Natural Birth Control Made Simple

Natural Birth Control Made Simple

by Barbara Kass-Annese, R.N., C.N.P., Hal C. Danzer

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This book gives specific instruction on the use of two methods of family planning: Natural Family Planning and Fertility Awareness Method.

These methods give couples natural choices:
1. To avoid pregnancy, you can determine when you are infertile and have sexual intercourse without conceiving.
2. To become pregnant, you can track the days of the


This book gives specific instruction on the use of two methods of family planning: Natural Family Planning and Fertility Awareness Method.

These methods give couples natural choices:
1. To avoid pregnancy, you can determine when you are infertile and have sexual intercourse without conceiving.
2. To become pregnant, you can track the days of the month when you are most fertile and have intercourse when you are most likely to conceive.
3. These safe non-invasive techniques can be used by themselves or combined with other contraception methods.
4. The techniques are noninvasive, have no side effects and carry no danger of toxic infection or cancer.

The authors, experts in fertility awareness, have completely revised and updated this newly titled edition of the book. The new material includes several new examples of natural birth control and the fertility awareness method, with illustrations. The book contains 40 charts for readers to use. The book is written in an accessible style and contains edifying case studies.

Editorial Reviews

Library Journal
First published in 1981 as The Fertility Handbook and in 1992 as The Fertility Awareness Handbook: The Natural Guide to Avoiding or Achieving Pregnancy, this new edition, coauthored by a nurse practitioner specializing in women's health and a gynecologist specializing in reproductive endocrinology, provides the latest information on the natural family planning and fertility awareness methods of birth control. Using these methods involves charting basal body temperatures, examining cervical mucus, and noting changes in the cervix to determine when ovulation occurs. A woman can then abstain from intercourse, use a barrier method of contraception, or dispense with protection if she wishes to conceive a child. The authors also offer information about the physiology of reproduction, the history of natural family planning, and the advantages and disadvantages of this method. They include sample contracts for women and couples who wish to make formal commitments and a short, well-chosen bibliography of traditional and alternative health resources. This is a good book for consumer health and public libraries in need of updated material on natural family planning, especially as most books on birth control omit this technique.-Barbara M. Bibel, Oakland P.L. Copyright 2003 Reed Business Information.

Product Details

Turner Publishing Company
Publication date:
Edition description:
Seventh Edition
Sales rank:
Product dimensions:
6.08(w) x 9.12(h) x 0.47(d)

Read an Excerpt

Natural Birth Control Made Simple

By Barbara Kass-Annese Hal C. Danzer

Hunter House Inc., Publishers

Copyright © 2003 Barbara Kass-Annese and Hal Danzer
All right reserved.

ISBN: 978-0-89793-403-9

Chapter One

Natural Family Planning and Fertility Awareness Methods: What Are They?

What is your family planning goal right now? Is it to delay having a child for a while? Is it to prevent pregnancy for the rest of your childbearing years because you do not want any children or any more children?

Is it to become pregnant now or at some point in the future?

If you want to prevent pregnancy, how do you want to do this? Perhaps you are comfortable using an abstinence-based method of family planning, meaning you won't have intercourse during the days you can become pregnant. Or, perhaps you use or are planning to use condoms or some other barrier and/or spermicidal method of contraception and want to use them only when they are needed, meaning only during your fertile days.

Regardless of your answer to these questions, you have something in common with all women who decide to learn about their fertility in ways that will help them reach their family planning goal. All of you must begin by learning the same information. This information is called fertility awareness education.

Fertility awareness (FA) education includes the most current and accurate information about reproduction and fertility signs, the naturally occurring changes in your body you experience from one menstrual period to the next. Fertility signs change in predictable and dependable ways for most healthy women in their reproductive years. Because of this, they can be used to accurately identify the days a woman can and cannot become pregnant:

Days you can become pregnant = Fertile days

Days you cannot become pregnant = Infertile days

If you want to prevent pregnancy by choosing to abstain from intercourse during the fertile days, you will be using what is known as natural family planning (NFP).

