Natural Family Planning: Nature's Way - God's Way

43. Use-Effectiveness of the Ovulation Method Initiated after Childbirth: Preliminary Report

During the period following childbirth couples request very frequently some family planning method. Therefore, any family planning method must be effective during the postpartum period. Some natural family planning methods have not been designed to be used during the postpartum and nursing period.

The Ovulation Method (OM) has been reported (Billings E.L. et al., 1977) to be suitable for being learned and used during the postpartum and nursing period. Nevertheless, no report has been published about the use-effectiveness of the OM initiated during the postpartum.

Our programme, the first on the OM in Chile, began in May 1978 sponsored by the World Health Organization, after the author of this preliminary report had made a training visit to Australia and New Zealand to learn the OM. During the first year we personally trained the programme's teachers.

In April 1979 we started the postpartum programme; couples who requested NFP were trained in the OM soon after childbirth. Couples were trained according to the technique proposed in the Atlas of the Ovulation Method (Billings E.L. et al., 1977). This preliminary report covers the ten month period from April 1979 to February 1980.

Daring this period, 44 couples were accepted for the study. All of them were white and belonged to the middle-class. All women were delivered in the Maternity Ward of the Universidad Catolica de Chile University Hospital. Their age range was 18 to 39 years, with a mean of 28.4 years.

Parity was from 1 to 8 live children with a mean of 2.7. Couples entered into the study between the 5th and 12th postpartum weeks. At the beginning of training 28 women were in full nursing (breast-feeding exclusively); 12 were in partial nursing (breast-feeding plus supplemental feeding); and 4 had already finished the nursing period.

Five out of 44 couples knew the Method previously; 39 learned it for the first time during this programme. 32 have already presented their first postpartum ovulation during the ten month programme; 31 of them recognized the mucus pattern of the first postpartum fertile period.

Table I shows woman months of use. During the ten month period 44 couples already completed 258 months of use. There was one pregnancy; this occurred in a woman in full nursing, during her fourth month on the Method and during her sixth postpartum month. This woman failed to recognize her first postpartum fertile period. We consider this pregnancy as a method failure.

Only one couple abandoned the programme, changing the Method, because the woman had extremely long fertile periods.

The Pearl Index of this 258 months of use with one pregnancy is 4.6. Nevertheless, if we subtract the postpartum amenorrhea months (41) and only consider the woman months of use after the re-initiation of menstrual periods (217) The Pearl Index is 5.5.

We consider the OM easy to use and to learn during the postpartum period, especially by full nursing mothers, since they have at least a non-ovulatory period of 70 days, (Perez, A., 1977). This allows them to recognize their infertile pattern; afterwards they will easily appreciate the changes toward fertility.

by Alfredo Perez-Sanchez, M.D.

Obstetrics, Gynecology and Perinatology Department, School of Medicine
Universidad Catolica de Chile, Santiago, Chile


Next Page: 44. Psychology and NFP
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58