Natural family planning 2573143 225050517 2008-07-11T17:24:38Z Kbdankbot 6505923 Robot - move category per [[WP:CFD|CFD]] [[Wikipedia:Categories for discussion/Log/2008 July 4|2008 July 4]] {{about|methods of [[family planning]] approved by the [[Roman Catholic Church]]|a more general use of the term|fertility awareness}} {{Infobox Birth control |name = Natural family planning |image = |width = |caption = |bc_type = natural birth control |date_first_use = Ancient: LAM, Rhythm<br/>mid-1930s: BBT<br/>1950s: mucus |rate_type = Failure |failure_measure = six months: LAM <br><div align="center">per year: symptoms- and calendar-based |perfect_failure% = LAM: 0.5%<br/>Symptoms based: 1-3%<br/>Calendar based: 5-9 |typical_failure% = LAM: 2%<br/>Symptoms based: 3-25%<br/>Calendar based: 25 |duration_effect = |reversibility = Yes |user_reminders = Dependent upon strict user adherence to methodology |clinic_interval = None |STD_protection_YesNo = No |periods_advantage = Prediction |benefits = In accord with Catholic teachings, no drug effects, can aid pregnancy achievement |periods_disadvantage = |risks = |medical_notes = }} '''Natural family planning''' (NFP) is a term referring to the [[family planning]] methods approved by the [[Roman Catholic Church]]. In accordance with the requirements for [[human sexual behavior|sexual behavior]] in keeping with the dignity of the human person, as maintained by this church, NFP excludes the use of [[birth control|contraception]], as well as acts intended to end in orgasm outside the context of intercourse. Periodic [[sexual abstinence|abstinence]] and the [[lactational amenorrhea method|natural infertility]] caused by [[breastfeeding]] are the only methods deemed moral for avoiding [[pregnancy]]. When used to avoid pregnancy, NFP limits sexual intercourse to naturally infertile periods: during infertile portions of the [[menstrual cycle]], during pregnancy, or after the [[menopause]]. Several methods may be used to identify whether a woman is likely to be [[fertility|fertile]], which NFP users make use of to either try to avoid or to achieve pregnancy. ==Prevalence== It is estimated that 2–3% of the world's reproductive age population relies on periodic abstinence to avoid pregnancy.<!-- --><ref>{{cite journal |author=Che Y, Cleland J, Ali M |title=Periodic abstinence in developing countries: an assessment of failure rates and consequences |journal=Contraception |volume=69 |issue=1 |pages=15–21 |year=2004 |pmid=14720614 |doi=10.1016/j.contraception.2003.08.006}}</ref> Breastfeeding is believed to reduce the world's fertility rate by 30–45%.<!-- --><ref>Kippley (1996), p. 145</ref> However, what portion of this population should be considered NFP users is unclear. Some Catholic sources consider couples that violate the religious restrictions associated with natural family planning to not be NFP users.<!-- --><ref>Kippley (1996), p. 13</ref><!-- --><ref>{{cite web |title=Question #8 |work=FREQUENTLY ASKED QUESTIONS |publisher=Serena Canada |date=2006 |url=http://web.archive.org/web/20041020125539/http://www.serena.ca/eng/faq.html#q8 |accessdate=2007-03-19 }}</ref> There is little data on the worldwide use of natural family planning. In Brazil, NFP is the third most popular family planning method.<!-- --><ref>{{cite journal |author=Keller S |title=Traditional beliefs part of people's lives |journal=Network |volume=17 |issue=1 |pages=10–1 |year=1996 |pmid=12320441}}</ref> The "safe period" method of [[fertility awareness]] is the most common family planning method used in India, although condoms are used by some.<!