No longer a game of Vatican roulette

Worried about the Pill? Turned off by the diaphragm? Maybe Natural Family Planning is the answer. Lee Rodwell takes a new look at the oldest contraceptive

Calls to the Family Planning Association's Helpline have quadrupled since the Government issued a health warning on seven brands of the contraceptive pill last month. The initial confusion is dying down, but in its wake many women may be thinking of switching to other forms of contraception.

Yet how many will seriously consider natural family planning, and how many will be offered it as an alternative by their GPs or family planning clinics?

Natural family planning (NFP) has come a long way since the days when doctors dismissed it as "Vatican roulette". Women no longer merely mark off safe and unsafe days on a calendar, based on a guess as to when they will ovulate. Instead, they learn how to become tuned into their bodies, using a range of physical symptoms, including temperature changes and observation of cervical mucus, to pinpoint ovulation and the fertile and infertile phases in their cycle.

Only 1 per cent of women use this method - comparable to the numbers using caps, diaphragms or injectable contraceptives, says the FPA. Seventeen per cent use condoms, 5 per cent IUDs, 3 per cent withdrawal and 25 per cent take the Pill. Studies show, however, that NFP works as well as other contraceptive methods, provided women are well motivated and well taught.

Even so, as Bob Ryder, consultant physician and endocrinologist of the City Hospital Trust, Birmingham, says: "NFP has an image problem in the medical and lay world. If you ask your doctor about it, you are likely to be told, 'You don't want to use that - you'll get pregnant'. Yet that attitude is based on out-of-date information."

Dr Ryder, who has worked in this field since the mid-Seventies, has collected data on all NFP studies so far reported in the Nineties. Of the 11 studies, only three reported pregnancy rates greater than 5 per cent. In the UK the rate was 2.7 per cent and in Belgium 1.7. These results compare favourably with reported pregnancy rates of between 0.18 per cent and 3.6 for artificial contraceptive methods in well motivated couples.

Women using NFP learn to interpret the changes in their cervical mucus. After a period there is often little mucus; it then becomes white and cloudy and, as ovulation approaches, transparent and stretchy. After ovulation, the mucus becomes white and cloudy again. Research being carried out in Sweden confirms that the changes in the appearance of the mucus are a reflection of the complex role cervical mucus plays in fertility. "It has several components with different functions, which we are now becoming more aware of," says Dr Ryder. "That is why mucus is such a reliable indicator."

Even so, most proponents of NFP agree that the method - which requires a couple to abstain from intercourse or use barrier methods in the fertile phase - works best if taught by someone experienced. Critics say this is expensive and time-consuming.

Jane Knight, a practice nurse in Oxford, does not agree. She carried out a GP study in 1990 in response to the increasing number of people wanting to use NFP. "We found that the average couple of normal fertility needed four hours of total teaching time spread over monthly intervals, although more time was needed for people with special needs, such as breast- feeding mothers, women coming off the Pill or women who were pre-menopausal.

"The cost for the first year was comparable to the cost of prescribing the Pill, but if the couple continued to use NFP, the costs were really low - and that's not taking into account any hidden costs, such as infection or tubal damage from an IUD. The trouble is, there is no funding coming into NFP. Unlike the Pill, there are no drug companies behind it."

Even so, an increasing number of family planning clinics and practice nurses are being trained in NFP. Colleen Norman, NFP tutor and director of the Fertility Education Trust, says: "Of course, something is easier when someone shows you how to do it. It's like the difference between following a recipe out of a cookery book or watching Delia Smith on television. But there aren't enough teachers at the moment, so we have to make DIY methods better."

Mrs Norman has produced simplified charts for women to use, based on the seasons, with winter representing the barren phase and summer the period of peak fertility. Her new book, Understanding Fertility, will be published in the new year.

Meanwhile, the Fertility Awareness Kit, launched in February and approved by the FPA, has already sold more than 10,000 copies. The kit, created by Andrew Hall, consists of a video, a digital thermometer and a book of charts.

Mr Hall says: "We are now talking to doctors and family planning clinics. We want the kit to be prescribed in the same way as any other contraceptive. There is tremendous ignorance among the medical profession about NFP. The point we are making is that it is no longer a choice motivated by dogma, it's motivated by science. It offers the same sort of reliability as any method bar sterilisation and we are offering a technological approach."

Many people involved in NFP, however, agree that the real breakthrough in terms of technology will come when Unipath launches its hand-held fertility monitor next year. The monitor, which looks rather like a felt-tip pen, detects chemical changes in urine that relate to hormonal changes in the body. Trials are already under way in Britain and the results are being analysed by Professor Robert Snowden at Exeter University. He says: "We are carrying out two studies: one is about effectiveness - does it work in the real world? The other is about acceptability - how couples feel about using it. This is the one kind of contraception, after all, that does require the commitment of two people."

The 'Fertility Awareness Kit', price pounds 19.99, is available by mail order from the FPA (01865 749333) and in some high-street chemists.

