Natural Family Planning
as Contraception
Alternative
Overpopulation Problem
• Environment problem
• Hunger
• Poverty
• Economic stagnation
Family Planning
5
Methods that allow individuals
Artificial Family Planning
Pandangan Gereja Katolik
tentang KB
1. Perkembangan sikap dan posisi positif terhadap gagasan pokok KB, dalam hal penentuan jumlah anak dan jarak antar kelahiran.
2. Ungkapan tanggungjawab sebagai makhluk Tuhan dalam bersikap dan berperilaku dalam masalah
prokreasi.
3. Kebutuhan Gereja akan panggilan khusus menjadi imam atau biarawan-biarawati.
4. Orangtua mempertimbangkan berbagai faktor untuk menentukan jumlah anak yang dapat dipertanggung-jawabkan.
Pandangan Gereja Katolik
tentang KB
Gereja mempersoalkan cara-cara dalam
mewujudkan Keluarga Bertanggungjawab itu.
Prinsip dasarnya adalah: tegas menolak setiap cara KB yang bersifat abortif (menggugurkan) dan umumnya tidak mendukung cara-cara
kontrasepsi buatan.
What does the Church really say?
• Sexual Intercourse is a sacred expression of a sacramental reality
– Love-giving/Unitive
Pandangan Gereja Katolik
tentang KB
KB-A dianjurkan Gereja Katolik dan KB-Buatan (kontrasepsi) tidak didukung.
What is the difference?
Birth Control
• Suppresses fertility
• Places barriers to
deliberately prevent the transmission of life
• Pregnancy occurs in spite of the couple’s actions
NFP
• Accepts fertility
• Always open to the possibility of life
• Pregnancy occurs because
of the couple’s actions
Natural Family Planning
• Methods of monitoring and interpreting
natural biological markers of fertility
• To help determine the fertile and
infertile times of a woman’s menstrual
cycle
• Information can be be used to
Abstinence
• Only 100% method of birth control
• Abstinence is when partners do not engage in sexual intercourse
WITHDRAWAL
• Removal of penis from the vagina before ejaculation occurs
• Effectiveness rate is 80%
Cara Menyusui Penuh/ MAL
• Mengandalkan pemberian ASI pada bayinya
• Mempunyai efek tidak terjadi ovulasi apabila menyusukan secara penuh (eksklusif)
• Efektif hingga 6 bulan
• Bila tetap belum ingin hamil, metode ini dapat diganti atau kombinasikan dengan metode KBA lain setelah
6 Day Fertile Window
• A man and woman together are fertile for only 6 days.
• The day of ovulation when a egg is released.
Phases of the Menstrual Cycle
Pre-Ovulatory
Infertile Phase
Fertile Phase
Post-Ovulatory
Natural Biological Signs of Fertility
Changes in
Resting Body Temp
Changes in
Cervical Mucus
METHODS OF NFP
• CALENDAR/RHYTHM
• BASAL BODY TEMPERATURE
• OVULATION METHOD
Metode Ovulasi Billings (MOB)
- Adanya lendir kesuburan
- Harus membedakan lendir
kesuburan dengan sperma
LENDIR SERVIKS
• Dasar:
Perubahan siklus dari lendir serviks yang terjadi karena perubahan kadar estrogen.
2 macam lendir serviks, yaitu:
– Lendir Type-E (Estrogenik)
Fase akhir pra-ovulasi dan fase ovulasi
Sifat : banyak, tipis, seperti air (jernih) dan bila dikeringkan terjadi bentuk seperti daun pakis
– Lendir Type G (Gestagenik)
• Ciri-ciri lendir serviks pada berbagai fase dari siklus haid:
- Fase 1 (hari 1-5)
Saat haid, lendir dapat ada / tidak dan tertutup oleh darah haid. Merasa basah
/ licin
- Fase 2 (hari 6-10)
Pasca haid, tidak ada lendir / sedikit sekali. merasa kering
- Fase 3 (hari 11-13)
- Fase 4 (hari 14-17)
segera sebelum, pada saat dan sesudah ovulasi. lendir bersifat jernih, licin, basah dan dapat di
regangkan. hari terakhir dari fase ini dikenal sebagai
“gejala puncak”. Merasa basah
- Fase 5 (hari 18-21)
Progesterone
Type Mucus Estrogen Type Mucus
Cervical Mucus
Mucus Cycle
Peak
Fertility
• Lendir awal, sedikit, tebal, putih, lengket . Merasa lembab atau lengket
• Lendir masa transisi, jumlahnya meningkat, lebih tipis, berawan, sedikit elastis. Merasa basah
• Lendir dengan kesuburan tinggi, banyak, tipis, transparan,
PRINSIP POLA PERUBAHAN KESUBURAN : seperti pola
Pagi-Siang-Sore-Malam
Haid PDTS Masa Subur sampai
Post-Ovulatory Phase Constant
Rules
1. Jangan berhubungan saat menstruasi
2. Pada saat periode tidak subur: Dapat berhubungan tiap 2 hari sekali
3. Hindari hubungan intim setiap hari ketika lendir, cairan atau pendarahan menyelingi Pola dasar tidak subur
Metode Simpto Termal
Merupakan
Gabungan antara
metode suhu basal
dengan
Standard Day method
▪ Identifies days 8 to19 of the cycle as fertile.
