Birth Control

Natural Family Planning Methods

Natural Family Planning (NFP)

Natural family planning (NFP) is a natural method that you can use to help you decide when to have sex, either to avoid getting pregnant or to increase your chances of becoming pregnant (other natural methods include abstinence, withdrawal, outercourse, and continuous breastfeeding/LAM). In a nutshell, NFP is basically fertility awareness. It consists of different methods that help you gain knowledge about your fertility and teaches you how to read the natural signs your body gives to help you determine which days of the month you are most likely to not get (or to get) pregnant.

Natural family planning includes birth control methods that do not require medication, physical devices, or surgery to prevent you from becoming pregnant.

How Does NFP Work?

Natural family planning relies on your fertility awareness. During your monthly cycle, several changes occur in a woman's body. For NFP to work, you need to become aware of your body's natural functioning, so you can figure out when you are ovulating and are most fertile (likely to get pregnant).

By keeping track of the changes that take place in your body, you can plan when you should and shouldn’t have sex (depending on your NFP goal). Each of the natural family planning methods work a little bit different.

What Are the Different Natural Family Planning Methods?

The following are some of your NFP options:

  • Standard Days Method (Calendar Method): This method has you track the length of your cycle (usually with CycleBeads) and suggests that you not have sex during your most fertile days of the month.
     
  • Basal Body Temperature Method: With this method, you use a special thermometer each morning when you first wake up to determine your baseline temperature. After doing this, and logging your readings, for a few months, your fertility pattern should be more clear. This can help you determine when you should have or not have sex.
     
  • Billings Method: This method instructs you to inspect and track changes in your cervical mucus. This can be helpful because your cervical mucus changes in reliable ways throughout your menstrual cycle.
     
  • Symptothermal Method: Under this method, you combine the other NFP methods. So, you check your cervical mucus, take your basal body temperature, and track your cycle length.

How Effective is Natural Family Planning?

The following is the average effectiveness rate of all the NFP methods:

  • Typical use: 77 percent to 88 percent effective (more accurately reflects how the average woman uses her NFP method: not correctly or consistently each and every time)
  • Perfect use: 95 percent to 99.6 percent effective (when you always use your NFP method correctly and consistently)

This means that of every 100 women who use one of the NFP methods, 12 to 23 will become pregnant within the first year (with typical use) and five or fewer will become pregnant with perfect use.

In order for naturally family planning to be most effective, you (and your partner) should fully understand your chosen NFP method.

You both need to support each other, be committed to naturally family planning, and sexually abstain (or use contraception) during your most fertile times. You must also be willing to monitor and chart your fertility signs.

If I Use NFP, What Changes Do I Need to Look For?

Natural family planning methods require you to monitor and track specific changes that occur in your body. This process will help you predict when you are most fertile (and likely to conceive). 

  • Cervical Mucus: The presence, color, and thickness of your cervical mucus can tell you what changes are happening in your body. After your period ends, you should have "dry days" (with no cervical mucus). You are not likely to get pregnant during this time. More mucus is made (and is often cloudy or whitish in color and sticky) as you are getting close to the time you will ovulate. You should be abstinent at this time or use back-up contraception if you don’t want to become pregnant. Right before you ovulate, you should see the most mucus. It it usually clear, slippery, and easily spreads apart on your fingers. This is when you are most fertile. If you have sex at this time, you may want to use a condom, sponge, or female condom to avoid getting pregnant.
  • Basal Body Temperature: Before you ovulate, your basal body temperature is usually between 96 and 98 degrees. It will rise a little bit (typically less than one degree) when you ovulate. Because the temperature changes are so small, you need to use a special basal body thermometer (which is designed to measure more specific temperatures). If you record your basal temperature every day, after a few months, you will have a better idea of when you will be fertile. In general, you are most likely to become pregnant two to three days before your temperature rises and one day after that. Once your temperature has been higher for at least three days, your chances of getting pregnant are much lower.

Why Do People Choose Natural Family Planning?

Some couples choose NFP for religious reasons or just as a personal preference. You may choose NFP because you feel more comfortable using a natural birth control method that has no side effects. Other people may turn to natural family planning because they are allergic to materials used in devices like IUDsimplantsdiaphragms, or condoms (though there are latex-free condoms, as well as polyurethane ones).

 Some women may decide on natural family planning because they cannot use hormonal birth control.

Is Natural Family Planning Not Advised for Some People?

Although there are a lot of advantages to using NFP, it may not be the best birth control option for all women. There are a couple of reasons for this.

  • In the beginning, natural family planning takes a lot of time and effort every day. You need to remember to track the days of your menstrual cycle, and chart temperature and/or cervical mucus.
  • Many women do not have completely regular menstrual cycles/periods. This can make it difficult to accurately pinpoint the definite time that you are fertile each month. 
  • Your menstrual cycle can be affected by many factors. Stress, being tired, or sick can cause shifts in your cycle.
  • Infections or colds that cause low-grade fevers can have an affect on your basal body temperature, so your temperatures that month may not reflect your overall fertility pattern.
  • Even though natural family planning is effective, this method may not be the best choice if preventing pregnancy is a high priority (either due to health reasons that being pregnant can cause or because you are not ready to have a baby).

Things to Consider if You're Going to Use NFP

Fertility awareness or natural family planning methods require training, commitment, discipline, and determination in order to be most effective. You and your partner need to be able to communicate, trust, and cooperate with each other. Because NFP does not protect you against sexually transmitted infections, you should also be in a stable, monogamous relationship.

Even though naturally family planning methods are typically inexpensive and do not require you to visit with your doctor, to be most effective, you should do your research and possibly receive specialized training. There are certified/qualified professionals who can fully teach you the NFP method of your choice. They can assist you in your monitoring to make sure that you are doing this the right way, and that you are correctly interpreting your body's signs and fertility pattern.

A Word From Verywell:

NFP is a great and empowering natural birth control method that can be used to help you determine when having sex may or may not result in pregnancy. Remember that sperm can live in your body for up to a week. If you have sex without any birth control up to seven days before and a day or two after you ovulate, you have a greater chance of becoming pregnant.

Know that your first task with natural family planning is to become familiar with your menstrual cycle and to then start charting your fertility patterns. Be patient because this monitoring can last for several months (and have a back-up contraception plan during this time). Also, keep in mind that if you do not completely or reliably follow the instructions of your chosen NFP method, it can be much less effective.

The truth is, in practice, NFP may not be as reliable as other forms of birth control. That being said, if you are committed to tracking and recording your fertility information, you can enjoy much higher success rates. You might find mobile apps dedicated to helping you chart your fertility useful.

    Sources:

    Evans C. "Natural family planning is effective and culturally acceptable." BMJ. 2012;345(jul23 2):e4908–e4908. doi:10.1136/bmj.e4908.

    Office of Population Affairs. (2014) "Natural Family Planning: The Facts." from United States Department of Health and Human Services website.

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