Monday, October 6, 2008


Everytime the debates on the proposed RH bill 5043 crops up, you can be sure that Natural Family Planning comes up as a convenient target.

The critics of Natural Family Planning (NFP) contend that the Rhythm method is highly unreliable and has high failure rates.

The above statement is right for the wrong reasons.

Contrary to the common misconception, Natural Family Planning (NFP) is not synonymous to the Rhythm (otherwise known as Calendar) Method. Natural Family Planning is based on the Billings Ovulation Method (BOM).

The rhythm method is based on three ideas. Firstly, that women ovulate 14 days before menstruation begins, give or take two days. Secondly, that sperm can survive inside a woman for three days. And lastly, that an egg can only be fertilized within 24 hours of being released from the ovaries.

Based on these assumptions, the rhythm method requires a woman to count back 14 days from the first day of her period. This will presumably be the day on which she ovulated and will ovulate the following month. In order to avoid pregnancy, she will need to abstain from sex within 3 to 5 days of the expected ovulation date.

While this method is fairly simple to follow, it is not necessarily applicable to all women. The first problem lies in the assumption that ovulation will always occur at the same time every month. While it would make life a lot easier for women if this were true, the reality is that the majority of women ovulate at a different time every month. Although they may follow a similar pattern, no woman has a menstrual cycle that is identical every month. Ovulation timing is also affected by stress, age, discontinuation of the pill, breastfeeding, menopause, and the varying health condition of the woman.

The Billings Method or the BOM is the most modern natural way to achieve or postpone pregnancy.
It has been named after the doctor and wife team who developed it 56 years ago: Dr. John Billings and Dr. Evelyn Billings.

It can be used by a woman in all stages of her reproductive life: regular, irregular cycling, breastfeeding, approaching menopause, recovering from emotional and physical stress or coming off contraceptive medication, literate, illiterate, whatever.

Fertility is signalled by the development of a particular type of mucus from the crypts of the cervix. Sperm live in the best type of mucus but without it they die within an hour or so. The mucus symptom, telling the woman she has begun her fertile phase, develops a few days prior to ovulation. The Peak day (the last day of the lubricative sensation) occurs very close to the time of ovulation. She is possibly fertile for a further three days and menstruation follows 11 - 16 days later.

A woman is not asked to do anything except pay attention to what she has already noticed just as she goes about her normal daily activies; keep a simple record and apply four common sense guidelines. The daily chart is very important in reminding her to pay attention to the changes in sensation at the vulva and the appearance of any discharge seen. It also gives valuable information to the couple so that they can make decisions about their joint fertility.

Clinical trials demonstrate how effective it is when avoiding pregnancy (better than 99%) while helping those couples labelled "low fertility" to conceive a long awaited baby 80% of the time (Australian trial, 2006). The Billings chart further gives valuable hormonal information to doctors and is increasingly used as a diagnostic tool in the treatment of infertility. More information on a woman’s fertility cycle may be found here.

So there.

Rhythm is not = NFP.
NFP is not = Rhythm.
Calendar method is not synonymous to NFP.
NFP is not...oh, never mind.

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