natural family planning: a healthy alternative with an overview of creighton model fertilitycare tm...
TRANSCRIPT
Natural Family Planning: A Healthy Alternative
With an overview of Creighton Model FertilityCareTM System By Mary Knutson RN, MSN, FCP
Goals and Objectives To improve health in individuals, families, and
communities by increasing use of Natural Family Planning (NFP)
To list one or more natural signs of fertility To describe two methods of Natural Family
Planning To discuss effectiveness of NFP To compare NFP’s advantages to its
disadvantages in your own situation To list a way to find out about NFP classes in
your area
What is Natural Family Planning? Using the natural signs of human fertility to
understand a woman’s cycle Making decisions about having children based on that
information NFP can be highly effective to avoid or achieve
pregnancy Develops a couple's respect for each other and their
fertility Fully supports the ideals of a Christian marriage and the
value of children as gifts or blessings NFP is safe, healthy and natural
Natural Signs of Fertility
There are signs of fertility that can be observed by a woman to understand her fertility patterns: Mucus secreted before and during the time of
ovulation A sensation of lubrication A small but measurable rise in basal body
temperature which occurs after ovulation Changes in the cervix that happen around the
time of ovulation
Natural Family Planning If a couple wants to avoid pregnancy, they avoid
intercourse or genital contact on days of fertility If a couple wants to achieve pregnancy, they focus
intercourse on the days of fertility Education by a qualified instructor is needed Observation and charting needs to be done
consistently An instructor guides the couple until they are
confident, and are using the method correctly Some methods offer self-study or online education
NFP is a Shared Method Both husband and wife share responsibility, and
the chart belongs to both of them Charting and interpreting observations at the end
of each day promotes the couple’s communication as they decide together whether to have intercourse or not
When they do come together in the marital act, they give themselves to each other fully
This method cooperates with the natural procreative cycle, and promotes both physical and spiritual health
Some Natural Family Planning Methods Ovulation Methods, like Creighton Model or
Billings Method do not involve taking temperatures Sympto-Thermal Methods include temperatures Basal Body Temperature Method-temperature only Calendar “Rhythm” is not effective because
irregular cycles cannot be predicted Cycle Beads or Standard Days Method is only
effective for regular cycles of 26-32 days Electronic fertility monitors, like the Marquette
Model, are new ways to check fertility hormones Child spacing through ecological breast feeding
Basal Body Temperature Method
BBT Chart Diagram by epigee.org (2004)
What is the Creighton Model FertilityCare System? A scientific, modern way to understand a
woman’s cycles of fertility Observing mucus and lubricative sensations on
the outside of the body Recognizing the approach of ovulation (when
the egg is released from the ovary and conception is possible)
Determining fertile and infertile days Sharing standardized charting with your doctor
(optional) to monitor reproductive health
Ovulation Events:Before ovulation, estrogen is dominant. Levels of estrogen peak sharply just before ovulation, causing changes in mucus that comes from the cervix to the opening of vagina.
In post-ovulatory phase, progesterone is higher, causing significant changes
Diagram by Hole, J., (1987), Human Anatomy and Physiology
Observations Only external checks are needed, using folded
toilet tissue and wiping front to back Women check for mucus before and after toileting Check sensation: lubricative (slippery) or dry
Check color and consistency by “finger testing” any mucus (“Stretchy” is a stretch of 1 inch or more)
Final check is at bedtime, after bearing down Chart the most fertile sign of the day, and how
often it was observed
Cervical Mucus Mucus is charted with white baby stamp as a
reminder of possible fertility Before ovulation, sperm can live several days in
cervical mucus, increasing possible pregnancy Sperm do not stay alive without cervical mucus Peak day, the last day of clear, stretchy or
slippery mucus, is the estimated ovulation time An additional count of 3 days past the peak day
is considered fertile Change occurs: Dry or non-peak mucus (sticky,
tacky, gummy, cloudy) usually follows peak
Charting Dry days that are not within the count of 3 are
marked with green stickers, because they are considered infertile days
Each new cycle begins with menstrual bleeding that is marked with red stickers
The length of cycles can vary widely, because of early ovulation or delayed ovulation, but the number of days in the cycle after the peak day (post-peak phase) is quite stable
NFP usually allows women to predict the date of their next menstrual period
Charting Examples: Regular, Short, and Long Cycles
Continuous Mucus: Using Yellow Stamps
How the Method is Taught FertilityCareTM Professionals introduce the
method at group Introductory Sessions Progressive instructions are scheduled for
individual couples (usually 8 follow-up sessions) Used with regular or irregular cycles Yellow stamps are often given to effectively
manage “continuous mucus” Additional instructions are given for infertility,
breastfeeding, post-pill, post abortion, premenopause, or postpartum-not breastfeeding
Basic Method Instructions
To avoid pregnancy, couples have intercourse only on dry days not within the count of 3
To achieve pregnancy, couples use the days that are the greatest quality and quantity of mucus, and the first 2 days after that
Menstrual Cycle Diagram by Epigee.org (2004)
Effective to Avoid Pregnancy Studies have shown Creighton Model
FertilityCareTM System to be as effective as oral contraceptives
More effective than barrier methods NFP methods can be used long-term throughout
reproductive years Has only positive “side effects”, like fertility
appreciation, and decreased divorce rate Couples can easily change their intention from
avoiding to achieving pregnancy at any time
Learning Activity and Discussion Find current NFP and contraceptive statistics Do continuation rates affect risk for pregnancy? Pregnancy rate of NFP in most studies include the
couples who chose to achieve pregnancy With that in mind, are NFP statistics truly
comparable with other methods? See Family Planning Method Comparison Chart
at the end of this presentation. (Those Creighton Model statistics show effectiveness for couples who were seriously trying to avoid pregnancy.)
