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New Simple Methods of Natural Family Planning

The Standard Days Method®

The Standard Days Method (SDM) is a new Clinical trials conducted in
simple fertility awareness-based method. It relies Bolivia, Peru, and the Philippines
on a "standard rule" or a fixed "window" of determined the effectiveness of
fertility that makes it easy for women to know the Standard Days Method. It is
when they are likely to become pregnant. more than 95% effective when
The fact that it involves no calculation or used correctly.
observation makes the SDM easy for service ~Contraception, 2002
providers to teach and for women to learn and
use. To avoid pregnancy, a woman with cycles
between 26 and 32 days long should not have
unprotected intercourse on cycle days 8 through
19.
A color-coded string of beads, called Cycle
Beads™, are used to help women keep track of
the days of their menstrual cycle and see which
days they are likely to get pregnant. More on the
SDM...

The TwoDay Method®

The TwoDay Method is a new simple approach to
NFP. It relies on a simple algorithm to help women
identify when they are fertile, based upon the
presence or absence of cervical secretions.
If the woman notices any secretions on the current or
previous day, then she is probably fertile today and
should not have unprotected intercourse if she wants
to avoid pregnancy.
If she notices no secretions today and yesterday (two
days in a row without secretions), then she is not
fertile today. More on the TDM...

Results of TwoDay Method clinical trial conducted in Guatemala, Peru

and the Philippines showed that the method is more than 96% effective in
preventing pregnancy when used correctly.
 ~Fertility and Sterility, 2004

Other Natural Family Planning Methods

The Ovulation Method

The Ovulation Method, also call the Cervical Mucus
Method, is based on understanding and interpreting
changing cervical secretions that are produced at the neck
of the uterus (cervix). At the time of greatest fertility,
these secretions become clear, stretchy, slippery and wet.
Couples who wish to avoid pregnancy abstain from
intercourse from the onset of cervical mucus symptom
until three days after the last day of fertile-type
secretions.
Basal Body Temperature (BBT)
Women using the Basal Body Temperature (BBT) Method identify their fertility by observing
their body temperature each morning before beginning any activity.
The body temperature is lower before ovulation and rises slightly to about .2 degrees Celsius or .
4 degrees Fahrenheit after ovulation.
Couples who wish to avoid a pregnancy abstain from intercourse from the onset of menses until
three days after the woman's basal body temperature has risen, to about .2 degrees Celsius or .4
degrees Fahrenheit, signifying the end of the fertile phase.

Symptothermal Method
The Symptothermal Method involves observing changes
in the cervical secretions, along with changes in the basal
body temperature, and the position and feel of the
opening of the cervix. Other fertility signs such as mid-
cycle pain or bleeding may accompany ovulation.
Couples who wish to avoid pregnancy abstain from
intercourse during the fertile period identified by all of
the fertility indicators.

Lactational Amenorrhea Method

The Lactational Amenorrhea Method (LAM) is based on scientific evidence that a woman is not
fertile and unlikely to become pregnant during full lactation or exclusive breastfeeding. Full
lactation describes breastfeeding when no regular supplemental feeding of any type is given (not
even water) and the infant is feeding both day and night with little separation from the mother.
LAM provides maximum protection as long as:
• Menstruation has not resumed and
• Bottle feeds or regular food supplements are not introduced and
• Baby is less than 6 months of age.
Effectiveness of Natural Family Planning Methods

Successful use of natural methods to prevent pregnancy depends upon:

• The accuracy of the method in identifying the woman's actual fertile days
• A couple's ability to correctly identify the fertile time
• The couple's ability to follow the rules of the method they are using
Unintended pregnancies among women practicing natural methods are primarily related to user
error. A sizable but unknown portion of the unintended pregnancies is attributable to improper
teaching and poor use of the methods. Experts at the World Health Organization (WHO) suspect
that among users of NFP, sexual-risk taking during fertile days--that is, having intercourse even
when they know the woman is fertile--accounts for more unintended pregnancy than does
inability to accurately identify the fertile time.
Couples who use natural methods correctly to prevent pregnancy have only a 1% to 9% chance
of becoming pregnant during one year of use, depending on which method they use.
Couples who do not use their method correctly—that is, they have intercourse on days when the
method's guidelines tell them that the woman is fertile—-have a much greater chance of
unintended pregnancy.