-- --><ref>{{cite paper |author=Urmil Dosajh, Ishita Ghosh, and Rebecka Lundgren |title=Feasibility of Incorporating the Standard Days Method into CASP Family Planning Services in Urban Slums of India |publisher=The Institute for Reproductive Health, Georgetown University |date=September 2005 | pages=p. vi |url=http://pdf.usaid.gov/pdf_docs/PNADG768.pdf |format=PDF |accessdate=2008-02-18 }}</ref> Use of NFP in developed countries is low, even among Catholics. While Catholics made up 24% of the U.S. population in [[2002]],<ref name="adherents">{{cite web |title=Largest Religious Groups in the United States of America |publisher=Adherents.com |date=2005 |url=http://www.adherents.com/rel_USA.html |accessdate=2007-03-19 }}</ref> of reproductive age American women using birth control, only 1.5% were using periodic abstinence.<ref name="cdc">{{cite journal | last= Chandra |first=A | coauthors = Martinez GM, Mosher WD, Abma JC, Jones J. |title=Fertility, Family Planning, and Reproductive Health of U.S. Women: Data From the 2002 National Survey of Family Growth |publisher=National Center for Health Statistics | journal = Vital Health Stat | volume = 23 | issue = 25 |year=2005 |url=http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf |format=PDF |accessdate=2007-05-20 }} See Table 56.</ref> Use of NFP is not restricted to Catholic couples. In 2002, Sam and Bethany Torode, then a [[Protestantism|Protestant Christian]] couple, published a book advocating NFP use.<!-- --><ref>{{cite book |author=Sam Torode, Bethany Torode, J. Budziszewski |title=Open Embrace: A Protestant Couple Rethinks Contraception |publisher=Wm. B. Eerdmans Publishing Company |location=Grand Rapids, Michigan |year=March 2002 |isbn=0-8028-3973-8 }}</ref> (Five years after writing the book, the Torodes retracted their advocacy of pure NFP and also supported barrier methods as moral; the couple also [[religious conversion|converted]] from Protestantism to the [[Eastern Orthodox Church]].)<!-- --><ref name="openembrace">{{cite web |last=Torode |first=Bethany |title=An Update From Bethany |date=2006 |url=http://www.openembrace.com/ |accessdate=2007-03-13 }}</ref> ==Methods== There are three main types of NFP: the symptoms-based methods, the calendar-based methods, and the [[lactational amenorrhea method]]. Symptoms-based methods rely on biological signs of fertility, while calendar-based methods estimate the likelihood of fertility based on the length of past menstrual cycles. ===Symptoms-based=== [[Image:cervical mucus1.jpg|thumb|125px|Cervical mucus]] Some methods of NFP track biological signs of fertility. When used outside of the Catholic concept of NFP, these methods are often referred to simply as [[fertility awareness]] methods rather than NFP.<ref>{{cite book | first=Toni | last=Weschler | year=2002 | title=Taking Charge of Your Fertility | pages=p.5 | edition=Revised Edition | publisher=HarperCollins | location=New York | id=ISBN 0-06-093764-5 }}</ref> The three primary signs of a woman's fertility are her [[basal body temperature]], her [[cervix|cervical]] mucus, and her cervical position.<ref>Weschler, p.52</ref> Computerized [[fertility monitor]]s may track basal body temperatures, hormonal levels in urine, or changes in electrical resistance of a woman's saliva.<ref>Basal body temperatures: [http://ladycomp-babycomp.com/show.php/index Ladycomp-babycomp.com]<br /> Hormone levels in urine: [http://clearblueeasy.com/FertilityMonitor.cfm Clearblue Easy Fertility Monitor home page]<br /> Changes in electrical resistance of saliva: [http://www.zetek.net/ovacue_fertility_monitor.htm Ovacue website]</ref> From these symptoms, a woman can learn to assess her fertility without use of a computerized device. Some systems use only cervical mucus to determine fertility. Two well-known mucus-only methods are the [[Billings ovulation method]] and the [[Creighton Model FertilityCare System]]. If two or more signs are tracked, the method is referred to as a symptothermal method. Two popular symptothermal systems are that taught by the [[Couple to Couple League]] and the Fertility Awareness Method (FAM) taught by [[Toni Weschler]].<ref>Unlike the organizations associated with other popular observational systems, Toni Weschler has no connection to the Roman Catholic Church.