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If you and your husband wish to postpone pregnancy, you have several contraceptive options available. One approach—natural family planning (NFP)—has many advantages, yet receives little attention in popular media or the medical community. What's the reason for this lack of awareness? Often it's the common but mistaken impression that any method of postponing pregnancy that doesn't involve medical technology is unreliable or even haphazard. However, studies indicate when couples are taught to use natural family planning methods consistently, NFP is as effective as oral contraceptives and easily surpasses the effectiveness of condoms, whose failure rate is widely considered to be as high as 10 to 15 percent per year. And natural family planning poses no moral or ethical dilemmas for those concerned about the use of other contraceptive technologies.
What are NFP's basic principles?All forms of NFP involve identifying a woman's "fertile" days, then abstaining from sexual intercourse on those days or engaging in intercourse if a baby is desired. The original calendar or "rhythm" method, devised in the '30s, was based on the knowledge that the time between ovulation (when the ovary releases an egg) and the beginning of menstruation is nearly always two weeks. Women with regular menstrual cycles are most successful with this method since they can predict the timing of their next period, then count back two weeks to determine their fertile days. Unfortunately, at least 25 percent of women don't experience cycles with clockwork regularity, and even those who do might have an unexpected change caused by stress, illness, or other factors.
More recent NFP methods can better pinpoint a woman's fertile period. In 1964, Australian neurologist John Billings and his wife, Lyn, a pediatrician, described a method of predicting fertility that involves a daily self-check of cervical mucus. When a woman nears ovulation, her mucus becomes increasingly clear, watery, and elastic, like egg white. Before and after these fertile days, the mucus is thicker, stickier, and virtually impenetrable, an effective barrier to sperm.
A key time in the cycle is the arrival of the "peak day," after which the mucus begins to revert to its former thick, sticky condition and/or disappears. The peak day correlates with ovulation. Couples who want to postpone pregnancy avoid intercourse when the mucus becomes thin and clear, and abstain for three days after the peak day. Even though an unfertilized egg lives only twelve to twenty-four hours, ovulation can take place two or even three days after the peak day. Abstinence is also necessary for a few days prior to the peak day because sperm survive for two to three days in the cervix when the mucus starts to thin. Here's an easy rhyme from an organization that teaches the Billings method to help you remember it: When mucus is wet, a baby you may get. When mucus is dry, the sperm will die.
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