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1.
Am J Obstet Gynecol ; 165(6 Pt 2): 2031-6, 1991 Dec.
Article in English | MEDLINE | ID: mdl-1755464

ABSTRACT

Data from two prospective studies of the ovulation method were used to assess pregnancy rates and users' fertility-related behaviors among breastfeeding women. The rate of unplanned pregnancy was less than 1% during the first 6 months of lactational amenorrhea. However, the unplanned pregnancy rate was elevated among breastfeeders during the months after menses return compared with the pregnancy rate during nonlactating cycles. Rates were also elevated at the time when infant feeding supplementation was started. This increase in unplanned pregnancies was not directly attributable to nonadherence to the ovulation method rules; there was some indication that adherence to the rules actually may be increased during those months. Therefore, special emphasis on both the need for improved breastfeeding support to delay menses return and the increased potential for method failure among new users during this period of time should be incorporated into ovulation method training and support programs.


PIP: Data from two prospective studies of the ovulation method in Nyahururu, Kenya, and Santiago, Chile, were analyzed to assess the occurrence of pregnancy and related behaviors among breastfeeding women. The rate of unplanned pregnancy was less than 1% during the first six months of lactational amenorrhea, but was elevated among breastfeeding women during the months after menses return compared with the pregnancy rate during nonlactating cycles. Rates were also elevated at the time when infant feeding supplementation was started. The authors note that the increase in unplanned pregnancies cannot be directly attributed to nonadherence to the ovulation method rules. In fact, there was some indication that adherence to the rules may even be increased during those months. The authors also encourage special emphasis in ovulation method training and support programs upon both the need for improved breastfeeding support to delay menses return and the increased potential for method failure among new users.


Subject(s)
Breast Feeding , Family Planning Services/methods , Ovulation/physiology , Chile , Female , Humans , Kenya , Pregnancy , Prospective Studies , Risk Factors
2.
Contraception ; 38(2): 227-42, 1988 Aug.
Article in English | MEDLINE | ID: mdl-2971507

ABSTRACT

Records of the occurrence of vaginal bleeding were obtained from women using either a natural method of contraception or one of four types of hormonal contraceptive. The relationships between their bleeding patterns and a number of demographic variables were examined, with the aim of identifying subgroups of women who, if they used a particular hormonal method of contraception, would be likely to suffer more or less disruption to their bleeding pattern than the 'norm'. Within contraceptive method, bleeding patterns were more closely related to the women's geographical region of residence than to any other factor. Some of the differences between regions were consistent across contraceptive methods. European women tended to have more bleeding/spotting days than women in other regions; Latin American women had relatively short episodes and long bleeding-free intervals, whether they were using the ovulation method, combined pills or a vaginal ring. Other differences were method-specific. Women using combined pills in India or Pakistan had fewer spotting episodes than women using the same method elsewhere; those using progestogen-only pills had more. Regional variations in bleeding patterns were particularly marked among women using DMPA, and increased over time: by their fourth injection interval, 25% of European women had amenorrhea, as compared with 72% of subjects in North Africa. These findings need to be confirmed by carefully controlled studies of menstrual bleeding patterns and their acceptability in various ethnic groups. The results would be valuable in counselling new contraceptive acceptors, and could eventually guide the choice of methods for introduction into national family planning programmes.


Subject(s)
Contraception/methods , Menstruation , Administration, Intravaginal , Africa , Asia , China , Clinical Trials as Topic , Contraceptives, Oral, Combined/pharmacology , Contraceptives, Oral, Hormonal/pharmacology , Europe , Female , Humans , Latin America , Levonorgestrel , Medroxyprogesterone/analogs & derivatives , Medroxyprogesterone/pharmacology , Medroxyprogesterone Acetate , Menstruation/drug effects , Multicenter Studies as Topic , Norgestrel/pharmacology , West Indies
3.
Stud Fam Plann ; 19(4): 215-26, 1988.
Article in English | MEDLINE | ID: mdl-3176094

ABSTRACT

A study of the knowledge, perceptions, and behavioral intentions of physicians regarding periodic abstinence (PA) methods was undertaken in Mauritius, Peru, the Philippines, and Sri Lanka. Most respondents considered PA to be useful, although even the PA providers prescribed mainly non-PA methods. Detailed knowledge of PA methods was not evident, but most physicians were willing to initiate general discussion about PA with patients. Physicians favored methods perceived as "scientific" and "modern," which primarily prevent pregnancy and secondarily avoid other health risks. When carefully presented as "scientific" and "modern," methods presented to medical audiences may find acceptance and be more likely to result in referral.


