These instructional classes are not often covered by private insurance plans or Medicaid. However, it is unclear whether plans would cover branded classes such as the Creighton Model Fertilitycare System. Some states, such as Illinois 11 and Minnesota, 12 require state-regulated private plans to cover natural family planning services without cost sharing. Natural family planning has always been an element of programs and providers that offer comprehensive family planning services.
While natural family planning is an approach that some women may seek, many women are precluded from using these methods, and the vast majority of women in the US prefer to rely on more effective methods of contraception to avoid pregnancy. Power to Decide. February Kavanaugh ML, Jerman J. Contraceptive method use in the United States: trends and characteristics between , and Contraception Journal. Trussell J, Grummer-Strawn L. Contraceptive failure of the ovulation method of periodic abstinence.
Family Planning Perspective ; 22 2 Office of Population Affairs. Department of Health and Human Services. Birth Control Methods. Food and Drug Administration. Ong, T. January 16, Contraceptive app hit with complaints after being blamed for 37 unwanted pregnancies. The Verge. Kaiser Family Foundation. Medicaid Coverage of Family Planning Services, results of a national survey report. Washington Apply Health Medicaid. Family Planning Billing Guide.
Iowa Department of Human Services. Progesterone produces a slight rise in basal body temperature temperature at rest after ovulation. Otherwise, the function of progesterone on the cervical mucus is just the opposite effect of oestrogen — it makes the cervical mucus thick, opaque and sticky.
There are three common techniques used in periodic abstinence methods, namely: Rhythm calendar method Basal body temperature BBT method Cervical mucus ovulation method. Calendar or rhythm method This method is the most widely used of the periodic abstinence techniques. What do you know about the regular and irregular menstrual cycle of a woman?
A regular menstrual cycle is when monthly bleeding happens every month or 28 days. Box 4. Subtract 18 from the shortest cycle gives the first day of the fertile phase. Subtract 11 from the longest cycle gives the last day of her fertile time. Avoid sex, use a barrier method, or use withdrawal during the fertile phase calculated. Her shortest cycle is 26 days. Her longest cycle is 29 days. Example 2 A client comes to you and asks about using the calendar method to prevent pregnancy.
Advantages of the calendar or rhythm method This method does not require daily monitoring of fertility indicators. Disadvantages of the calendar or rhythm method It is associated with a high failure rate and can be difficult to use in the case of irregular menstrual cycles. What can a couple do if they are not confident about using this method?
Basal body temperature BBT method The basal body temperature method is based on the slight increase in the body temperature of women at rest by about 0. Table 4. Advantages Disadvantages No side-effects for this method.
Requires several days of abstinence. A special thermometer may be required. Method of BBT To use the basal body temperature method effectively, you need to know and teach women how to read a thermometer and record the results on a special chart or graph paper. Note that the pattern varies in different women.
It rises on days 15, 16 and This indicates that ovulation has happened and passed. How long does the ovum remain viable?
Cervical mucus method CMM The cervical mucus m ethod or Billings method is based on the recognition and interpretation of changes in cervical mucus and sensations in the vagina, due to the effect of changes in oestrogen levels during the menstrual cycle.
Mechanism of action of CMM You may remember from the description of natural family planning methods, that the rise in the level of oestrogen during the menstrual cycle influences the cervical gland to secrete mucus that changes from a sensation of dryness in the vagina characterised by thick, viscous and sticky mucus , to a sensation of wetness in the vulva characterised by thin, white, slippery and stretchy thread-like, transparent strands — similar to uncooked egg white , during ovulation.
Using this method, these are the times when it is safe to have sexual intercourse: After menstruation ends the dry days absence of cervical secretions will start, and during these days it is safe to have sexual intercourse every other night until a woman starts to feel wet in her vagina. Every other night is suggested, as it will help women from confusing semen with cervical mucus. It is also safe from the evening of the fourth day after the peak day, to the beginning of the next menstruation.
Once a woman has ovulated, her cervical mucus will begin to dry up, so the p eak day is the last day of cervical or vaginal wetness. If a woman has recently had sexual stimulation which will increase vaginal secretions.
If a woman is currently taking drugs for colds or sinusitis, which may dry up mucus secretions. If a woman is in physical or emotional stress. If a woman is currently breastfeeding. Advantages of CMM The advantages of this method are similar to those associated with the use of the basal body temperature method.
