miércoles, 27 de abril de 2016

MercatorNet: The rise and rise of natural family planning

MercatorNet: The rise and rise of natural family planning



The rise and rise of natural family planning

It could change family planning aid in developing countries.
Shannon Roberts | Apr 27 2016 | comment 1 

All the way back in 2010 Laura Wershler, executive director of Sexual Health Access Alberta (formerly known as Planned Parenthood Alberta), lamented the lack of knowledge in her field regarding natural family planning and cited the trend toward natural products, better health and environmentalism as women looked for alternatives to hormonal contraception.  Since that time women have continued to worry about the effect of contraceptive hormones on their bodies and on the environment, and interest in natural family planning methods has continued to grow. From a feminist perspective, women also appreciate the fact that the method means their partners must be respectful of their bodies. 
As more Western women change their lives through the discovery of natural family planning as an effective alternative to the pill, it could also change the way family planning aid is given to developing countries.  For many years the West has pushed hormonal contraceptives, along with all their side effects and risks, onto women in developing countries, and largely ignored natural family planning as a valid family planning option.  Yet it is cheap, effective, without side effects, and for these reasons often particularly acceptable to people in areas of poverty.  One study of 19,843 poor women in India using natural family planning found them to have a pregnancy rate approaching zero.
Another study found that surprisingly large numbers of women in West Africa already use natural family planning. Of the women surveyed, almost 25% reported that they used a natural method for family planning, but health surveys carried out by USAID and other population control-minded organizations completely ignored this.  Instead, they recorded that only 35% of Burkina Faso women used artificial contraception and then wrongly concluded from this that the other 65% have an “unmet need” to be put on the pill, injected with Depo Provera, or sterilized.   
New technology is now making natural family planning easier to use than ever.  While many would argue more holistic natural methods such as the Billings or Creighton’s methods are superior because they encourage women to really know what is going on and don't require any devices at all, you could simply ‘Meet Daysy – your personal fertility calculator.  According to its creator: “Daysy will show you if you are fertile or not with an accuracy of 99.3%. It is all natural and free of side effects. As easy as 1,2,3...Just 60 seconds once a day”.   Daysy’s algorithm has a proven Pearl Index of 0.7 and it is designed and certified as a medical device with registration in Europe. 
If you’re not into Daysy there are a number of alternatives on the market.  The Daily Mail recently discussed Natural Cycles software, an app which asks the user to digitally record their body heat each morning and then produces an algorithm to build a fertility schedule.  The app was created by Dr Elina Berglund, a former physicist, who - along with her husband, Dr Raoul Scherwitzl - wanted to provide an alternative for women the side effects of the pill.   According to the Daily Mail:
Results of an independent clinical study, published in the European Journal of Contraception and Reproductive Health Care, bodes well. The research, by contraception experts at Sweden’s Karolinska Institute, involved 4,054 women aged 20 to 35, who used the app for contraception. It found that for every 1,000 women using the app perfectly, only five would experience an accidental pregnancy in a year. 
The couple comment that “so many [women] tell us they enjoy the lack of side-effects you commonly get on the pill, like depression. It is so nice to hear so many stories of women feeling better.' 
It also now looks like organisations aiming to control population in developing countries are increasingly taking natural family planning into account as a valid family planning method.  In a peer-reviewed commentary published in the 21 March 2016 edition of online journal Global Health: Science and Practice, the Office of Population and Reproductive Health of the United States Agency for International Development (USAID) laid out their technical position for classifying fertility awareness methods as ‘modern contraceptives’.  It stated that USAID supports fertility awareness methods (another name for natural family planning) as modern contraceptives because they:
  1. Are effective at pregnancy prevention;
  2. Are safe;
  3. Are based on a sound understanding of reproductive biology;
  4. Include a defined protocol for correct use; and
  5. Have been tested in appropriately designed studies to assess effectiveness under various conditions.

    They also said it has the following additional benefits:
    1. Fertility awareness methods are knowledge-based, relying on women’s understanding of their fertile cycle;
    2. They do not require clinical intervention, such as hormones, devices, or procedures;
    3. They are controlled by a woman and her partner;
    4. They increase a woman’s understanding of her fertility and biological processes;
    5. They provide the opportunity to facilitate pregnancy planning; and
    6. They can be offered through a wide variety of channels, including settings completely outside the health system. 

      Could this mean that we might soon see warehouses full of natural family planning aids instead of Depo-Provera injections in developing countries?  I note here as an aside that many women in Africa also actually want to have large families (and this will in fact also benefit their economies), despite the West's move towards smaller ones and disbelief that all others would not wish to follow.
      It will also be interesting to see if greater interest in natural family planning continues among women in the West.  A number of years ago I discussed natural family planning with a friend at work.  She was a well-educated lawyer I was training to take over my job at the time, but she simply would not believe me that there was only a possibility of pregnancy on six days out of every menstrual cycle on average – a scientific fact. Now, at least anecdotally, I think more women are becoming receptive to the idea because they worry more about the effects of hormonal contraception.  Discussion of natural family planning is increasingly making its way into magazine-style women's forums.  As infertility problems seem to grow, natural family planning is also hugely helpful for women wanting to get pregnant because they can know with great accuracy when they are most fertile, another factor increasing its popularity and women's desire to better understand their own bodies.
      Even many doctors seem to have little idea tof the difference between modern natural family planning methods and the old, unreliable "rhythm" method. Will education improve for them?  The trend toward natural products, better health and environmentally sustainable family planning options looks only set to continue, so let us hope so.
      - See more at: http://www.mercatornet.com/demography/view/the-rise-and-rise-of-natural-family-planning/17955#sthash.TSnfmj8d.dpuf





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