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Show Utah Couples' Potential Use of Natural Family Planning Joseph B. Stanford, M.D., M.S.P.H.; Anne Galbraith Hutchinson, M.D.; Jane Gregory Payne, M.D. The purpose of this study was to assess the potential use of modern methods of natural family planning (NFP) by Utah women and their male partners. Written questionnaires were mailed to women ages 18-50, randomly selected from driver's license renewal records in the state of Utah, and their male partners, where applicable. Of the 900 questionnaires sent to women, 432 were returned; results were analyzed for 317 women who were potentially fertile and 181 men who were in a relationship where both partners were potentially fertile. Nearly 30% of the women (40.4% of men) indicated that they would be likely to use NFP in the future to avoid pregnancy, and 56.4% of women (57.6% of men) indicated that they would be likely to use NFP in the future to try to get pregnant. Only 13.3% of couples reported currently using some method of NFP (3.9% were using NFP alone). There is a potential for increased use of modern natural family planning in Utah, both to avoid pregnancy and to conceive. There are approximately 6 days in each menstrual cycle during which pregnancy can occur from intercourse (Wilcox, Weinberg, & Baird, 1995). Natural family planning consists of methods to identify these days, allowing couples to have sexual intercourse on only "infertile days" to avoid pregnancy, or on "fertile days" to conceive. The first such method to be developed was calendar rhythm. Calendar rhythm is widely known, but it is less accurate and outdated (Geerling, 1995). Modern methods of natural family planning (NFP) include the Creighton Model Fertility Care System and the Billings Ovulation Method, both based on observation of vaginal discharge of cervical mucus, and the synipto-thermal method, encompassing mucus observation as well as basal body temperature measurement. These NFP methods are taught in a structured educational format through a number of organizations. Modern NFP is an effective option for couples who desire to avoid pregnancy, with pregnancy rates during "perfect use" generally less than 1%, and total pregnancy rates during "typical use" from about 3% up to 20% (Hilgers & Stanford, 1998; Kam-bic, 1991; Trussell & Kowal, 1998). Modern methods can be used effectively to avoid pregnancy by women who have irregular cycles or who are breastfeeding (Howard & Stanford, 1999). NFP based on observation of vaginal discharge is an ideal approach to conceive as rapidly as possible (Stanford, White, & Hatasaka, 2002). NFP has many potential advantages, including effectiveness to avoid pregnancy that is comparable to other reversible family planning methods, lack of medical side effects, education of women about their bodies, shared responsibility between the woman and the man for use, versatility (the same method can be used to avoid pregnancy or to get pregnant), and compatibility with religious or philosophical values for those who may not wish to use contraceptives (Klaus, 1982; Stanford & Larimore, 1999). Potential disadvantages of NFP include that it requires the participation and cooperation of both partners, requires times of abstinence from genital intercourse to be effective in avoiding pregnancy, and does not reduce the transmission of sexually transmitted disease, if exposed, hi the United States, less than 3% of all sexually active women of reproductive age currently use a form of NFP to prevent pregnancy, and most of these women are using calendar rhythm rather than a modern NFP method (Trussell & Kowal, 1998). Two previous population-based studies have found a high level of potential use of modern NFP. In western Germany, where over 5% of women currently use modern NFP (Oddens, 1999), 47% of the women stated they were likely to use it in the future to avoid pregnancy (Freundl, Frank, Bauer, & Doring, 1988). hi Missouri, women who were still fertile (484), about one quarter indicated they would be likely or very likely to use NFP hi the future to avoid pregnancy, and about a third indicated that they would be likely or very likely to use NFP in the future to conceive (Stanford, Lemaire, & Thurman, 1998). However, as noted, NFP requires the cooperation of both the male and the female partner for successful use. To date, men's attitudes about NFP have not been studied. We conducted the present study to assess the potential for use of modern NFP among women in Utah, either to avoid pregnancy, or to conceive. We also sought to determine the potential for use among male partners. METHODS We developed a 4-page written questionnaire for women, adapted from the questionnaire used in the Missouri study (Stanford, Lamaire & Thurman , 1998). It included questions about demographics and reproductive and family planning history. A brief explanation of the modern methods on NFP was included in the questionnaire. This was followed by questions to assess possible future use of NFP to avoid pregnancy or to conceive. The questionnaire was mailed to 900 women ages 18-50 randomly chosen from drivers' license renewal records in the state of Utah. Two follow-up mailings were sent to potential subjects that had not yet responded; these three mailings were completed during 1994-1995. We also developed a 3-page written questionnaire for men, similar to the women's, and included it in the mailing to the women with instructions to give it to their spouse or male partner if they had one. Separate envelopes to return the surveys were enclosed. 40 Utah's Health: An Annual Review Volume DC |