NFP is actually a name that was chosen over thirty years ago by people involved in the research and teaching of abstinence-based methods. Natural family planning seemed an appropriate name for methods that combine the use of monitoring fertility signs and abstinence from intercourse during fertile days, because they are based on using changes in naturally occurring signs and symptoms of fertility to identify fertile and infertile days. There are several NFP methods available for use, and you will learn about all of them in later chapters.

Approximately twenty years ago, several of us working in the field of family planning discussed the idea that, while fertile and infertile days could be accurately determined by observing fertility signs, a woman or couple should have other choices during the fertile days besides abstinence. Abstinence might not fit into some people's lifestyles. These people should be able to use a different birth control method, such as condoms, diaphragms, or spermicide, during the fertile days. We decided to use the term fertility awareness method (FAM) when such contraceptive methods are used during the fertile days instead of abstinence.

Regardless of whether NFP or FAM is used, the significant point is this: Your body reveals fertility signs that enable you to identify the fertile and infertile days during each menstrual or fertility cycle. This is a natural language that is spoken by your body. By learning this language, you can join the thousands of women and men who are now enjoying these alternative approaches to family planning!

Chapter Two

The Evolution of Natural Family Planning and Fertility Awareness Methods

Since the beginning of recorded history, people have sought reliable methods to prevent pregnancy and enhance fertility. Women beyond the healthy childbearing years or women who were ill were not expected to bear children. The woman who experienced repeated stillbirths or very difficult deliveries often sought to avoid future pregnancies. Times of war, famine, or inability to adequately provide for the health and safety of a child were also important factors in the choice to delay pregnancy. As you can see from these examples, people throughout the ages had many of the same reasons for pregnancy prevention as we do today.

How Have People Attempted to Prevent Pregnancy?

Beginning with pre-Biblical times, people have used abstinence, breastfeeding, withdrawal, magical potions, charms, and herbal mixtures to prevent pregnancy.

During the time of the ancient Hebrews, one method used was a spongy substance placed inside the vagina to block sperm. Greek and Roman literature tells us of many methods of birth control, such as the use of vaginal suppositories made from honey and peppermint juice.

During the Middle Ages, both European and Islamic cultures used a number of recipes, many magical, to avoid pregnancy. One unusual recipe instructed a woman who did not want to become pregnant to soak a piece of cloth in the oil of a barberry tree and place it on the left side of her forehead. Other supposed methods of birth control included eating beans on an empty stomach; rubbing tar on the penis prior to intercourse; douching with solutions made of lemon juice; placing algae, seaweed, or the husks of mahogany nuts inside the vagina before intercourse; carrying a child's tooth; and drinking thyme and lavender tea.

Since fertility was usually not understood, it was often considered mystical. Slowly, as a truer understanding about the facts of physiology and reproduction emerged, science and technology began to take the place of magical interpretations.

Around the middle of the eighteenth century, although potions and ceremonies continued to be used, modern mechanical forms of birth control began emerging. The condom was one of the first of these to be introduced.

The birth control movement in America had begun by 1828. Techniques included withdrawal, using a vaginal sponge made from sheep's wool or silk, and using douching solutions made from white oak bark, green tea, or vinegar and water. Although the use of the diaphragm emerged in Holland during the early 1880s, it was not introduced to American women until the early 1920s. Between the 1920s and 1930s the rhythm method, Gräfenberg intrauterine silver ring, and spermicides began to be used. From that point on, several types of intrauterine devices were developed. Finally "the Pill" entered the mainstream of American life during the 1960s, and several hormonal methods have been developed since then. Today, hormones are administered in the form of pills, injectables, patches, and rings to prevent pregnancy.

What Is the History of Natural Family Planning?

