Overview of Fertility Awareness
& Natural Family Planning
Fertility and reproductive health are largely neglected areas in health education.
This ignorance and the lack of easily available accurate information about the increasingly
popular natural methods of family planning, means that women are frequently denied the full
range of family planning choices.
The results of a survey carried out in 1993 in six Western European countries found that
the majority of women lacked knowledge concerning basic facts about menstruation,
fertility and pregnancy.
- One fifth of women had no idea what was happening when their periods
- There was misunderstanding regarding the process of ovulation and
the timing of conception.
- In the UK, one third of the women questioned believed that :
'ovulation occurs during menstruation'.
- The number of fertile days in the menstrual cycle was over estimated.
In the UK, 21% of women thought that :
'there were more than 21 fertile days'
(the average number is 7)
More - WISE Report
Family planning is not only concerned with avoiding pregnancy. It should aim to provide
the means for couples to choose whether and when to have a baby, give information about
birth-spacing and infertility advice, where appropriate.
The ideal method of family planning should not be damaging to health or fertility,
and should not affect the enjoyment of the sexual relationship.
Most women rely on medical advice when looking for a method of family planning.
It is usually the woman who makes the decisions, although the Wise Report showed that
the majority of women would prefer to share the decision-making with their partner.
What is fertility awareness?
- Understanding basic information about fertility and reproduction.
- Identifying the signs and symptoms of fertility during the
womans fertility cycle.
- Applying this information to oneself, discussing it with a partner,
and with health professionals.
Why is fertility awareness important?
- Fertility Awareness is fundamental to understanding and making
informed decisions about family planning choice and reproductive health.
- Fertility Awareness is fundamental to understanding and using
natural family planning, whether to plan or avoid pregnancy.
- Fertility Awareness helps women to value their fertility, which can
be easily damaged by infections, especially sexually transmitted diseases,
many of which can result in fertility problems.
Fertility Awareness is relevant throughout a womans fertile
- Puberty and adolescence
- Considering an appropriate method of family planning.
- Preparing for pregnancy
- Following childbirth and during breast-feeding
- Approaching the menopause
What is Natural Family Planning (NFP)?
Natural methods of family planning use fertility awareness to identify
the fertile and infertile phases of a womans menstrual cycle. This
involves observing the natural signs and symptoms or clinical indicators
NFP can help to plan pregnancy:
As many as one couple in six experience some difficulty in conceiving.
Fertility Awareness can help couples to maximise their chances of conception, by
recognising signs of fertility and optimising the timing of intercourse.
NFP can be used to avoid pregnancy:
Couples learn to identify the fertile and infertile phases of the cycle and to abstain
from intercourse during the fertile phase if pregnancy is to be avoided. This method
requires observation of more than one clinical indicator of fertility - a multiple index
approach - usually a combination of waking temperature and cervical mucus. This ensures
the highest degree of efficiency in avoiding pregnancy.
Efficiency - When motivated couples are taught by experienced teachers, natural
methods can be up to 98% effective. (Range 85-98% effective - FPA 1996)
Advantages and disadvantages of natural family planning
Advantages of NFP
- No interference with the womans normal physiology
- Requires no drugs or devices
- No known physical side effects
- Can be used at all stages of reproductive life
- Both partners share the responsibility for family planning.
- May improve communication about sexuality
- May help sub-fertile couples to conceive
- Enables a couple to take control of their fertility
- Women can monitor their health and observe changes in sexual health.
- Morally and culturally acceptable when artificial contraception is
- Cost-effective - Once properly taught, couples do not require medical
- It takes time to learn to recognise and chart fertility symptoms
- Requires initial teaching from an experienced NFP teacher
- Some women find charting difficult.
- There may be fear of unplanned pregnancy because though method
failure is low, there is a higher user failure rate particularly
during the learning phase.
- Both partners require a high degree of motivation, and commitment.
Modifications to sexual behaviour are needed to ensure abstinence
during the fertile phase.
- There may be difficulty using natural methods at times of stress,
after childbirth, after taking the contraceptive pill and during the
Where do I go to learn NFP?
Fertility Awareness may be given as part of Well-Woman health checks, or through
local medical and family planning services. Where these services are not known
locally contact us for details of your local NFP Teacher. We maintain a database of
experienced teachers to support you with all aspects of Fertility Awareness and NFP.
Information contained here is for interest only.
To use this method effectively - a full course of instruction by a recognised
NFP teacher is vital!
FertilityUK - The National Fertility Awareness and Natural Family Planning Service UK,