Natural family planning
methods
By Milion R(BSc, MScN)
Objectives
At the end of this session you will be able to:
List the natural family planning methods
Describe withdrawal method
Describe the fertility awareness methods
Describe the symptom-based methods
Describe LAM (Lactational Amenorrhea Method)
4/29/2026 By Milion R(BSc, MScN) 2
Natural FP methods cont…
Natural family planning refers to methods used
by giving attention to natural reproductive events
related to fertility
All natural methods except for LAM require
partners’ cooperation.
Methods do not have side effects or health risks.
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Natural FP methods cont…
Withdrawal method
Fertility awareness method
Rhythm /calendar method
Cervical mucus methods
BBT
Symptom based methods
Lactational amenorrhea method
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Coitus interruptus
It involves withdrawal of the entire penis from
the vagina before ejaculation.
Fertilization is prevented by lack of contact
between spermatozoa and the ovum.
Is one of the least effective methods
It doesn't protect from STI
It needs discipline from the partner
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Lactational Amenorrhea Methods
(LAM)
A temporary family planning method based on
the natural effect of breastfeeding on fertility.
Elevated prolactin levels and a reduction of
gonadotropin-releasing hormone from the
hypothalamus during lactation suppress
ovulation.
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LAM: Mechanisms of Action
Frequent intense suckling
disrupts secretion of GnRH
Irregular secretion of
GnRH interferes with
release of FSH and LH
Decreased FSH and LH
disrupts follicular
development in the
ovary to suppress
ovulation
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LAM cont…
LAM requires 3 conditions. All 3 conditions must be
met:
i. The mother’s monthly bleeding has not returned
ii. The baby is fully or nearly fully breastfed
iii. The baby is less than 6 months old
The perfect-use failure rate within the first 6 months
is 0.5%.
Involution of the uterus occurs more rapidly
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Fertility awareness methods
Fertility awareness method- a woman knows
when the fertile time of her menstrual cycle
starts and ends.
It is sometimes called periodic abstinence
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Calendar method cont…
The first day of monthly bleeding is always counted
as day 1
The record of at least 6 consecutive menses is
needed.
The woman subtracts 18 days from the length of her
shortest recorded cycle.
– This tells her the estimated first day of her fertile time.
She subtracts 11 days from the length of her longest
recorded cycle.
– This tells her the estimated last day of her fertile time.
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Example
A woman‘s last six menstrual cycles
were 28, 29, 29, 27, 31 and 27 days.
Using this information, calculate and
instruct her about how to use the
calendar method to prevent
pregnancy?
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Cervical Mucus Method-Billings
method
The woman attempts to predict her fertile period
by quantifying the cervical mucus with her
fingers.
Under the influence of estrogen, the mucus
increases in quantity and becomes progressively
more elastic and copious until a peak day is
reached
Intercourse is allowed 4 days after the maximal
cervical mucus untilBy Milion
4/29/2026
menstruation.
R(BSc, MScN) 12
Cervical Mucus Method cont…
Around the time of
ovulation cervical mucus
becomes profuse, thin
transparent, watery, and
slippery.
Avoid unprotected sex
when cervical secretions
begin to appear and
until 4 days after the
peak mucus day.
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cont…
Remember
If a woman has a vaginal infection or another
condition that changes cervical mucus, this
method may be difficult to use.
The woman checks every day for any cervical
secretions on fingers, underwear, or tissue paper
or by sensation in or around the vagina.
Look at their cervical mucus in the morning, and
every time after using the toilet
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Basal Body Temperature-BBT
This requires measuring of BBT before rising from
the bed daily starting from the first day of
menstrual cycle.
The BBT of a woman is relatively low during the
follicular phase and rises in the luteal phase of
the menstrual cycle in response to the
thermogenic effect of progesterone.
There is a temperature rise of 0.2-0.5oc following
ovulation
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Cont…
The third day after the onset of elevated
temperature is the end of the fertile period
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Symptothermal method
This method is a combination of;
i. Cervical mucus method &
ii. Temperature method
The 1st day of abstinence is predicted by using
billings method & the last day by BBT.
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Thank you
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