</ref> ===Calendar-based=== [[Calendar-based methods]] determine fertility based on a record of the length of previous menstrual cycles. They include the Rhythm Method and the Standard Days Method.<ref name="who">{{cite paper |title=Medical Eligibility Criteria for Contraceptive Use:Fertility awareness-based methods | version = Third edition |publisher=World Health Organization |year=2004 |url=http://www.who.int/reproductive-health/publications/mec/fab.html |accessdate=2008-04-29 }}</ref> ===Lactational amenorrhea=== The lactational amenorrhea method (LAM) is a method of avoiding pregnancy based on the natural [[postpartum]] [[infertility]] that occurs when a woman is [[amenorrhea|amenorrheic]] and fully [[breastfeeding]]. The rules of the method help a women identify and possibly lengthen her infertile period. A strict version of LAM is known as ''ecological breastfeeding''.<ref>{{cite web |title=Ecological Breastfeeding |work=Couple to Couple League International |publisher=Internet Archive |date=2006 |url=http://web.archive.org/web/20060111170320/ccli.org/nfp/ebf/summary.php |format=Internet Archive|accessdate=2008-06-04}}</ref> ===Effectiveness=== Calendar-based methods, which are sometimes considered NFP,<ref>Examples being: {{cite web |title=Natural Family Planning |url=http://www.vpul.upenn.edu/shs/natural_family_planning.html |work=Student Health Service |publisher=University of Pennsylvania}}, {{cite web |title=natural family planning |url=http://www.perimon.com/en/naturalfamilyplanning.html |publisher=Perimon}} and {{cite web |title=Fertility Awareness Methods: Natural Family Planning |url=http://www.babyart.org/trying-to-conceive/fertility-awareness-methods-natural-family-planning.html |publisher=Baby Art}}</ref> but also not classified as NFP by the [[United States Conference of Catholic Bishops]],<ref>{{cite web|year=2007| title=Basic Information on Natural Family Planning| month =July |url=http://www.usccb.org/prolife/issues/nfp/information.shtml |publisher=United States Conference of Catholic Bishops}}</ref> have perfect-use failure rates of 5–9% per year, while symptoms-based and lactational methods of NFP have lower perfect-use failure rates: between 1%–3% per year. The common usage failure rate is up to 25% per year.<!-- --><ref>{{cite web|year=2005| month = March |url=http://www.guttmacher.org/pubs/fb_contr_use.html |title=Facts in Brief: Contraceptive Use |publisher=Guttmacher Institute |accessdate=2006-06-19}}</ref><!-- --><ref name="pmid1755469">{{cite journal |author=Frank-Herrmann P, Freundl G, Baur S, ''et al'' |title=Effectiveness and acceptibility of the symptothermal method of natural family planning in Germany |journal=Am. J. Obstet. Gynecol. |volume=165 |issue=6 Pt 2 |pages=2052–4 |year=1991 |pmid=1755469 |doi=}}</ref><!-- --><ref>{{cite conference | author=Clubb EM, Pyper CM, Knight J | title=A pilot study on teaching natural family planning (NFP) in general practice | booktitle=Proceedings of the Conference at Georgetown University, Washington, DC | year=1991 | url=http://www.fertilityuk.org/nfps822.html}}</ref><!-- --><ref name="pmid8147240">{{cite journal |author=The European Natural Family Planning Study Groups |title=Prospective European multi-center study of natural family planning (1989-1992): interim results |journal=Adv Contracept |volume=9 |issue=4 |pages=269–83 |year=1993 |pmid=8147240 |doi=}}</ref><!-- --><ref name="pmid9288336">{{cite journal |author=Frank-Herrmann P, Freundl G, Gnoth C, ''et al'' |title=Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study |journal=Adv Contracept |volume=13 |issue=2-3 |pages=179–89 |year=1997 |month=June-September |pmid=9288336 |doi=}}</ref> ==Theology== {{main|Christian views on contraception#Roman Catholic Church}} ===Official Catholic=== Catholic doctrine holds that [[God]] created sexual intercourse to be both unitive and [[procreation|procreative]].