We know from the past to the present, in various areas throughout the world, women have used and continue to use breastfeeding as a natural means of child spacing. Yet compared to the thousands of real and "magical" methods of contraception that have evolved and been recorded, little has been written about other forms of natural family planning. Some groups of Africans, Native Americans, and others appear to have had some knowledge of their fertility cycles and practiced abstinence from intercourse, but there is little information available on their traditional birth control practices. What we do know is that some women in traditional cultures did use one of the major fertility signs, cervical mucus, as a means to achieve or avoid pregnancy, and it is still used by them today.

Over 150 years ago a researcher, Dr. Theodore Bischoff, found eggs present in the uterus and fallopian tubes of a female dog while the dog was bleeding, or "in heat." Because of this discovery he assumed that women must also have eggs present during their menstrual bleeding. Therefore, he believed that women became pregnant if they had intercourse during their periods. As a result of his findings, a natural birth control schedule was developed. It stated that if pregnancy was to be avoided, intercourse should not occur during the menstrual period, as well as 5 days before it and 9 days after it. It was considered that these were the days when the woman could become pregnant. We now know that just the opposite is true!

This "natural birth control" continued to be practiced until the 1930s, and countless women became pregnant trying to use this totally incorrect information.

However, not all past information on fertility signs was incorrect. As early as 1857, there were descriptions of women who believed they could tell when they were ovulating because once a month they experienced internal aching or a painful feeling in the area of the ovaries. (Ovulation is the release of the egg from the ovary.)

This pain with ovulation continued to be discussed and written about for years. In 1935, Dr. Cyrus Anderson wrote a paper entitled, "Teaching the Patient to Observe Symptoms of Ovulation." In it he discussed ovulation pain and how women could be taught to recognize it.

Ovulation pain, as you will soon learn, can be used by some women as a fertility sign. One of the other fertility signs you will learn about is the temperature of the body at rest, known as basal body temperature. It was studied as early as 1876 by Dr. Marie Putnam Jacobi. She found that the basal body temperature increases and decreases at certain times during the menstrual or fertility cycle and these temperature changes follow a very distinct pattern.

Researchers in the 1800s also wrote about another fertility sign-cervical mucus, the substance made in the cervix (the bottom part of the uterus). In fact, around the mid-1800s it was observed that this mucus changed in amount and quality throughout the menstrual or fertility cycle. These observations led researchers to believe that a particular kind of mucus was needed to achieve a pregnancy. This belief, of course, later proved to be scientific fact!

Finally, in 1929, the rhythm method was developed when two men on opposite sides of the world, and working independently of each other, discovered that an egg is released from the ovary approximately fourteen days before each menstrual period.. This discovery formed the basis of the Ogina-Knaus Calendar Rhythm Method, named after the two discoverers, Dr. Kyusaku Ogina and Dr. Hermann Knaus. The rhythm method has been shown to be very effective for the woman who experiences consistently regular cycles. However, unlike modern natural family planning methods, it does not take into account that a woman's fertile days can begin earlier or later than usual. This has contributed to unplanned pregnancies for some rhythm method users. In addition, the rhythm method usually requires longer periods of abstinence from intercourse than the modern methods of natural family planning.

In 1962, Dr. William Hartman found that sperm could live in the woman's body for three days, while the egg survives for one day after being released from the ovary. This added up to a four-day period of time during the menstrual or fertility cycle when a woman could become pregnant. We now know that if the proper conditions are present in the woman's body, sperm may live and remain capable of fertilizing the egg for a period of up to five days. This means that there are approximately six to seven days during the menstrual or fertility cycle when a pregnancy is possible.

During the 1960s, an Australian team of physicians, Drs. John and Evelyn Billings, sought to develop a method of natural family planning that would be more accurate than the rhythm method. They conducted extensive research on cervical mucus, which led to the development of the Billings Method, also known as the cervical mucus method or the ovulation method. This method is based on using observations of one fertility sign, the cervical mucus, to determine the fertile and infertile days of the menstrual or fertility cycle.

