The use of periodic abstinence for family planning
Labbok, M.H.; Queenan, J.T.
Clinical Obstetrics and Gynecology 32(2): 387-402
1989
ISSN/ISBN: 0009-9201 PMID: 2663279 DOI: 10.1097/00003081-198906000-00023Document Number: 368949
This review of periodic abstinence for family planning emphasizes terminology and distinctions between the prevalent methods, and issues that will enable the health practitioner to be informed about this family planning choice. Periodic abstinence developed in the 1930s when Ogino and Knaus independently discovered the timing of ovulation, and consequently the calendar-based rhythm method became sanctioned by the church. Philippine surveys find a 40/100 woman-year pregnancy rate with rhythm. The cervical mucus method is also known as the ovulation, Billings or mucus method. Coitus is permitted by the 4th night after the peak day. Symptoms may be obscured by vaginal or seminal fluids, infections, allergies, or drugs. The symptothermal method employs mucus symptoms and basal body temperature. Coitus is allowed on the 3rd night after the temperature rise. It has the lowest failure rate, ranging from 11.2-19.8. Some family planning groups also use other symptoms such as midcycle spotting or pain, cervical position, dilation or texture, moods or libido. Various teaching groups have published charts that facilitate charting symptoms, such as temperature graphs with wide scales to make it easier to read the temperature rise. Measuring efficacy rates is difficult, and different definitions are used for several types of failures. The most important factor in success with natural family planning is the motivation of the couple. The most common cause of failure is conscious departure from the rules. Some current issues regarding abstinence are possible risks of birth defects from aged gametes, the difficulty of predicting ovulation in women with irregular cycles, the effects of vaginal infection and illness on the mucus signs, the potential for sex selection through the use of timing of intercourse and development of tests and devices to predict ovulation.