<!-- --><ref name="cotcc2368">{{cite web |year=2000 | url=http://www.usccb.org/catechism/text/pt3sect2chpt2art6.htm#2363 | title =#2363-2370 | work =Catechism of the Catholic Church, Second Edition | pages =Article 6: The Sixth Commandment | publisher =United States Catholic Conference |accessdate=2006-06-15}}</ref> This church considers deliberately altering fertility or the marital act with the intention of preventing procreation to be sinful. Thus, artificial birth control methods are forbidden, as are acts intended to end in orgasm outside the context of intercourse (e.g. masturbation or oral sex that is not part of foreplay).<!-- --><ref name="cwest">{{cite book |year=2000 | author= Christopher West | title =Good News about Sex and Marriage: Answers to Your Honest Questions about Catholic Teaching | pages =88-91 | publisher =Servant Publications}}</ref> At the same time, not having sex at all (abstinence) is considered morally acceptable.<ref name="cotcc2368" /> Having sex at an infertile time in a woman's life (such as pregnancy or post-[[menopause]]) is also considered acceptable, since the infertile condition is considered to be created by God, rather than as an act by the couple.<!-- --><ref>{{cite web |year=1930 | url=http://www.vatican.va/holy_father/pius_xi/encyclicals/documents/hf_p-xi_enc_31121930_casti-connubii_en.html | title =Casti Connubii | work =Encyclical of Pope Pius XI |pages=Section 59 | publisher =United States Catholic Conference |accessdate=2006-06-15}}</ref> Similarly, under Catholic theology, it may be morally acceptable to abstain during the fertile part of the woman's [[menstrual cycle]].<ref name="cotcc2368" /> Increasing the [[Postnatal|postpartum]] infertile period through particular breastfeeding practices &mdash; the lactational amenorrhea method &mdash; is also considered a natural and morally unobjectionable way to space a family's children.<!-- --><ref>{{cite web | title=NFP - Two basic forms | work=Couple to Couple League | url=http://www.ccli.org/nfp |accessdate=2006-06-24}}</ref> The Catholic Church acknowledges a potential benefit of spacing children<ref name="cotcc2368" /> and use of NFP for this reason is encouraged. ''[[Humanae Vitae]]'' cites "physical, economic, psychological and social conditions" as possibly compelling reasons to avoid pregnancy.<!-- --><ref>Humane Vitae (1968) Section I.10</ref> Couples are warned, however, against using NFP for selfish, immoral, or insincere reasons.<!-- --><ref name="cotcc2368" /> A few Catholic theologians argue that couples with several children may morally choose to avoid pregnancy, even if their circumstances (emotional, physical, and economic) would allow for more children.<!-- --><ref>{{cite paper |author=Thomas Storck |title=NFP: A Defense and an Explanation |year=2006 |url=http://www.ignatius.com/magazines/hprweb/storck.htm |accessdate=2007-04-27 }}, which cites:<br/> :{{cite book |last=Ford |first=John C. | coauthors = Gerald Kelly |title=Contemporary Moral Theology: Vol.2 (II), Marriage Questions |publisher=Newman Press |date=1963 |location=Westminster, Md |pages=422-423 }}</ref> More commonly, Catholic sources extol the benefits children bring to their parents, their siblings, and society in general, and encourage couples to have as many children as their circumstances make practical.<!-- --><ref>Humanae Vitae (1968) Section I.9</ref><!-- --><ref>{{cite web | title=The Blessings of Children | publisher=One More Soul |url=http://www.omsoul.com/the-blessings-of-children.php |accessdate=2006-06-24}}</ref><!-- --><ref>{{cite web | title=In Praise of Big Families | publisher=CatholicExchange.com |url=http://www.catholicexchange.com/vm/index.asp?art_id=32777 |accessdate=2006-06-24}}</ref><!-- --><ref>{{cite web | title=Principles of the Couple to Couple League | publisher=Couple to Couple League International |url=http://ccli.org/learn/promote/principles.php |accessdate=2006-06-24}}</ref> ===Dissident and other opposing=== {{seealso|Christian views on contraception#Natural Family Planning only or "artificial" methods too?