NFP: Scientific, Healthy, and Effective

by Mary Davenport, MD, MS
Summer 2023

Natural Family Planning (NFP) is a couple’s observation and acceptance of their phases of fertility for the purposes of achieving and avoiding pregnancy or monitoring health. It is a very effective method in the range of 97-99%, for preventing conception when a couple abstains from sexual intercourse during the fertile time. The World Health Organization estimates that 93% of women can easily be taught to monitor their fertility, and the remainder can also learn with an experienced teacher.

Effective, modern natural family planning did not come into existence until the latter part of the twentieth century. The calendar rhythm method was developed in the 1930’s and calculated a woman’s fertile and infertile periods according to cycle length. However, the rhythm method had high failure rates up to 20% per year because of variations in the cycle. In contrast, modern methods of NFP rely on the observation of biomarkers, including cervical mucus, and in some methods temperature, other cycle characteristics, or urinary hormones.
Ovulation Method

There are three main types of natural family planning.

OVULATION METHOD
One type is the ovulation method, which was initially developed by Billings, and includes variations such as the Creighton method (FertilityCare) and Femm. Ovulation methods rely principally on observations of cervical mucus. It was noted in 1847 by Pouchet that “from the tenth to the fifteenth day…the utero-vaginal mucus…now appears to be more liquid and much more abundant than ever. Often there is such a quantity of discharge that it moistens the genital organs and overflows the important parts.”

We now know that this mucus flow coincides with ovulation and can occur earlier or later than the tenth to fifteenth day of the cycle, but this description is still valid. The increase in mucus correlates with the rise in estrogen, which peaks just before ovulation. If there is good, fertile mucus, sperm can live as long as five days. Observing the mucus as well as noting its sensation are important markers of fertility. These observations are recorded on a chart, and the woman is taught patterns that mark fertile and infertile phases of the cycle.

SYMPTO THERMAL METHOD
The second type of NFP, the symptothermal methods, includes those taught by Couple to Couple League, Sensiplan, Natural Cycles or Symptopro. In these methods, the basal body temperature of the woman is taken on awakening daily. This can be done with a simple basal thermometer, a high-tech thermometer, or a sophisticated device such as Tempdrop which is worn 24 hours. A temperature rise, due to the hormone progesterone, signals the beginning of the infertile phase of the cycle after ovulation. In addition to temperature, a woman may also be taught to monitor changes in her mucus, cycle length, and consistency, shape, and position of her cervix.

SYMPTO HORMONAL METHOD
The third type of NFP uses devices that measure urinary hormones. The Marquette method uses the ClearBlue fertility monitor. The woman uses urinary test strips, and the monitor uses the test strip to detect two hormones. These include estrogen, which rises at the start of the fertile period, and the LH hormone that signals ovulation. In addition to urinary hormones, calculations of cycle length and monitoring mucus can be used. Currently a newer device, the Mira, is being tested with the Marquette method. This device measures four urinary hormones, FSH, LH, E3G and PgD. PgD, pregnanediol, is the urinary metabolite of progesterone which is produced after ovulation.

This proliferation in fertility tracking technology that has occurred in the last decade is truly amazing. But it is still unclear if these devices are really helpful in preventing pregnancy or infertility therapy. Using technology is a matter of personal preference; some couples are attracted to devices (which tend to be expensive) and others are not.

Mention must also be made of smartphone apps for cycle tracking, which are very popular. There are over 100 apps, of widely varying quality. It has been demonstrated that good teaching is essential to understanding one’s cycle and success in achieving or avoiding pregnancy. The most important variable is instruction by a certified teacher in an established method backed up by research. All the well-researched programs have phone apps than can be used., but apps and devices are not substitute for individual instruction and the understanding it brings.

Couples using NFP to prevent pregnancy will be spared the health risks of contraception, IUDs, and sterilization as well as the messiness of barrier methods, in addition to having a highly effective method of fertility control. In recent years, NFP has increasingly been used by couples wanting to achieve pregnancy, and is especially useful for the rising number experiencing problems with their fertility. Those using NFP to become pregnant will do so more easily than couples relying on random chance, and more safely than those undergoing the expense and moral hazards of IVF. NFP, in monitoring biomarkers, can also be helpful in treating PMS, menstrual disorders, and perimenopausal symptoms

webmd_rf_photo_of_pms_graph-300x204
Modern-NFP-Methods-graphic
Ten-Reasons-to-Avoid-Birth-Control-Pills