Effective to Achieve Pregnancy Very effective for couples with normal
fertility. Also is effective for many infertile
couples, but is most effective to achieve pregnancy when also using medical testing and intervention
Creighton Model FertilityCareTM Medical Consultants can be used to diagnose and treat reproductive problems or infertility in morally acceptable ways
Some Disadvantages of NFP Abstinence during fertile time can be difficult –
Couples can plan ahead to do other things to show their love
Genital contact (even without intercourse) can cause pregnancy during fertile time
It takes time and effort to learn the method NFP is recommended for couples in a stable,
marital relationship Does not protect against Sexually Transmitted
Diseases
Using Barrier Methods with NFP Using condoms, spermicides, or other barriers
along with NFP is discouraged because they: Cause irritation and confusing mucus signs Barrier methods take away from the open
giving of each other in marital acts Cause increased chance of pregnancy -
Effectiveness of barrier methods is poor when calculated over the whole cycle. But using them with NFP would focus their use on the few days that are actually fertile
NFP’s Advantages and Benefits Completely natural No side effects Morally acceptable to all religions Cost-effective, and comparatively inexpensive Can be used by women in all stages of their
reproductive lives Cooperative with the body’s natural cycles,
and its procreative, reproductive system NFP is a shared system that respects the
dignity of women and marriage
How to Find Out More: NFP information and resources are available from
a Catholic Diocese Office in your area Couples of any religion are encouraged to find
out more about NFP methods Visit informational websites for NFP programs
and various methods, like www.creightonmodel.com or www.fertilitycare.org
Browse some of the following websites to learn about NFP, its moral foundations, and research to support its benefits:
Browse NFP Websites Optional learning activity: Choose a website to browse.
Write a short summary of what you learned about NFP. Share it with other students.
www.nfpsite.aldred.org for overview of NFP www.boma-usa.org or www.woomb.org or
www.nfpoutreach.org for information on the Billings method, and some moral and religious aspects of contraception and natural family planning
www.nfpandmore.org International site including research and a downloadable manual called Natural Family Planning: The Complete Approach
www.omsoul.com is a website called One More Soul. It includes NFP information, stories, resources, and research
Browse NFP Websites www.canfp.org California Association of NFP includes
and “Ask the Expert” feature www.MyFertilityCycle.NET includes online education
for charting, and an online charting system http://www.marquette.edu/nursing/NFP/Model.shtml
for NFP using electronic fertility monitors, or http://www.epigee.org/guide/computers.html overview
www2.cyclebeads.com www.ccli.org/nfp Couple to Couple League includes
ecological breastfeeding (lactational amenorrhea) http://healthmattersmagazine.com/issues/hmm15.pdf
See page 19 for a fun, colorful article
References Hilgers, T.W., (2001), Creighton Model FertilityCareTM
System: An authentic language of a woman’s health and fertility. (5th ed.) Omaha: Pope Paul VI Institute Press.
Hole, J., (1987), Reproductive systems. In Human anatomy and physiology. (4th ed., p.833). Dubuque: Brown.
Williams, M. T. (2009). Family Planning. In epigee.org website. Retrieved 10-22-09 from http://www.epigee.org/guide/natural.html or http://www.epigee.org/family-planning-new-methods.html
Family Planning Method Comparison ChartAdapted from brochure by American Academy of Natural Family Planning Feb. 1999
Methods Possible Side Effects Effectiveness % Theoretical
Effectiveness % Actual
Continuation Rate at 1 year
Creighton Model FertilityCare System None 99.5 96.8 89%
Barrier Methods (condom,
diaghragm,
sponge
Allergic reactions and irritation, inc. risk of toxic shock syndrome
97
94
80-91
88
82
64-82
63%
58%
52%
Vaginal Spermicides Allergic reaction or irritation 94 79 43%
Sterilization Surgeries
Tubal ligation
and vasectomy
Surgical bleeding and infection, inc. risk of hysterectomy, ectopic pregnancy, painful periods, prostate cancer
99.8
99.9
99.6
99.8
100%
100%
Intrauterine Device
(IUD)
- requires replacement every 5 years
Heavy, irregular or painful periods, painful intercourse, infection, ectopic pregnancy, perforation of uterus, infertility
98 97 80
Birth Control Pill (2 hormones) Breast tenderness, wt. gain, headaches, nausea and vomiting, depression. May delay return of fertility and inc. risk of CV disease and some CA
99.6 94 72
Progestational Agents (Norplant, and Depo-Provera )
Local infection and bruising , anxiety, acne, wt. gain, headaches, breast pain and irregular menses
99.9
99.7
99.9
99.7
85
70
Which Family Planning
Method is Most Ideal?
Rate these: Condom BCP IUD NFP Sterilization
Completely Safe
Effective
No Side effects
Obtainable
Affordable
Acceptable
Future pregnancy
Give 1 point for poor, 2 points for satisfactory, and 3 points for good. Total up the points at the bottom of page.
This presentation was sponsored by Health Vista, Inc.
Revised 10-22-09