}} Some Catholics have voiced significant disagreement with this church's stance on contraception.<!-- --><ref name="isbn0-8191-7683-4">{{cite book |editor=Ed. Starr, Bradley E.; Gard, Donald; Benjamin J. Hubbard |title=Anxiety, guilt, and freedom: religious studies perspectives: essays in honor of Donald Gard |chapter=The Evolution of Freedom as Catholicity in Catholic Ethics |author=Roderick Hindery |publisher=University Press of America |location=Washington, D.C |year=1990 |pages= |isbn=0-8191-7683-4 |oclc= |doi=}} - A summary and restatement of the debate</ref> The [[Canadian Conference of Catholic Bishops]] issued a heavily dissenting document, the [[Winnipeg Statement]]. In it, the bishops argued that many Catholics found it very difficult, if not sometimes impossible, to obey ''Humanae Vitae''. Additionally, they reasserted the Catholic principle of [[Conscience#Conscience in Catholic theology|primacy of conscience]].<!-- --><ref name="Winnipeg">{{cite web | url=http://www.catholic-legate.com/articles/winnipeg.html | title=Canadian Bishops' Statement on the Encyclical "Humanae Vitae" |accessdate=2006-10-02 }}</ref> Catholics such as [[Charles Curran (theologian)|Fr. Charles Curran]] have also criticized the stance of ''Vitae'' on artificial birth control.<!-- --><ref name="isbn1-58901-087-6">{{cite book |author=Curran, Charles E. |title=Loyal Dissent: Memoir of a Catholic Theologian (Moral Traditions) |publisher=Georgetown University Press |location=Washington, D.C |year=2006 |pages= |isbn=1-58901-087-6 |oclc= |doi=}}</ref> Theological opposition has additionally come from Protestant Christianity. [[John Piper]]'s ''Desiring God'' ministry states of [[NFP]], ''"There is no reason to conclude that natural family planning is appropriate but that 'artificial' means are not."''<!-- --><ref>{{cite web |url=http://www.desiringgod.org/ResourceLibrary/AskPastorJohn/ByTopic/45/1440_Does_the_Bible_permit_birth_control/ |title=Does the Bible permit birth control? |accessdate=2006-10-27 | publisher=Desiring God | year=2006 | author=Desiring God Staff | work=Questions and Answers | format=html}}</ref> Sam and Bethany Torode, former advocates of NFP-only, have redacted their position to include barrier methods and explain their current theology this way: :''We also see honest congruity with the language of the body by saying "no" to conception with our bodies (via barrier methods or sensual massage) when our minds and hearts are also saying "no" to conception. We don’t believe this angers God, nor that it leads to the slippery slope of relativism or divorce. We strongly disagree with the idea that this is a mortal sin.... it’s a theological attack on women to always require that abstinence during the time of the wife’s peak sexual desire (ovulation) for the entire duration of her fertile life, except for the handful of times when she conceives.''<ref name="openembrace" /> ==Potential advantages== [[Fertility awareness]] methods of NFP can be used to track reproductive health in general, and aid in the diagnosis of gynecological health and/or fertility problems. Particularly with the symptothermal method, which is based on a scientific method of self-observation, temperature, external and internal mucus, and cervical observations are all recorded daily on a calendar. Any observation of irregularities may prove helpful, providing a doctor or [[gynecologist]] with important diagnostic information with dates and a personal history of any abnormalities.<!-- --><ref>{{cite web | last =Cimperman | first =Sarah |year=2005 | month =August | url=http://www.drsarahcimperman.com/newsletter/August2005.htm | title =Fertility Awareness for Reproductive Health | work =Santé! Holistic Health News from Dr. Sarah Cimperman Newsletter |accessdate=2006-06-15}}</ref> The fertility knowledge gained from NFP methods may also be used to help achieve pregnancy.