Abstract

PIP: Withdrawal, barrier method use, and sexual abstinence are fertility awareness-based family planning methods. They depend on a woman being able to identify the fertile period during each menstrual cycle. Identification of potentially fertile days allows couples to time intercourse either to avoid or to achieve pregnancy. A basic understanding about fertility puts couples in a better position to understand how any family planning method works and to choose the best method for their circumstances. For example, use of a barrier method or withdrawal requires a couple to clearly understand the importance of using the method consistently and correctly during the fertile period. Fertility awareness also helps couples know that most family planning methods do not affect their longterm fertility. Familiarity with fertility signs allows a woman to detect a change in her usual patterns and to seek health care at an early stage of a developing health problem. Use of natural family planning methods can be very important in areas where contraceptives are costly or their supply is unreliable. Most family planning programs do not provide fertility awareness education. Some studies indicate that combining fertility awareness with the use of barrier methods or withdrawal during the fertile period is an acceptable option to using barriers or withdrawal all the time. To identify the fertile period, women need to observe cervical secretions, to monitor basal body temperature, to use calendar calculations based upon cycle length, or to use a combination of these indicators. Development of new ways to improve fertility awareness include new rules that are better able to detect the fertile period and are easier to use and a home test kit tracking cycle length and hormone metabolites in urine. The University of Oxford in the UK is conducting a clinical trial examining the impact of fertility awareness education among condom users. It specifically aims to determine whether fertility awareness education improves the consistent use of condoms during the fertile period.