PIP: This study attempts to assess the level of knowledge about periodic abstinence methods and willingness to communicate that knowledge to patients among a sample of 375 physicians from 4 developing countries: Mauritius, Peru, the Philippines, and Sri Lanka. For purposes of this study, periodic abstinence includes the calendar method (rhythm), the Billings method (ovulation method), the temperature method (basal body temperature), and the sympto-thermal method (temperature and cervical mucus observation). 54% of the doctors interviewed did not provide periodic abstinence services. 67% were male, 60% were over 40, 92% were not strongly Catholic, and 42% were general practitioners. Older doctors, female doctors, and strongly Catholic doctors were most likely to provide periodic abstinence services. 54% of providers were general practitioners, 46% were gynecologists, and 36% were clinicians. Both providers and nonproviders were most likely to recommend the pill or the IUD as a contraceptive method. The calendar method was the most commonly provided abstinence method. Providers, in general, had more knowledge about abstinence methods than did nonproviders, but even providers were deficient in knowledge about methods that they did not supply. Of the 3 main abstinence methods, the calendar method was perceived as most traditional, the Billings method as most modern. The sympto-thermal method was perceived as modern but also as "artificial." On a scale of 1 to 7 from bad/nonscientific to good/scientific, the pill scored highest (6.4), while the temperature, Billings, and calendar methods scored 5.2 or 5.1. 47% of all the physicians surveyed said that they would not recommend periodic abstinence to their patients. The majority said that they would respond to inquiries about these methods but would not initiate discussions about them. Among nonproviders, 12% said they would seek future training, but 17% said they had no future plans for either training or service.


Subject(s)
Attitude of Health Personnel , Natural Family Planning Methods , Physicians , Adult , Body Temperature , Catholicism , Cervix Mucus , Contraception/methods , Cross-Cultural Comparison , Female , Humans , Male , Mauritius , Peru , Philippines , Sri Lanka
4.
Rev Chil Obstet Ginecol ; 49(3): 175-86, 1984.
Article in Spanish | MEDLINE | ID: mdl-6533711

ABSTRACT

PIP: This work describes a study of factors determining the acceptability of the ovulation method of family planning conducted at the Natural Methods Clinic of the University of Chile Hospital's Department of Obstetrics and Gynecology. Persons desiring instruction concerning natural family planning complete a questionnaire, hear an introductory talk which stresses the Billings method, and receive personal instruction in modular units. Multiple factors were studied for both acceptance of registration and acceptance of the course. Entrance into the course constituted acceptance of registration, and achievement of the status of dependent users constituted acceptance of the instruction phase. 147 of the 224 couples registering in the natural family planning clinic between November 1981-August 1983 began the course of instruction, and 96 subsequently adopted the method. 42.9% of the original 224 couples thus became dependent users. A significantly positive statistical association with registration was found for 73 factors. 4 separate elements of acceptability were measured: predictive value, acceptability rate, sensitivity, and frequency. The ideal factors in terms of acceptability would have positive values on all 4 dimensions nearing 100%. The most important factors identified in the study in the phase of registration and their measures for predictive value, frequency, sensitivity, and rate of acceptability respectively were: both partners shared the decision to try the method (71%, 75%, 90%, and 53%), the method is not harmful (71%, 75%, 90%, and 53%), the male understands the basics of the method (71%, 73%, 89%, and 52%), the woman understood the functioning of natural methods (70%, 57%, 66%, and 40%). All the above factors are modifiable through information and education. Statistically significant associations were found for only 16 factors in the phase of instruction. The most important factors were that both partners had previous knowledge of the method and had no prior experience with the IUD. The predictive power of the acceptability factors varied from 17%-80% for the registration phase and from 38%-81% for the instruction phase.^ieng


Subject(s)
Natural Family Planning Methods , Body Temperature , Female , Health Education , Health Knowledge, Attitudes, Practice , Humans , Male , Ovulation Detection/methods
5.
Res Reprod ; 14(3): 1, 1982 Jul.
Article in English | MEDLINE | ID: mdl-12279312

