Saturday, January 31, 2009

The Return of the Rhythm Method

My credo is that the more contraceptive options women have, the better. There is no one right method for all women, and a wide variety of methods increases the likelihood that any given woman will be able to find a method that works for her. However, I recently found that I'm not quite as broadminded as I thought it was on this topic. Georgetown University's Institute for Reproductive Health recently received a 3 year, $600,000 grant to increase the availability of natural family planning here in the US, primarily to low income women. Sounds great, right? So why am I angry and slightly nauseated? Because the method they are going to be promoting is the Standard Days Method, aka Cyclebeads. And Cyclebeads use exactly the same principles as the Rhythm, or Calendar Method. It is a purely statistical method that does not take into account individual variability or use any observational methods except for keeping track of menstruation. Mind you, this heavily field-tested and deeply funded method can be very effective. If women fall strictly within the parameters for its usage (regular cycles always between 26 and 32 days), they can expect a 95% effectiveness rate. And I have stated in the past that I think this method, along with the Two Day Method, can and will be a boon to women in the global south who lack access to decent health care. My objection is not to the effectiveness of the methodology, but rather to the return to the dark ages that this grant represents. Are American women really so stupid and unmotivated that they cannot be taught to observe their fertility? No, not everyone is going to be up for detailed charting and lessons in anatomy & physiology, but even a simple temperature-only method would empower women far more than this Birth Control for Dummies approach, in which fertility is regarded as a great mystery that cannot be understood. Women all over the world, many of whom lack numeracy and literacy, have been taught to observe their cervical mucus and track it with colors and pictures (as with the Billings Method). Surely if rural women in China can learn this technique, and practice it effectively, women in this country can, too. 

Is this really the direction we want reproductive health care and sex education to be moving in this country???