April 12, 2018
Elisa Yao, MD
This is a fourth in a series on the 50th anniversary of the papal encyclical “Humanae Vitae.”
Modern natural family planning methods are very effective, and are safer alternatives to hormonal birth controls. By observing physical signs and symptoms that change with hormonal changes throughout a woman’s menstrual cycle, modern NFP methods can be used fairly accurately to predict a woman’s fertility. In essence, women can choose to abstain from intercourse during predicted time of fertility and choose to have intercourse during predicted time of infertility to avoid pregnancy.
Unfortunately, most people and most physicians are not familiar with modern NFP methods as medical schools do not teach about these methods. Thus most physicians associate NFP with the calendar or rhythm method, which was introduced nearly 100 years ago (and superseded in the late 1950s). However, it should be noted that the rhythm method was the most effective means of birth control at that time, as hormonal birth controls were not yet available.
The modern NFP methods include Billings Ovulation Method, Creighton Model and Symptothermal Method. Briefly, the first two methods involve noting the presence or absence of cervical secretions, and to further characterize the secretions’ color, texture and stretch. STM, on the other hand, combines basal body temperature, cervical methods, cervical position and/or historical data to identify the fertile period.
With BOM and CrM, the unintended pregnancy rates within one year of perfect use are both only 0.5 percent, whereas with typical use, the rates are 3-22 percent. With no planning, the rate of unplanned pregnancy rate is 85 percent. A World Health Organization study of nearly 200 typical use pregnancies, found that 70 percent of these unintended pregnancies were caused by a purposeful departure from method rules, and another 17 percent due to inaccurate application of the rules.
Interesting, a randomized trial involving nearly 1,000 women in China (where there was a strict one-child policy and with severe repercussion if policy was violated) reported that even the typical-use pregnancy rate with the BOM was 0.5 percent and it enjoyed a higher adherence than the copper IUD to which it was compared. Certainly it seems how motivated the couples are at adhering to the method instructions makes a significant impact on typical use pregnancy rate.
With the STM, the rate of unintended pregnancy within one year of perfect use is 0.3 percent, but with typical use ranges from 0.2-20 percent, according to older studies. With both BOM and STM, more recent international studies show progressively lower unintended pregnancy rates.
Learning these modern NFP methods does not require a high level of education. In fact, studies conducted by the WHO indicate that 93 percent of women, regardless of their education level, are capable of identifying and distinguishing fertile and infertile cervical secretions. And with the China study mentioned earlier that exhibited extremely high effectiveness of the BOM, 63 percent were peasants and 22 percent were laborers (largely illiterate).
In conclusion, with adequate motivation, the modern NFP methods are safe and effective alternatives compared to hormonal birth controls. Additionally, the modern NFP methods can also be used to achieve pregnancy and can provide useful information to address various women’s health issues ranging from premenstrual syndrome to infertility.
NaProTECHNOLOGY (Natural Procreative Technology), which uses CrM as its foundation, can be just as effective as in vitro fertilization in helping infertile couples achieve live births, according to a 2008 paper published in the Journal of American Board of Family Medicine. The aim of NaProTECHNOLOGY is to restore the normal function of the woman’s cycle, instead of suppressing it as with hormonal contraceptives or to overstimulate it as in IVF.
Dr. Elisa Yao grew up in the Bay Area, attended Lowell High School, graduated from UC Berkeley and completed her medical degree at UC Davis. She is board certified in integrative and holistic medicine as well as physical medicine and rehabilitation. She is completing her training in NaProTECHNOLOGY, which aims to restore normal function of woman’s health. www.elisayaomd.com.