ABSTRACT

PIP: The concept of utilizing changes in cervical secretion offers a potentially simple method of natural family planning. A detailed international trial has been conducted to test the effectiveness of the method. 5 centers are involved: Auckland; Bangalore; Dublin; Manila; and San Miguel. The observations provide an indication of the value and success of the method. They also reveal interesting variations between the different centers and between various socioeconomic classes. The work was divided into a teaching phase and an effectiveness phase. The initial phase was designed to teach individual women how to recognize the symptoms in cervical mucus, and it usually covered the first 3 complete cycles. The subjects were ovulatory, of proven fertility, less than 39 years, nonlactating, and with a history of a menstrual cycle of between 23 and 35 days. Data were collected from the patient and returned to the organizers for analysis. Comparisons were then made between different centers on the 2 study phases. In the teaching phase 94% of the women could soon recognize and record their own cervical mucus symptoms. Many women could understand the principle of the method within the 1st teaching cycle. Almost 90% of the subjects completed the teaching phase, and 7% discontinued for various reasons, including 1.3% who failed to learn the method, and 5% who became pregnant. The average number of days of abstinence by the method was 17 in the 3rd teaching cycle, a high proportion of the length of the average menstrual cycle. After the teaching phase, 725 subjects were studied in an effectiveness phase which lasted for 13 cycles. More than 7500 cycles were analysed. High rates of method failures were found in the 2 most socially developed centers, Auckland and Dublin. Pearl rates for method failure ranged from 9.4/100 women years in Auckland to 1.1 in Manila and 0 in Bangalore and San Miguel. The accumulative probability of discontinuation after 13 cycles was 35.6%, more than half of this figure being due to pregnancy. Detailed pregnancy rates/100 woman years, using the modified Pearl Index, were found to be as follows: conscious departure from the rules of the method, 15.4; inaccurate application of instructions 3.5; method failure 2.8; inadequate teaching 0.4; and uncertain reasons 0.5. Subjects were not selected randomly.^ieng


Subject(s)
Evaluation Studies as Topic , Family Planning Services , Natural Family Planning Methods , Ovulation Detection , Sex Education , Americas , Asia , Asia, Southeastern , Australia , Central America , Contraception , Developed Countries , Developing Countries , Education , El Salvador , Europe , India , Ireland , Latin America , North America , Pacific Islands , Philippines , Socioeconomic Factors
6.
Fertil Steril ; 36(5): 591-8, 1981 Nov.
Article in English | MEDLINE | ID: mdl-7308503

ABSTRACT

A five-country prospective study was undertaken to determine the effectiveness of the ovulation method of natural family planning. After successful completion of a teaching phase of three cycles, 725 subjects entered a 13-cycle effectiveness phase and contributed 7514 cycles of observation. The overall cumulative net probability of discontinuation for the effectiveness study after 13 cycles was 35.6%, 19.6% due to pregnancy. Pregnancy rates per 100 woman-years calculated using the modified Pearl index were as follows: conscious departure from the rules of the method, 15.4; inaccurate application of instructions, 3.5; method failure, 2.8; inadequate teaching, 0.4; and uncertain, 0.5.


PIP: A 5 country prospective study was undertaken to determine the effectiveness of the ovulation method of natural family planning. 869 subjects of proven fertility from 5 centers (Auckland, Bangalore, Dublin, Manila, and San Miguel) entered the teaching phase of 3-6 cycles; 765 (88%) completed the phase. 725 subjects entered a 13-cycle effectiveness phase and contributed 7514 cycles of observation. The overall cumulative net probability of discontinuation for the effectiveness study after 13 cycles was 35.6%, 19.6% due to pregnancy. Pregnancy rates per 100 woman-years calculated using the modified Pearl index were as follows: conscious departure from the rules of the method, 15.4; inaccurate application of instructions, 3.5; method failure, 2.8; inadequate teaching, 0.4; and uncertain, 0.5. Cycle characteristics included: 1) average duration of the fertile period of 9.6 days, 2) mean of 13.5 days occurred from the mucus peak to the end of the cycle, 3) a mean of 15.4 days of abstinence was required, and 4) a mean of 13.1 days of intercourse was permitted. Almost all women were able to identify the fertile period by observing their cervical mucus but pregnancy rates ranged from 27.9 in Australia and 26.9 in Dublin to 12.8 in Manila. Continuation was relatively high ranging from 52% in Auckland to 74% in Bangalore.


