACTATIONAL AMENORRHEA METHOD
COITUS INTERRUPTUS OR WITHDRAWAL METHOD
Natural methods of contraception are defined as family planning methods that utilize the normal changes in the body to determine when a woman is fertile or safe. They include all methods that do not utilize birth control measures to prevent pregnancy. Although they have no side effects, they often require time to master and a lot of discipline to practice accurately. Quite unreliable when used incorrectly, they are usually not routinely offered by most family planning providers unless requested by the client. Fueled by some religious and cultural bias against modern methods of family planning, natural methods of family planning still remain relevanct till date and its knowledge is still invaluable to some women who desires it’s use.
TYPES OF NATURAL METHODS OF FAMILY PLANNING
1. PERIODIC ABSTINENCE
2. LACTATIONAL AMENORRHEA METHOD
3. COITUS INTERRUPTUS OR WITHDRAWAL METHOD
Also known as fertility awareness method, this refers to the process by which normal observable changes in a woman’s body caused by the effect of the two hormones (oestrogen and progesterone) secreted by the ovary during the menstrual cycle is used in determining the fertile and the safe period of a woman. During this fertile period, the woman abstains from sex, hence the name periodic abstinence. Highly effective if used accurately, they require a learning curve of about 6 months and a strict period of abstinence or the use of a barrier method of contraception such as condom during the fertile period. Because it requires a long learning time and a high level of discipline to abstain from sex during the fertile period, it is quite common to see people default and eventually get pregnant while using this method. Secondly, it does not protect against sexually transmitted diseases and hinder spontaneous sex for a long period of days during the menstrual cycle. It can be divided basically into
1. CALENDAR OR RYTHM PERIOD
2. BILLINGS OR CERVICAL MUCUS METHOD
3. BASAL BODY TEMPERATURE METHOD
CALENDAR OR RYTHM METHOD
This is a very common method used widely by many women either for protection against unwanted pregnancy or for timed intercourse in those desirous of pregnancy. It entails a good understanding of the mentrual cycle and can only be used relaibly in a woman with a regular menstrual cycle. To know if you have a regular menstrual cycle, please read the article NORMAL AND ABNORMAL MENSTRUAL CYCLE. By subtracting 8 days from the likely ovulation day and adding 2 days to it, you can calculate your fertile period and extrapolate your safe period. To understand the basis behind this please read the article UNDERSTANDING YOUR FERTILE AND SAFE PERIOD. If your menses is irregular, because it is difficult to calculate and anticipate your exact ovulation day, this method can not be relibaly used by you.
BILLING OR CERVICAL MUCUS METHOD
As mentioned above, one of the effects of the ovarian hormones on the body which can be used in monitor a woman’s fertile and safe period include changes to the cervical mucus secretions. This is also known as Billing method. At the beginning of the fertile period, few days after menses, the cervical mucus becomes sticky under the influence of oestrogen hormone and becomes increasingly wet as both the hormone and the woman’s fertility heightens. At the peak of fertility a day or two before ovulation, it becomes very copious, wet and slippery resembling the appearance of an egg white in liquid form, signifying impending ovulation. After ovulation, about 4 days after the peak of the wetness, the cervical mucus starts becomes scanty and dry, signifying the beginning of the safe period. To understand how to use this process to determine fertile and safe period please read the article PRIMARY SIGNS OF OVULATION. Although very effective when gotten right, factors such as vaginal and cervical infections, sexual stimulation, and use of medications that can dry the mucus production e.g. some cough syrup can all alter its secretion.
BASAL BODY TEMPERATURE METHOD
Progesterone secreted after ovulation increases the body temperature subtely by about 0.2 Celsius about a day or two after ovulation. By monitoring the body temperature daily from the beginning of one’s menses to the beginning of the subsequent menses consecutively for 6 to 12 months, one can reliably state the ovulation day within a regular menstrual cycle and use it to time intercourse. The safe period coincides with the period when an the increased temperature is noticed in each cycle, till the beginning of the next menses. To understand how to use this method judiciously please read the article PRIMARY SIGNS OF OVULATION. When combined with any of the above two methods, it is referred to as Symptothermal method. Although very accurate, it requires a very sensitive thermometer, a long learning curve and it can easily be disrupted by anything that may cause fever around the period of ovulation.
LACTATIONAL AMENORRHEA METHOD (LAM)
This refers to the use of breastfeeding as a means of contraception. In pregnancy, the high level of prolactin hormone prevents ovulation. This high level is maintained after birth by continuous nipple stimulation experienced by the mother during breastfeeding. As breast feeding reduces, the prolactin level decreases resulting in the commencement of ovulation and a return of a woman’s menstrual flow. If unprotected sexual intercourse continues, a woman may get pregnant.
Because different women experience different levels of prolactin secretion, they also exhibit different levels of ovulation suppression as well as different rates of return to fertility. Criteria however for continuous use of LAM include:
1. The baby must be exclusively breastfed on demand, without adding food or liquid to it’s meal.
2. The woman must not have resumed her menses
3. The baby must be less than six months old.
If these three criteria are met, LAM is 98% effective in preventing pregnancy, without disturbing sexaul intercourse, unlike periodic abstinence method.
After six months of age, because it is obliged to feed the baby complementary foods to match the baby’s energy and nutritional requirement, while continuing breastfeeding, the prolactin level begins to drop as the breast feeding reduces resulting in ovulation and a return of menstruation and or pregnancy, if birth control measures are not put in place. Even before six months of age, any factor that causes a decrease in suckling can also result in the return of ovulation and decreased milk production. Hence, it is not reliable in mothers who resmued work soon after delivery, and those who feed their infants with artifical milk or those who have to stop breast feeding due to illnesses in themselves or their children. Secondly, it doesn’t protect against sexually transmitted diseases and in some cases can lead to transmission of infection to the baby.
COITUS INTERRUPTUS OR WITHDRAWAL METHOD
This is an age long method and the least effective means of contraception. I wouldn’t reccomend it, yet it is important to open people’s eyes to its shortcomings. It is quite common and errorneously believed to be effective. It refers to the pulling out of the male penis before ejaculation into the woman’s vagina. At best it is estimated to be about 70% efffective even when used the right way compared to about 98 to 99% effectiveness associated with the other natural methods of family planning. It is however fraught with so many flaws:
1. It is associated with decreased sexual pleasures for both partners during interruption of sexual intercourse
2. It is always difficult to be ensure avoidance of ejaculation due to the discipline it requires to interrupt sex at the height of sexual excitement hence often leading to inconsistency in it’s use
3. It is associated with a high failure rate due not only to a lack of self-control, but also due to leakage of sperms into the vagina prior to ejaculation from sperm rich semen that often comes out of the penis in the heat of sexual excitement.
4. There is also a risk of premature ejaculation by many men
5. It still carries a risk of sexually transmitted infection including HIV.
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