I have an article in the Guardian about natural family planning. Please follow this link, http://www.guardian.co.uk/g2/story/0,,2022065,00.html, to read it online, or see below for my original piece.
Can natural family planning really be as effective as the pill? New research suggests that it is, says Sarah Ebner - once you have learned the ropes
Tuesday February 27, 2007
Women rejoice! Finally there appears to be an effective method of contraception which is in sync with your body. Except that it isn’t new at all as latest research suggests going back to basics. Could natural family planning - which removes the need for hormones, injections and the delightfully named intrauterine devices - really be the answer?
“Women know about all types of contraception from the pill to the cap, but nobody talks about what you can do naturally,” says Toni Belfield from the Family Planning Association. “If you’re taught right, then this is a method you can use for life.”
The new research, which is published in the journal Human Reproduction, showed that one particular method of natural family planning was just as effective as the pill. The Sympto-thermal method or STM, uses two indicators - body temperature, and changes in cervical mucus - to identify the most fertile phase of a woman’s menstrual cycle.
“This puts contraception under a woman’s control,” says Toni Belfield. “It’s easy to learn, it can enhance a relationship, and it’s also very easy to stop if a woman decides she does want to become pregnant.”
Rebecca is just one woman who was eager to try the Sympto-thermal method. The 25-year-old musician began using it after a bad experience with an IUD (intrauterine device) which left her in constant pain and bleeding. Ironically, she only started using that because the vaginal ring – which contains a combination of oestrogen and progesterone – had left her unhappy and suffering from mood swings.
“I loved the fact that STM didn’t require hormones, or putting anything unnatural in my body,” she says. “It wasn’t going to give me any pain, and was also going to make me more aware of my body. I was very happy to try it.”
Rebecca, 25, and her husband Geoff, were taught how to use the method by Jane Knight, a specialist nurse who runs a NHS fertility clinic in Oxford. Now Rebecca takes her body temperature each morning, is aware of any changes in her cervix and monitors any changes in her cervical secretions.
“STM has helped me to be aware of my fertility cycle,” says Rebecca. “It did take a little time to get used to, but then it became obvious. It hasn’t been at all problematic.”
Professor Petra Frank-Hermann, from the University of Heidelberg, led the new research.
“For a contraceptive method to be rated as highly as the hormonal pill, there should be less than one pregnancy per 100 women per year when the method is used correctly,” she says. “The pregnancy rate for women who correctly used the STM method in our study was 0.4%, which can be interpreted as one pregnancy occurring per 250 women per year. Therefore, we maintain that the effectiveness of STM is comparable to the effectiveness of modern contraceptive methods such as oral contraceptives.”
Of course, natural family planning has been around for years, and has often been used by those who oppose contraception on religious grounds. But the so-called rhythm method – which simply involved counting the days of the menstrual cycle - has long caused despair in family planning circles.
“It went out with the ark,” says Toni Belfield. “People talk about rhythm and natural family planning as a kind of Russian roulette, but once you know the signs and symptoms of your body, they’re so powerful. There really shouldn’t be any stigma about it.”
According to the most recent statistics, the pill, which is used by nearly a quarter of women, is still the most common method of contraception in the UK. The second most popular method of contraception is the condom, used by 22 per cent of couples, with around four per cent using hormonal injections or implants, and another four percent using IUDs. Condoms are the only barrier against sexually transmitted diseases, but have a 2 per cent failure rate, as opposed to around one percent for the pill and IUDs. Diaphragms and caps are only around 92 to 96 per cent effective.
“Natural family planning is successful, but less than one percent are using it,” says Toni Belfield.
Jane Knight, who runs the website, www.fertilityuk.org, has taught hundreds of women the natural family planning method.
“Many of them are at a time in their lives where they don’t want to be using pills anymore,” she says. “They’re often in their mid twenties to thirties and in a steady relationship. We need to get away from the idea that this is for particularly well-educated women. It’s a lot simpler if you’re a bit more in touch with your body, and it’s a method which needs both partners to be committed, but it’s not just for the educated.”
It’s true that anybody can use this natural method, but it certainly does need commitment. It’s not for the scatterbrained, as women must keep daily records, and according to Jane Knight, there’s a “learning phase” of around three months. However, this can take longer if a woman is stopping a hormonal contraceptive, as hormones can interfere with the calculations.
Perhaps more importantly, anyone following STM has to realise that there will be certain times each month – when a woman is most fertile, and according to some, most lustful - when sex is simply not allowed. The obvious solution would be to use a condom, but Toni Belfield says that might not be the only answer.
“There are other things you can do in the fertile time, just not penetration,” she says. “And all those other things can enhance a relationship.”
Rebecca agrees. “Eventually we’re hoping never to use the barrier method at all,” she says.
It all sounds perfect, if you’re organised, but it’s clearly not suitable for people who are still looking for their perfect match. After all, it might be difficult to explain that you’re abstaining from sex because of your chosen method of contraception.
Some people also feel that natural family planning is not for the young.
“If someone undergoes the necessary training, it’s very effective,” says Catherine Evans, from Brook, the sexual health charity for young people. “But it doesn’t protect you against sexually transmitted infections, so it’s not a method we would promote.
“Unless you’re in a relationship where there’s no risk of infection, we don’t think it’s a good idea. We would recommend using condoms.”
Rebecca admits that the first time she and Geoff “took the leap” into having sex with no other contraception, it was “a little scary.”
“But we did it,” she says. “And I feel that we’re learning more all the time. Taking these steps has led me to become more curious in other ways. It’s made me more aware of what’s going on in my body and I feel it’s really changed our sexual life in a positive way. It’s really liberating.”
The Family Planning Association can provide more details about natural family planning, and also about NFP teachers.
'I didn't want hormones or condoms'
Penny Warren and her husband Martin, an Anglican minister, came across the natural family planning method 26 years ago through the Couple to Couple League, an American-led organisation which aims “to share the Good News of Natural Family Planning”.
The couple are enthusiastic proponents, still use the method and teach it too. They have three children, and live in North Devon.
Penny, 47, says:
“I was looking for something which didn’t involve going to the doctor. I didn’t want hormones or condoms and I didn’t fancy IUDs.
Martin was studying in Cambridge and Couple to Couple were running a course. Although it was run from a Catholic perspective and we aren’t Catholic, we went to four sessions (across four months) and it taught us the basic rules.
What we learnt, very clearly, was how to take your temperature and how to chart it. We were also taught how I could use my mucus signs, which change throughout your cycle. I was told what to look for, and charted this alongside my temperature.
We were advised not to use the method while we were still learning, but that wasn’t a problem for us, because we weren’t sleeping together at that point.
From our experience, it’s been terrific. We haven’t ever found it difficult to manage - it becomes an everyday habit, like brushing your teeth - and I wouldn’t swap it for anything. The only problem comes when your body’s feeling very fertile, you’re crying out for sex and you can’t have it!
Lots of people say they can’t follow this type of family planning, perhaps because they don’t have regular periods. But the whole point is that it’s personal to you, so it can work for anyone. What it does is teach you exactly what’s going on with your body. I know my body really well and that’s very liberating for a woman.”
More on The Couple to Couple League in Great Britain can be found at: http://www.cclgb.org.uk/