Transcript Creighton Model FertilityCare System

Natural Family Planning:
A Healthy Alternative
Including 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 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 ideals of 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 do not require 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 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
Creighton Model 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
Creighton Model 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
Natural Family Planning 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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Creighton Model 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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Research show Creighton Model FertilityCareTM
System, the Sympto-Thermal Method, and Billings
Ovulation Method TM are as effective as “the pill”
They are theoretically 99% effective – much 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
online or in reference books
How do methods compare for effectiveness?
Compare continuation rates. How could
continuation rates affect pregnancy risk?
Pregnancy rates in many NFP studies include
couples who chose to achieve pregnancy. Could
some NFP statistical comparisons with other
methods be unfair?
Family Planning Method Comparison Chart at the
end of this presentation shows couples 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,
but 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
Does not protect against Sexually Transmitted
Diseases
NFP is recommended for couples in a stable,
marital relationship
Using Barrier Methods with NFP
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Using condoms, spermicides, or other barriers
along with NFP is discouraged because they:
 They cause irritation and confusing mucus
signs
 Barrier methods take away from the open
giving of each other in marital acts
 They cause increased chance of pregnancy
 Effectiveness of barrier methods is poor
when calculated over the whole cycle.
 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 and to use them
Visit informational websites for NFP programs
and methods, like www.creightonmodel.com
Optional learning activity: Write a short
summary of what you learned from some of the
following NFP websites and share it with others.
Read about various NFP methods and the moral
foundations and research that supports their
benefits:
Browse NFP Websites
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www.nfpsite.aldred.org for an overview of NFP
www.boma-usa.org or www.woomb.org or
www.nfpoutreach.org for information on the Billings
OvulationTM 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
www.creightonmodel.com or www.fertilitycare.org for
Creighton Model FertilityCareTM Services (an ovulation
method)
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
information about breastfeeding and child spacing
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
Sponsored by Health Vista, Inc.
Revised 2-11-10