Subject(s)
Family Planning Services , Ovulation Detection , Adult , El Salvador , Evaluation Studies as Topic , Female , Health Knowledge, Attitudes, Practice , Humans , India , Ireland , New Zealand , Philippines , Pregnancy , Prospective Studies , World Health Organization
7.
Fertil Steril ; 36(2): 152-8, 1981 Aug.
Article in English | MEDLINE | ID: mdl-7021189

ABSTRACT

The percentage of 869 women in five countries capable of being taught to recognize the periovulatory cervical mucus symptom of the fertile period was determined in a prospective multicentre trial of the ovulation method of natural family planning. The women were ovulating, of proven fertility, represented a spectrum of cultures and socioeconomic levels, and ranged from illiteracy to having postgraduate education. In the first of three standard teaching cycles, 93% recorded on interpretable ovulatory mucus pattern. Eighty-eight per cent of subjects successfully completed the teaching phase; 7% discontinued for reasons other than pregnancy, including 1.3% who failed to learn the method. Forty-five subjects (5%) became pregnant during the average 3.1-cycle teaching phase. The average number of days of abstinence required by the rules of the method was 17 in the third teaching cycle (58.2% of the average cycle length). To what extent the findings of this study can be extended to other couples remains to be demonstrated.


PIP: A prospective multicenter study was conducted in 5 cities (Auckland, Bangalore, Dublin, Manilla, and San Miguel) to assess the teaching phase of a program on the ovulation method (OM) of natural family planning. 869 ovulating women of proven fertility representing a wide range of cultural, educational, and socioeconomic characteristics (83% Catholic) were taught to recognize the cervical mucus symptom of the fertile period and were then tested on the effectiveness of their learning. 52% of the subjects did not wish to have any more children. 93% were able to understand the method after 1 cycle and 97% after 3 cycles. In the 3rd cycle, the mean number of days of abstinence required was 17. 75.1% of the subjects entered the 2nd phase of the trial after the 1st 3 training cycles and an additional 8.3% after an extended period of up to 3 more cycles. 45 (5.2%) became pregnant during teaching and 99 (11.4%) withdrew from the study. 2, possibly 3, subjects became pregnant while following OM rules. 32 pregnancies occurred when couples had intercourse during the fertile period and 11 more resulted from inaccurate application of the instructions. Subjects who required teaching beyond the 1st 3 teaching cycles reported both pregnancy and discontinuation rates more than 4 times higher than women who did not require additional teaching.


Subject(s)
Family Planning Services , Ovulation , Patient Education as Topic , Adult , Cervix Mucus/physiology , Clinical Trials as Topic , El Salvador , Female , Humans , India , Ireland , New Zealand , Philippines , Pregnancy , Prospective Studies , Time Factors
8.
Temas Poblac ; 7(12): 14, 1981 May.
Article in Spanish | MEDLINE | ID: mdl-12311398

ABSTRACT

PIP: The World Health Organization (WHO) has financed a study of the Billings method of family planning in 3 developing and 2 developed countries to obtain objective data on the effectiveness of the method. Although 40% of the 870 couples had previously used another abstinence method and all were highly motivated to use the technique, the life-table pregnancy rate for the year following training in the method reached 20%. 11 studies of the cervical mucus method have been carried out in India, Tonga, Colombia, and Chile and in the US and Australia, often in new programs which did not employ uniform teaching methods. 2 Indian studies showed pregnancy rates of under 6/100 woman years, while 2 studies in developed countries showed rates under 15 and 2 showed rates over 30/100 woman years. Most of the studies have attributed the high pregnancy rates to the failure of couples to observe abstinence. Pregnancy occurred in the 5 countries partcipating in the WHO studies primarily as a result of the failure of couples to abstain from sexual relations during periods identified as fertile, despite active promotion of natural family planning and assistance from instructors at monthly intervals. Other reasons for the high failure rate were late occurrance of mucus flow relative to the time of ovulation, overly early appearance of mucus, and failure to observe or to interpret correctly the mucus symptom. Mucus patterns and facility of interpretation can be affected by various physiological or psychological factors, such as vaginal or cervical infection, vaginal secretion due to sexual stimulation, medicines, tension, and illness. The common observation of higher pregnancy rates among couples who wish to postpone rather than prevent a birth appears to be particularly important in the case of abstinence methods.^ieng