The following is the probability of pregnancy for women using natural methods:

Unintended Pregnancies
with Natural Methods
Number of pregnancies per 100 women
per year of use

Perfect Use % Typical Use %

Standard Days Method 5 12

TwoDay Method 4 14

Lactational Amenorrhea Method 0.5 - 1.5* 2*

Billings Ovulation Method 3-5 20

Symptothermal Method 2-5 20

Sources: Guida M., et al. Gynecological Endocrinology 1997.: Arévalo M., et al. Contraception May 2002, World Health
Organization, Fertility and Sterility, 1981, Trussell, et al., Family Planning Perspectives, 1990
* 6 month life table

Advantages and Disadvantages of Natural Family Planning

Method

Advantages
 • Increased self-awareness and knowledge of their fertility
• Increased reliance on their own resources rather than a family planning program or other
sources of contraception
• Increased independence from costly or distant medical services
• Freedom from artificial substances and the side effects or potential medical risks of other
methods
• Reduced re-supply costs associated with commodity-based methods
• Enhanced communication and intimacy with partner
• Encourages male involvement in family planning
• For some, the ability to adhere to religious and cultural norms
Disadvantages
• The commitment, motivation and cooperation of both partners is necessary
• For women using symptom-based methods, keeping daily records of fertility signs and
symptoms
• When used for pregnancy prevention, a couple may experience stress as a result of not
being able to have unprotected intercourse for several days in a row during the fertile
days

Standard Days Method

It is important that both men and women are able to have some control over their own fertility.
Although most people think of hormonal and barrier-type methods of birth control when they
think of contraception, there are also number of natural family planning methods available to
couples. Because they are easy to use and lack side effects, these natural family planning
methods are becoming more and more popular. When of the newest types of birth control to fall
under this category is the Standard Days Method.
What is the Standard Days Method?
The Standard Days Method (SDM) is a relatively new method of natural family planning. It can
be used to help you and your partner avoid unwanted pregnancies. Developed by researchers at
the Institute for Reproductive Health at Georgetown University School of Medicine, SDM helps
couples to recognize when they are most fertile. This can help you to avoid having unprotected
sex during fertile periods of your menstrual cycle.
How Was The Standard Days Method Developed?
The Standard Days Method was actually developed using highly sophisticated analyses of
thousands of menstrual cycles lasting between 26 and 32 days. Data from more than 7,500
different menstrual cycles was compiled and recorded by computers. This data was then
analyzed in order to find out when fertile days occurred during a woman's menstrual cycle.
All aspects of fertility were taken into account, including ovulation and the typical lifespan of
both sperm and eggs. Based on this information, SDM concludes that the most fertile days of a
woman's cycle are Days 8 through 19.
How Do You Use the Standard Days Method?
The Standard Days Method is fairly straightforward to use. All you need to do is keep track of
how long your menstrual cycle is, in order to determine when Days 8 through 19 occur.
• When the first day of your period arrives, this is Day1 of your cycle. Mark this on your
calendar.
• Between Day 1 and Day 7, it is highly unlikely that you will become pregnant, so it is
safe to participate in sexual intercourse without using birth control.
• Between Day 8 and Day 19, you are at your most fertile. You and your partner should
abstain from sex or you should use an alternate type of birth control, such as a condom.
• Between Day 20 and 32 you are unlikely to get pregnant, so you can resume sexual
intercourse.
CycleBeads and the Standard Days Method
Many women who practice SDM use CycleBeads to help them keep track of the days in their
menstrual cycle. CycleBeads are a string of 32 color-coded beads, shaped into a necklace. There
is a rubber ring that can be placed around individual beads on the necklace to help identify what
day you are on in your cycle. There are three colors of beads on the CycleBead necklace:
• Red: There is one red bead on the CycleBead
necklace. This red bead stands for the first day in your
menstrual cycle. It is on this day that you get your
menstrual period.
• Brown: The brown beads signify the days during
your cycle when it is highly unlikely that you will get
pregnant.
• White: The white, glow-in-the-dark beads represent
the fertile days of your menstrual cycle (Days 8 to
19).
As you move through each day of your cycle, you slip the rubber ring on a different bead. When
the rubber ring is moved onto the white beads, you will know to abstain from sex or to use a
form of contraception.
Who Can Use the Standard Days Method?
The Standard Days Method can be used by the majority of women, however, before you try the
method it is important that you meet the following criteria:
• Your menstrual cycles are regular
• Your cycle is between 26 and 32 days long (SDM is less effective if your cycles are
shorter than 26 days or longer than 32 days).
• You and your partner are willing to abstain from intercourse or use protection during
your fertile days
How Effective is the Standard Days Method?
When used regularly and consistently, SDM has been shown to be a highly effective birth control
method. When used perfectly, only five out of every 100 women will get pregnant. This means
that the method is 95% effective against pregnancy.
If you do not follow the method consistently, or if your cycle falls outside of the 26 to 32 day
range, SDM will be less effective. With normal use, the Standard Days Method is approximately
88% effective in preventing pregnancy.
Benefits of Using the Standard Days Method
There are a number of benefits to using this type of natural planning method to help prevent
pregnancy.
• SDM is very easy to learn.
• This method requires no calculations, record-keeping, or physical exams, unlike the
rhythm method or the ovulation method.
• The method is very inexpensive. It can be performed without CycleBeads, or CycleBeads
can be purchased for around twelve dollars.
• There are no associated birth control side effects.
Drawbacks to the Standard Days Method
Unfortunately, the Standard Days Method is not meant for everyone. It cannot be used
effectively by women with:
• irregular periods
• cycles shorter than 26 days
• cycles lasting longer than 32 days
Effectiveness also depends upon abstinence or the use of contraception during the fertile period.
Some couples may find it difficult to temporarily abstain from sex or using an alternate form of
birth control.

