Contraception: natural methods

Good to know 

• Contraception is also sometimes called birth control or family planning.
• There are different contraceptive methods, including hormone medications, intrauterine contraceptive devices, barrier contraception, periods of abstaining from sex, and surgery. Some methods are more effective than others.
• Reasons for using contraception include personal desires (to never have, postpone, or stop having children); medical conditions that could threaten the health of mother or child; and social concerns about environmental effects of overpopulation.
• The effectiveness of the different methods is often given in percentage. A more accurate dimension for effectiveness is the so-called Pearl Index which measures the number of pregnancies in 100 women, using a contraceptive technique for one year. For example, the Pearl Index of the "pill" is less than one which means there will be less than one pregnancy among 100 women who are using the pill correctly for one year.

"Natural" methods 

These methods do not make use of any contraceptive devices or medications.

Natural family planning (rhythm method) 
This involves a woman keeping a menstrual calendar to enable her to accurately predict her fertile period. Most women ovulate about 14 days before the start of the next menstrual period which, in a 28-day cycle, is at the midpoint of the cycle. An unfertilised egg may live two days, while sperms were found to stay alive in the genital tract up to 10 days after intercourse although they may be able to cause fertilisation for about four days. So, intercourse should be avoided during the phase when there's the greatest chance for sperms and eggs to meet.

• Advantage: no hormones are taken, so there are no side-effects from these.
• Disadvantage: not a very reliable method of contraception.
• Effectiveness: if the fertile time is predicted correctly with the help of a menstrual calendar and additional use of basal body temperature, the effectiveness is around 80 percent.

Coitus interruptus (withdrawal)

• Involves removing the penis from the vagina immediately before ejaculation.
• By preventing sperms to enter the vagina, fertilisation does not occur.
• Effectiveness depends on the male's ability to withdraw before ejaculation. Often, some sperms are deposited in the vagina before or during withdrawal, making this method unreliable.
• Disadvantage: doesn't provide protection against sexually transmitted infections (STIs). STI-organisms can be transmitted by direct contact with surface lesions in both partners and from vaginal and pre-ejaculatory fluid.
• Effectiveness: Pearl Index of 8-17.

Breastfeeding

• In nursing mothers, ovulation is often suppressed which has the advantage that breastfeeding acts as a contraceptive measure. However, this isn't a reliable method and breastfeeding women are often advised by their doctor to use the "mini-pill" to provide additional protection. The "mini-pill" contains only progestogens which has the advantage that it will not interfere with milk production. The importance with this pill is that it must be taken every day at the same time.
• Once breastfeeding is stopped, a more effective contraceptive method should be used.