Another method of natural family planning was also being used around the time the Billings Method was introduced. It was called the sympto-thermal method because it includes the use of several symptoms of ovulation and basal body temperature to determine the infertile and fertile days of the menstrual or fertility cycle.

All this adds up to the fact that reliable methods of natural family planning, the ovulation and sympto-thermal methods, have been used by people throughout the world for over thirty-five years!

How Effective Are These Methods of Natural Family Planning?

Before answering this question, it is important to acknowledge that a couple's feelings about pregnancy play a very important role in how a method of birth control is used. Women and men who are motivated to prevent a pregnancy tend to use a method more carefully, and careful use means fewer pregnancies.

Because of this fact and others, effectiveness rates, or how successful a method of birth control is, are discussed in two ways. One is the perfect or theoretical effectiveness rate. This type of effectiveness rate tells us how well a method works when used perfectly. In other words, no mistakes are made on the parts of the clinician or instructor providing the birth control method or the person using the method. The second type of effectiveness rate is called actual or use effectiveness rate. This is the real-life effectiveness of the method, taking into account human error made by the user of the method, the clinician, or the instructor.

For example, if a couple using NFP chose to have intercourse during a fertile time and the woman became pregnant, this would be called a user pregnancy. A pregnancy may also occur because of the inability of the couple to understand the method, and this may be due to the teacher, the couple, or a combination of both. These unplanned pregnancies would be counted toward the method's actual or use effectiveness rate.

If a couple using NFP perfectly becomes pregnant, this is a theoretical or perfect use pregnancy-a failure of the method itself to prevent pregnancy. Every method that exists today has a perfect user pregnancy rate. For whatever reason, even when the pill is taken every day or when a vasectomy seems to be performed perfectly, some women will eventually become pregnant!

A three-year study, supported by the Department of Health, Education, and Welfare, and completed in 1979 at Cedar-Sinai Medical Center in Los Angeles, compared the effectiveness of the ovulation method with that of the sympto-thermal method. Over 1,200 couples participated in this study. It was found that the ovulation method had a user effectiveness rate of approximately 78 percent. This means that 22 out of every 100 women who began use of the method, and who did not stop using it for any reason, became pregnant within one year. The sympto-thermal method was determined to be approximately 89 percent use effective, which means that out of every 100 women who began use of this method and did not stop using it for any reason, 11 became pregnant within one year. The results of this particular study are generally similar to many others that have been conducted throughout the world.

Most of the pregnancies in this study occurred because people took chances and had intercourse during the fertile time, did not understand the use of the methods, or did not follow other instructions necessary for the effective use of these two methods.

The reason why the couples using the sympto-thermal (S-T) method experienced a lower number of pregnancies is not completely understood. However, the Cedar-Sinai study and others, in addition to our own experience in working with these methods, suggest that for many people the S-T method is easier to teach, to learn, and to use properly. The findings of this particular study, in addition to many others, have consistently suggested that the perfect use effectiveness rates of both methods are approximately equal. When instructed correctly by the teachers, in combination with the couples' understanding and proper use of the methods, the effectiveness rates are approximately 98 percent.

Other studies conducted since that time have shown comparable rates. The effectiveness rates of the natural family planning methods are comparable with almost all of the other methods of contraception.

Only a couple of very small FAM studies have been conducted, none of which have completely documented the effectiveness of the use of barrier and spermicidal methods of contraception during the fertile time. Many family planning professionals believe, however, that the effectiveness rate of using a barrier and/or spermicidal method only during the fertile days should be about the same as the rates achieved when the diaphragm, condom, and spermicide are used in traditional fashion (i.e., used every time intercourse takes place throughout the menstrual or fertility cycle).


Excerpted from Natural Birth Control Made Simple by Barbara Kass-Annese Hal C. Danzer Copyright © 2003 by Barbara Kass-Annese and Hal Danzer. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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