▪ Is appropriate for women with menstrual
cycles between 26 and 32 days long (women
who have their periods about once a month fit within this range)
▪ Helps a couple avoid pregnancy by knowing
which days they should not have sex
▪ Helps a couple plan a pregnancy by
knowing which days they should have sex
Day 8 Day 19
Determining the Fertile Window
5 days (sperm life) 12 to 24 hours (ovum life)
Terms
The perfect or correct use unintended pregnancy rate refers to those pregnancies that occur when the method is used consistently and according to instructions.
The typical use (or total) pregnancy rate includes the
Billings Ovulation Method
▪ Cervical Mucus
▪ Perfect Use = 99 - 100%
▪ Typical Use = 89 - 99%
Representative Studies of the BOM
S. Thapa, M. V. Wonga, P. G. Lampe, H. Pitojo, A. Soejoenoes. “Efficacy of three variations of periodic abstinence for family
planning in Indonesia.” Studies in Family Planning, 21: 327-34, 1990.
J. X. Xu, J. H. Yan, D. Z. Fan, D. W. Zhang. “Billings natural family planning in Shanghai, China.”
Advances in Contraception, 10: 195-204, 1994.
Indian Council of Medical Research Task Force on NFP. “Field Trial of the Billings Ovulation Method of a Natural Family Planning.”
Sympto-Thermal Methods (STM)
• Combines indicators offertility
• Common indicators are BBT, cervical mucus, and calendar formulas
• Provided by Couple to Couple League and Northwest Family Systems
• Perfect Use = 99%
• Typical Use = 90 – 94%
Rice, F. J. & Lanctot, C. A. “Results of a Recent Study of the Sympto-Thermal Method of Natural Family Planning.”
Effectiveness of NFP*
• Perfect Use - 97%
• Typical Use - 84%
• Perfect Use - 98%
• Typical Use - 90% Single Index
Methods
Multiple Indexed Methods
•Kambic, R - The Effectiveness of Natural Family Planning, Current Medical Research; Vol 11; Winter/Spring, 2000. Based on
meta-analysis of 23 ovulation methods studies and 15 STM studies.
Pregnancy rate over one year by family
planning method
Correct Use Typical Use
• CHANCE 85 85
• SPERMICIDES 18 29
• WITHDRAWAL 4 27
• CONDOMS 2 15
• SDM 5 12
• OVULATION METHOD 3 16
• MAL 0,5 2
• SYMPTOTHERMAL 0,6 1,8
• PILL 0.3 8
• IUD 0.1 0.6
• Vasectomy 0,1 0,1
Benefits of using NFP
➢No harmful side effects
➢Supports
reproductive health
➢Environmentally friendly
➢Virtually cost free
➢Are adaptable—to achieve or avoid
pregnancy
➢Requires couple communication
➢A “shared” responsibility
“Cons”
• Require dilligence from both partners
• Require periode of abstinence
• Consistent and accurate record keeping
Whom NFP best for
• Couples who don’t desire hormonal methods or devices
•Regular menses
Take Home Message
• Family planning is one of the solution for overpopulation problem
• Natural family planning offer advantageous benefit for couples
• With correct use, the effectiveness come close to artificial family planning
Six Countries1 U.S.2
Doesn’t affect health 70% 80%
No side effects 20% 30%
Economical 30% 5%
Easy to learn/use 10% 45%
1 Interviews with users in 6 countries; 2 Survey of internet purchasers
On WHITE bead days you can get pregnant.
Do not have intercourse to prevent a pregnancy. On the day you start your
period, move the ring to the RED bead.
Every morning move the ring to the next bead. Move the ring even on days when you’re having your monthly bleeding
Also, mark this date on your calendar
Keep moving the ring one bead every day. When you start your next period, move the ring directly to the red bead and begin again.
On BROWN bead days you can have intercourse.
If you have not started your period by the day after you put the ring on the last brown bread, contact your NFP teacher.
If you start your period before you put the ring on the darker brown bead, contact your NFP teacher.
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