News
Ian Thorpe had Rio 2016 in his sights
people
Sport
Jonathan de Guzman of the Netherlands and Willian of Brazil compete for the ball
world cup 2014LIVE BLOG: Hosts Brazil take on the Netherlands in third-place play-off
News
Tommy Ramone performing at The Old Waldorf Nightclub in 1978 in San Francisco, California.
peopleDrummer Tommy was last surviving member of seminal band
Life and Style
Swimsuit, £245, by Agent Provocateur
fashion

Diving in at the deep end is no excuse for shirking the style stakes

PROMOTED VIDEO
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Life and Style
Several male celebrities have confessed to being on a diet, including, from left to right, Hugh Grant, Benedict Cumberbatch and Ryan Reynolds
life...and the weight loss industry is rubbing its hands in glee
Voices
Spectators photograph the Tour de France riders as they make their way through the Yorkshire countryside
voicesHoward Jacobson: Line the streets for a cycling race? You might just as well watch a swarm of wasps
Life and Style
lifeHere's one answer to an inquisitive Reddit user's question
Arts and Entertainment
'Eminem's recovery from substance abuse has made him a more potent performer, with physical charisma and energy he never had before'
arts + entsReview: Wembley Stadium ***
Sport
Joe Root and James Anderson celebrate their record-beaking partnership
cricketEngland's last-wicket stand against India rewrites the history books
News
peopleDave Legeno, the actor who played werewolf Fenrir Greyback in the Harry Potter films, has died
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Information Security Manager (ISO 27001, Accreditation, ITIL)

    £70000 per annum: Harrington Starr: Information Security Manager (ISO 27001, A...

    C# Developer (HTML5, JavaScript, ASP.NET, Mathematics, Entity)

    £30000 - £45000 per annum + Benefits + Bonus: Harrington Starr: C# Developer (...

    C# Integration Developer (.NET, Tibco EMS, SQL 2008/2012, XML)

    £60000 - £80000 per annum + Benefits + Bonus: Harrington Starr: C# Integration...

    Biztalk - outstanding opportunity

    £75000 - £85000 per annum + ex bens: Deerfoot IT Resources Limited: Biztalk Te...

    Day In a Page

    A History of the First World War in 100 Moments: Peace without magnanimity - the summit in a railway siding that ended the fighting

    A History of the First World War in 100 Moments

    Peace without magnanimity - the summit in a railway siding that ended the fighting
    Scottish independence: How the Commonwealth Games could swing the vote

    Scottish independence: How the Commonwealth Games could swing the vote

    In the final part of our series, Chris Green arrives in Glasgow - a host city struggling to keep the politics out of its celebration of sport
    Out in the cold: A writer spends a night on the streets and hears the stories of the homeless

    A writer spends a night on the streets

    Rough sleepers - the homeless, the destitute and the drunk - exist in every city. Will Nicoll meets those whose luck has run out
    Striking new stations, high-speed links and (whisper it) better services - the UK's railways are entering a new golden age

    UK's railways are entering a new golden age

    New stations are opening across the country and our railways appear to be entering an era not seen in Britain since the early 1950s
    Conchita Wurst becomes a 'bride' on the Paris catwalk - and proves there is life after Eurovision

    Conchita becomes a 'bride' on Paris catwalk

    Alexander Fury salutes the Eurovision Song Contest winner's latest triumph
    Pétanque World Championship in Marseilles hit by

    Pétanque 'world cup' hit by death threats

    This year's most acrimonious sporting event took place in France, not Brazil. How did pétanque get so passionate?
    Whelks are healthy, versatile and sustainable - so why did we stop eating them in the UK?

    Why did we stop eating whelks?

    Whelks were the Victorian equivalent of the donor kebab and our stocks are abundant. So why do we now export them all to the Far East?
    10 best women's sunglasses

    In the shade: 10 best women's sunglasses

    From luxury bespoke eyewear to fun festival sunnies, we round up the shades to be seen in this summer
    Germany vs Argentina World Cup 2014: Lionel Messi? Javier Mascherano is key for Argentina...

    World Cup final: Messi? Mascherano is key for Argentina...

    No 10 is always centre of attention but Barça team-mate is just as crucial to finalists’ hopes
    Siobhan-Marie O’Connor: Swimmer knows she needs Glasgow joy on road to Rio

    Siobhan-Marie O’Connor: Swimmer needs Glasgow joy on road to Rio

    18-year-old says this month’s Commonwealth Games are a key staging post in her career before time slips away
    The true Gaza back-story that the Israelis aren’t telling this week

    The true Gaza back-story that the Israelis aren’t telling this week

    A future Palestine state will have no borders and be an enclave within Israel, surrounded on all sides by Israeli-held territory, says Robert Fisk
    A History of the First World War in 100 Moments: The German people demand an end to the fighting

    A History of the First World War in 100 Moments

    The German people demand an end to the fighting
    New play by Oscar Wilde's grandson reveals what the Irish wit said at his trials

    New play reveals what Oscar Wilde said at trials

    For a century, what Wilde actually said at his trials was a mystery. But the recent discovery of shorthand notes changed that. Now his grandson Merlin Holland has turned them into a play
    Can scientists save the world's sea life from

    Can scientists save our sea life?

    By the end of the century, the only living things left in our oceans could be plankton and jellyfish. Alex Renton meets the scientists who are trying to turn the tide
    Richard III, Trafalgar Studios, review: Martin Freeman gives highly intelligent performance

    Richard III review

    Martin Freeman’s psychotic monarch is big on mockery but wanting in malice