• Short summary
• Basic Philosophy of Natural Family Planning
• The Ovulation Method
• The Organization of Teaching
• The Role of the Doctor
• Effectiveness
• References
  

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Natural methods of family planning are by definition those which take advantage of the biological fact that women are at most times infertile throughout the whole of the reproductive phase of their lives. The days of infertility when it is impossible for an act of intercourse to cause conception are more numerous than fertile days when conception is possible. Abstinence from genital contact during the days of possible fertility is required for the avoidance of pregnancy in all natural methods. They do not involve drug taking nor the use of any appliances, and acts of sexual intercourse are always normal.

Basic Philosophy of
Natural Family Planning

Family planning
is only one of the responsibilities of married persons. They must decide the size of their families after careful consideration of the many factors involved - medical, economic and social. This is their decision, and no other persons or authority can impose upon them an instruction to have more or fewer children. The fertility of the husband and wife is a special bond between them and part of the intimate, exclusive gift of themselves to each other in marriage There will be some husbands and wives who choose to make a generous decision to raise a large family exercising in so-doing their freedom to take no action at all to avoid pregnancy.

Sexuality in marriage
carries a responsible role for both husband and wife in order that it will foster those virtues and qualities which are necessary to make a success of the marriage and create a family and atmosphere of happiness and love appropriate to the physical care and psychological development of their children. Responsible sexuality demands the fidelity of each partner to the other and a satisfying sexual relationship built upon mutual love and generosity.

Pre-marital and extra-marital sexual unions
undermine the basic structure of marriage and the stability of the family which is the essential unit of a healthy society. Success in the use of a natural method of family planning depends upon the sort of motivation that is required to make a success of marriage itself and the exercise of the same qualities.

The Ovulation Method

It is the occurrence of ovulation which determines the disposition of the fertile days within the menstrual cycle. The Ovulation Method depends upon the fact that the occurrence of fertility in a woman is always accompanied by the secretion of a particular type of mucus from the glands of the cervix of the uterus. The mucus symptom develops ahead of ovulation and gives warning of the approach of ovulation, and the preservation of sperm cells in a virile state and their transport to the site of fertilization depend upon the presence of satisfactory mucus.
Thus the Ovulation Method is applicable to all variations of reproductive physiology in the female:

1. Regular cycles
2. Irregular cycles
3. Anovular cycles
4. Lactation
5. The approach to menopause
6. Low fertility. The mucus symptom pin-points the location of maximum fertility in the cycle, providing the information in time for it to be useful.

Changes in the cervical mucus secretion accurately indicate the time of ovulation. These changes comprise:

1. A change in the sensation caused by the presence of the mucus. At about ovulation time the mucus gives a definitely slippery, lubricative sensation.
   At about ovulation time it becomes stretchy, so that it may hang in strings, and also becomes thinner, as a rule.
2. At about ovulation time the mucus may become clearer than formerly, although it may be cloudy even bloodstained.

The last day on which the mucus is clear, stretchy and slippery is referred to as the day of the "Peak symptom". On the following day the mucus becomes cloudy and sticky again or disappears altogether, leaving a dry sensation.

Unless the cycle is short there will be an interval between the end of the period and the beginning of the mucus symptom. These early days are infertile until the mucus begins a few days before ovulation. This unchanging pattern of dry days or of mucus which remains the same day after day, is called the Basic Infertile Pattern (B.I.P.) This Basic Infertile Pattern may last for weeks or months when a woman is breast-feeding or when she is getting near to the menopause, or when ovulation is delayed as a result of severe emotional or physical shock.

There will be no infertile early days when ovulation occurs very early in the cycle.

If it is intended to avoid pregnancy, the husband and wife must avoid all genital contact except on the days of the Basic Infertile Pattern in the pre-ovulatory phase of the cycle, and until the fourth day past the Peak mucus symptom. This means that genital contact must be avoided during the menstrual period. On the days of the cycle which are not defined as infertile days in the way specified, sexual intercourse, coitus interruptus and all intimate contact between the sexual organs must be avoided.

In teaching the Peak symptom it is particularly to be noted that the time when the maximal amount of mucus is observed bears a variable relationship to ovulation. An increased amount of mucus does not necessarily indicate the Peak symptom and may precede it by some days.

The Organization of Teaching

The details of the teaching are best left to the women themselves. All women who are capable of bearing children are familiar with the mucus symptom as a normal physiological event, and there is really no substitute for first-hand experience in the making of a good teacher.

The Role of the Doctor

One of the outstanding advantages of the Ovulation Method is that it is ecomomical in the use of the resources of medical manpower. The time required for teaching the method and the supervision of the learning period is provided by the women teachers. Their competence is greatly increased by the support of a doctor who is well informed about the method, and who is available for referral of those women who have pathological conditions, such as irregular bleeding and persistent vaginal discharges. Although these disorders do not prevent the woman identifying the days of possible fertility, she will find it easier if they are treated and it is to be recommended on general principles that expert advice and treatment be obtained. Drugs other than the synthetic sex hormones do not interfere with the normal symptom.

Effectiveness

The Ovulation Method is of primary importance in the management of infertility, and has been used successfully all over the world to help apparently infertile couples to have a child. Success has occurred even after years of involuntary childlessness. It is the presence of mucus producing a distinctly slippery sensation as it leaves the vagina which indicates the time when intercourse has the best chance of resulting in conception.

In the avoidance of pregnancy, it has been demonstrated by field trials in many different countries, in different socio-economic conditions and in people of different cultures, that the Ovulation Method is easy to learn and is highly effective. When applied according to the rules for the avoidance of pregnancy, the pregnancy rates average 1 to 1 .5%, which compares very favourably with rates after sterilizing operations and when using the contraceptive pill and is considerably better than those obtained with the intra-uterine device (lUD), withdrawal and barrier methods such as the condom and diaphragm.

The Billings Method by Evelyn L. Billings and
Ann Westmore

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