Ovulation Method
Also known as the cervical mucus method, this technique is not for every woman. It requires a
woman to be very comfortable with her body since she will need to regularly check her

cervical mucus. But it can also help a woman become much more attuned to the
changes that happen within her body every month.
How it Works

This family planning technique is based on the idea that a lack of

cervical mucus indicates that an egg has not yet been released by the ovaries. Additionally,
without the mucus, sperm will not be able to survive inside a woman until the time that an egg is
released.
Like the rest of your reproductive system, your cervix is affected by the monthly changes in your
body. Just after you finish your period, your cervix produces very little, if any, mucus causing
you to have a few days where your vagina appears to be quite dry. As you progress through your

cycle, you body will begin to produce more cervical mucus.

As you get closer to ovulation, your cervical mucus will become thinner and

stickier. When ovulation is about to occur, your cervical mucus will be clear,
slippery and very stretchy, similar to a raw egg white. This type of mucus is ideal for sperm to
swim in and helps the sperm swim up to your uterus. While this is great for women who are
trying to conceive, women who are trying to avoid pregnancy will want to abstain from sex or
use another form of birth control, like condoms or the sponge, during this time.
After ovulation, the production of mucus is slowed down again. If you do notice any mucus, it
will likely be thicker and cloudier.
Checking the Mucus

There are three ways in which you can check your cervical mucus:
• Use your finger or toilet paper to wipe across the opening of vagina and then take a look
at the mucus.

• Wear a panty liner and examine any cervical mucus that may be left on it
(this can be hard to detect, though)

• The best way: reach in and get a sample of your cervical mucus. Examine
the consistency and try to stretch the mucus between your fingers. If you can stretch it at
least three inches without it breaking, then ovulation is about to occur.

If you do not want to get pregnant, then sex should be avoided from the time you
begin to notice the slippery, stretchy mucus until at least two days after it is gone.
Effectiveness
By itself, this method is not as reliable as other methods of birth control and has an average

failure rate of 20% per year. However, using the cervical mucus method along
with another form of fertility awareness, like the symptom-thermal method, can offer you more
insight as to when you are most fertile.
If you plan to use this method of natural birth control, it is strongly recommended that you

receive training in the technique by your doctor or another trained professional.

Rhythm Method
The rhythm method is one of the first fertility awareness methods to be widely practiced. It is one
of the oldest methods of natural birth control and by far one of the best-known forms of

fertility awareness. Unfortunately, it is not necessarily the most reliable method of

preventing a pregnancy.
Theory and Practice

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 or use another form of birth control, like condoms, around this time.
Problems

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.

Another issue with the rhythm method is the belief that sperm are only viable

inside a woman for up to three days. It has been found that sperm may be able to
survive for as much as seven days inside a woman. Therefore, it would be necessary to avoid
having sex for at least a week prior to when a woman believes ovulation will occur.
Moreover, this type of contraception offers absolutely no protection against sexually transmitted
diseases. Therefore, it will still be necessary to use a condom if you think you may be at risk of
an STD.
Effectiveness

The rhythm method has an average failure rate of 13 to 20%. It is not

recommended for women who have irregular cycles or who do not have
menstrual cycles that are exactly the same number of days every month.
Visit Contraception Information Resource to learn more about natural forms of birth control.