Disadvantages of CMM CMM has a high failure rate because it needs several days of abstinence and a lot of experience in using the method to be effective. Method of CMM You will need to carefully instruct women to be able to: Use a chart to record their mucus pattern. Look at their cervical mucus in the morning, and every time after using the toilet, using a clean cloth or tissue paper to determine the colour and consistency of the mucus.
Touch the secretion to determine its stretchiness and slipperiness see Figure 4. Feel how wet the sensation is in their genitalia when they are walking. Factors affecting LAM Any factor that causes a decrease in suckling can result in the return of ovulation and decreased milk production. Advantages Disadvantages Effectively prevents pregnancy for at least six months. Encourages the best breastfeeding pattern. Can be used immediately after birth.
Does not interfere with sexual intercourse. No hormonal side-effects. Not effective after six months. Important points about LAM Women should use both breasts to breastfeed their babies on demand, with no more than a four hour interval between breastfeeds during the daytime, and no more than a six hour interval between breastfeeds during the night-time. All these contraceptive methods are fully described in later study sessions in this Module.
Mechanism of action of withdrawal method Coitus interruptus prevents fertilisation by stopping contact between spermatozoa in the sperm and the ovum or egg. The number of days before ovulation can typically range from 13 to 20 days.
The last half of the cycle is usually more similar for every woman because there are about days from the day of ovulation until the start of the next period. Calendar tracking method: Tracking your menstrual cycles may help you estimate your fertile times.
I n order to track your menstrual cycle and identify your expected window of ovulation, follow the steps below:. Step 1 : Plan on tracking your menstrual cycle for 8 to 12 months. Step 2: Day 1 will be the first day you start menstruation. Step 4 : The first day of your fertility window is determined by subtracting 18 days from the length of your shortest cycle. If your shortest menstrual cycle was 26 days, subtract 18 from 26, which gives you the number 8.
This means that the first day of your fertility window starts on the 8th day of your cycle. Step 5: The last fertile day is determined by subtracting 11 from the length of your longest cycle. If 32 days was your longest menstrual cycle, take 32 and subtract 11, which give you This means that the last day of your fertility period is on the 21st day of your cycle. The time in between these are considered your fertility window.
In the above example, your fertility window would be from the 8th day to the 21st day of your cycle. Your ovulation is expected to occur on one day during this time frame. You cannot get pregnant every day during this time, but it is during one hour time frame during this window that pregnancy can occur. If you are trying to avoid getting pregnant, you need to abstain from sexual intercourse or use a barrier form of birth control during your fertility window.
If you are trying to get pregnant, this fertility window would be the targeted time for sexual intercourse. Keep in mind that the calendar method and tracking of past cycles is only a guide. Menstruation and ovulation can change from month to month. However, by combining the calendar method with the other natural methods of tracking your ovulation described below, you can have a fairly accurate understanding of when you are ovulating. Basal body temperature method: The basal body temperature method helps identify a change in temperature that occurs after ovulation and remains elevated until your next period.
By looking at charting from a few cycles, your temperatures can reveal a pattern from which ovulation can be anticipated. The steps below can help you as you begin to track your temperature and identify when you are ovulating. Step 2: Use a basal thermometer, which recognizes small changes in your temperature. Your body temperature will only rise between 0. Buy a Basal Thermometer Now. Some women choose to use the rhythm method if a complex medical history limits traditional birth control options, or for religious reasons.
The rhythm method is an inexpensive and safe way to help you chart your fertility — the time of month when you're most likely to be able to get pregnant.
Using the rhythm method as a form of birth control doesn't pose any direct risks. However, it's considered one of the least effective forms of birth control. How well the rhythm method works varies between couples.
In general, as many as 24 out of women who use natural family planning for birth control become pregnant the first year. Tracking your menstrual history doesn't require special preparation. However, if you want to use the rhythm method for birth control, talk to your health care provider first if:.
Keep in mind that many factors, including medications, stress and illness, can affect the exact timing of ovulation. Using the rhythm method to predict ovulation can be inaccurate, especially if your cycle is irregular.
A more modern approach to the calendar rhythm method is the Standard Days method. This method works best if your menstrual cycles are usually between 26 and 32 days long.
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