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Contraception - Management
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What natural family planning methods are recommended for use in the UK?

  • Natural family planning methods (techniques to avoid conception) that are recommended fall into two categories: fertility awareness–based methods (which involves abstinence), and the lactational amenorrhoea method (that does not involve abstinence).
  • Fertility awareness–based methods monitor changes in one or more indicators of fertility such as basal body temperature, cervical secretions, hormone levels, and/or estimating the fertile days of the menstrual cycle.
  • The lactational amenorrhoea method can be used provided:
    • Complete amenorrhoea, and
    • Fully or very nearly fully breastfeeding, and
    • No longer than 6 months since birth of the baby.

In depth

How do I assess a woman who is planning to use a fertility awareness-based method?

  • Assessment should include answers to the following questions:
    • Does she have a medical condition that would make pregnancy especially dangerous?
    • Is her menstrual cycle sufficiently regular to reliably estimate the fertile time?
    • Does she have a chronic condition that could affect fertility signs, making fertility awareness–based methods hard to use?
    • Does she have a temporary condition that could affect fertility signs, making fertility awareness–based methods hard to use?
    • Does she take any drug that affects cervical mucus, making fertility awareness–based methods hard to use?
    • Is she at increased risk for sexually transmitted infection?

In depth

What advice and information should I give a woman who is considering using a fertility awareness-based method?

  • Give advice and information about:
    • The need for her to receive counselling, training, and ongoing support from a family planning specialist.
    • The advantages, disadvantages and risks of the method.
    • Alternative methods of contraception, taking into account her personal, cultural, and religious sensitivities.
    • Where to purchase or seek accurate information about fertility predictors (e.g. Persona®).
  • The fpa (Family Planning Association) has information both about natural family planning methods and where women can find teachers of natural planning methods. Visit the fpa website www.fpa.org.uk, or phone their helpline on 0845 122 8690.

In depth

How do I assess a woman who is planning to use the lactational amenorrhoea method?

  • Assessment should include answers to the following questions:
    • Can she use the lactational amenorrhoea method?
    • Does she have a condition in which breastfeeding is not advisable?

In depth

What advice and information should I give a woman who is considering using the lactational amenorrhoea method?

  • Give advice and information about:
    • The advantages, disadvantages and risks of the method.
    • The conditions for it to be reliable:
      • Complete amenorrhoea, and
      • Fully or very nearly fully breastfeeding, and
      • No longer than 6 months since birth of the baby.
    • Alternative methods of contraception for when the lactational amenorrhoea method becomes unreliable or for now if she wants additional protection, taking into account her personal, cultural, and religious sensitivities.

In depth

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