<!-- --><ref name="usccb1">{{cite web | url=http://www.usccb.org/prolife/issues/nfp/information.shtml | title =Basic Information on Natural Family Planning | work =Natural Family Planning | publisher =United States Conference of Catholic Bishops |accessdate=2006-06-15}}</ref> NFP has none of the side effects associated with hormonal methods and spermicides.<ref name="cwest"/> During the infertile period, NFP also allows for intercourse without barrier methods. This is held to allow for more spontaneous sex, as barrier methods are commonly considered to reduce sexual spontaneity.<ref>{{cite web |title=Advantages of NFP |work=Natural beauty |publisher=Couple to Couple League |date=2005 |url=http://ccli.org/nfp/basics/advantages.php#naturalbeauty |accessdate=2008-02-01}}</ref> NFP can be free or very low-cost.<ref name="usccb1" /> Some methods encourage the use of a thermometer and/or photocopied charts, which can be obtained relatively inexpensively. Some couples choose to use [[software]] or to use other devices such as a string of beads for counting the days. ===Divorce rate=== Proponents of NFP say it increases marital satisfaction and helps lower divorce rates. Anecdotal evidence and small studies are put forth in support of this view.<ref name="ccli">{{cite web |title=Marital Duration and Natural Family Planning |url=http://web.archive.org/web/20070818184432/http://ccli.org/nfp/marriage/maritalduration.php |year=2005 |publisher=The Couple to Couple League |accessdate=2008-03-30}}</ref> One study involving 505 women using NFP found a correlation between lower divorce rates and the use of NFP.<!-- --><ref name="familyplanning">{{cite journal |author=Wilson, Mercedes Arzú |title=The Practice Of Natural Family Planning Versus The Use Of Artificial Birth Control: Family, Sexual And Moral Issues |journal=Catholic Social Science Review |volume=VII |year=2002 |month=November |url=http://www.familyplanning.net/CSSRPublishCOLOR.pdf |format=PDF |accessdate=2008-03-30}}</ref> ===Claims regarding communication=== Fertility awareness forms of NFP have resulted in couples communicating more about their bodies and sexuality; supporters say it improves communication skills throughout the entire marriage. One proposed explanation, called a "courtship and honeymoon effect",<!-- --><ref>Kippley (1996), p. 246</ref><!-- --><ref>{{cite book | first=Toni | last=Weschler | year=2002 | title=Taking Charge of Your Fertility | pages=p. 123 | edition=Revised Edition | publisher=HarperCollins | location=New York | id=ISBN 0-06-093764-5 }}</ref> is that the scheduled abstinence encourages couples to express love in non-sexual ways, and to have a greater appreciation for intercourse when it does happen.<!-- --><ref name="usccb2">{{cite web | last =Shivanandan | first =Mary | coauthors =Richard Fehring, and Stella Kitchen | year =1999 | url=http://www.usccb.org/prolife/issues/nfp/intronfp.shtml | title =NFP & the Couple's Relationship | work Diocesan Development Program for Natural Family Planning | publisher =Diocesan Development Program for Natural Family Planning |accessdate=2006-06-15}}</ref> ==Potential disadvantages== ===Abstinence requirement=== *The fertility awareness and statistical forms of NFP require periodic abstinence, known as [[sexual continence]], typically for 8–10 days of each menstrual cycle. It is common for the woman's sexual desire to be highest on those fertile days, and low in other parts of the cycle.<!-- --><ref name="pmid15216427">{{cite journal |author=Bullivant SB, Sellergren SA, Stern K, ''et al'' |title=Women's sexual experience during the menstrual cycle: identification of the sexual phase by noninvasive measurement of luteinizing hormone |journal=J Sex Res |volume=41 |issue=1 |pages=82–93 |year=2004 |month=February |pmid=15216427 |doi= |url=http://www.findarticles.com/p/articles/mi_m2372/is_1_41/ai_n6032944}} - in online article, see pp.14-15,18-22</ref> That the couple must abstain from sex during the woman's periods of peak sexual desire may be deeply frustrating for both partners, and lead to feelings of isolation.