1. Beal, Judy A. DNSc, PNP, RN
  2. Wood, Sylvia H. MSN, CNM, RN

Article Content

Ferhing, R. J. (2005).Journal of Midwifery & Women's Health,50(1), 31-38.


Although the numbers of women using natural family planning methods have dropped since the introduction of hormonal methods of contraception, millions of women in the United States today still rely on natural markers of fertility in preventing or planning pregnancy. This article introduces new ways of using old methods of family planning with the assistance of calendars, beads, and handheld electronic chemical light refraction systems, along with cervical mucous monitoring and fertility algorithms.


The Standard Days Method (SDM) is a modified rhythm method with a fixed number of fertile days per cycle. It is intended for women who have regular cycles (26 to 32 days) and is supported by the use of the Cycle-Bead System to allow women to more easily track the fertile days in their cycles. There are 32 beads, which are in the form of a necklace. One red bead, which indicates the beginning of the menstrual cycle, is followed by 6 brown, 12 white, and 13 brown beads, with a dark brown bead at the 27th day of the cycle. Women are instructed to avoid intercourse on the white bead days to avoid pregnancy. Studies presented found the efficacy of this method to be comparable to the male condom and much better than other barrier methods. This system is inexpensive ($12.00) and does not require Food and Drug Administration (FDA) approval since it is not a drug or a medical device.

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Also discussed is the use of fertility monitors such as Persona (not available in the United States) and Clearplan Easy (CPEFM) to determine fertile and infertile times in the cycle through infrared lights to monitor for urinary estrogens and luteinizing hormone. CPEFM along with the daily monitoring of cervical mucus as a "double check" for the prevention of pregnancy was also discussed. The author points out that the use of the CPEFM for this purpose is currently defined as "off label" by the FDA, but preliminary results of the Marquette University College of Nursing study using this combined method appear to be well supported, with a 12-month 93% typical use effectiveness for this combination method. Combining the use of CPEFM with other simpler methods such as the calendar or algorithm method is also presented. This article is an excellent update on what's new in the field of natural family planning.


Comment by Sylvia Wood