Transcript Creighton Model FertilityCare System

Natural Family Planning:
A Healthy Alternative
With an overview of Creighton Model FertilityCareTM System
By Mary Knutson RN, MSN, FCP
Goals and Objectives
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To improve health in individuals, families, and
communities by increasing use of Natural Family
Planning (NFP)
To list one or more natural signs of fertility
To describe two methods of Natural Family
Planning
To discuss effectiveness of NFP
To compare NFP’s advantages to its
disadvantages in your own situation
To list a way to find out about NFP classes in
your area
What is Natural Family Planning?
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Using the natural signs of human fertility to
understand a woman’s cycle
Making decisions about having children based on that
information
NFP can be highly effective to avoid or achieve
pregnancy
Develops a couple's respect for each other and their
fertility
Fully supports the ideals of a Christian marriage and the
value of children as gifts or blessings
NFP is safe, healthy and natural
Natural Signs of Fertility
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There are signs of fertility that can be observed
by a woman to understand her fertility patterns:
 Mucus secreted before and during the time of
ovulation
 A sensation of lubrication
 A small but measurable rise in basal body
temperature which occurs after ovulation
 Changes in the cervix that happen around the
time of ovulation
Natural Family Planning
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If a couple wants to avoid pregnancy, they avoid
intercourse or genital contact on days of fertility
If a couple wants to achieve pregnancy, they focus
intercourse on the days of fertility
Education by a qualified instructor is needed
Observation and charting needs to be done
consistently
An instructor guides the couple until they are
confident, and are using the method correctly
Some methods offer self-study or online education
NFP is a Shared Method
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Both husband and wife share responsibility, and
the chart belongs to both of them
Charting and interpreting observations at the end
of each day promotes the couple’s
communication as they decide together whether
to have intercourse or not
When they do come together in the marital act,
they give themselves to each other fully
This method cooperates with the natural
procreative cycle, and promotes both physical and
spiritual health
Some Natural Family Planning Methods
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Ovulation Methods, like Creighton Model or
Billings Method do not involve taking temperatures
Sympto-Thermal Methods include temperatures
Basal Body Temperature Method-temperature only
Calendar “Rhythm” is not effective because
irregular cycles cannot be predicted
Cycle Beads or Standard Days Method is only
effective for regular cycles of 26-32 days
Electronic fertility monitors, like the Marquette
Model, are new ways to check fertility hormones
Child spacing through ecological breast feeding
Basal Body Temperature Method
BBT Chart Diagram by epigee.org (2004)
What is the Creighton Model
FertilityCare System?
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A scientific, modern way to understand a
woman’s cycles of fertility
Observing mucus and lubricative sensations on
the outside of the body
Recognizing the approach of ovulation (when
the egg is released from the ovary and
conception is possible)
Determining fertile and infertile days
Sharing standardized charting with your doctor
(optional) to monitor reproductive health
Ovulation Events:
Before ovulation,
estrogen is dominant.
Levels of estrogen peak
sharply just before
ovulation, causing
changes in mucus that
comes from the cervix to
the opening of vagina.
In post-ovulatory phase,
progesterone is higher,
causing significant
changes
Diagram by Hole, J., (1987), Human Anatomy and Physiology
Observations
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Only external checks are needed, using folded
toilet tissue and wiping front to back
Women check for mucus before and after toileting
Check sensation: lubricative (slippery) or dry
 Check color and consistency by “finger
testing” any mucus (“Stretchy” is a stretch of
1 inch or more)
 Final check is at bedtime, after bearing down
Chart the most fertile sign of the day, and how
often it was observed
Cervical Mucus
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Mucus is charted with white baby stamp as a
reminder of possible fertility
Before ovulation, sperm can live several days in
cervical mucus, increasing possible pregnancy
Sperm do not stay alive without cervical mucus
Peak day, the last day of clear, stretchy or
slippery mucus, is the estimated ovulation time
An additional count of 3 days past the peak day
is considered fertile
Change occurs: Dry or non-peak mucus (sticky,
tacky, gummy, cloudy) usually follows peak
Charting
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Dry days that are not within the count of 3 are
marked with green stickers, because they are
considered infertile days
Each new cycle begins with menstrual bleeding
that is marked with red stickers
The length of cycles can vary widely, because of
early ovulation or delayed ovulation, but the
number of days in the cycle after the peak day
(post-peak phase) is quite stable
NFP usually allows women to predict the date of
their next menstrual period
Charting Examples: Regular, Short, and Long Cycles
Continuous Mucus: Using Yellow Stamps
How the Method is Taught
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FertilityCareTM Professionals introduce the
method at group Introductory Sessions
Progressive instructions are scheduled for
individual couples (usually 8 follow-up sessions)
 Used with regular or irregular cycles
 Yellow stamps are often given to effectively
manage “continuous mucus”
Additional instructions are given for infertility,
breastfeeding, post-pill, post abortion,
premenopause, or postpartum-not breastfeeding
Basic Method Instructions
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To avoid pregnancy, couples
have intercourse only on dry
days not within the count of 3
To achieve pregnancy, couples
use the days that are the
greatest quality and quantity
of mucus, and the first 2 days
after that
Menstrual Cycle Diagram
by Epigee.org (2004)
Effective to Avoid Pregnancy
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Studies have shown Creighton Model
FertilityCareTM System to be as effective as oral
contraceptives
More effective than barrier methods
NFP methods can be used long-term throughout
reproductive years
Has only positive “side effects”, like fertility
appreciation, and decreased divorce rate
Couples can easily change their intention from
avoiding to achieving pregnancy at any time
Learning Activity and Discussion
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Find current NFP and contraceptive statistics
Do continuation rates affect risk for pregnancy?