Subject(s)
Contraception , Evaluation Studies as Topic , Family Planning Services , Ovulation Detection , Sexual Abstinence , Contraception Behavior , Developed Countries , Developing Countries , International Agencies , World Health Organization
9.
Temas Poblac ; 7(12): 12-3, 1981 May.
Article in Spanish | MEDLINE | ID: mdl-12311397

ABSTRACT

PIP: Experience with family planning mehods requiring periodic sexual abstinence has been varied. During the last decade interest has centered on 2 methods, the cervical mucus and the sympto-thermal, which are based on identifying the onset of the fertile period. During the 1970s, the Australian physicians John and Evelyn Billings developed the cervical mucus method, in which changes in the quanitity and characteristics of cervical mucus are used to determine the moment of ovulation. The sympto-thermal method depends on identification of the slight rise in basal body temperature that occurs in the latter part of the menstrual cycle as well as cervical mucus changes and sometimes the calendar to determine the fertile period. The Catholic Church has been the main proponent of periodic abstinence methods, but since 1973 the World Health Organization has invested US$3.3 million on research in such methods. The Billings method requires differentiating between dry, wet, and very wet mucus in the vagina and between different consistencies of mucus. The method ususally requires 1-3 months for instruction and sexual abstinence is usually recommended for the 1st month. The average number of days of required abstinence was 9 in a study of 66 women and 15-18 in a study of 870 women. Many women with short menstrual cycles do not experience postmenstrual dry days, in which case abstinence may be required as many as 13 days out of 23. 18.8% of users of periodic abstinence methods in 1 North American study became pregnant in the 1st year, but most were using the calendar method. Women who desired to terminate childbearing had only about 1/2 as many failures with periodic abstinence methods as did women wishing to postpone a birth.^ieng


Subject(s)
Contraception , Family Planning Services , Ovulation Detection , Sexual Abstinence , Contraception Behavior
10.
Rev Esc Enferm USP ; 14(3): 257-63, 1980 Dec.
Article in Portuguese | MEDLINE | ID: mdl-6910749

ABSTRACT

PIP: The Billings method of contraception, or cervical mucus method, is being introduced, apparently with great success, in Brazil. This method was studied and perfected by the Drs. Billings during the 1950s in Australia; the book explaining how the method works, was published in 1964, and it was soon followed by many other studies. The method is based on the observation of the cyclic changes of cervical mucus. During the first phase of the cycle, or proliferative phase, the increased estrogen secretion produces abundant, wet, elastic mucus, of a quality very conducive to sperm transport; the peak of the mucus symptom coincides with ovulation or precedes it about 1 day. Couples must refrain from intercouse during this period. The second phase of the cycle, or secretory phase, is characterized by increased progesterone secretion which inhibits production of cervical mucus; these are the infertile days of the cycle; mucus will be scant, and dry. This method, which implies periodic sexual abstinence, can by very advantageously used to prevent or to obtain pregnancy. A couple wanting to use this method will have to carefully chart the daily appearance in quantity and quality of cervical mucus, and will have to be instructed on how to do so. The failure rate of the method goes from 0.48 to 2.9/100 women year. The method is totally safe and it promotes marital communication and understanding.^ieng


Subject(s)
Contraception/methods , Family Planning Services , Ovulation , Female , Humans
11.
Am J Obstet Gynecol ; 138(8): 1142-7, 1980 Dec 15.
Article in English | MEDLINE | ID: mdl-7446621

ABSTRACT

Results of a comparative study of the ovulation method (OM) and symptothermal method (STM) of natural family planning in Colombia are presented. Recruitment of volunteer couples began in August, 1976, and continued through December, 1978, during which time 566 couples were randomly assigned to one or the other of the two methods. The study included 3 to 5 months of training in the method assigned, after which the couples entered the follow-up phase of the study. They remained in follow-up until (1) they dropped out or (2) the study closed in June, 1979. Total dropout rates were high for both methods of natural family planning. One year after entry into the follow-up phase of the study, net pregnancy rates were 24.2% for OM users and 19.8% for STM users. Gross pregnancy rates were 29.2% for OM and 26.1% for STM. Differences in pregnancy rates between the two methods were not statistically significant.


