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Motivation, Natural family planning method, Pregnancy rates, Rhythm.



  1. Fehring, Richard J. PhD, RN, FAAN
  2. Schneider, Mary MSN, APRN, FNP-BC
  3. Barron, Mary Lee PhD, APRN, FNP-BC
  4. Pruszynski, Jessica PhD


Purpose: To determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy.


Study Design and Methods: Using an online taught NFP method, 358 women and (their male partners) indicated "how much" and "how hard" they wished to avoid pregnancy on a scale of 0 to 10 before each menstrual cycle charted over 12 month of use. This motivation scale is used in the National Survey of Family Growth as a measure of motivation. All pregnancies were verified with an online pregnancy evaluation and urine-based pregnancy test. A combined motivation score was used in analysis.


Results: There were 28 pregnancies among the low-motivation participants (N = 60) and 16 among the high-motivation participants (N = 298). At 12 months of use, there were 75 pregnancies per 100 users for the low-motivation group and only 8 for the high-motivation group. There was an 80% greater likelihood of a pregnancy with the low-motivation group ([chi]2 = 25.5, p < .001, odds ratio = 1.80; 95% confidence interval = 1.61-1.90).


Clinical Implications: High motivation to avoid pregnancy by both the female user of a behavioral method of family planning and her male partner is required for high efficacy. Assessing motivation of both the woman and her male partner before prescribing NFP methods is recommended.