<ref name="openembrace" /> *Some methods of NFP require up to six months of research and observation (and abstinence) in order to collect baseline data, so these methods cannot be immediately implemented by a new user.<!-- --><ref>{{cite web |year=2005 | url=http://www.fpv.org.au/2_12_7.html | title =Safer Sex and Contraception - Natural Family Planning | publisher =Family Planning Victoria |accessdate=2006-07-06 }}</ref> *Couples seeking the lowest risk of pregnancy (less than 1% per year) may be required to abstain for more than half of each menstrual cycle.<ref name="german study">{{cite journal |author=Frank-Herrmann P, Heil J, Gnoth C, ''et al'' |title=The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple's sexual behaviour during the fertile time: a prospective longitudinal study |journal=Hum. Reprod. |volume=22 |issue=5 |pages=1310–9 |year=2007 |pmid=17314078 |doi=10.1093/humrep/dem003}}</ref> *For women in certain situations — breastfeeding, perimenopause, or with hormonal disorders such as [[Polycystic ovary syndrome|PCOS]] - abstinence may be required for months at a time.<ref name="openembrace" /> *When taught in the context of Catholicism, this church teaches that orgasmic acts outside of intercourse, such as consummated [[masturbation]] and [[fellatio|oral sex]], are morally incompatible with the correct practice of NFP. Some couples are not comfortable with this restriction. Periodic abstinence also limits spontaneous sex.<!-- --><ref name="uihc">{{cite web |year=2003 | url=http://www.uihealthcare.com/topics/familyplanning/fami4535.html | title =Natural family planning | work =University of Iowa Health Care Website | publisher =McKesson Health Solutions |accessdate=2006-06-15 }}</ref> ===Method limitations=== *Some fertility awareness forms of NFP require observation or touching of [[Cervix|cervical mucus]], an activity with which some women are not comfortable. *Some drugs, such as decongestants, can change cervical mucus. Women may not be able to rely on mucus-only forms of NFP while taking these drugs.<!-- --><ref name="ffh">{{cite web |year=2004 | url=http://www.fertilityfriend.com/HelpCenter/FFBook/ff_fertility_signs.html | title =How to Observe and Record Your Fertility Signs | work =Fertility Friend Handbook |publisher=Tamtris Web Services|accessdate=2005-06-15}}</ref> *Some fertility awareness forms require tracking of basal body temperatures. Because irregular sleep can interfere with the accuracy of basal body temperatures, shift workers and those with very young children, for example, might not be able to rely on those methods.<ref name="ffh" /> *The NFP methods that encourage breastfeeding infertility can only be used until the woman's first post-partum menstruation. Even the most strict form results in average return of menses at 14 months post-partum,<!-- --><ref name="pmid4485271">{{cite journal |author=Kippley SK, Kippley JF |title=The relation between breastfeeding and amenorrhea: report of a survey |journal=JOGN Nurs |volume=1 |issue=4 |pages=15–21 |year=1972 |month=November-December |pmid=4485271 |doi=}}</ref><!-- --><ref>{{cite journal | author=Sheila Kippley | title= Breastfeeding survey results similar to 1971 study | journal=The CCL News | year=November-December 1986 | volume=13 | issue=3 | pages=10 | url=http://ccli.org/nfp/ebf/spacebabies.php }} and 13:4 (January-February 1987) 5.</ref> and menstruation can return as early as 6 weeks post-partum.<!-- --><ref>{{cite web | title=Postpartum Visit Checklist | work=StorkNet.com | url=http://www.storknet.com/cubbies/childbirth/ppchecklist.htm |accessdate=2006-06-24}}</ref> *NFP does not protect against [[sexually transmitted disease]].