Pregnancy rate of NFP in most studies include the
couples who chose to achieve pregnancy
With that in mind, are NFP statistics truly
comparable with other methods?
See Family Planning Method Comparison Chart
at the end of this presentation. (Those Creighton
Model statistics show effectiveness for couples
who were seriously trying to avoid pregnancy.)
Effective to Achieve Pregnancy
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Very effective for couples with normal
fertility.
Also is effective for many infertile
couples, but is most effective to achieve
pregnancy when also using medical testing
and intervention
Creighton Model FertilityCareTM Medical
Consultants can be used to diagnose and
treat reproductive problems or infertility in
morally acceptable ways
Some Disadvantages of NFP
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Abstinence during fertile time can be difficult –
Couples can plan ahead to do other things to
show their love
Genital contact (even without intercourse) can
cause pregnancy during fertile time
It takes time and effort to learn the method
NFP is recommended for couples in a stable,
marital relationship
Does not protect against Sexually Transmitted
Diseases
Using Barrier Methods with NFP
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Using condoms, spermicides, or other barriers
along with NFP is discouraged because they:
 Cause irritation and confusing mucus signs
 Barrier methods take away from the open
giving of each other in marital acts
 Cause increased chance of pregnancy Effectiveness of barrier methods is poor when
calculated over the whole cycle. But using
them with NFP would focus their use on the
few days that are actually fertile
NFP’s Advantages and Benefits
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Completely natural
No side effects
Morally acceptable to all religions
Cost-effective, and comparatively inexpensive
Can be used by women in all stages of their
reproductive lives
Cooperative with the body’s natural cycles,
and its procreative, reproductive system
NFP is a shared system that respects the
dignity of women and marriage
How to Find Out More:
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NFP information and resources are available from
a Catholic Diocese Office in your area
Couples of any religion are encouraged to find
out more about NFP methods
Visit informational websites for NFP programs
and various methods, like
www.creightonmodel.com or
www.fertilitycare.org
Browse some of the following websites to learn
about NFP, its moral foundations, and research to
support its benefits:
Browse NFP Websites
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Optional learning activity: Choose a website to browse.
Write a short summary of what you learned about NFP.
Share it with other students.
www.nfpsite.aldred.org for overview of NFP
www.boma-usa.org or www.woomb.org or
www.nfpoutreach.org for information on the Billings
method, and some moral and religious aspects of
contraception and natural family planning
www.nfpandmore.org International site including
research and a downloadable manual called Natural
Family Planning: The Complete Approach
www.omsoul.com is a website called One More Soul. It
includes NFP information, stories, resources, and research
Browse NFP Websites
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www.canfp.org California Association of NFP includes
and “Ask the Expert” feature
www.MyFertilityCycle.NET includes online education
for charting, and an online charting system
http://www.marquette.edu/nursing/NFP/Model.shtml
for NFP using electronic fertility monitors, or
http://www.epigee.org/guide/computers.html overview
www2.cyclebeads.com
www.ccli.org/nfp Couple to Couple League includes
ecological breastfeeding (lactational amenorrhea)
http://healthmattersmagazine.com/issues/hmm15.pdf
See page 19 for a fun, colorful article
References
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Hilgers, T.W., (2001), Creighton Model FertilityCare
System: An authentic language of a woman’s health and
fertility. (5th ed.) Omaha: Pope Paul VI Institute Press.
Hole, J., (1987), Reproductive systems. In Human
anatomy and physiology. (4th ed., p.833). Dubuque:
Brown.
Williams, M. T. (2009). Family Planning. In epigee.org
website. Retrieved 10-22-09 from
http://www.epigee.org/guide/natural.html or
http://www.epigee.org/family-planning-newmethods.html
TM
Family Planning Method Comparison Chart
Adapted from brochure by American Academy of Natural Family Planning Feb. 1999
Methods
Possible Side Effects
Effectiveness %
Theoretical
Effectiveness
% Actual
Continuation
Rate at 1 year
Creighton Model FertilityCare System
None
99.5
96.8
89%
Barrier Methods (condom,
diaghragm,
sponge
Allergic reactions and irritation, inc. risk of toxic
shock syndrome
97
94
80-91
88
82
64-82
63%
58%
52%
Vaginal Spermicides
Allergic reaction or irritation
94
79
43%
Sterilization Surgeries
Tubal ligation
Surgical bleeding and infection, inc. risk of
hysterectomy, ectopic pregnancy, painful periods,
prostate cancer
99.8
99.6
100%
99.9
99.8
100%
and vasectomy
Intrauterine Device
(IUD)
- requires replacement every 5 years
Heavy, irregular or painful periods, painful
intercourse, infection, ectopic pregnancy,
perforation of uterus, infertility
98
97
80
Birth Control Pill (2 hormones)
Breast tenderness, wt. gain, headaches, nausea
and vomiting, depression. May delay return of
fertility and inc. risk of CV disease and some CA
99.6
94
72
Progestational Agents (Norplant, and
Depo-Provera )
Local infection and bruising , anxiety, acne, wt.
gain, headaches, breast pain and irregular menses
99.9
99.7
99.9
99.7
85
70
Which Family Planning
Method is Most Ideal?
Rate these:
Completely Safe
Effective
No Side effects
Obtainable
Affordable
Acceptable
Future pregnancy
Condom
BCP
Give 1 point for poor, 2
points for satisfactory, and 3
points for good. Total up the
points at the bottom of page.
IUD
NFP
Sterilization
This presentation was sponsored by Health Vista, Inc.
Revised 10-22-09