What nurses should know about natural family planning

Two common natural family planning (NFP) methods are the ovulation method based on characteristics of cervical mucus and the symptothermal method based on changes in cervical mucus, basal body temperature, and the cervix. Both methods are effective when used correctly. Nurses should understand the principles of NFP and introduce these methods in discussions of family planning options. Interested clients should be referred to a certified NFP instructor for education and supervision. Despite beliefs to the contrary, natural family planning (NFP) methods can be 97-99% effective when used correctly by motivated couples. Lack of knowledge of different NFP methods hinders use, however, so nurses involved in family planning education should understand NFP methods and the characteristics of clients who could use NFP successfully. NFP identifies the 5-13 day fertile period that can be recognized by examination of changes in the amount and quality of cervical mucus or by changes in the cervix and in basal body temperature (BBT). During the fertile period, cervical mucus increases in amount and has the consistency of raw egg white. The risk of pregnancy is approximately 35% for 4 or more days after the last day the peak mucus appears. During ovulation, changes in the cervix, which softens and rises slightly, can be palpated. In addition, BBT increases about 0.4 degrees Fahrenheit after ovulation. The fertile period is determined to be concluded when the BBT has been elevated for 3 days. Some experts recommend the ovulation method, while others cite the benefits of the sympto-thermal method. Women must be taught how to use NFP properly through detailed instruction and supervised monitoring over an extended period of time. Women may chose to use NFP for religious, health, financial, or other reasons, and nurses should assess clients to help identify those most likely to be successful. These clients should be referred to specialists to learn NFP, and a variety of organizations (names and addresses of five are given) can refer clients to certified instructors or provide materials for correspondence study.