<!-- --><ref name="uihc" /> ===Implantation failure and miscarriage=== *In 2006, a moral philosopher authored a widely read article in which he speculated that unprotected intercourse in the infertile periods of the menstrual cycle may still result in conceptions, but create embryos incapable of implanting.<!-- --><ref>{{cite journal | author=Luc Bovens | title=The rhythm method and embryonic death | journal=[http://jme.bmj.com/ Journal of Medical Ethics] | year=2006 | volume=32 | pages=355–356 | url=http://web.archive.org/web/20070623231409/http://press.psprings.co.uk/jme/june/355_me13920.pdf }}</ref> *In the 1980s, some epidemiologic studies suggested that pregnancies resulting from method failures of NFP were at increased risk of miscarriage and birth defects due to aged gametes at the time of conception.<!-- Some sources also suggest an increased risk of down syndrome in children conceived during the infertile period. --><ref name="pmid6509983">{{cite journal |author=Gray RH |title=Aged gametes, adverse pregnancy outcomes and natural family planning. An epidemiologic review |journal=Contraception |volume=30 |issue=4 |pages=297–309 |year=1984 |month=October |pmid=6509983 |doi=}}</ref> The most recent research, however, suggests timing of conception has no effect on miscarriage rates,<!-- --><ref name="pmid7755073">{{cite journal |author=Gray RH, Simpson JL, Kambic RT, ''et al'' |title=Timing of conception and the risk of spontaneous abortion among pregnancies occurring during the use of natural family planning |journal=Am. J. Obstet. Gynecol. |volume=172 |issue=5 |pages=1567–72 |year=1995 |month=May |pmid=7755073 |doi=}}</ref> low birth weight, or preterm delivery.<!-- --><ref name="pmid9288339">{{cite journal |author=Barbato M, Bitto A, Gray RH, ''et al'' |title=Effects of timing of conception on birth weight and preterm delivery of natural family planning users |journal=Adv Contracept |volume=13 |issue=2-3 |pages=215–28 |year=1997 |month=June-September |pmid=9288339 |doi=}}</ref> ==See also== * [[Catholic teachings on sexual morality]] * [[New feminism]] * [[Theology of the Body]] ==References== {{refbegin}} * {{cite web | work =Encyclical of Pope Paul VI |date=[[July 25]] [[1968]] | url=http://www.vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html | title =Humane Vitae | publisher =The Holy See |accessdate=2006-06-15}} * {{cite book |author=Kippley, Sheila; Kippley, John F. |title=The art of natural family planning |publisher=Couple to Couple League International |location=Cincinnati, OH |year=1996 |edition=4th Edition |pages= |isbn=0-926412-13-2 |oclc= |doi=}} {{refend}} ==Notes== {{reflist|3}} ==External links==<!-- This section is linked from [[Fertility awareness]] --> {{dmoz|Health/Reproductive_Health/Birth_Control/Natural_Family_Planning/|Natural Family Planning}} ===Press=== * [http://www.time.com/time/magazine/article/0,9171,968461,00.html ''New Life for Family Planning''], Michael P. Harris, ''Time'', [[September 19]] [[1988]] * [http://www.observer.com/node/49443 The Orgasmatron Finally Shows Up: High Tech Rhythm] ''New York Observer'', [[June 27]] [[2004]] ===NFP information=== *[http://www.woomb.org/ Billings Ovulation Method] *[http://www.creightonmodel.com/ Creighton Model System] *[http://www.ccli.org/ The Couple to Couple League] *[http://www.nwfs.org/ Northwest Family Services] *[http://www.audiosancto.org/auweb/20040718-Holy-Matrimony-and-NFP.mp3 Pope John Paul II on Distorted Views of Marriage & Family] Sermon examining NFP in light of tradition. {{Menstrual cycle}} [[Category:Catholic theology of the body]] [[Category:Fertility tracking]] [[cs:Přirozené plánování rodičovství]] [[de:Empfängnisverhütung#Natürliche Methoden]] [[fr:Planification familiale naturelle]] [[lt:Natūralusis šeimos planavimas]] [[pl:Naturalne planowanie rodziny]] [[pt:Planejamento familiar natural]] [[sk:Prirodzené plánovanie rodičovstva]]