From a global perspective, many countries are currently facing the problem of rapid growth in human population. And this appears to threaten the survival of the human race.

The 2003 World Population Data Sheet of the Population Reference Bureau estimated the world’s current growth rate at 1.3 per cent. Based on this, it is expected that the population will double in 53.8 years.

The rate of increase in the less developed world (births minus deaths, without migration) is 1.6 per cent. Therefore, it is believed that the population in these countries will double in 43.8 years.

Today, the voluntary control of fertility is very important to married couples and to our society. The practice of birth control or prevention of pregnancy is as old as human existence. For centuries, man has relied on his imagination to avoid pregnancy.

However, some of the factors responsible for lack of continuity and good result include ignorance, misinformation, and wrong method applied. Today, we shall look into the various types of methods that is available and at any couple’s disposal to enhance a better marital life. A couple’s choice of birth-control method involves factors, such as how easy it is to use, safety, risks, cost and personal consideration.

Starting from the natural point, there is the continuous abstinence method, which requires you to completely refrain from having sexual intercourse. There are no hormonal side effects, and many religious groups endorse abstinence. It costs nothing and it is 100 per cent effective in preventing pregnancy. Abstinence is recommended for the unmarried.

Coitus interruption involves withdrawal of the male sex organ from the vagina before ejaculation takes place. Fertilisation is prevented because the male sperm does not come in contact with the female egg.

This method remains a significant means of fertility control in less advantaged countries. The effectiveness depends largely on the husband’s capability to withdraw prior to ejaculation. The failure rate is estimated to be about four percent in the first year of using this method.

In typical use, the rate is more like 19 per cent during the first year. Failure means that this method does not prevent pregnancy and more women using it will become pregnant.

The higher the rate of failure, the more likely a woman will have an unwanted pregnancy. The advantage of this method is that it can be used at any time, with no devices and no cost.

It does not involve chemicals or hormones and may offer a lower risk for other problems. Nevertheless, there is a high risk for unwanted pregnancy and it does not offer protection against sexually transmitted diseases.

Natural Family Planning is one of the most widely used methods of fertility regulation, particularly for those whose religious or cultural beliefs do not permit devices or drugs for birth control.

This method involves periodic abstinence from sex by couples, especially during the woman’s time of ovulation.

Wives who use this method monitor signs of cervical mucus in their body, their waking temperature (basal body temperature), and cycle history. They may also monitor physical changes in the cervix. This method breaks a woman’s cycle into three phases.

The first phase is pre-ovulation infertility, which begins with the first day of menstruation. The second and third phases are the fertile period, in which conception could occur, and the period of infertility, which occurs after ovulation. The third phase is best used by wives who have consistent and regular menstrual cycles.

The symptom-thermal method determines the first day of non sexual activity, which is based on the number of days since the first day of the menstrual period, or the first day that mucus is detected. The end of the fertile period (phase two) is determined by the basal body temperature (body temperature at rest first thing in the morning, before getting out of bed).

The basal body temperature of a woman is relatively low during the follicular phase (first half of her menstrual cycle) and rises in the luteal phase of the menstrual cycle in response so the thermogenic effect of progesterone (the second half leading up to her menstrual period beginning).

The rise in temperature can vary from 0.2-0.5°C. The higher temperatures begin one to two days after ovulation and correspond to the rising level of progesterone. Intercourse can resume three days after the temperature rise.

To monitor cervical mucus, the woman examines her cervical mucus with her fingers. Under the influence of estrogens, the mucus increases in quantity and becomes progressively more stretchy and abundant until a peak day is reached. This is followed by scanty and dry mucus because of the influence of progesterone, which remains until the outset of her period. Intercourse is allowed four days after the maximal cervical mucus, coinciding with the rise in temperature, until menstruation.

The advantages of this is that the Symptom-Thermal Method of Natural Family Planning can be used at the 99 per cent level of effectiveness in avoiding pregnancy and it has no harmful effects from hormone use, if a couple takes chances and has intercourse during Phase two, the fertile period. This is most suitable for women with regular and predictable menstrual cycles. Complete abstinence is necessary during the fertile period. This method requires discipline and systematic charting. The method is not effective with improper use. To use this method effectively, a couple should be trained by a medical professional or qualified counsellor. A relatively 20 per cent of high failure rate has been reported. This method does not protect you against STDs.

For maximum effectiveness, intercourse is allowed in the first five days of the menstrual cycle (beginning with the first day of your period) if you had an obvious temperature shift 12 to 16 days before. Before ovulation, intercourse is allowed in the evening of every dry cervical fluid day. Intercourse can resume on the night of the third consecutive day that your temperature rises to post-ovulatory level.

Intercourse can resume in the evening of the fourth consecutive day after your peak cervical fluid day. It is not considered “safe” for avoiding pregnancy unless all of these rules are met. It is recommended that two full cycles be charted before relying on this method.

If a couple takes chances and has intercourse without backup protection during the fertile period, the odds of pregnancy increase dramatically. These methods can also be used to achieve pregnancy. However, complete abstinence is necessary during the fertile period. This method requires discipline and systematic charting. The method is not effective with improper use.

There are other methods of periodic abstinence, such as the rhythm method. Married couples who practice the rhythm method, also called the calendar method, decide when to abstain from intercourse based on calendar calculations of the past six menstrual cycles. However, allowances are not made for the normal variations in the menstrual cycle that many women experience. This method is not as reliable as the natural family planning method.

We also have the cervical mucus method, which is called the ovulation method. It involves the monitoring of only cervical mucus without recording basal body temperature or menstrual history. The safe period is considered to be any number of dry mucus days, just after menstruation and the usual 10 or 11 days at the end of the cycle.

The days of menstrual bleeding are deemed as infertile. However, pregnancy can occur during menstruation. Vaginal infections, sexual excitement, lubricants, and certain medications can significantly affect the accuracy of cervical mucus assessment.

The basal body temperature method involves the monitoring of basal body temperature only, without also recording cervical mucus or other signs. Sex is avoided from the end of the menstrual period until three days after temperature increases.


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