Natural family planning described by detractors as the rhythm method or Roman roulette is finally beginning to be recognized by the medical establishment as a safe and effective method of contraception. It relies on the woman learning to recognize t

Recently, Birmingham researchers have drawn together a wealth of evidence demonstrating that with the right teaching and motivation, NFP can be as effective as the combined Pill, with a success rate of 98 per cent.

Not that the Birmingham findings are anything new. Five years earlier, the naturopath Laurie Baillie similarly brought together scientific proof of the reliability and effectiveness of monitoring ovulation as a means of contraception (JE Pizzorno and MT Murray, Text Book of Natural Medicine, Seattle: Bastyr Publications, 1985).

Breast feeding can also be an effective method of spacing births, and is widely used for this purpose in the Third World (SL Corson et al, Fertility Control, Boston, Little, Brown & Co, 1985).

However, a number of factors determine the effectiveness of this method. RA Hatcher and others (Contraceptive Technology, New York, Irvington, 1985) reported the importance of frequency, duration and of feeding on demand. A study in Bangladesh (SL Huffmann et al, J Biosoc Sci 1987, 19: 171-179) concluded that levels of prolactin, which suppresses ovulation, are also affected by the vigour of the infant’s grasp of the breast, total suckling time, the number of feeds, intervals between feeds and night feeding. They concluded that more than 10 feeds a day will ward off fertility.

Breast feeding women can remain infertile for up to three years, whereas non breast feeding new mothers may have their first period as soon as three weeks after giving birth (H Klaus, Obstet Gyn Surv, 1982, 37: 128-150).

Nevertheless, a few fully breast feeding women have been known to conceive as early as five weeks after giving birth, so depending on nursing alone as a means of contraception is unreliable.

In his general review of NFP, Laurie Baillie suggests that as a back up, nursing mothers should use the symptothermal symptoms of NFP to predict when ovulation returns. One key symptom is that ovarian activity has not yet resumed, he says, is dryness in the vaginal canal with no mucus present.

One caveat: atrophic vaginitis due to low oestrogen levels may confuse the picture (Gaier, Int J Alt Comp Med, Sept 1993).

Other spaceage methods of contraception currently under review don’t seem to offer any advantages over this tried and tested method.

Harald Gaier is a registered naturopath, osteopath & homeopath.

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