PIP: A comparative study of the use-effectiveness of the OM (ovulation method) and the STM (symptothermal method) of natural family planning was conducted in Bogota and Palmira, Colombia. The pregnancy rates obtained in the study were high for both methods and no significant difference was observed in the pregnancy rates for couples using the OM and for couples using the STM. The study was initiated by the government and the Javeriana University, sponsored by the World Health Organization, and designed and analyzed by the Department of Biostatistics of the University of North Carolina. The planned study was widely publicized and couples were urged to volunteer as study participants. 544 couples, who meet specified requirements, were recruited and randomly assigned to receive training in either the OM or the STM. Training lasted from 3-5 months. 57% of the participants dropped out during the training phase. The remaining 241 couples were then included in the formal follow-up phase of the study and were followed-up monthly for 1 year. Pregnancy rates were computed using both the life table method and the Pearl method. The net cumulative drop-out rate after 1 year of follow up for the 241 couples was 60.1% for OM users and 53.0% for STM users. Net cumulative rate of voluntary withdrawal was 30.3% for OM users and 26.0% for STM users, and the net cumulative pregnancy rate was 24.2% for OM users and 19.8% for STM users. The Pearl pregnancy rate was 33.8/100 users for the OM and 26.0/100 users for the STM users. There were no significant differences in the characteristics of OM and STM participants who took part in the follow-up phase nor between OM and STM drop-outs. The high drop-out and pregnancy rates observed in this study suggested that natural family planning was probably not an effective form of contraception for a large proportion of the Colombian population.


Subject(s)
Contraception/methods , Natural Family Planning Methods , Adolescent , Adult , Body Temperature , Colombia , Female , Humans , Male , Patient Dropouts , Patient Education as Topic , Pregnancy , Random Allocation
12.
Acta Med Rom ; 16(3): 349-56, 1978.
Article in English | MEDLINE | ID: mdl-12309199

ABSTRACT

PIP: A 2-year prospective study of the sympto-thermal method of rhythm was conducted. The primary objective was the statistical evaluation of the biological effectiveness of sympto-thermal rhythm. The study was international in scope, comprising over 1000 couples living in 5 countries of the world (Canada, Colombia, France, Mauritius, and the United States). The image many people have of rhythm users is that of older couples with 5 or 6 children desperately trying to avoid another child. Analysis of the study participants shows otherwises. The age of the wives on January 1, 1971 varied from 20-44, and the size of the families was from 1-9 with the curve skewed heavily to the left. Only 205 of 1014 couples registered in the study failed to complete the full 24 months. During this time there were 236 pregnancies, 103 of which were planned and 133 unplanned. Most countries had a use effectiveness of between 6 and 7.5 conceptions/100 woman years. Colombia was the notable exception with slightly over 22 conceptions/100 woman years. For those using sympto-thermal only, 9 of 110 unplanned pregnancies were judged to be due to method failure and 101 to user failure. The user effectiveness is 7.18 pregnancies/100 woman years of exposure, and the biological effectiveness rate is 0.64 pregnancies/100 woman years of exposure.^ieng


Subject(s)
Age Factors , Evaluation Studies as Topic , Ovulation Detection , Parity , Prospective Studies , Social Class , Africa , Africa South of the Sahara , Africa, Eastern , Africa, Northern , Americas , Birth Rate , Canada , Colombia , Contraception , Demography , Developed Countries , Developing Countries , Economics , Europe , Family Planning Services , Fertility , France , Latin America , Mauritius , Natural Family Planning Methods , North America , Patient Acceptance of Health Care , Population , Population Characteristics , Population Dynamics , Research , Socioeconomic Factors , South America , United States
13.
ICMH Newsl ; 8(94): 1, 1977 Jul.
Article in English | MEDLINE | ID: mdl-12260102

ABSTRACT

PIP: The World Health Organization (WHO) is sponsoring clinical studies in El Salvador, India, Ireland, New Zealand, and the Philippines into the Ovulation Method (OM) of birth control. The method, a variation of the rhythm method, involves a woman's self-analysis of the wetness or dryness of her genital area. Wetness would indicate imminent ovulation and sexual activity could be regulated accordingly. Advantages of OM are: 1) acceptability to Catholics, 2) no necessity for basal temperature taking, 3) easy charting, and 4) no complications and side effects. Procedure of the WHO-sponsored trials is explained.^ieng


Subject(s)
Family Planning Services , Ovulation Detection , El Salvador , India , Ireland , Natural Family Planning Methods , New Zealand , Philippines , World Health Organization
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