About The Author

Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.
webmd_rf_photo_of_pms_graph-300x204
Modern-NFP-Methods-graphic
Ten-Reasons-to-Avoid-Birth-Control-Pills

Comments

Commenting on articles is a member-only feature. Please sign up for one of our memberships to leave a comment.
0 Comments
Inline Feedbacks
View all comments

Continue Reading Similar Articles

Fall 2023

Sleep: Time to Heal

by Lynn Keenan, MD

Have you ever wondered why we spend so much time sleeping? I remember my first trip to Ireland, standing outside

Spring 2023

Be Bella. Be Natural.

by Dolores Meehan, RN

On January 22, 2005, our pro life community shocked the mainstream media, the abortion industrial complex and our own local

Winter 2023

Preventing Miscarriage With Progesterone

by Robert Chasuk, MD

Pregnancy is a progesterone rich state in a woman’s reproductive life. Levels of progesterone markedly increase as pregnancy progresses. Progesterone

Summer 2022

Essential Tests For Assessing Female Fertility

by Elisa Yao, MD

Having worked with many couples wanting to get pregnant naturally, I know most couples do not understand what blood tests

Spring 2022

Teens and Fertility Charting

by Gretchen Marsh, D.O.

I am a strong advocate of teaching teenage girls how to chart their fertility in a medically significant way with

Winter 2022

NFP Burnout

by Amie Holmes, MD, OBGYN, NaPro Surgeon

As I write this article, I reflect on the last few months. Admittedly, I am a busy working mom. I

Honoring the NFP Professional

by Lynn Keenan, MD

I was delighted when I received the request to write an article honoring NFP professionals. I started providing restorative reproductive medicine

Learning About NFP in the ER

by Dave Hammons, MD

How do Natural Family Planning and working in the Emergency Department interact with each other? Well, at first glance, it

Vaccination Against COVID-19 in Those Who Are Pregnant, Plan to Conceive or Are Breastfeeding

by George Delgado, M.D., F.A.A.F.P.

It is always frustrating to ask rhetorical questions to which you do not have clear answers. Such is the case

Oral Contraceptives & Adolescents——Impact on Mood and Risk of Mental Disorders

by Lauren Rubal, MD, FACOG

Being a teenage girl is tough. As an adolescent, I remember a multitude of social, academic, and extracurricular pressures, and

Reflections on 30 Years as an ObGyn and 50 Years of Marriage

by M. Suzanne Regul, MD

My life as a married ObGyn has spanned the development of NFP. Our marriage of 50 years began with knowledge

Male Fertility Appreciation

by Francisco Javier Diaz, SJ, MD

Fertility appreciation implies respecting the possibility of being able to conceive a child. This appreciation is embodied in methods, models

Create An Account

This is not a membership, this is an account for our CANFP website. If you decide you would like to sign up for one of our memberships later, you can do so with or without this account.

First Name *
Last Name *
E-mail *
Username *
Password *
Confirm Password *
Edit Profile
Information
Subscriptions
Payments
Order History
Downloads
Shipping and Billing
Donations
Settings
Login Information
Notification Settings
Notification Subscriptions
Profile

CANFP conducts varied outreach programs to the community at large, in addition to serving our members (NFP users, teachers, and advocates).

CANFP provides education programs tailored to the audience, not only on Natural Family Planning, but on the wide variety of topics related to it.

Programs can be continuing education for NFP Professionals, introductory information for a lay audience of youth or adults new to the topic, or specifically tailored to the interests of a professional audience, such as educators, physicians, or clergy. Content is faith based or secular, whichever is suitable for situation.

CANFP offers a variety of resources for those just discovering Natural Family Planning, as well as to meet the varied needs of our CANFP Members. Most resources are available to any visitors to our site. Some resources do ask you to register as a site user in order to access them, others are available only to CANFP Members.

CANFP statewide conferences, regional events offered in collaboration with local partners, events featuring CANFP speakers, or exhbit, as well as other events throughout the state of interest to our NFP community.  Come meet one of our experts at one of these events or book a speaker for your own upcoming event.

CANFP depends on the gifts, talents, and generosity of our members and supporters. The success of our mission depends on the collaboration of our members. Please consider contributing your time treasure and talent through CANFP to share the good news of NFP with the world! Both volunteer and contracted positions available.

Stay informed by joining our email list

* indicates required
Which role(s) best describes you?