The choices Natural methods

What is it?

Natural family planning, also known as ‘fertility awareness', is a method of contraception that uses the menstrual cycle to predict your most fertile time of the month - that is when you are most likely to become pregnant. Once you have identified your most fertile time, you avoid sex or use a barrier method of contraception during that time period.

How does it work?

Natural family planning works by observing and recording your body's different natural signs or fertility indicators on each day of your menstrual cycle.

The main indicators are:

• Body temperature
• Cervical mucus
• Calculating how long your menstrual cycle lasts

With this knowledge it now becomes possible to identify three phases of fertility during each menstrual cycle. However, if a woman's cycle is irregular then clearly it is more difficult to predict when ovulation is likely.

The first phase is the first infertile phase, or the first safe period when the woman is unlikely to fall pregnant. This starts on the first day of the woman's period and ends on the earliest date from which sperm could survive long enough to fertilise the egg. This first safe period is short because sperm can survive for up to seven days after intercourse and a woman may ovulate early. Therefore, unprotected intercourse during this first phase may result in pregnancy.

The fertile phase is the time when a woman is most likely to fall pregnant. Couples not wishing to become pregnant should avoid intercourse during this time or use other methods of contraception such as condoms. If pregnancy is desired then this is the time when a woman is most likely to conceive. The fertile phase lasts from the end of the first phase until 24 hours after ovulation.

The second infertile phase or safe period when a woman is less likely to fall pregnant is more predictable than the first phase. This phase lasts from the end of the fertile phase until the beginning of the woman's next period.

How effective is it?

Effectiveness depends on:

• How old you are
• How often you have sex
• Whether you follow the instructions exactly

If used according to teaching and instructions the natural family planning method is up to 99% effective. Some people choose to combine their fertility awareness knowledge with condoms to increase the effectiveness. This method is not usually recommended as most women will occasionally have irregular cycles and it can be difficult to predict ovulation every month with sufficient accuracy.

What are the benefits?

• There aren't any side-effects
• It is completely natural

Who not be able to / may not want to use it?

Women who:

• Don't want to wait three to six menstrual cycles to learn the process effectively
• Don't want to keep daily records
• Don't constantly want to be monitoring factors that impact on fertility such as illness, lifestyle, stress, or travel
• Don't want to avoid sex or use male or female condoms during fertile time

Possible side-effects?

None.

What if:

I want to become pregnant?

The natural family planning method will highlight when your most fertile periods are, this will make it easier for you to be aware when you have a higher chance of becoming pregnant. You can start taking your pre-pregnancy care, including folic acid and stopping smoking at any time.

Can anyone use the natural family planning method?

Most women can use fertility awareness as long as they receive good instructions. It may not be suitable method for some women who do not have periods or have very irregular cycles.

This method does not protect you against sexually transmitted infections, so you may need to use a condom as well.

Remember: Contact your doctor or nurse if you have any concerns or are worried / unsure about anything to do with your contraception.