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A prospective multicentre trial of the ovulation method of natural family planning. Pt. 2. The effectiveness phase.
Fertility and Sterility. 1981 Nov; 36(5):591-98.A 5 country prospective study was undertaken to determine the effectiveness of the ovulation method of natural family planning. 869 subjects of proven fertility from 5 centers (Auckland, Bangalore, Dublin, Manila, and San Miguel) entered the teaching phase of 3-6 cycles; 765 (88%) completed the phase. 725 subjects entered a 13-cycle effectiveness phase and contributed 7514 cycles of observation. The overall cumulative net probability of discontinuation for the effectiveness study after 13 cycles was 35.6%, 19.6% due to pregnancy. Pregnancy rates per 100 woman-years calculated using the modified Pearl index were as follows: conscious departure from the rules of the method, 15.4; inaccurate application of instructions, 3.5; method failure, 2.8; inadequate teaching, 0.4; and uncertain, 0.5. Cycle characteristics included: 1) average duration of the fertile period of 9.6 days, 2) mean of 13.5 days occurred from the mucus peak to the end of the cycle, 3) a mean of 15.4 days of abstinence was required, and 4) a mean of 13.1 days of intercourse was permitted. Almost all women were able to identify the fertile period by observing their cervical mucus but pregnancy rates ranged from 27.9 in Australia and 26.9 in Dublin to 12.8 in Manila. Continuation was relatively high ranging from 52% in Auckland to 74% in Bangalore.
International Review of Natural Family Planning. 1982 Fall; 6(3):290-8.This article summarizes the experiences of the author, a priest, in teaching natural family planning, (NFP), for the past 7 years in the rural areas of Central America, the Caribbean, Ghana, and Mexico, including his participation in a multicentered WHO study. He 1st points out that it is important to use information that people already know. The article contains a sample illustration which relates the fertile period of growth that accompanies rain in the natural environment to the period of ovulation. The WHO study included 900 women from India, the Philippines, Ireland and New Zealand, in addition to the author's parish in El Salvador. Illiterate women in El Salvador learned to identify the fertile times in their cycles with the same facility as the women of New Zealand, who had an average of 12 years of education. The study also found that the method had a theoretical effectiveness of 98.2%, although the participants in rural El Salvador got pregnant at a rater higher than anywhere else. This was not due to a failure of the method, but instead could be attributed to user related pregnancies. That is, the women that got pregnant didn't follow the rules of the method. He states that people in rural areas learn the natural method of birth control easily because it costs nothing and because of their reverence for nature, it seems natural. In addition to the child spacing advantage, the beneficial effects of natural methods include the discipline of periodic abstinence and the education of children about the beauty and dignity of sex. The author stresses the need to educate rural people that artificial methods of birth control, especially sterilization, have harmful and evil side effects.